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Background and Objective: Modification of life style, nutrional regiment and insulin therapy is used for improvement of pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). This study was done to evaluate the effect of the dietary approaches to stop hypertension (DASH) eating plan on pregnancy outcomes in pregnant women with gestational diabetes mellitus. Methods: In this clinical trial study, 52 women with GDM were randomly divided into DASH and control groups for 4 weeks. The control diet contained 45-55% carbohydrates, 15-20% protein and 25-30% total fat. The DASH was rich in fruits, vegetables, whole grains and low-fat dairy products, and contained lower amounts of saturated fats, cholesterol and refined grains with a total of 2400 mg/day sodium. The numbers of women whom commenced insulin therapy after dietary intervention, the mode of delivery and prevalence of polyhydramnios were assessed. The length, weight and head circumference of infants were measured during the first 24 h after birth. Results: 46.2% of women in the DASH group needed to have a cesarean section, this rate for the control group was 80.8% (P<0.05). The percentage of those who needed to commence insulin therapy after intervention was 23% for DASH group vs 73% for controls (P<0.05). Infants born to mothers on the DASH group had significantly lower body weight (3222.7 vs 3818.8 g, P<0.05), head circumference (34.2 vs 35.1 cm, P<0.05) and ponderal index (2.50 vs 2.87 kg/m3, P<0.05) compared to those born to mothers on the control diet. Conclusion: Consumption of dietary approaches to stop hypertension for 4 weeks among pregnant women with GDM resulted in improved pregnancy outcomes.

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Background and Objective: Obesity presented as the most pivotal public health problem. Motivational interviewing is a client-centered and direct technique to improve intrinsic motivation of people to change behavior using search and resolve ambivalence that its beneficial outcomes have widely been confirmed. This study was carried out to evaluate the effect of motivational interviewing on weight loss in women. Methods: In this randomized clinical trial study, 150 women with overweight and obesity were randomly divided into control, motivational interviewing and motivational interviewing and intention implementation groups. Data were collected through a researcher made questionnaire at baseline and 2 month follow up. Results: The score of protection motivation theory constructs including susceptibility, severity, rewards, self-efficacy, response efficacy and cost were significantly increased in the two intervention groups compared to the control group (P<0.05). Anthropometric characteristics were significantly reduced in the motivational interviewing and motivational interviewing with intention implementation group (P<0.05) in compare to the control group (P<0.05). Conclusion: Motivational interviewing integrated into intention implementation causes weight loss and increase the constructs score in women.

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Background and Objective: Overweight and obesity are increasing in the last three decades indicates the strong influence of environmental factors. Fats are the most important sources of human food which is considered as one of the reason for obesity. Among the components of the diet, poly unsaturated fatty acids (PUFA) are resulting in obesity. This study was done to evaluate the effect of diets containing poly unsaturated fatty acid on body weight and colon macroscopic properties in rabbit. Methods: In this experimental study, 24 female rabbits were allocated into three experimental groups including short, medium and long term and control groups (three subgroups). Animals in experimental groups were received diet containing corn oil for one month (short term), two months (medium term) and three months (long term). Animals at the end of the first, second and third months, were weighed and dissected and taken biopsy from colon. The macroscopic properties of the samples including shape and arrangement of Haustration were evaluated. Results: Over weight was not in the long – term consumption of corn oil in comparison with controls, but Haustra organization in different parts of the colon were disappeard in experimental animals. Conclusion: The diet containing poly unsaturated fatty acid causes macroscopic alteration in rabbit colon.

