Background Investigating the effect of metabolic disorders on chronic kidney disease (CKD) in the presence or the absence of obesity is of great importance. This study aimed to examine the independent and joint relationships of obesity and metabolic syndrome (MetS) with CKD.  Methods  The present study was performed on 9,762 participants from the baseline phase of the Ravansar non- communicable diseases (RaNCD) study. Thereafter, the CKD was estimated by glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) equation. All the included participants were categorized into the following four phenotypes: metabolically healthy non-overweight/obesity (MHNO), metabolically unhealthy non-overweight/obesity (MUNO), metabolically healthy overweight/obesity (MHO), and metabolically unhealthy overweight/obesity (MUO). Finally, Logistic regression analysis was used to estimate the odds ratio (ORs). Results The mean age of the included participants was 47.33 ± 8.27 years old, %48.16 (4,701) of whom were men. As well, 1,058(10.84%) participants had CKD (eGFR less than 60 ml/min/1.73m2). The overweight/obesity was not significantly associated with odds of CKD. The odds of CKD in male subjects with MetS was 1.48 times higher than non-MetS ones (95% CI: 1.10, 2.01). After adjusting the confounders, the odds of CKD were 1.54 times (95% CI: 1.12, 2.11) higher in the MUNO and 2.22 times (95% CI: 1.44, 3.41) higher in the MUO compared to MHNO phenotype in male subjects. The odds of CKD in the MUNO and MUO was 1.31 times (95% CI: 1.10, 1.60) and 1.23 times (95% CI: 1.01, 1.54) higher than MHNO phenotype in female subjects, respectively. Conclusion The odds of CKD were higher in MUNO and MUO phenotypes. Therefore, lifestyle modification is recommended to control normal weight and healthy metabolism.

Background: Plant-based diet has antioxidant and anti-inflammatory properties. Therefore, this hypothesis is raised that following a plant-based diet may improve the functioning of the kidneys. The aim of study was to determine the association between plant-based diet index (PDI) and chronic kidney disease (CKD).Methods: This cross-sectional study was conducted using data from Ravansar non-communicable diseases (RaNCD) cohort study on 9,746 participants aged 35-65 years, in western Iran. CKD was assessed by glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) equation. The PDI was calculated based on food intake using a food frequency questionnaire (FFQ), and The food items were distributed into 18 food groups. We used multivariable logistic regression models to estimate odds ratio (ORs).Results: 1,058 (10.86%) of participants had CKD (eGFR<60 ml/min/1.73 m2), and the mean of PDI was 54.22± 6.68. The mean of eGFR in the group with high PDI score was significantly higher than the group with low PDI score (forth quartile: 79.20± 0.36 vs. first quartile: 72.95± 0.31, P<0.001). Adherence to a plant-based diet was more prevalent in the higher socioeconomic status (P<0.001). After adjusting for potential confounders, the odds of CKD in the third and fourth quartile of PDI was 25% (OR: 0.75; 95% CI: 0.62- 0.91) and 39% (OR: 0.61; 95% CI: 0.48- 0.78, P trend<0.001) lower than the first quartile, respectively.Conclusions: The findings of this study suggest that having a plant-based diet may be preventing the development of CDK. However, further studies are recommended.

Background: Plant-based diet has antioxidant and anti-inflammatory properties. Therefore, this hypothesis is raised that following a plant-based diet may improve the functioning of the kidneys. The aim of study was to determine the association between plant-based diet index (PDI) and chronic kidney disease (CKD).Methods: This cross-sectional study was conducted using data from Ravansar non-communicable diseases (RaNCD) cohort study on 9,746 participants aged 35-65 years, in western Iran. CKD was assessed by glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) equation. The PDI was calculated based on food intake using a food frequency questionnaire (FFQ), and The food items were distributed into 18 food groups. We used multivariable logistic regression models to estimate odds ratio (ORs).Results: 1,058 (10.86%) of participants had CKD (eGFR<60 ml/min/1.73 m2), and the mean of PDI was 54.22± 6.68. The mean of eGFR in the group with high PDI score was significantly higher than the group with low PDI score (forth quartile: 79.20± 0.36 vs. first quartile: 72.95± 0.31, P<0.001). Adherence to a plant-based diet was more prevalent in the higher socioeconomic status (P<0.001). After adjusting for potential confounders, the odds of CKD in the third and fourth quartile of PDI was 25% (OR: 0.75; 95% CI: 0.62- 0.91) and 39% (OR: 0.61; 95% CI: 0.48- 0.78, P trend<0.001) lower than the first quartile, respectively.Conclusions: The findings of this study suggest that having a plant-based diet may be preventing the development of CDK. However, further studies are recommended.

Background The incidence of colorectal cancer (CRC) is increasing in low- and middle-income countries. This study aimed to estimate the burden of CRC attributable to nutritional risk in the Middle East and North Africa (MENA) region. Method The GBD 2019 methods were used to estimate age-standardized mortality rates (ASMRs) and disability-adjusted life-years (DALYs) in 2019 and over the past three decades. We evaluated the 30-year trend in DALYs and mortality rates from nutrition-related risks of CRC, from 1990 to 2019 by sex and age groups in 21 countries in the MENA region. Results The rate of DALYs/100,000 due to diet-related risks for CRC in 2019 was 79.71 (95% UI: 56.79, 98.44) and 65.16(95% UI: 45.86, 80.95) in men and women, respectively. The percent changes of DALYs/100,000 in men and women were 8.15% and 2.50%, respectively, between 1990 and 2019. The percent changes in ASMRs in men and women were 8.32% and 3.44%, respectively. The highest DALYs and ASMRs were observed in both sexes in the age group 75–79 years and above. The highest percent changes in DALYs/100,000 and ASMRs were observed between 1990 and 2019 in Afghanistan, Egypt, Iran, Iraq, Lebanon, Libya, Morocco, Palestine, Qatar, Saudi Arabia, Sudan and Yemen. Conclusion DALYs and ASMRs attributed to dietary risk for CRC increased in 21 countries in the MENA region from 1990 to 2019. A modified diet with more fiber, dairy products and less red meat intake is a highly recommended strategy for prevention CRC.

Background: Colorectal cancer (CRC) in low-income and middle-income countries, there is an increasing trend. This study aimed to estimate the burden of CRC attributable to dietary risk in the Middle East and North Africa (MENA) region.Method: In current study, data of the Global Burden of Disease (GBD) 2019 study were used to estimate the age-standardized mortality rates (ASMR) and disability-adjusted life-years (DALYs). We evaluated the 30-year trend of DALYs and mortality rate of CRC attributable to dietary risk, from 1990 to 2019 by sex and age groups, in 21 countries of MENA region.Results: Percent changes ASMR attributed to dietary risk for CRC in men and women were 8.32% and 3.44%, respectively. The percent changes related to DALYs/100,000 in men and women was 8.15% and 2.50%, respectively. The highest DALYs and ASMR were in the age group of 75-79. The highest percent changes of DALYs/100,000 and ASMR was observed in Afghanistan, Egypt, Iran, Iraq, Lebanon, Libya, Morocco, Palestine, Qatar, Saudi Arabia, Sudan and Yemen from 1990 to 2019. Trend of ASMR and DALYs attributed to diet high in red meat; low in calcium, low in milk, low in fiber and low in whole grain risk have been increasing for CRC.Conclusion: The DALYs and ASMR attributed to dietary risk for CRC has increased in 21 countries of the MENA regions from 1990 to 2019. Dietary modification with increasing fiber, dairy products and reducing red meat intake are highly recommended strategies in preventing CRC.