Overweight and Obesity in the Eastern Mediterranean Region
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PARTICIPANTS: Two hundred six adults.
MAIN OUTCOME MEASURES: Waist circumference, body mass index, and waist-to-hip ratio. ANALYSIS: Food patterns were derived using factor analysis. RESULTS: Three dietary patterns, the healthful (HDP), the western (WDP), and the mix, were identified. Increased WDP score was directly related to change in body mass index (β = .41, R(2) = 0.22, P < .001) among overweight/obese individuals. Alterations in waist circumference was be er predicted by increased WDP score (β = .49, R(2) = 0.21, P < .01) than by increased HDP score (β = -.20, R(2) = 0.11, P < .05). Subjects in the higher quartile of increased HDP score had lesser change in waist-to-hip ratio (β = - .77, R(2) = 0.43, P < .01). CONCLUSION: Results of this study indicate that increased adherence to the WDP and decreased adherence to the HDP could contribute to obesity.
Minerva Endocrinol. 2011 Mar;36(1):13-21. Evidence of a Role of ANGPTL6 in Resting Metabolic Rate and its Potential Application in Treatment of Obesity. Mirzaei K, Hossein-Nezhad A, Chamari M, Shahbazi S. 80
Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
Abstract AIM: ANGPTL6 (Angiopoie n-related growth factor 6) is a circula ng protein which is suggested to antagonize obesity. The purpose of this study was to evaluate a potential relationship between fasting serum ANGPTL6 and res ng metabolic rate (RMR) as well as the body composition in obese and subjects with normal weight. METHODS: Par cipants were 62 obese and 41 non-obese subjects who were assessed following an overnight fasting for RMR by means of indirect calorimetry. Body composition was measured using Bodystat devise. Serum ANGPTL6 levels were quan fied by ELISA method.
RESULTS: Based on ROC analysis best RMR/kg cut-off value for predicting the risk of obesity was 20 kcal/24h /kg. The participants with RMR/kg≥20 kcal/24h/kg were considered as and subjects with RMR/kg<20 kcal/24h/kg were categorized as. In group I, 72.3% of subjects were obese, whereas, 47.4% subjects in group II were suffering from the disease. Participants in group II who showed significantly lower HDL and ANGPTL6 levels. Moreover, we found significantly higher triglyceride and hs-CRP levels in this group. There was significant difference in weight, body mass index, fat mass, visceral fat, RMR/kg, fasting serum glucose, insulin and hs-CRP among those with different levels of the serum ANGPTL6 concentration. We found higher values of RMR/kg in subjects with higher circula ng ANGPTL6 concentra on.
and slightly does so regarding insulin concentrations and sensitivity to it. Further study is warranted as it seems that the results of this study might potentially lead to advent of a pharmacological treatment for obesity.
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April 2011, 29(125) Associates of Visceral Obesity among Women Leila Azadbakht, Maryam Bahreinian, Ahmad Esmaillzadeh Abstract BACKGROUND: Previous studies in Iranused the World Health Organization (WHO) cut-off points to determine visceral Obesity and no studies used the suggested cut-off points. This study was performed to investigate the correlates of centralobasity based on the optimal cut-off values in a representative population of women.
usual dietary intakes were assessed by means of a semi quantative food frequency questionnaire. Demographic data and anthropometric indices were collected according to standard protocols. The suggested cut-off points for waist-to-hip ratio (WHR ≥ 0.84) were used to determine the correlates of visceral obesity. The components of dietary intakes were determined by factor analysis.
central obesity among less ac ve women (odds ra o: 2.11; 95% confidence interval: 1.40-2.53). Depression (1.36; 1.02-1.93), smoking (1.21; 1.02-1.56), and unemployment (1.41; 1.13-1.72) were correlated with central adiposity. 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 also associated with central fat accumulation. We found an inverse relationship between dairy consumption and central obesity (r = -0.2, P < 0.05).
age, unemployment, marriage, parity and poor lifestyle factors like inactivity, smoking, depression, low intake of vitamin C and calcium, and high fat consumption, lifestyle modifications should be encouraged to achieve a healthier body shape.
