Overweight and Obesity in the Eastern Mediterranean Region
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2 Dept. of Basic Sciences, School of Medicine, Shahroud University of Medical Sciences, Iran
Dept. of Statistics and Computer, University of Welfare and Rehabilitation Sciences, Iran
status and obesity in non-menopause women aged 15-49 years in Tehran, Iran.
in 1999. Obesity is defined as a Body Mass Index over ≥30. Constructed area (per-person), educational level and job are considered as factors indicating the socioeconomic status. The results have been adjusted for age and mental health using univariate and multiple logistic regression.
from urban areas of Tehran have been studied. The prevalence of obesity and overweight were 16.4% and 28.4% respec vely. Women aged 30-49 yr had greater risk of obesity (adjusted OR=2.53, 95%CI: 1.99-3.20). Comparing with students, homemakers and employees were at higher risk of obesity (adjusted OR= 4.33, 95%CI: 2.47-7.76, adjusted OR= 2.82, 95%CI: 1.41-5.63 respec vely). Those with >= 12 yr of education had lower risk of obesity compared to illiterate women (adjusted OR=.57, 95%CI: 0.38-0.86). CONCLUSION: The role of social factors is dominant over economic factor 179
on obesity. This fact should be considered as one of the most important research priorities in future researches.
Pediatrics, 2009;19(2) : 135-140
Fatemeh Taheri, MD; Toba Kazemi, MD; Birjand University of Medical Sciences, Birjand, IR Iran
overweight and obesity in 7 to 18-year-old children in Birjand (east Iran) in 2005-2006. Individuals selected using mul stage stra fied random sampling. METHODS: This cross-sec onal study was performed on 6093 students (2995 boys and 3098 girls) aged 7-18 years in Birjand (2005-2006). Subjects were selected via step-wised random sampling in four districts of the city. Body weight and height were measured directly. Percentiles were calculated for body mass index (BMI) Overweight and obesity was defined based on the 85th and 95th percen les of body mass index for age and sex, respec vely, as proposed by CDC in 2000.
4.8% and 1.8%, respec vely. Overweight prevalence varied by age from 1.6% to 9.1% in girls and 0.5% to 7.8% in boys, with obesity rate from 0.8% to 2.5% in girls and 0.5% to 3.7% in boys. CONCLUSION: According to this study, prevalence rate of overweight and obesity in Birjandi children is lower than that in many other parts of Iran and some neighboring countries.
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Int J Cardiol. 2008 Dec 17;131(1):90-6.. Metabolic Syndrome: An Emerging Public Health Problem In Iranian Women: Isfahan Healthy Heart Program. Sarrafzadegan N, Kelishadi R, Baghaei A, Hussein Sadri G, Malekafzali H, Mohammadifard N, Rabiei K, Bahonar A, Sadeghi M, O'Laughlin J. Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. crc@mui.ac.ir
syndrome (Met S) in a representative sample of Iranian adults, and to identify some possible related lifestyle factors.
program entitled Isfahan Healthy Heart Program, we performed this cross- sec onal study on 12,514 adults (> or =19 years) living in urban and rural areas of 3 ci es in Iran. We assessed the prevalence of the Met S (according to the ATP III criteria) as well as dietary intake (based on food frequency questionnaire) and physical activity habits of all of the participants. We also evaluated dietary intake at the micronutrient level by using a one-day food record in a sub-sample of 2000 par cipants. RESULTS: The age-adjusted prevalence of Met S was 23.3%, with a higher prevalence in women compared to men (35.1% vs. 10.7%, P<0.05) and in urban residents compared to rural residents (24.2% vs. 19.5%, P<0.05). In all age groups and in both urban and rural areas, the Met S affected a significantly larger number of women than men. Among women, abdominal obesity (71.7%) was more prevalent followed by low HDL-C (60.9%) and hypertriglyceridemia (56.6%), whereas among men, the most frequent components were hypertriglyceridemia (49.1%) and low HDL-C (35.1%), respectively. Abdominal obesity was nearly six times as prevalent in women as in men (71.7% vs. 12%, P<0.05) and had a significant associa on with metabolic disorders even after adjustment for age, sex and the living area. In general, dietary intake had no effect on the prevalence of Met S. The prevalence of Met S in subjects with a sedentary lifestyle was significantly higher than in ac ve subjects of both genders (25.6% vs. 14.4%, respec vely, P<0.05).
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CONCLUSION: The Met S is highly prevalent in the Iranian population, notably in women living in urban areas. Abdominal obesity and dyslipidemia characterize this syndrome. Implementing community-based strategies for lifestyle change is of great significance.