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Background and Objective: Neonatal mortality rate is one of the most important health criteria, worldwide. Understanding the major neonatal mortality causes will help to plan for better pregnancy, prenatal and neonatal care systems. This study was conducted to determine the neonatal mortality risk factors in Maraveh Tapeh County in Golestan province, north of Iran. Methods: In this case-control study, according to either death or live in 28th day after birth, 52 neonates were considered as case group and 201 neonates were considered as control group. Data collection questionnair were adjusted and completed for each neonate. Results: Neonatal mortality rate was 11.76, 13.36 and 6.46 per 1000 live birth in 2011, 2012 and 2013, respectively. Five main causes of death were prematurity, events, birth defect, respiratory distress syndrome and sepsis, respectively. There was a significant relation between death and prematurity, birth weight and gender (P<0.05). There was relationship between birth weight and neonatal mortality (Odds Ratio=29.6). Conclusion: Prematurity and low birth weight were the most important causes of neonatal mortality in Maraveh Tapeh county in Golestan province, north of Iran.

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Background and Objective: After chronic stress, brain volume and weight reduces and in turn, adrenal weight and volume increases. This study was performed to determine the effect of chronic stress and memantine administration within amygdala on the alterations of brain’s volume and weight ratio to volume and weight of the adrenal gland on male mice.

Methods: In this experimental study, bi- or unilateral amygdala cannulation was preformed stereotaxically. A week after recovery, animals were received different doses of memantine (1, 0.5, and 0.1 µg/mouse), five min before stress induction. Electric foot shock induced to animals for seven consecutive days. At the end of the seventh day, animals were sacrificed and their brain and adrenal glands were fixed in formalin 4%. The volume and weight was determined by mercury immersion and accurate balance respectively.

Results: Stress non- significantly reduced brain’s volume ratio to volume of the adrenal gland and brain’s weight ratio to weight of the adrenal gland. Memantine administration within amygdala inhibited stress effect. Memantine administration in low and medium doses within right and left amygdala significantly increased brain’s volume and weight ratio to volume and weight of the adrenal gland (P<0.05).

Conclusion: Memantine dose and side dependently inhibits the effect of induced stress in male mice. Also, unilateral memantine administration within the left and right amygdala was more effective.

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Background and Objective: Obesity and overwight affects on respiratory phyological indeces including pulmonary voulume, spirometery function, mechanical function of air ways neuro-muscular functions and capacity of exchange of gases. The obese and overwight subjects have high risk in reduction respiratory valume syndrome. This study was done to compare the effects of three resistance training programs with different intensities on pulmonary function, physical function and body composition in overweight girls.
Methods: In this quasi - experimental study, thirty overweight inactive girls were non-randomly divided into 3 equal groups (n=10) of resistance training with different intensity based on their 1 RM (light, 55-65%, moderate, 65-75%, and heavy, 75-85%, repsctively). The training progams were done for 9 weeks (3 sessions per week). Each session consists of 5 stations with 3 sets while rest intervals between the repetiotions and stations were 60-90 seconds and 90-120 seconds, respectively. Before and after the end of the training programs, spirometry, body composition, muscular strength and endurance of the upper body and VO2max were measured.
Results: 9 weeks resistance training program with 55-65%, 65-75%, and 75-85% 1RM intensities had no significant effect in the spirometry parameters, body weight, body mass index, upper body muscular endurance and VO2max. Fat percentage in 55-65% group significantly reduced in compared to those of 65-75%, and 75-85% 1RM groups (P<0.05). The upper body muscular strength in group with 75-85% 1RM significantly increased in compared to groups with 55-65% and 65-75% 1RM (P<0.05).
Conclusion: Overweight girls can apply resistance training with 55-65% 1RM to reduce the percent of body fat, and enhance the upper body strength through trainings with 75-85% 1RM. In relation to pulmonary function indices and indices of physical function and body composition, there was no dference between three training programs.

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Background and Objective: Oxidative stress plays an important role in the pathogenesis of some diseases such as atherosclerosis and doing high intensity training may enhance oxidative stress. This study was done to evaluate the effect of eight weeks resistance training on malondialdehyd, total, antioxidant capacity, liver enzymes and lipid profile in overweight and obese women.
Methods: In this quasi-experimental study, 16 overweight and obese women were non-randomly divided into intervention (n=9) and control (n=7) groups. The resistance training included the resistance training (with intensity of 50-80% one repetition maximum) that lasted for 8 weeks and 3 sessions per week. Every session lasted for 60 minutes. Malondialdehyd, total antioxidant capacity, liver enzymes and lipid profile for each subject was measured.
Results: The eight weeks resistance training significantly increased total antioxidant capacity high density lipoprotein and triglyceride in interventional group in compared to controls (p<0.05). The eight weeks resistance training significantly reduced alanine aminotransferase in comparison with control group (p<0.05).
Conclusion: Eight weeks resistance training by reducing malondialdehyd and increasing total antioxidant capacity may reduce the risk of atherosclerosis disease and improving cardiovascular health.