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J Med Syst. 2011 May 10. [Epub ahead of print] Comparison of Artificial Neural Networks with Logistic Regression for Detection of Obesity. Heydari ST, Ayatollahi SM, Zare N. Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR, Iran. Abstract Obesity is a common problem in nutrition, both in the developed and developing countries. The aim of this study was to classify obesity by artificial neural networks and logistic regression. This cross-sectional study comprised of 414 healthy military personnel in southern Iran. All subjects completed questionnaires on their socio-economic status and their anthropometric measures were measured by a trained nurse. Classification of obesity was done by artificial neural networks and logistic regression. The mean age±SD of par cipants was 34.4 ± 7.5 years. A total of 187 (45.2%) were obese. In regard to logis c regression and neural networks the respec ve values were 80.2% and 81.2% when correctly classified, 80.2 and 79.7 for sensi vity and 81.9 and 83.7 for specificity; while the area under Receiver-Opera ng Characteris c (ROC) curve were 0.888 and 0.884 and the Kappa sta s c were 0.600 and 0.629 for logis c regression and neural networks model respectively. We conclude that the neural networks and logistic regression both were good classifier for obesity detection but they were not significantly different in classification.
BMC Public Health. 2011 May 25;11:383. "Predictability of Body Mass Index for Diabetes: Affected by the Presence of Metabolic Syndrome?". Hadaegh F, Bozorgmanesh M, Safarkhani M, Khalili D, Azizi F. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. fzhadaegh@endocrine.ac.ir
kg.m(-2)) are established independent risk factors in the development of 83
diabetes; we prospectively examined their relative contributions and joint relationship with incident diabetes in a Middle Eastern cohort. METHOD: participants of the ongoing Tehran lipid and glucose study are followed on a triennial basis. Among non-diabetic participants aged≥ 20 years at baseline (8,121) those with at least one follow-up examination (5,250) were included for the current study. Multivariate logistic regression models were used to estimate sex-specific adjusted odd ratios (ORs) and 95% confidence intervals (CIs) of baseline BMI-MetS categories (normal weight without MetS as reference group) for incident diabetes among 2186 men and 3064 women, aged ≥ 20 years, free of diabetes at baseline. RESULT: During follow up (median 6.5 years); there were 369 incident diabetes (147 in men). In women without MetS, the mul variate adjusted ORs (95% CIs) for overweight (BMI 25-30 kg/m(2)) and obese (BMI≥30) par cipants were 2.3 (1.2-4.3) and 2.2 (1.0-4.7), respec vely. The corresponding ORs for men without MetS were 1.6 (0.9-2.9) and 3.6 (1.5- 8.4) respec vely. As compared to the normal-weight/without MetS, normal-weight women and men with MetS, had a multivariate-adjusted ORs for incident diabetes of 8.8 (3.7-21.2) and 3.1 (1.3-7.0), respec vely. The corresponding ORs for overweight and obese women with MetS reached to 7.7 (4.0-14.9) and 12.6 (6.9-23.2) and for men reached to 3.4(2.0-5.8) and 5.7(3.9-9.9), respec vely.
normal weight individuals. Obesity increases diabetes risk in the absence of MetS, underscores the need for more stringent criteria to define healthy metabolic state among obese individuals. Weight reduction measures, thus, should be encouraged in conjunction with achieving metabolic targets not addressed by current definition of MetS, both in every day encounter and public health setting.
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Epidemiol Rev. 2007;29:62-76. Epub 2007 May 3. Childhood Overweight, Obesity, and the Metabolic Syndrome in Developing Countries. Kelishadi R. Department of Preventive Pediatric Cardiology, Isfahan Cardiovascular Research Center (WHO Collaborating Center), Isfahan University of Medical Sciences, Isfahan, Iran. kroya@aap.net
The incidence of chronic disease is escalating much more rapidly in developing countries than in industrialized countries. A potential emerging public health issue may be the increasing incidence of childhood obesity in developing countries and the resulting socioeconomic and public health burden faced by these countries in the near future. In a systematic review carried out through an electronic search of the literature from 1950-2007, the author compared data from surveys on the prevalence of overweight, obesity, and the metabolic syndrome among children living in developing countries. The highest prevalence of childhood overweight was found in Eastern Europe and the Middle East, whereas India and Sri Lanka had the lowest prevalence. The few studies conducted in developing countries showed a considerably high prevalence of the metabolic syndrome among youth. These findings provide alarming data for health professionals and policy-makers about the extent of these problems in developing countries, many of which are still grappling with malnutrition and micronutrient deficiencies. Time trends in childhood obesity and its metabolic consequences, defined by uniform criteria, should be monitored in developing countries in order to obtain useful insights for primordial and primary prevention of the upcoming chronic disease epidemic in such communities.