J Public Health (Oxf). 2008 Dec;30(4):429-35. Epub 2008 Apr 8. Sociodemographic and Smoking Associated with Obesity in Adult Women in Iran: Results from the National Health Survey. Bakhshi E, Eshraghian MR, Mohammad K, Foroushani AR, Zeraati H, Fotouhi A, Siassi F, Seifi B. Department of Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University/Medical Sciences, Iran.
the association between sociodemographic and smoking with obesity in Iran. The goal was to investigate these associations in the Iranian women.
between 20 and 69 years of age. Height and weight were measured rather than self-reported.
educa on were 0.78 and 0.41, respec vely, compared with basic level. Using low economy index as the reference, Obesity OR(S) for the urban women were 1.29, 1.25 and 1.28 for the lower-middle, upper-middle and high groups, respectively. Obesity OR(S) for the rural women were 1.71, 1.71 and 2.02 for the lower-middle, upper-middle and high groups, respec vely. Obesity OR was 0.48 for ac ve workforce compared with inac ve group. Obesity OR was 0.70 for smokers women compared with nonsmokers. Using non-married as the reference group, Obesity OR(S) were 1.23 and 2.34 for married urban and rural women, respec vely. CONCLUSIONS: Our results on the associations between age, smoking, education level, workforce and obesity are consistent with most studies, but between economic level and obesity are consistent with some study in developing countries. 182
Ann Nutr Metab. 2008;53(3-4):162-6. Epub 2008 Nov 14. Comparison of Body Mass Index and Waist/Height Ratio in Predicting Definite Coronary Artery Disease. Siavash M, Sadeghi M, Salarifar F, Amini M, Shojaee-Moradie F. Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. siavash@med.mui.ac.ir Abstract BACKGROUND: Body mass index (BMI), waist circumference (WC), waist/hip ratio, waist/height ratio (WHtR) and skin fold thickness are clinical tools enabling the evaluation of obesity. WHtR is a recently introduced index to assess central fat distribution. This study was performed to compare the prognostic value of WHtR and BMI for definite coronary artery disease (CAD). METHODS: A cross-sectional study was performed in the Shahid-Chamran Hospital, Isfahan, Iran. The study included 591 pa ents undergoing coronary angiography for suspected ischemia. We measured BMI, WC and coronary artery scores of the patients. Prevalence of CAD was compared between obese (BMI >or= 30) and abdominal obese (WHtR >or= 0.55) participants. RESULTS: Prevalence of CAD was significantly higher in abdominal obese patients (WHtR >or= 0.55) than in pa ents without abdominal obesity (odds ra o, OR=1.63, p=0.008). The difference in CAD prevalence between obese (BMI >or= 30) and non-obese patients nearly reached significance (OR=1.48, p=0.058). There was a significant posi ve correlation between CAD score and age (p<0.01), WC (p<0.05), and WHtR (p<0.01) in male participants.
better predict CAD than BMI and WC. 183
Clin Endocrinol (Oxf). 2008 Nov;69(5):721-9. Epub 2008 Feb 11. Short- and Long-Term Relationships of Serum Ghrelin with Changes in Body Composition and the Metabolic Syndrome in Prepubescent Obese Children Following Two Different Weight Loss Programmes. Kelishadi R, Hashemipour M, Mohammadifard N, Alikhassy H, Adeli K. Preventive Paediatric Cardiology Department, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. kroya@aap.net
balance, and its dysregulation may be important in obesity. The aims of this study were (i) to compare short- and long-term changes in circulating ghrelin concentration after increasing energy expenditure vs. its changes after decreasing energy intake, (ii) to determine factors associated with changes in ghrelin level, and (iii) to assess relationships of ghrelin concentration with metabolic syndrome (MetS) in prepubescent obese children. DESIGN: Randomized controlled trial. PATIENTS: About 100 obese children aged 7-9 years. MEASUREMENTS: After baseline testing, children were randomly assigned to two interventional groups, either receiving dietary recommendations or engaging in physical training classes for 6 months. Ghrelin, insulin, lep n, fasting blood sugar, lipid profile and anthropometric indexes, as well as energy intake and expenditure were measured.
returned for the 1-year follow-up. Except ghrelin level, other biochemical variables had no significant change at 12- vs. 6-month follow-up. In both groups, ghrelin showed a progressive increase in the periods of time with significant reduction of overweight and negative energy balance; while after the end of the trial, when children regained weight, it decreased toward baseline levels. Baseline ghrelin had strong negative correlation with measures of central obesity. The odds of having the MetS were 12% lower in the middle and 37% lower in the highest ter le of ghrelin level. As the number of MetS components increased, there was a progressive 184
decrease in ghrelin and quantitative insulin sensitivity check index (QUICKI), with a progressive increase in serum insulin, HOMA-R and leptin levels. CONCLUSIONS: Ghrelin increases in response to overweight reduction and negative energy balance resulting from either an exercise intervention or reduction in food intake in prepubescent obese children. It is unlikely to regulate long-term energy balance in young obese children.
