A high percentage of women in their childbearing years suffer from subclinical vitamin A deficiency; 10% to 20% of pregnant women worldwide are vitamin A deficient. This study aimed to design and validate a short food-frequency questionnaire to serve as a simple screening tool for vitamin A status in women of childbearing age. The sample consisted of 187 healthy, nonpregnant, nonlactating women 15 to 49 years of age, from urban and rural areas of Marand district in East Azerbaijan. Dietary intake was evaluated by a face-to-face interview using a 24-hour dietary recall for two consecutive days and a 41-item qualitative food frequency questionnaire. Height, weight, and serum retinol were measured. Serum retinol values were less than 20 micrograms/dl for three subjects, while an additional 34 subjects (18%) had values between 21 and 30 micrograms/dl. Principal-component analysis performed on the food-frequency questionnaire identified five components that together defined 34.4% of the variance in estimated vitamin A intake and were used to derive a 20-item short food-frequency questionnaire. Internal consistency of the short instrument was acceptable (Cronbach's alpha = .59). Serum retinol was significantly correlated with total vitamin A intake and with intake of vitamin A from plant sources, as estimated by the short food-frequency questionnaire. Important sources of provitamin A in these women's diets included some not typical of other populations: nuts and green leaves of types used elsewhere in small quantities as herbs, but important in Iran because the amount and frequency of consumption are relatively high. We conclude that the questionnaire is relatively valid and potentially useful in identifying women at risk for vitamin A deficiency in this population.

Using a systematic review of all available studies between 1991 and 2011, the prevalence of food insecurity in the Islamic Republic of Iran was estimated. After document evaluation and data aggregation, studies were analysed in separate categories based on the methods used: dietary recall, household income/expenditure or experiential/ perception-based surveys. Meta-analysis of dietary-recall studies showed small non-significant increases between 1994 and 2004 in the prevalence of mild (from 8.8% to 9.3%) and moderate food insecurity (from 5.4% to 5.6%). Severe food insecurity was 3.8% and 3.7% in 1994 and 2004 respectively. Prevalence of food insecurity (moderate to severe) based on household income/expenditure surveys was consistently reported to be 10%. A separate meta-analysis of experiential/perception-based studies revealed rates of mild, moderate and severe food insecurity of 28.6%, 14.9% and 6.0% respectively. By combining study results in this manner makes it possible to come up with more realistic estimates for evidence-informed policy-making, until development of a national food insecurity surveillance system. Une méta-analyse distincte des études fondées sur l'expérience/la perception a révélé des pourcentages d'insécurité alimentaire légère, modérée et sévère de 28,6 %, 14,9 % et 6,0 %, respectivement. En associant les résultats d'étude de cette façon, il est possible de parvenir à des estimations plus réalistes pour alimenter des politiques fondées sur des preuves, en attendant d'avoir mis en place un système de surveillance de l'insécurité alimentaire au niveau national. ‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫العرشون‬ ‫املجلد‬ ‫عرش‬ ‫احلادي‬ ‫العدد‬ 699

Iran is undergoing an epidemiological and nutritional transition. Over the last 2–3 decades, major changes in lifestyle and food consumption patterns have occurred, as well as in the socio-economic situation. Disease patterns have changed and some micronutrient deficiencies and chronic nutritional diseases, including obesity, are on the increase. Considering these, food habits, and the national food system, the Nutrition Department, Ministry of Health and Medical Education and the Iranian Nutrition Society jointly undertook to prepare food-based dietary guidelines (FBDGs). The process consisted of three phases: agreeing on food groups, designing pictorial FBDGs, and field testing them. Three working teams, supported by a large group of advisors consisting of nutritionists, epidemiologists, food/nutrition planners, and other relevant experts were formed. The first draft of the food groups consisted of 7 groups: Bread and Cereals; Meats and Eggs; Pulses; Fruits; Vegetables; Milk and Dairy Products; Miscellaneous (nuts, oils and fats, sugar and sweets, soft drinks). It was sent to 20 nutrition and public health experts for feedback. A suggestion was made to divide the Miscellaneous group into two – oils and fats, and Miscellaneous (sugars and sweets, pickled and salted food items). Three pictorial FBDGs were then designed: a plate, a pyramid, and a rectangle. Thus, three posters were prepared by the working teams and revised by a group of experts, followed by a preliminary evaluation. The final step will be field testing of the three revised, modified designs by the public and experts and their final evaluation.

Objective: This study aimed to assess the validity and reliability of a dish-based, semi-quantitative food frequency questionnaire (DFFQ) for epidemiological studies in Iran. The DFFQ included 142 items (84 foods and 58 mixed dishes) which was filled in by 230 adults (110 men). All participants completed two separate DFFQs with a 6 months interval as well as six 24-h recalls, each month. Dietary biomarkers and anthropometric measurements were made. The validity was evaluated by comparing the DFFQ against 24-h dietary recalls and dietary biomarkers, including serum retinol and beta-carotene. Reliability was evaluated using intra-class correlation coefficient (ICC) and validity was determined by unadjusted and energy adjusted correlation coefficients (CC), de-attenuated CC, and cross-classification analyses. Results: ICC for reliability ranged between 0.42 and 0.76. De-attenuated CC for the FFQ and the 24-h recalls ranged between 0.13 and 0.54 (Mean = 0.38). The de-attenuated CC between the DFFQ and plasma levels of retinol and beta-carotene were 0.58 (P = 0.0001) and 0.40 (P = 0.0001), respectively. Cross-classification analysis revealed that on average 73% were correctly classified into same or adjacent quartiles and 5% were classified in opposite quartiles.