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Background and Objective: Life style with Low activity and overweight increased the risk of cardiovascular diseases. This study was done to evaluate the effect of ginger supplementation on Lactate dehydrogenase (LDH) changes and delayed muscle soreness following exhaustive eccentric exercise on overweight girls.
Methods: In this randomized clinical trial study, 22 overweight girls were randomly divided into the two groups including intervention (n=12) and control (n=10) groups. For subjects in interventional group were used a daily supplement of 2 grams of ginger powder, each serving a capsule, containing one gram of ginger powder  and subjects in control group were received  daily two capsules containing starch, for two weeks. Physical activity was performed consisting of two sessions of exhausting activity (negative tilt on treadmill, one session before supplementation and one session after two weeks of supplementation). Blood samples were measured in order to measure changes in LDH in four stages and the use of the pain questionnaire for evaluation of delayed muscular brittleness in both pre and post gingival supplementation. Pain scale (visual analogue scale: VAS) was used to measure the delay fatigue.
Results: The results showed that extrinsic exercise increased LDH and delayed muscle soreness after exercise (P<0.05). Also, taking two weeks of ginger supplementation significantly reduced LDH and delayed muscle soreness in the supplement group in comparison with controls (P<0.05).
Conclusion: Ginger can reduces the muscle gain and delayed onset muscle soreness resulting from eccentric exercise in overweight girls.

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Background and Objective: Dietary acid load affects acid–base homeostasis, which may be associated with overweight and obesity as well as dietary quality index international (DQI-I), mean adequacy ratio (MAR), energy density (ED). This study was done to determine the association between dietary acid load with weight status and dietary quality indices among women.
Methods: This descriptive-analytic study was randomly performed on 306 women aged 20 to 55years. Dietary acid load was calculated by potential renal acid load (PRAL), net endogenous acid production (NEAP) and dietary acid load (DAL). DQI-I, MAR, ED were estimated for the participants.
Results: The probability of obesity (95% CI=0.97-5.50, OR=2.33, P=0.04), as well as abdominal adiposity (95% CI=1.21-4.50, OR=2.4, P=0.005) was significantly increased with tertile of DAL (P<0.05). While even after control of confounder variables, other dietary acid load indices (PRAL and NEAP) showed no significant association between dietary acid load and obesity, overweight or abdominal obesity. Also ,with increasing dietary acid load scores, DQI-I and MAR significantly decreased whereas energy density showed a significant increased across tertile categories of dietary acid load indices (P<0.05).
Conclusion: DAL was associated with increased risk of obesity and abdominal obesity. PRAL, NEAP and DAL were good indicators of diet quality indices.
 

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Background and Objective: Lung volume loss, airway obstruction and air flow limitation, and also hypertension are risk factors for mortality in patients with type 2 diabetes. This study was done to determine the effect of supplementation of saffron and exercise training on blood pressure changes, pulmonary function and spirometric indices in obese and overweight women affected by type 2 diabetes.

Methods: In this quasi-experimental study, forty-eight type 2 diabetic obese and overweight women were non randomly divided into four equal groups including placebo, saffron + training, training + placebo, saffron plus placebo). The saffron group + training and training + placebo groups did aerobic training with intensity of 60-75% of maximal heart rate for 8 weeks (three sessions per week). A daily dose of 400 mg of saffron sprout powder (once a day) was used for two months. The variables were measured in the pre-test, 48 hours and two weeks after the last training session.