Arch Med Res. 2008 Nov;39(8):803-8. Metabolic Syndrome and Insulin Resistance Significantly Correlate with Body Mass Index. Esteghamati A, Khalilzadeh O, Anvari M, Ahadi MS, Abbasi M, Rashidi A . Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Medical Sciences/University of Tehran, Tehran, Iran. esteghamati@tums.ac.ir Abstract BACKGROUND: Metabolic syndrome (MetS) is a cluster of metabolic risk factors for cardiovascular disease. This study aimed to compare the prevalence of MetS and its components in different degrees of obesity in Iranian subjects. METHODS: A total of 2309 adults were divided into four groups according to their body mass index (BMI): 1511 subjects were non-obese (BMI <30 kg/m(2)); 535 were moderately obese (BMI > or =30-<35); 176 were severely obese (BMI > or =35-<40) and 87 were morbidly obese (BMI > or =40). Fas ng blood samples were obtained and plasma glucose, lipids, insulin and HbA1c were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The prevalence of MetS, according to the definitions of the International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (ATPIII), was compared across increasing grades of BMI. RESULTS: Prevalence of MetS gradually rose with increasing grades of obesity (p<0.001), from 31.9% in the non-obese to 69.0% in the morbidly obese according to the IDF criteria and from 31.2% to 62.1% according to the ATPIII criteria. After controlling for age and sex, one grade increase in the BMI category was associated with 2.5-3 mes higher risk of MetS depending on the definition used. In addition, HOMA-IR was significantly correlated with BMI in all subjects (r=0.343, p<0.001) and in moderately (r=0.184, p<0.01), severely (r=0.147, p<0.01) and morbidly (r=0.101, p<0.05) obese par cipants separately.
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CONCLUSIONS: MetS and its components, including high blood pressure, central obesity, hyperglycemia, IR, hypertriglyceridemia and low high- density lipoprotein-cholesterol increase in parallel with increasing obesity grades.
Eur J Clin Nutr. 2008 Nov;62(11):1326-32. Epub 2007 Jul 25. Physical Activity and Body Mass Index in Elderly Iranians in Sweden: A Population-Based Study. Koochek A, Johansson SE, Kocturk TO, Sundquist J, Sundquist K. Karolinska Institutet, Center for Family and Community Medicine, Stockholm, Sweden. Afsaneh.koochek@ki.se Abstract BACKGROUND/OBJECTIVES: To analyze whether elderly Iranians in Sweden have a higher mean body mass index (BMI) and are less physically active than elderly Swedes after adjustment for possible confounders.
and 235 Swedish-born) aged 60-84 years residing in Stockholm, Sweden, were included in this population-based survey. Iranian participants were weighed and their height was measured. BMI values from the Swedish participants were based on self-reported data adjusted for the known discrepancy between objectively measured and self-reported weight and height. The outcome variables, BMI and self-reported leisure-time
physical activity, were analyzed by linear regression and unconditional logistic regression. RESULTS: Overall, Iranian women had the highest mean BMI (29.2) of all subgroups. The model that included an interaction between sex and length of time in Sweden showed that there was no significant difference in BMI between Swedish men (reference) and Swedish women or Iranian men. In contrast, Iranian women had significantly higher BMI than the reference group after adjustment for age, education and marital status. The largest difference in BMI compared to the reference group was found among Iranian women who immigrated to Sweden in 1989 or later (beta- coefficient=3.41, 95% CI=1.99-4.83). Iranians and Swedes had almost the same odds of >or= once-weekly leisure-time physical activity. CONCLUSIONS: Elderly Iranian immigrants and especially women who immigrated to Sweden in 1989 or later must be targeted in order to decrease their burden of risk factors for cardiovascular disease.
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East Mediterr Health J. 2008 Sep-Oct;14(5):1070-9. Cardiovascular Disease Risk Factors, Metabolic Syndrome and Obesity in an Iranian Population. Kelishadi R, Gharipour M, Sadri GH, Tavasoli AA, Amani A. Isfahan Cardiovascular Research Centre of Isfahan University of Medical Sciences, WHO Collaborating Centre, Isfahan, Islamic Republic of Iran. kelishadi@med.mui.as.ir
As part of the Isfahan Healthy Heart Program, we evaluated the prevalence of cardiovascular disease risk factors in Iranians with generalized and abdominal obesity. We carried out a cross-sec onal study on 3694 > or = 19 years. Overall, 36.6% of men and 35.9% of women were overweight; 11.2% of men and 28.l% of women were obese. Mean body mass index (BMI), waist circumference (WC) and waist/hip ratio (WHR) increased with age up to 65 years. Total serum cholesterol, triglycerides and 2-hour post-load plasma glucose increased with BMI, WC and WHR in both sexes. Prevalence of metabolic syndrome was 19.8% in females with normal BMI, 48.1% in overweight females and 63.2% in obese females. In males, corresponding values were 3.7%, 18.0% and 40.1%.
BMC Cancer. 2008 Sep 30;8:278. Weight, Height, Body Mass Index and Risk of Breast Cancer in Postmenopausal Women: A Case-Control Study. Montazeri A, Sadighi J, Farzadi F, Maftoon F, Vahdaninia M, Ansari M, Sajadian A, Ebrahimi M, Haghighat S, Harirchi I. Iranian Institute for Health Sciences Research, Tehran, Iran. montazeri@acecr.ac.ir
index. To investigate whether the condition contributes to excess breast cancer cases, a case-control study was conducted to assess the relationships between anthropometric variables and breast cancer risk in Tehran, Iran.
