Background:Different types of nutrients in adequate amounts are required to meet the increased demands of the mother and the developing fetus. Therefore, we examined the impact of nutrition education on the number of food servings per day.Materials and Methods:Pregnant mothers were recruited to a prospective, randomized clinical trial from May to September, 2016. At 6–10 weeks of gestation, the participants were randomly divided into the intervention (n = 96) or the control group (n = 96), and were followed-up until the end of pregnancy. Each woman in the experimental group met the study nutritionist at the time of enrollment and an individualized nutrition plan was developed. In addition, the nutrition education based on Pender's Health Promotion Model (HPM) was designed, including three 45–60 min training sessions in 6–10, 18, and 26 weeks of pregnancy. The participants' usual food intake using a three-day dietary record was assessed at 6–10 weeks and 34–36 weeks of gestation.Results:The mean scores of the perceived benefits, self-efficacy, activity-related affect, interpersonal influences (husband support), and commitment to action increased while the competing demand scores decreased in the interventional group compared with the control group. The mean standard deviation (SD) of food portions from grain [10.40 (1.96) versus 12.70 (1.93) in the control group], vegetable [3.88 (1.33) versus 2.96 (0.91)], fruit [4.02 (0.05) versus 3.95 (0.91)], dairy [2.33 (0.68) versus 2.11 (0.45)], and meat [3.17 (0.68) versus 2.96 (0.67)] were improved in the experimental group.Conclusions:Pender's HPM for nutrition education is effective based on the compliance of pregnant women to the dietary guideline and the food guide pyramid.

Background:Chronic insulin resistance (IR) is a basic part of the pathophysiology of gestational diabetes mellitus. Nutrition significantly impacts IR and weight loss reduces insulin levels, whereas weight gain increases the concentrations. Therefore, we surveyed the effect of nutrition intervention on IR in pregnant women and whether this effect is irrespective of weight gaining in accordance with Institute of Medicine limits.Methods:This prospective, randomized clinical trial was carried out among 150 primiparous pregnant mothers in fifteen health centers, five hospitals, and 15 private obstetrical offices in Isfahan. The nutrition intervention included education of healthy diet with emphasize on 50%–55% of total energy intake from carbohydrate (especially complex carbohydrates), 25%–30% from fat (to increase mono unsaturated fatty acids and decrease saturated and trans-fatty acids), and 15%–20% from protein during pregnancy for experimental group. The controls received the usual prenatal care by their health-care providers.Results:This trial decreased pregnancy-induced insulin increases (P = 0.01) and IR marginally (P = 0.05). ANCOVA demonstrated that control of gestational weight gaining was more effective to decrease IR (P = 0.02) while insulin values decreased by nutrition intervention and irrespective of weight control (P = 0.06). Fasting plasma glucose (FPG) concentrations did not decrease by intervention (P = 0.56) or weight management (P = 0.15).Conclusions:The current intervention was effective to decrease pregnancy-induced insulin increases and IR. Considering study results on FPG levels and incidence of GDM, we suggest repeat of study design in a larger sample.

Background: Follow-up studies have shown an increased risk of thyroid dysfunction in individuals with normal serum thyroid-stimulating hormone (TSH) levels. Furthermore, the possible consequences of minor differences in thyroid function (without achieving poor thyroid function) in the risk of weight gain during pregnancy are questionable, too. The production of TSH is under the hypothalamus–pituitary control, and food is one of the most effective environmental agents that control hypothalamic–pituitary–thyroid axis activity. Regarding the few available studies, we assessed the association of minor variations of TSH concentrations and nutritional status in the first trimester of pregnancy. Materials and Methods: This cross-sectional descriptive and analytical study was performed on 150 primiparous healthy women. Demographic and family characteristics were collected using a researcher-administered questionnaire. Nutrients intake were extracted from a 72-h recall, and physical activity scores were determined by the pregnancy physical activity scale. Results: The prepregnancy body mass index (BMI) (β =0.022, P = 0.004) and participants' weight at 6–10 weeks of gestation (β =0.006, P = 0.024) were positively associated with TSH concentrations, while total physical activity score was negatively correlated (β = ‒0.006, P = 0.047). We did not find any significant association between TSH values and energy-adjusted nutrients intake ( P > 0.05). Conclusion: We suggest that differences in TSH concentrations within normal range in the first trimester are correlated with gaining weight, physical activity level, and prepregnancy BMI. TSH concentration and consequently thyroid function may influence on gestational weight gain or vice versa.

Background: Some studies have shown that Socioeconomic Status (SES) is positively related to insulin resistance among different population groups, except for pregnant women. Therefore, we examined the relationship between SES and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index as well as mediating variables. Materials and Methods: This study was performed on 138 primiparous healthy women at 6–10 weeks of pregnancy. The association between SES and HOMA-IR was analyzed by regression analysis, and mediating variables were determined by mediation analysis. Results: SES score was positively correlated with HOMA-IR index [β = 0.02, t101 = 2.20, p = 0.03, 95% CI: (0.00–0.05]. The higher percentage of mediation was related to maternal weigh (70.80%). Job activity had a protective effect on the association between SES and HOMA-IR (-62.50%). The total percentage of two mediators was 25%. Conclusions: The positive relationship between SES and (HOMA-IR) in early pregnancy may provide a way to control this condition.

BACKGROUND Successful pain management depends on acknowledgment of barriers that interfere with providing adequate pain relief. However, there are no consensus tools in Persian to identify these barriers. This article presents the psychometric properties of a Persian questionnaire for assessing perceived barriers to manage cancer pain. In this study, we aimed to determine the barriers to achieving optimal pain management, and assess validity and reliability of IR-BQII scale among Iranian patients. Assessment of the barriers in our society using this questionnaire guides effective plans of pain management to bring about more relief and welfare for cancer patients. MATERIALS AND METHODS 170 cancer patients participated in this cross-sectional study. Subjects were either new outpatients or previous outpatients (now hospitalized) who were referred to the oncology clinic of Imam Khomeini Hospital (Cancer Research Center, Tehran University of Medical Sciences) in Tehran, Iran. BQII validity was determined by exploratory factor analysis (FA). Reliability and consistency were assessed using Cronbach's alpha coefficient. RESULTS Four factors sufficiently explained the variability in the data: Communication and Psychological Side Effects, Addiction and Fatalism, Physiological Side Effects, and Beliefs about Consciousness Status. Internal reliability was 0.708 based on Cronbach's alpha coefficient. The internal consistency of the different subscales was within 0.69-0.80. Pain management barriers' score was higher among middle-aged patients. CONCLUSION IR-BQII is a valid and reliable instrument for physicians, nurses and other clinical staff to identify pain management barriers and eliminate or modify them to help ease the pain for cancer patients.