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Findings from clinical trials on the effect of Mg supplementation on depression and anxiety are not generalisable to the community owing to high-dose intervention in short-term periods. Limited observational data are available linking dietary intake of Mg and psychiatric disorders. We aimed to investigate the association between dietary intake of Mg and psychiatric disorders in a large cross-sectional study on Iranian adults. A total of 3172 Iranian adults (with an age range of 18–55 years) were included in this study. Data on dietary intakes were collected using a validated dish-based 106-item semi-quantitative FFQ. To assess depression and anxiety, an Iranian validated version of the Hospital Anxiety and Depression Scale was used. Furthermore, psychological distress was examined using the General Health Questionnaire. The mean age of men and women was 38·4 (sd 8·2) and 35·1 (sd 7·4) years, respectively. In unadjusted analyses, we found that higher dietary Mg intake was associated with lower odds of anxiety among women (OR 0·61; 95 % CI 0·41, 0·90), such that after taking potential confounders into account women in the highest quintile of Mg intake had a 39 % lower odds of anxiety compared with those in the lowest quintile (OR 0·61; 95 % CI 0·40, 0·93). Moreover, deficient Mg intake was positively associated with anxiety among all women (OR 1·80; 95 % CI 1·19, 2·72) and also normal-weight women (OR 1·73; 95 % CI 1·01, 2·95). In addition, a significant inverse association was found between dietary Mg intake and depression among normal-weight men (OR 0·45; 95 % CI 0·20, 0·99) and overweight women (OR 0·45; 95 % CI 0·24, 0·85). In conclusion, dietary intake of Mg was inversely associated with depression and anxiety. However, such findings were not seen for psychological distress.

Given that there is an inconsistency in the findings related to the relationship between coffee and caffeine consumption and symptoms of psychological disorders, we performed a cross-sectional analysis to examine the association between coffee and caffeine intake and symptoms of psychological disorders among adults. In this cross-sectional study, 3362 participants were included. We assessed the coffee and caffeine intakes using a self-completed food frequency questionnaire (FFQ). Symptoms of depression, anxiety, and psychological distress were assessed using HADS and GHQ screening tools. The mean age of participants in this study was 36.2±7.8 years. After controlling for potential confounders, individuals who consumed coffee weekly or more had a significantly lower odds of symptoms of depression (OR: 0.67; 95% CI: 0.46-0.96) and symptoms of anxiety (OR: 0.57; 95% CI: 0.34-0.95) compared with those who did not consume coffee. However, no significant association was found between coffee intake and symptoms of psychological distress (OR: 0.98; 95%CI: 0.68-1.42). No significant relationship was found between caffeine intake and odds of symptoms of depression (OR: 0.94; 95% CI: 0.75-1.16), symptoms of anxiety (OR: 0.90; 95% CI: 0.67-1.20), and symptoms of psychological distress (OR: 1.13; 95% CI: 0.89-1.42). Compared with lack of coffee intake, weekly or more coffee consumption might be correlated with symptoms of depression and anxiety.

The present study was carried out to determine whether the dietary insulin index (DII) and dietary insulin load (DIL) are related to psychological disorders in a cross-sectional study among adults. A total of 3172 Iranian adults (age range of 18–55 years) were included. Data on dietary intakes were collected using a validated dish-based 106-item semi-quantitative FFQ. DII and DIL were calculated using food insulin index values published earlier. To assess depression and anxiety, an Iranian validated version of the Hospital Anxiety and Depression Scale was used. Furthermore, psychological distress was examined using the General Health Questionnaire. Among women, a significant positive association was seen; such that women in the highest quartile of DIL had higher odds of depression than those in the lowest quartile (OR 1·84; 95 % CI 1·14, 2·96). In terms of DII, in the fully adjusted model, women in the top quartile of DII were more likely to be depressed compared with those in the bottom quartile (OR 1·65; 95 % CI 1·05, 2·58). In conclusion, we found a significant positive association between DIL and DII and odds of depression among women, but not in men. However, such findings were not seen for anxiety and psychological distress.

We investigated the association of dietary Mg intake with insulin resistance and markers of endothelial function among Iranian women. A cross-sectional study. Usual dietary intakes were assessed using a validated FFQ. Dietary Mg intake was calculated by summing up the amount of Mg in all foods. A fasting blood sample was taken to measure serum concentrations of glycemic indices (fasting plasma glucose and insulin) and endothelial function markers (E-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1). Insulin resistance and sensitivity were estimated using the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), Homeostasis Model Assessment β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI). Iranian female nurses (n 345) selected by a multistage cluster random sampling method. The Mg intake across energy-adjusted quartiles was 205 (se 7), 221·4 (se 8), 254·3 (se 7) and 355·2 (se 9) mg/d, respectively. After adjustments for potential confounders, QUICKI level was significantly different across quartiles of Mg intake (Q1: 0·34 (se 0·02), Q2: 0·36 (se 0·01), Q3: 0·40 (se 0·01), and Q4: 0·39 (se 0·02), P = 0·02); however, this association disappeared after considering markers of endothelial function, indicating that this relation might be mediated through endothelial dysfunction. After controlling for all potential confounders, Mg intake was inversely, but not significantly, associated with serum concentrations of sICAM (Q1: 239 (se 17), Q2: 214 (se 12), Q3: 196 (se 12), and Q4: 195 (se 17), P = 0·29). There was no other significant association between dietary Mg intake and other indicators of glucose homoeostasis or endothelial markers. Higher dietary Mg intake was associated with better insulin sensitivity in Iranian females. This linkage was mediated through reduced endothelial dysfunction.