Results: Intra-group results showed a significant increase in pulmonary function variables (VO2max, FVC, FEV1, FVC/FEV1, PEF, MVV), and significant reduction in systolic blood pressure and anthropometric indices (weight, BMI, and body fat percentage) in all three groups of exercise, saffron and practice + saffron (P<0.05). However, the results intra-group showed a significant difference in the above variables between the exercise + saffron supplement group in compared to other intervention groups (P<0.05), also, the highest effect was observed in the exercise + supplemental group.

Conclusion: According to the results of this study, saffron with exercise led to significant improvement in pulmonary volume and capacities, as well as a decrease in blood pressure in obese and overweight women affected by type 2 diabetes.

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Background and Objective: Obesity plays an important role in the development of chronic diseases including diabetes, hyperlipidemia, and cardiovascular diseases (CVD). This study was conducted to evaluate the association of the age of onset of obesity with resting metabolic rate (RMR) in overweight and obese women during adulthood.
Methods: This descriptive-analytical study was done on 295 overweight and obese women aged 18-50 years in Tehran, Iran. The anthropometric measurements of all participants were measured. Dietary intake and total daily energy intake were assessed by using a semi-quantitative food-frequency questionnaire (FFQ) which the list including 147 food items. Resting metabolic rate was measured by indirect calorimetric method. In order to measure the physical activity International Physical Activity Questionnaire (IPAQ) was used. The questionnaire includes 7 items to assess the intensity of activities by the vigorous, medium, and light for at least 10 minutes during the last week.
Results: There was a significant difference between those whose age of onset of obesity was under 18 or over 18, in RMR per body weight (kg) (Beta: 0.16, CI: 0.11 to 0.00, P: 0.03). In addition, it was seen a significant inverse correlation between age of onset of obesity and body weight (Beta: -0.11, CI: -0.30 to 0.00, P: 0.005) and adipose tissue content (Beta: -0.13,
CI: -0.23 to -0.01, P: 0.02). After adjustment for confounders including (age, physical activities, and energy intake), the correlations still remain significant.
Conclusion: Age of onset of obesity was associated with increased weight and fat and decreased resting metabolic rate in adulthood. In fact, people with lower obesity age have higher body weight and fat and lower RMR.

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Background and Objective: Physical activity and the use of herbal supplements can affect liver enzymes. Nano-curcumin is an effective ingredient (deferulovl methane) in turmeric with antioxidant, antibacterial, antifungal, antiviral, anti-inflammatory and anti-proliferative properties and can play an important role in preventing liver fibrosis. This study was performed to determine the effect of 6 weeks of high intensity interval training (HIIT) with Nano-curcumin supplementation on liver enzyme levels in overweight female students.
Methods: This clinical trial study was performed on 48 overweight female students of Shahid Chamran University of Ahvaz, Iran with an average age of 21.7±1.32 years and a BMI equals 27.8±2.46kg/m² during 2018. Participants were randomly divided into 4 groups: control, Nano-curcumin supplementation (One 80 mg capsule daily), training and training combined with nano-curcumin supplementation (one 80 mg capsule daily). Training groups performed an exercise protocol of HIIT training with maximum heart rate for 6 weeks (three sessions per week). Blood samples were obtained to liver enzymes measurement (ALT, AST and ALP) before and after the intervention period.
Results: Performing six weeks of high intensity interval training along with taking nano-curcumin supplemen led to a significant reduction in serum level of AST and ALT compared to control group (P<0.05). In the supplement-training group, a significant decrease was observed in serum levels of ALT and AST compared to pre-test (P<0.05). But no statistically significant changes were observed in ALP serum level.
Conclusion: It seems taking nano-curcumin supplement along with high intensity interval training have a favorable effects on improving some of the liver characteristics of overweight female students.