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METHODS: All incident cases of breast cancer in the Iranian Centre for Breast Cancer (ICBC) were identified through the case records. Eligible cases were all postmenopausal women with histological confirmed diagnosis of breast cancer during 1996 to year 2000. Controls were randomly selected postmenopausal women attending the ICBC for clinical breast examination during the same period. The body mass index (BMI) was calculated based on weights and heights as measured by the ICBC nursing staff. Both tests for trend and logistic regression analysis were performed to calculate odds ra os and 95% confidence intervals as measures of relative risk.
There were no significant differences between cases and control with regard to most independent variables studied. However, a significant difference was observed between cases and controls indicating that the mean BMI was higher in cases as compared to controls (P = 0.004). Performing logistic regression analysis while controlling for age, age at menopause, family history of breast cancer and parity, the results showed that women with a BMI in the obese range had a three fold increased risk of breast cancer [odds ra o (OR) = 3.21, 95% confidence interval (CI): 1.15- 8.47].
CONCLUSION: The results suggest that obesity in postmenopausal women could increase risk of breast cancer and it merits further investigation in populations such as Iran where it seems that many women are short in height, and have a relatively high body mass index.
Ann Nutr Metab. 2008;53(1):13-22. Epub 2008 Sep 5. Temporal Changes in Anthropometric Parameters and Lipid Profile According to Body Mass Index Among an Adult Iranian Urban Population. Bozorgmanesh MR, Hadaegh F, Padyab M, Mehrabi Y, Azizi F. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University (M.C.), Tehran, Islamic Republic of Iran.
over a period of 3.6 years in an Iranian adult popula on according to body mass index (BMI) groups.
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METHODS: Between 1998 and 2001 (phase 1) and 2002 and 2005 (phase 2), 5,618 nondiabe c Iranian adults aged > or =20 years were examined. Analysis of covariance was used to delineate trends in anthropometric parameters as well as total and low- and high-density lipoprotein cholesterol (TC, LDL-C and HDL-C, respectively) across BMI groups.
significant in obese persons. Among the men, however, a significant increase in BMI was observed only in lean persons. Waist circumference (WC) increased across all BMI groups in both sexes. A significant decrease was observed in TC [men: -0.83 mmol/l, 95% confidence interval (CI) -1.27 to -0.40; women: -0.78 mmol/l, CI -0.97 to -0.60] and LDL-C (men: -0.63 mmol/l, CI -1.13 to -0.13; women: -0.51 mmol/l, CI -0.78 to -0.24). A significant decrease in mean HDL-C was observed only among men (-0.09 mmol/l, CI -0.13 to -0.04), with no difference among BMI groups (p = 0.3). There were no significant decreases in TC/HDL-C and LDL-C/HDL-C ratios in men or women.
in TC and LDL-C levels. The favorable trend in TC levels was counterbalanced by changes in HDL-C, as reflected by the absence of a significant decrease in TC/HDL-C or LDL-C/HDL-C.
Indian J Gastroenterol. 2008 Jul-Aug;27(4):153-5. Gastro-Esophageal Reflux Symptoms and Body Mass Index: No Relation Among the Iranian Population. Solhpour A, Pourhoseingholi MA, Soltani F, Zarghi A, Habibi M, Ghafarnejad F, Tajik Z, Rostaminejad M, Ramezankhani A, Zali MR. Research Center For Gastroenterology and Liver Diseases, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. solhpourali@yahoo.com Abstract An association between obesity and symptoms of gastro-esophageal reflux disease (GERD) has been frequently reported in western societies. A recent study indicated a consistent association between abdominal diameter and reflux-type symptoms in the white population, but no consistent association in the black population or Asians. It is unclear whether an association persists after adjusting for known risk factors of GERD among Asian populations. We did a population-based, cross-sectional interview 189
study to estimate the strength of association between body mass and symptoms of reflux. During interviews, participants completed a valid gastro-esophageal reflux ques onnaire. Odds ra o (OR) with 95% confidence interval (CI), calculated by logistic regression with multivariate adjustments for covariates, were the measures of association. Symptoms of reflux at least once a week over the past 3 months were reported by 522 (9.1%) of the 5733 interviewees. Among those who were overweight or obese (BMI> 25 kg/m2), the OR of having symptoms of reflux was 0.88 (95% CI: 0.66-1.16) compared with those who were not overweight or obese. Thus, among Asians, symptoms of GERD occur independently of body mass index.
The Effects of Socio-Economic Status on BMI, Waist:Hip Ratio and Waist Circumference in a Group of Iranian Women. Shahraki M, Shahraki T, Ansari H. Department of Nutrition, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran. Abstract OBJECTIVE: To assess the effects of socio-economic status (SES) on BMI, waist:hip ratio (WHR) and waist circumference (WC) in a group of Iranian women.
and Baluchestan Province. SES was measured using level of education. In addition, parity, marital status and physical activity were assessed. Standardized measurements were taken, BMI and WHR were calculated. RESULTS: Low education level was a strong determinant of overweight and obesity among Iranian women. After controlling for age, women with higher education level had significantly lower BMI, WC and parity. Multiple linear regression analysis found a significant negative association of BMI and WC with education level and a significant positive association of BMI and WC with parity. Significant factors associated with obesity by a logistic regression model were education level (OR for university graduates v. illiterate or low literacy levels: 1.00 v. 3.70; P = 0.01), living with spouse (OR for married v. single subjects: 1.00 v. 0.15; P = 0.05), parity (OR for more
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than five v. less than two pregnancies: 1.00 v. 0.34; P = 0.03) and WC (OR for < 0.88 cm v. > or = 0.88 cm: 1.00 v. 11.20; P = 0.001). CONCLUSION: The present study revealed that educational level, multiple pregnancies, marital status and lack of exercise are some possible explanations for the obesity among Sistan and Baluchestan women.
