وضعيت چربي خون و چربي رژيم غذايي نوجوانان: برنامه قلب سالم اصفهان- پروژه ارتقاء سلامت قلب از دوران كودكي

Lipid profile and fat intake of adolescents: Isfashan healthy heart program-heart health promotion from children

سابقه و هدف: ارزيابي وضعيت چربي‌هاي سرم نوجوانان و ارتباط آن با رژيم غذايي و ارزيابي رفتار، نگرش، عملكرد و آگاهي (BASK) دانش‌آموزان، والدين و مسئولين مدارس در اين رابطه، به منظور طراحي مداخلات جامعه‌نگر در جهت پيشگيري و كنترل عوامل خطرساز بيماري‌هاي قلبي عروقي. مواد و روش‌ها: افراد مورد بررسي، 2000 دانش‌آموز 18-11 ساله انتخاب شده به روش تصادفي ساده چند مرحله‌اي (1000 دختر و 1000 پسر)، والدين آنها (2000 نمونه) و مسئولين مدارس (500 نمونه) در مناطق شهري و روستايي دو استان اصفهان و مركزي بوده‌اند (استان اصفهان براي مداخلات بعدي در نظر گرفته شده و استان مركزي به عنوان ناحيه مرجع در نظر گرفته شده است). يافته‌ها توسط پرسشنامه، معاينه فيزيكي و فرم ثبت غذاي سه روزه و پرسشنامه تكرّر مصرف مواد غذايي به دست آمد و ليپيدهاي سرم در آزمايشگاه مركز تحقيقات قلب و عروق اصفهان، اندازه‌گيري شد. يافته‌‌ها توسط نرم‌افزار SpssV10/win و با استفاده از آزمون‌‌هاي آماريStudent T و رگرسيون خطي چندگانه در سطح معني‌دار 0/05

Introduction: The serum lipid profiles of Iranian adolescents and its correlation with dietary fat intake and evaluation of the behavior, attitude, skills and knowledge (BASK) of students, parents and school staffs was evaluated, regardingly, in order to design an effective community- based intervention program for cardiovascular disease risk factors prevention and control. Material & Methods: The subjects have been 2000 randomly selected students (1000 girls, 1000 boys) aged between 11-18 years, their parents (2000 samples) and their school stuffs (500 samples) in urban and rural areas of two provinces in Iran (one considered for further interventions and the other as reference area). The data were obtained by questionnaires anthropometrics measurements, 3 days food record form and serum lipids were measured in the central laboratory of Isfahan cardiovascular Research Center. Data have been analyzed by SPSSV10/ Win software using the student t- and multiple linear regression tests at significant level of P<0.05. Results: Most of students, parents and school staffs had enough knowledge about a healthy nutrition but their practice was against it. This is suggested to be mostly due to considerable higher price of liquid oil than solid oil. Although the percent of the adolescents fat intake (21.2±0.4%) was within recommended daily allowance (30%), but in most cases, the percentiles of serum total cholesterol, LDL-C and triglyceride were significantly higher and the percentiles of HDL-C were significantly lower than normal values, e.g. the mean obtained cholesterol for girls in 11-14 and 15-18 years age groups were significantly higher than standard values (169 and 172 vs. 160 and 159 mg/dl respectively, P<0.05). this difference was also significant in boys (167 and 168 vs. 160 and 153 mg/dl, P<0.05). A direct relationship was shown between adolescents’ dyslipidemia and consumption of hydrogenated fat, fast foods and fat /salty snacks (P<0.05). Although the percent of protein intake was lower than recommended daily allowance (13.4% vs. 15%, P<0.05) but regarding the consumption of high fat containing lamb meat in most cases, the frequency of red meat consumption had direct correlation with dyslipidemia (P<0.05). Hypertriglyceridemia is in part suggested to be an effect of the percent of carbohydrate intake being higher than RDA (65.2% vs. 55%, P<0.05) Conclusion: Dietary guidelines for fat intake during childhood and adolescence must be developed within individual countries, taking into account the changes in availability and quality of the food supply.