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Background and Objective: Sedentary life and vitamin D deficiency are considered as related factors to increased inflammation and oxidative stress in obese individuals. This study was performed to determine the effect of Pilates training with vitamin D supplement on Monocyte chemoattractant protein-1(MCP-1) level and superoxide dismutase (SOD) activity in overweight men.
Methods: In this single-blind clinical trial, 56 overweight men were randomly assigned to control, Pilates, vitamin D and combination groups. The Pilates training was performed for 8 weeks with the intensity of 50-75% of reserve heart rate, 3sessions/week. The vitamin D and combination groups received 50,000 units of vitamin D per week. The levels of MCP1 and SOD activity were in the first and 8 weeks after interventions.
Results: Vitamin D status in subjects was lower than normal level. MCP-1 level in Pilates, vitamin D and combination groups significantly reduced and SOD activity increased after 8 weeks (P<0.05), but the combined intervention had a stronger effect on the modulation of MCP-1 level and SOD activity compared to the other two interventional groups (P<0.05). In addition, the effect of Pilates exercises on increasing SOD activity was more than vitamin D intake (P<0.05).
Conclusion: It seems that Pilates training and Vitamin D intake can be exert their protective effects in overweight individuals with abnormal vitamin D status by an increase on the SOD activity and decreasing the inflammatory index of MCP-1. Although these effects developed with combined intervention, Pilate training was associated with greater increases in antioxidant levels than vitamin D.
 

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Background and Objective: Aging and old age are associated with an increase in inflammatory cytokines. Due to their anti-inflammatory properties, constituents of spirulina may be able to reduce or even improve this process. This study was performed to determine the effects of endurance training and spirulina supplementation on the level of inflammatory cytokines in overweight men.
Methods: In this clinical trial, 40 overweight, middle-aged and elderly men were randomly selected and divided into 5 groups: control-normal, control-overweight, overweight + training, overweight + supplement, and overweight + training + supplement. The training program consisting of an hour of walking on a treadmill, stationary bike workout, and climbing stairs was performed at an intensity of 65% of the maximum heart rate, 3 sessions a week, for 8 weeks. Individuals in the supplement groups received a spirulina tablet (500 mg) twice daily in the morning and evening. Blood sampling was performed after 12 hours of fasting at baseline and 48 hours after the last training session. The level of inflammatory cytokines including transforming growth factor-beta (TGF-β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) was measured by enzyme-linked immunosorbent assay.
Results: The levels of TGF-β, IL-6, and TNF-α were higher in the control-overweight group than in the healthy control-normal group (P<0.05). Training and supplementation significantly reduced the inflammatory markers in overweight men (P<0.05). Moreover, the level of inflammatory markers was significantly lower in the training + supplement group compared with the training group and the supplement group (P<0.05).
Conclusion: Endurance training combined with spirulina supplementation can significantly reduce inflammatory factors in overweight individuals.
 

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Background and Objective: Obesity and overweight, one of which symptoms is chronic inflammation, is associated with changes in tryptophan metabolism, culminating in numerous diseases. Sport training is among the ways to control obesity and overweight. This study was conducted to determine the effect of eight weeks of endurance training on amino acid tryptophan serum levels and body mass of overweight women.
Methods: This quasi-experimental study was conducted on 24 overweight women in two groups of 12 people, including the control and experimental groups. The mean age and standard deviation of the control and experimental groups were 41.16±3.45 and 41.08±2.93 years, respectively. The body mass was measured using the anthropometric device, and blood samples were taken in the pre-test and post-test in a 12-hour fasting condition. The subjects of the experimental group underwent endurance training 3 sessions a week for 8 weeks with an intensity of 60% to 75% of the maximal heart rate reserve. Serum tryptophan level was measured by enzyme-linked immunosorbent assay (ELISA) method.
Results: Eight weeks of endurance training led to enhancing serum tryptophan levels, reducing fat mass, and reducing body mass index (BMI) (P<0.05), and also resulted in a statistically insignificant increase in fat-free mass in overweight women.
Conclusion: Eight weeks of endurance training could be effective in improving the physiological status and body composition of overweight women.