BMC Public Health. 2008 Jun 15;8:213. The Positive Association between Number of Children and Obesity in Iranian Women and Men: Results from the National Health Survey. Bakhshi E, Eshraghian MR, Mohammad K, Foroushani AR, Zeraati H, Fotouhi A, Siassi F, Seifi B. Department of Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University/Medical Sciences, Iran.
eshraghian@yahoo.com Abstract BACKGROUND: To date, few studies have assessed the association between the number of children and obesity in couples. We aimed to inves gate this associa on in men and women aged 20-75 years.
investigation. It included 2728 women and men (1364 couples) aged 20-75 years. Height and weight were actually measured rather than self-reported. A generalized estimating equation model was used to estimate the odds of obesity (body mass index (BMI > or = 30)) as a func on of the number of children adjusted for age, sex, education, economic index, workforce, smoking and place of residence.
34% increase in the odds of obesity in men and at least 4% and at most 29% increase in the odds of obesity in women. Our test of interaction by sex showed that the association between the number of children and obesity was not different among men and women. Among women, factors that increased obesity included age, low education, having more children, being inactive workforce and being nonsmoker. Among men, these factors included high economic index, low education, having more children, and being nonsmoker.
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CONCLUSION: Our results show an association between the number of children and obesity among men. We would recommend interventions to reduce the number of children to prevent obesity in men.
BMC Public Health. 2008 May 24;8:176. High Prevalence of Undiagnosed Diabetes and Abnormal Glucose Tolerance in the Iranian Urban Population: Tehran Lipid and Glucose Study. Hadaegh F, Bozorgmanesh MR, Ghasemi A, Harati H, Saadat N, Azizi F . Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University (M.C), Tehran, Iran. fzhadaegh@endocrine.ac.ir Abstract BACKGROUND: To estimate the prevalence of diagnosed and undiagnosed diabetes mellitus, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and combined IFG/IGT in a large urban Iranian population aged > or = 20 years. METHODS: The study popula on included 9,489 par cipants of the Tehran Lipid and Glucose Study with full relevant clinical data. Age-standardized prevalence of diabetes and glucose intolerance categories were reported according to the 2003 American Diabetes Associa on defini ons. Age- adjusted logistic regression models were used to estimate the numbers needed to screen (NNTS) to find one person with undiagnosed diabetes. RESULTS: The prevalence of diagnosed and undiagnosed diabetes, isolated IFG, isolated IGT, and combined IFG/IGT were 8.1%, 5.1%, 8.7%, 5.4% and 4.0% in men and 10%, 4.7%, 6.3%, 7.6%, and 4.5% in women respec vely. Participants with undiagnosed diabetes had higher age, body mass index (BMI), waist circumference, systolic and diastolic blood pressures, triglycerides (all p values <0.001) and lower HDL-cholesterol (only in women, p < 0.01) compared to normoglycemic subjects. Undiagnosed diabetes was associated with family history of diabetes, increased BMI (> or = 25 kg/m2), abdominal obesity, hypertriglyceridemia, hypertension and low HDL-cholesterol levels. Among men, a combination of increased BMI, hypertension, and family history of diabetes led to a NNTS of 1.6 (95% CI: 1.57-1.71) and among women a combina on of family history of diabetes and abdominal obesity, yielded a NNTS of 2.2 (95% CI: 2.1-2.4).
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CONCLUSION: In conclusion, about one third of Tehranian adults had disturbed glucose tolerance or diabetes. One- third of total cases with diabetes were undiagnosed. Screening individuals with BMI > or = 25 kg/m2 (men), hypertension (men), abdominal obesity (women) and family history of diabetes may be more efficient.
Public Health Nutr. 2008 May;11(5):528-34. Epub 2007 Sep 3. Dietary and Non-Dietary Determinants of Central Adiposity among Tehrani Women. Azadbakht L, Esmaillzadeh A. Department of Nutrition, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran. azadbakht@hlth.mui.ac.ir Abstract OBJECTIVE: To determine the correlates of central adiposity. DESIGN: Population-based cross-sectional study. SUBJECTS: A total of 926 women (aged 40-60 years) from all districts of Tehran.