Joint association of lifestyle-related factors and mental health has been less studied in earlier studies, especially in Middle Eastern countries. This study aimed to examine how combinations of several lifestyle-related factors related to depression and anxiety in a large group of middle-age Iranian population. In a cross-sectional study on 3363 Iranian adults, a healthy lifestyle score was constructed by the use of data from dietary intakes, physical activity, smoking status, psychological distress and obesity. A dish-based 106-item semi-quantitative validated food frequency questionnaire (FFQ), General Practice Physical Activity Questionnaire (GPPAQ), General Health Questionnaire (GHQ) and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. The Hospital Anxiety and Depression Scale (HADS) was applied to screen for anxiety and depression. After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle were 95% less likely to be anxious (OR: 0.05; 95% CI: 0.01-0.27) and 96% less likely to be depressed (OR: 0.04; 95% CI: 0.01-0.15), compared with those with the lowest score. In addition, non-smokers had lower odds of anxiety (OR: 0.64; 95% CI: 0.47-0.88) and depression (OR: 0.62; 95% CI: 0.48-0.81) compared with smokers. Individuals with low levels of psychological distress had expectedly lower odds of anxiety (OR: 0.13; 95% CI: 0.10-0.16) and depression (OR: 0.10; 95% CI: 0.08-0.12) than those with high levels. Individuals with a healthy diet had 29% lower odds of depression (OR: 0.71; 95% CI: 0.59-0.87) than those with a non-healthy diet. We found evidence indicating that healthy lifestyle score was associated with lower odds of anxiety and depression in this group of Iranian adults. Healthy diet, psychological distress, and smoking status were independent predictors of mental disorders.

Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorder worldwide. Physical activity in relation to IBS has been investigated in few studies and data in this regard are conflicting. To investigate the association between physical activity and IBS in a large sample of Iranian adults. This cross-sectional study was done on 4763 Iranian adults in the framework of SEPAHAN (The Study on the Epidemiology of Psycho-Alimentary Health and Nutrition) project. The physical activity of study participants was assessed using the General Practice Physical Activity Questionnaire (GPPAQ). Using a validated self-administered modified Rome III questionnaire, functional gastrointestinal disorders including irritable bowel syndrome was assessed. The mean age of study participants was 36.5 years. Irritable bowel syndrome was prevalent among 21.5% of participants. Compared with physically active individuals (≥ 1 hour/wk), those with sedentary physical activity (<1 hour/wk) had 1.27 times greater probability of suffering from IBS (OR: 1.27, 95% CI: 1.08-1.49). However, this association was attenuated after adjusting for age, sex, cigarette smoking and medical history of colitis and diabetes. When the analysis was additionally adjusted for diet-related practices and body mass index (BMI), a non-significant association was found between sedentary physical activity and IBS (OR: 1.18, 95% CI: 0.98-1.41). Gender-stratified analysis revealed similar findings in women either before (OR: 1.29, 95% CI: 1.04-1.61) or after controlling for covariates (OR: 1.27, 95% CI: 0.99-1.62). In BMI-stratified analysis, a significant positive association was seen between sedentary physical activity and IBS among individuals with normal BMI (OR: 1.38, 95% CI: 1.07-1.79). We found a significant positive association between sedentary physical activity and IBS, particularly among women and individuals of normal weight.

Background No earlier study has examined the association between dairy intake and prevalence of depression and anxiety in Middle Eastern population. Objective This cross-sectional study was done to investigate the association between consumption of total dairy intake and prevalence of depression and anxiety in a large group of adult population in Isfahan, Iran. Methods Dairy intake was assessed for 3362 participants using a validated 106-item Willet-format dish-based semi-quantitative FFQ. A validated questionnaire of Hospital Anxiety and Depression Scale was used to examine depression and anxiety. We defined scores of > 8 as depressed and anxious people in this analysis. Information about covariates were collected using pre-tested questionnaires. Results Mean age of study population was 36.2, 58.3% of them were females. Participants in the highest quintile of dairy intake had a 40% lower chance for depression compared to those in the lowest quintile (OR = 0.60; 95%CI 0.47–0.76, P trend  = 0.001) in crude model. This association remained significant after controlling for several confounders (0.57; 95%CI 0.40–0.80 P trend  = 0.02). Although we observed a significant association between dairy intake and anxiety in crude model (OR: 0.63; 95%CI 0.46–0.87, P trend  = 0.02), the association was not significant when we took into account potential confounders (0.63; 95%CI 0.39–1.00). Conclusion We found an inverse association between consumption of dairy products and depression but the results for anxiety were not significant. Further studies, in particular of prospective nature, are recommended to confirm our findings.