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Background and Objective: Weight regain following bariatric surgery is a significant challenge for this obesity treatment method. This study aimed to identify factors associated with weight regain after bariatric surgeries in obese patients in Gorgan, Iran.
Methods: This longitudinal study included 143 obese individuals (125 women and 18 men) with a mean age of 43.13±9.83 years who underwent bariatric surgery in Gorgan, Iran during 2013-19. Participants were invited to join the study via phone calls. Research variables (type of surgery, blood group, pre-surgery weight, and body mass index [BMI]) were extracted from patient records, and their current weight and waist circumference were measured and recorded. Weight regain was determined based on one of three different criteria: (1) regaining more than 25% of the maximum weight lost post-surgery, (2) regaining more than 10 kg from the minimum weight post-surgery, or (3) an increase of more than 5 BMI units from the lowest BMI post-surgery.
Results: Overall, 33% of individuals experienced weight regain, with 26.6% according to the first definition, 29.4% according to the second definition, and 18.2% according to the third definition. Men had a higher rate of weight regain (P<0.05). Additionally, 93.6% (44 cases) of those with weight regain had abdominal obesity. On average, 79.7% of participants who were 48 months post-bariatric surgery experienced some degree of weight regain. Individuals with a pre-surgery BMI of 50 or higher had a 2.69 times greater chance of weight regain compared to those with BMI lower 50 (P<0.05). The mean weight loss after surgery was significantly higher in individuals who experienced weight regain than those who did not (P<0.05). There was no significant statistical association between weight regain and the type of surgery, age, education level, marital status, or blood group.
Conclusion: Weight regain over time is a reality after bariatric surgery, indicating that this method is not a definitive cure for obesity. Therefore, long-term follow-up for weight control is crucial, especially for individuals with a pre-surgery BMI of 50 or higher or those who experienced significant weight loss post-surgery.

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Background and Objective: The widespread use of digital devices by children has become a significant threat to global health. This study was conducted to evaluate the correlation among screen time, sleep quality, and overweight in preschool children.
Methods: This descriptive-analytical study was conducted on 100 preschool children (46 boys and 54 girls) aged 3 to 6 years and their parents in the city of Qazvin, Iran during 2019-2020. Data were collected using interviews and the Factors Associated with Screen Time in Iranian Children and Adolescents Questionnaire (Mozafarian et al., 2017).
Results: Seventy-six percent of the children were the firstborn in their families. The mean cumulative screen time for the children was four hours per day. Fifty percent of the parents did not adequately supervise their child’s television screen time at home. A statistically significant positive correlation was found between body mass index (BMI) and television screen time duration (r=0.24, P=0.01). With an increase in the children’s cumulative screen time, a statistically significant decrease was observed in the child’s sleep duration (r=−0.21, P=0.04). Although mothers had a significantly higher mean screen time compared to fathers (P<0.001), children’s television screen time exhibited a statistically significant correlation with their fathers’ television screen time (r=0.23, P=0.002).
Conclusion: The mean screen time for preschool children is high. Furthermore, the mean screen time is associated with children’s decreased sleep duration and increased BMI.
 

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Excessive weight gain during pregnancy is recognized as a global epidemic and is associated with complications, such as gestational diabetes. While a healthy diet and regular physical activity positively influence weight control and overall well-being, in-person consultations can be costly and time-consuming. The use of digital technologies, particularly smartphones, has increased for delivering lifestyle interventions and improving well-being. These technologies provide affordable access to health services for pregnant women, especially those in remote areas. This narrative review was conducted to evaluate the effect of telehealth on weight control and the promotion of a healthy lifestyle among pregnant women. A search was performed in the PubMed, Google Scholar, and Scopus databases. Of the 631 initial articles published during 2020-2024,
15 were selected and evaluated after excluding irrelevant articles, review articles, and those without full texts. The selected articles showed that mobile health (mHealth) could improve indicators, such as weight, body mass index (BMI), maternal and infant health, and lifestyle. However, certain limitations, including access issues, cultural barriers, and fluctuations in service quality, impacted their effectiveness. Based on the findings of these articles, it is suggested that personalized interventions be designed with continuous consultations and daily reminders. Forming virtual groups and providing timely feedback can strengthen the sense of belonging and promote adherence. These strategies are valuable for telehealth clinics and online counseling programs.
 