METHODS: Demographic data were collected and anthropometric indices were measured according to standard protocols. Dietary intakes were assessed by means of a semi-quantitative food-frequency questionnaire. The suggested cut-off point for waist-to-hip ra o (WHR>or=0.84) for Tehrani people, adjusted for their age group, was used to determine central adiposity. Logistic regression analysis was used to determine the correlates of WHR, which were adjusted for age, taking medications and body mass index (BMI). The components of dietary intake were determined by factor analysis. Pearson correlation was used to determine the association between the dietary components and WHR. Analysis of covariance was employed to compare the mean values of WHR in different lifestyle groups, with adjustment for BMI and age. RESULTS: Mean WHR was 0.82 +/- 0.06. The possibility of being centrally obese was higher in women with light physical ac vity (odds ra o: 2.11; 95% confidence interval: 1.40-2.53), depressed women (1.36; 1.02-1.93), smokers (1.21; 1.02-1.56) and unemployed women (1.41; 1.13-1.72). Marriage (1.31; 1.10-1.82), menopause (1.22; 1.02-1.61), low vitamin C intake (2.31; 1.25-4.25) and low calcium intake (1.30; 1.07-3.78) were 193
associated with central fat accumulation. Dairy consumption was inversely correlated with central fat accumulation (r = -0.2, P < 0.05). CONCLUSION: Central adiposity is associated with poor lifestyle factors including low physical activity, depression, smoking, low intake of vitamin C, low intake of calcium and dairy products and high fat consumption. Thus lifestyle modifications should be encouraged to achieve a healthier body shape.
Arch Iran Med. 2008 May;11(3):274-81. Association of Body Mass Index and Abdominal Obesity with Marital Status in Adults. Janghorbani M, Amini M, Rezvanian H, Gouya MM, Delavari A, Alikhani S, Mahdavi A. Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical
Sciences, Isfahan, Iran. janghorbani@yahoo.com Abstract BACKGROUND: Obesity continues to be an important public health problem worldwide. The objective of this study was to determine the association of body mass index and abdominal obesity with current marital status among the adult population of Iran. METHODS: A nation-wide cross-sectional survey was conducted from December 2004 through February 2005.The subjects were selected by stratified probability cluster sampling through household family members in Iran. Weight, height, waist circumference, and marital status of 89,404 men and women aged 15 - 65 (mean: 39.2) years were recorded. Four classes of body mass index, i.e., <18.5, 18.5 - 24.9, 25 - 29.9, and > or =30 kg/cm2, and three marital status, i.e., currently-, formerly-, and never- married were used. Abdominal obesity was defined as waist circumference > or =102 cm in men and > or =88 cm in women.
(OR: 2.24; 95% CI: 2.08 - 2.41) and women (OR: 2.36; 95% CI: 2.20 - 2.53) than never-married men and women, even when age, educational level, leisure time physical activity, smoking habits, and place of residence were controlled. The multivariate OR of obesity was increased about threefold in married men (2.82; 95% CI: 2.51 - 3.18) and women (3.64; 95% CI: 3.31 - 3.99). The prevalence of abdominal obesity was twofold higher among
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married men (2.02; 95% CI: 1.79 - 2.29) and about threefold higher among married women (2.87; 95% CI: 2.69 - 3.06). CONCLUSION: The marital status appears to influence the likelihood of developing overweight, obesity, and abdominal obesity in both men and women in Iran.
Int J Cardiol. 2008 May 23;126(2):292-4. Epub 2007 Apr 30. Childhood Obesity and Early Prevention of Cardiovascular Disease: Iranian Families Act Too Late. Maddah M. Abstract This study described overweight/obese children and adolescents seeking weight loss treatment regarding their age, gender, severity of obesity and maternal educa on in Rasht city, northern Iran. Data on 1465 overweight/obese children and adolescents aged 2-18 years engaged in weight loss program were analyzed in this study. These data included age, sex, weight, height, self-reported parental weight and height, history of dieting, and mother's level of education. There were more overweight/obese girls engaged in weight loss program than overweight/obese boys (71.2% vs. 28.8% p<0.0001). These data showed that only 18.2% of the overweight/obese children and adolescents were from families with low maternal education. These data suggest that parents of overweight/obese children and adolescents from low social level, boys and young children across all maternal educational levels should be warned against the risk of obesity.
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Indian Heart J. 2008 Mar-Apr;60(2):110-2. The Relation between Total Daily Caloric Intake and Blood Pressure. Najafian J, Nushin M. Department of Cardiology, Isfahan University of Medical Science, Isfahan, Iran. najafian@crc.mui.ac.ir Abstract BACKGROUND: More caloric intake and less physical activity engenders more obesity and any degree of weight gain even to the level that is not defined as overweight is associated with an increase of hypertension. It is not defined that if total caloric intake irrespective of weight gain had any effect on blood pressure. This is an observational study about the rela onships between blood pressure and daily calorie intake in 1,061 female and 890 male aged 20-51 years.
normotensive and hypertensive samples. Dietary data were obtained from a food-frequency questionnaire which was analyzed by software designed for Iranian foods designed by Isfahan cardiovascular research center to calculate the total daily caloric intake. Blood pressure was measured three times by korotkoff method. The relation between daily total caloric intake and blood pressure was analyzed by general linear regression and logistic regression. RESULTS: Generalized linear regression revealed no significant relation between either systolic or diastolic blood pressure and daily total caloric intake irrespective of normal or abnormal blood pressure. This association remained non-significant even after adjustment for body mass index (BMI) p<0.05. Logis c regression analysis revealed that there is no significant relation between total caloric intake and existence of systolic or diastolic hypertension OR=1, p>0.05. A er adjustment for BMI also, there was no significant relation between these two parameters OR=1, p>0.05. CONCLUSION: Usual relation between caloric intake and blood pressure in obese may be due to insulin resistance induced by obesity. So total daily caloric intake in general population had no significant effect on blood pressure and on development of hypertension when the effect of obesity is adjusted.