No previous study examined the association between whole-day water intake and odds of irritable bowel syndrome (IBS). We examined the association between whole-day water intake and odds of IBS in a large sample of Iranian adults. This cross-sectional study was conducted among 4763 adults in Isfahan, Iran. Daily water intake was assessed using a pre-tested questionnaire by asking questions about the average number of glasses of water consumed in a day. IBS was assessed and defined using a modified Persian version of Rome III questionnaire. After taking potential confounders into account, no significant association between water consumption and odds of IBS was seen (OR: 1.14; 95% CI: 0.74-1.78). We observed that participants who were taking >8 glasses/d of water had greater odds of IBS-M in comparison to those who consumed <2 glasses daily (OR: 2.07; 95% CI: 1.01-4.22). No significant association was observed between water intake and odds of IBS in either gender as well [for men: OR: 1.15; 95% CI: 0.59-2.24 and for women: OR: 1.15; 95% CI: 0.62-2.12]. By BMI status, no significant association was observed between whole day water intake and odds of IBS among normal weight (BMI<25 kg/m2) or overweight and obese people (BMI≥25 kg/m2). We found that whole-day water intake was not associated with odds of IBS. A significant association between consumption of >8 glasses of water per day and odds of IBS-M was observed.

(1) Background: Limited evidence from laboratory-based studies suggests that specific dietary macronutrients, particularly fat, can induce dyspeptic symptoms. Through a population-based study, we investigated the relationship between dietary macronutrients and dyspeptic symptoms and sought to determine macronutrient intake thresholds to predict or prevent dyspepsia and reduce symptoms in patients with dyspepsia. (2) Methods: A total of 4763 Iranian people were enrolled in this population-based, cross-sectional study. Uninvestigated dyspepsia (UD) and its symptoms, including postprandial fullness, early satiation, and epigastric pain, were evaluated using a modified Persian version of the Rome III criteria. The dietary intakes of participants were evaluated using a validated food–frequency questionnaire. Receiver operating characteristic (ROC) curve analysis was used to calculate threshold intakes of dietary macronutrients to prevent UD in the general population. The analysis was then repeated in those with UD to calculate intake thresholds for reducing UD symptoms. (3) Results: Early satiation occurred in 6.3% (n = 302), postprandial fullness in 8.0% (n = 384) and epigastric pain in 7.8% (n = 371) of participants. The prevalence of UD was 15.2%. Compared with individuals without UD, those with UD had a lower intake of carbohydrates (48.2% vs. 49.1%) and a higher intake of fats (38.3% vs. 37.4%), while protein and energy intakes did not differ. Higher dietary fat and protein intakes were associated with a higher prevalence of postprandial fullness and epigastric pain, respectively. Macronutrient intakes to predict UD in the general population were <49% of energy from carbohydrates, >14.7% from protein, and >37.7% from fats. Carbohydrate, protein, and fat intakes to prevent symptoms among those with UD were calculated to be >48.2%, <14.6%, and <38.6%, respectively. (4) Conclusion: Higher carbohydrate intake and lower fat or protein intakes were associated with a lower likelihood of UD. Prospective studies carefully manipulating dietary macronutrient composition are warranted to investigate the value of dietary changes to improve symptoms in people with UD.

Limited data are available on the association of dietary calcium intake and ulcerative colitis (UC). We aimed to investigate the relation between dietary calcium intake and UC prevalence in Iranian adults. In this population-based case–control study, diagnosed patients with UC by gastroenterologists that were registered in the Iranian inflammatory bowel disease registry were included as cases. Age and sex-matched healthy controls were selected from Study on the Epidemiology of Psychological, Alimentary Health and Nutrition (SEPAHAN) dataset. Dietary calcium intakes of participants were examined through a validated food frequency questionnaire. We included 327 middle-aged participants (109 cases and 218 controls) in the analysis; 52.1% of them were females. After adjustments for potential confounders, individuals in the third tertile of dietary calcium intake had 92% lower odds of UC, compared to those in the first tertile (OR = 0.08, 95% CI 0.02–0.27). Our analysis based on recommended dietary allowances (RDAs) intake showed that dietary Ca intake deficiency was related to increased odds of UC (OR = 9.5, 95% CI 2.98–30.91). Stratified analysis by gender revealed that these associations were significant in both genders; although the results were stronger in the male population. A Significant decreasing trend was observed for odds of UC in tertiles of dietary calcium intakes, in both males and females. Higher dietary calcium intake was associated with lower UC prevalence in Iranian adults. Inadequate dietary calcium intake was also linked to elevated odds of UC. Further prospective investigations are needed to affirm these findings.