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Background and Objective: Bariatric surgeries are among the most effective methods for treating obesity. A key postoperative challenge is insufficient weight loss or weight regain, which may be associated with eating disorders after surgery. This study was conducted to evaluate the prevalence of binge eating (BE) disorder following bariatric surgery in Gorgan, Iran.
Methods: This descriptive analytical study was performed on 133 patients (mean age = 42.65±9.78 years) who underwent bariatric surgery performed by a single surgeon for the treatment of obesity at Dr. Mousavi Hospital in Gorgan, Iran, during 2013-2019. Patients were invited for an interview, physical examination, and to complete a questionnaire via a phone call. After obtaining informed consent, participants' current height and weight were measured using a standard method, and the Binge Eating Disorder Scale (BEDS) was completed. Variables, such as the type of surgery and preoperative height and weight were extracted and recorded from patients' medical records. The prevalence of BE disorder was compared between patients with and without weight regain.
Results: Out of 133 participants, 44 (33.1%) experienced weight regain. Moderate or severe BE disorder was identified in 59 individuals (44.4%). The prevalence of BE disorder was significantly higher in patients with weight regain compared to those without (P<0.05). The odds of ratios (ORs) for weight regain were 3.7 and 3.9 times higher in individuals with moderate and severe BE disorder, respectively, compared to those without the disorder. No statistically significant association was observed between BE disorder and variables, such as gender, education, occupation, and marital status. However, among individuals who experienced weight regain, being a housewife had a statistically significant association with the disorder (P<0.05).
Conclusion: BE disorder is a significant factor in patient weight regain in the years following surgery, particularly among housewives.
 

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Background and Objective: Tuberculosis (TB), caused by a bacterium called Mycobacterium TB, is the most prevalent infectious disease leading to mortality worldwide. Weight loss is frequently observed in TB patients at the time of diagnosis. Body weight changes have been identified as a potential predictive marker for TB treatment outcomes, particularly in drug-susceptible cases. This study was conducted to evaluate weight changes during TB treatment and associated factors in Golestan Province, Iran.
Methods: This historical cohort study was conducted on 348 patients (178 males and 170 females) with TB referring to health centers in Golestan Province, Iran, in 2020. Data including age, gender, type of TB, pre- and post-treatment weight, place of residence (urban or rural), and treatment outcomes were extracted from patients’ medical records in the TB Register System. Weight changes were then compared before and after treatment across three groups: Smear-positive pulmonary TB, smear-negative pulmonary TB, and extra-pulmonary TB.
Results: Patients’ post-treatment weight showed a statistically significant mean increase of 1.98 kg (P<0.05). Based on the grade of sputum smear positivity, post-treatment weight gain was higher in pulmonary TB patients (both smear-positive and smear-negative) compared to extra-pulmonary cases. Overall, weight gain in all three groups (smear-positive pulmonary TB, smear-negative pulmonary TB, and extra-pulmonary TB) was statistically significant (P<0.05). Furthermore, weight gain was significant across all groups of sputum smear positivity (+ to +++) (P<0.05), with the most substantial weight changes occurring in patients with a ++ sputum smear. Mean weight gain was also significant in both smear-negative patients and other categories (P<0.05), with smear-negative individuals showing higher weight gain than other states. Although weight gain was slightly higher in men than in women, it was statistically significant in both genders (P<0.05). Weight gain was significant in both urban and rural residents (P<0.05), with rural patients exhibiting more pronounced weight gain. Significant weight gain was observed across individuals under 15, 15–65, and over 65 years of age (P<0.05). The least weight changes were observed in the over 65 age group, while the most significant changes occurred in those under 15.
Conclusion: The type of TB (pulmonary versus extra-pulmonary), the grade of sputum smear positivity, treatment outcomes, gender, place of residence, and age were identified as factors associated with weight changes in patients with TB.