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J Hypertens. 2008 Mar;26(3):419-26. Nationwide Survey of Prevalence and Risk Factors of Prehypertension and Hypertension in Iranian Adults. Janghorbani M, Amini M, Gouya MM, Delavari A, Alikhani S, Mahdavi A. Department of Epidemiology and Biostatistics, School of Public Health, Isfahan
University of
Medical Sciences, Isfahan, Iran.
janghorbani@yahoo.com Abstract OBJECTIVE: The aim of this study was to estimate the prevalence and risk factors of prehypertension (Pre-HTN) and hypertension (HTN) among the adult population of Iran.
December 2004 to February 2005. The selec on was conducted by stratified probability cluster sampling through household family members in Iran. Blood pressure (BP) and associated risk factors of 35 048 men and 34 674 women aged 25-65 years (mean 44.1 years) were measured.
women; and 19.8% of men and 26.9% of women were hypertensive, according to Joint Na onal Commi ee 7 criteria. Pre-HTN was more common among men whereas HTN was more common among women. Multivariate analysis revealed that age, overweight, obesity, abdominal obesity and high cholesterol were strongly associated with Pre-HTN in both genders. In women, low educational attainment, residence in an urban area and high blood glucose were also associated with Pre-HTN. Age, low educational attainment, overweight, obesity, abdominal obesity and high cholesterol and blood glucose were strongly associated with HTN in both genders.
were associated with obesity. More men than women present with Pre- HTN, whereas more women than men present with HTN. Prevention and treatment strategies are urgently needed to address the health burden of Pre-HTN and HTN and to prevent prehypertensive people from developing HTN and cardiovascular disease.
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Food Nutr Bull. 2008 Mar;29(1):43-8. Determination of the Leading Central Obesity Index among Cardiovascular Risk Factors In Iranian Women. Shahraki T, Shahraki M, Roudbari M, Gargari BP. Research Center for Children and Adolescents' Health, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran. Abstract BACKGROUND: It is unknown whether the waist circumference (WC) or the waist-to-hip ratio (WHR) is a better predictor of cardiovascular risk factors at different ages.
factors and to determine the prevalence of some cardiovascular risk factors in overweight and obese adult women at different ages.
women aged 20 to 70 years who were referred to two nutri on clinics in Sistan and Baluchestan province, Islamic Republic of Iran, were studied. The subjects were classified into three groups, 20 to < 35, 35 to < 50, and > or = 50 years of age. Anthropometric indices were measured according to the standard protocol. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and TC/HDL-C ratios were enzymatically determined. RESULTS: Older subjects (> or = 50 years old) had significantly higher values of body mass index (BMI), WC, TC, TG, and LDL-C than those in the two younger age classes. The prevalence rates of obesity, high WC, high WHR, high TC, high TG, high LDL-C, and high TC/ HDL-C ratios were higher in the older subjects. After adjustment for age and BMI, multiple linear regressions showed that WC was significantly related to TC and TG in the 20- to < 35-year-old group and to TG in the 35- to < 50-year-old group. In the older participants, WHR was significantly related to TG. CONCLUSIONS: The prevalence of cardiovascular risk factors increases with age. In clinical practice, WC is a better index for predicting some cardiovascular risk factors in younger and middle-aged women; however, for older women, WHR is better.
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Arch Iran Med. 2008 Mar;11(2):210-3. Triceps Skinfold Thickness Centile Charts in Primary School Children in Shiraz, Iran. Ayatollahi SM, Mostajabi F. Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran. ayatolahim@sums.ac.ir Abstract Triceps skinfold thickness charts of a random sample of 2,234 healthy school children (1,161 boys and 1,073 girls) in Shiraz, Iran are presented. Triceps skinfold thickness increases by age and is higher in girls than boys, except for upper extreme centiles. Triceps skinfold thickness may be used with reasonable success to detect childhood obesity, which would be of great importance in public health promotion. It favors adequacy and simplicity in screening for adiposity. The charts presented here are likely to be applied to urban population of school-aged children in Iran, however, it should be updated periodically.
Public Health Nutr. 2008 Mar;11(3):246-51. Epub 2007 Jul 12. Obesity and Associated Lifestyle Behaviours in Iran: Findings from the First National Non-Communicable Disease Risk Factor Surveillance Survey. Kelishadi R, Alikhani S, Delavari A, Alaedini F, Safaie A, Hojatzadeh E. Isfahan Cardiovascular Research Center, WHO - Collaborating Center in the EMR, Isfahan University of Medical Sciences, PO Box 81465-1148, Isfahan, Iran. kelishadi@med.mui.ac.ir
as well as some associated lifestyle behaviours, for the first time in Iran. DESIGN AND SETTINGS: This population-based study was performed in early 2005 as part of the World Health Organiza on (WHO) STEPwise approach to non-communicable diseases' risk factor surveillance. Dietary and physical activity habits were assessed by WHO questionnaires. SUBJECTS: The study popula on comprised 89,532 subjects aged over 15 years living in the 28 provinces of Iran. 199
RESULTS: Overall, 50.4% (n = 45,113) of the par cipants were male and 64.6% (n = 57 866) were from the urban areas. The na onal es mates of overweight, obesity and morbid obesity were 28.6%, 10.8% and 3.4%, respec vely. Body mass index (BMI) > or = 25 kg m-2 in men, women, urban residents and rural residents were found in 37%, 48%, 46.7% and 35.5%, respec vely. Abdominal obesity was present in 43.4% of women, 9.7% of men, 28.5% of the urban residents and 23% of the rural residents. Overweight as well as generalised and abdominal obesity were more prevalent in the 45-64-year age group. Although there was no significant difference in frequency of consumption of the food groups in subjects with different BMI categories, various kinds of physical activities showed a steady decline with increasing BMI. CONCLUSIONS: The findings of the present study provide alarming evidence for health professionals and policy makers about the very high prevalence of generalised and abdominal obesity in Iran. The unhealthy lifestyle habits, notably sedentary lifestyles in our community, are the major contributing factors for this emerging public health problem.
J Nutr. 2008 Feb;138(2):358-63. Major Dietary Patterns In Relation To General Obesity and Central Adiposity among Iranian Women. Esmaillzadeh A, Azadbakht L. Department of Nutrition, School of Public Health and Food Security and Nutrition Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. esmaillzadeh@hlth.mui.ac.ir
Studying the links between dietary patterns and obesity is especially relevant for Middle-Eastern populations because of their high prevalence of a particular type of obesity, the so-called Middle-Eastern pattern, and their diets' unique characteristics. Therefore, we wondered if major dietary patterns are related to the prevalence of general obesity and central adiposity among Iranian women. In this cross-sec onal study of 486 women aged 40-60 y, usual dietary intakes were evaluated using a FFQ and anthropometric measurements. By the use of factor analysis, we extracted 3 major dietary pa erns: healthy dietary pa ern, western dietary pa ern, and Iranian dietary pattern. Individuals in the upper category of the healthy pa ern score were less likely to be generally (OR = 0.28; 95% CI = 0.14-0.53) and centrally obese (OR = 0.30; 95% CI = 0.16-0.55), whereas those in the
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upper quintile of western pattern had greater odds (for general obesity: 2.73; 95% CI = 1.46-5.08 and for central obesity: 5.74; 95% CI =2.99-10.99). Controlling for potential confounders attenuated the associations, but even after adjusting for energy intake, the associations were significant for both general and central obesity. Although the Iranian dietary pattern and general obesity were not significantly associated, subjects in the highest quin le had greater odds of being centrally obese, either before (OR = 2.15; 95% CI = 1.18-3.90) or a er (OR = 2.08; 95% CI = 1.09-3.65) control for confounders. This study indicates significant associations among major dietary patterns, general obesity, and central adiposity in a Middle-Eastern country. Further prospective investigations are required to confirm such associations.
Pak J Biol Sci. 2008 Feb 1;11(3):443-7. Is There Any Association between Overweight, Obesity and Symptoms of Reflux Disease? Ebrahimi-Mameghani M, Saghafi-Asl M, Arefhosseini S, Khoshbaten M. Department of Nutrition, School of Health and Nutrition, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Abstract The present study was aimed to identify the association of overweight and obesity with gastroesophageal reflux disease (GERD). This age- and sex- matched case-control study was carried out in a sample of subjects referred to the specialized clinic of Tabriz University of Medical Sciences from November 2006 to March 2007. Data were collected using a demographic questionnaire and a checklist to determine reflux symptoms. Weight and height were measured and Body Mass Index (BMI) was calculated. Logistic regression was used to examine the association between overweight, obesity and reflux symptoms. The study popula on included 106 cases (with reflux symptoms) and 111 controls with a mean age of 35.2 +/- 12.9 years. The mean BMI was 2.4 units greater in cases than controls (p = 0.0001). In unadjusted model, overweight (OR = 3.41, CI: 1.8-6.44) and obesity (OR = 2.84, CI: 1.38-5.82) were significantly associated with GERD. Results of multivariate logistic regression revealed significant association between overweight and GERD after adjusting for confounders (OR = 2.87, CI: 1.49-5.53). Given the increasing prevalence of pa ents with both overweight/obesity and GERD, Serious dietary intervention studies for weight loss as a therapeutic strategy should be carried out in GERD patients complicated with obesity. 201
Int Dent J. 2008 Feb;58(1):36-40. Relationship between Obesity and Periodontal Status in a Sample of Young Iranian Adults. Sarlati F, Akhondi N, Ettehad T, Neyestani T, Kamali Z. Faculty of
Dentistry, Azad
University of
Iran, Tehran.
fatima_sarlati@yahoo.com Abstract AIM: To examine the possible relationship between body weight and periodontal disease in a sample of the young Iranian population. DESIGN: An analytical (Case-Control) study. Download 5.37 Mb. Do'stlaringiz bilan baham: 
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