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Epidemiol Rev. 2007;29:62-76. Epub 2007 May 3. Childhood Overweight, Obesity, and the Metabolic Syndrome in Developing Countries. Kelishadi R. Department of Preventive Pediatric Cardiology, Isfahan Cardiovascular Research Center (WHO Collaborating Center), Isfahan University of Medical Sciences, Isfahan, Iran. kroya@aap.net
The incidence of chronic disease is escalating much more rapidly in developing countries than in industrialized countries. A potential emerging public health issue may be the increasing incidence of childhood obesity in developing countries and the resulting socioeconomic and public health burden faced by these countries in the near future. In a systematic review carried out through an electronic search of the literature from 1950-2007, the author compared data from surveys on the prevalence of overweight, obesity, and the metabolic syndrome among children living in developing countries. The highest prevalence of childhood overweight was found in Eastern Europe and the Middle East, whereas India and Sri Lanka had the lowest prevalence. The few studies conducted in developing countries showed a considerably high prevalence of the metabolic syndrome among youth. These findings provide alarming data for health professionals and policy-makers about the extent of these problems in developing countries, many of which are still grappling with malnutrition and micronutrient deficiencies. Time trends in childhood obesity and its metabolic consequences, defined by uniform criteria, should be monitored in developing countries in order to obtain useful insights for primordial and primary prevention of the upcoming chronic disease epidemic in such communities.
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Arch Med Res. 2011 Apr;42(3):244-51. Contribution of Serum Leptin to Metabolic Syndrome in Obese and Nonobese Subjects. Esteghamati A, Noshad S, Khalilzadeh O, Morteza A, Nazeri A, Meysamie A, Esteghamati A, Nakhjavani M. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. esteghamati@tums.ac.ir Abstract BACKGROUND AND AIMS: Little evidence exists regarding the association of leptin with metabolic syndrome (MetS) as defined by conventional criteria. Moreover, the contribution of obesity to this relationship is not well understood. This study aimed to evaluate the association between leptin concentrations with MetS in obese and nonobese subjects.
Non-Communicable Diseases (SuRFNCD) in Iran was used. In a cross- sec onal study of 3045 adults (48.2% men) aged 25-64 years, anthropometric indices, blood pressure, fasting plasma glucose, fasting insulin, lipid profile [triglycerides, high-density lipoprotein cholesterol (HDL- C), low-density lipoprotein cholesterol (LDL-C) and triglycerides], and fasting leptin were measured. Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) was also calculated. RESULTS: Lep n concentra ons were 2.6 fold higher in women compared with men. Subjects with MetS had significantly higher leptin concentrations. Leptin concentrations increased steadily with an increment in the number of MetS components (p <0.001). Lep n was significantly associated with MetS after adjustment for age, cigarette smoking, medication use, physical activity, HOMA-IR, and LDL-C. The significant association between leptin and MetS persisted a er adjustment for body mass index (OR: 1.31, 95% CI: 1.09-1.58 in males and 1.17, 95% CI: 1.01-1.38 in females) and waist circumference (OR: 1.24 95% CI: 1.01-1.51 in men and 1.22, 95% CI: 1.04- 1.43 in women). A er dividing subjects into obese and nonobese, lep n concentrations were again significantly higher in subjects with MetS in both groups.
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CONCLUSIONS: We demonstrated that leptin concentrations are significantly associated with International Diabetes Federation (IDF)-defined MetS, independent of overall and central obesity. Our findings point to an independent role for leptin in development of MetS.
Int J Public Health. 2011 Apr;56(2):181-9. Epub 2010 Feb 9. Barriers to a Healthy Lifestyle among Obese Adolescents: A Qualitative Study from Iran. Amiri P, Ghofranipour F, Ahmadi F, Hosseinpanah F, Montazeri A, Jalali- Farahani S, Rastegarpour A. Department of Health Education, Tarbiat Modares University, 14115-111, Tehran, Iran. parisaamiri@yahoo.com
among Iranian adolescents. The current study investigates adolescents' perceptions regarding overweight/obesity and explores barriers to a healthy life style among Iranian adolescents. METHODS: A grounded theory approach was used for analyzing the participants' experiences, and their perceptions. To collect data, semi- structured focus group discussions and in-depth interviews were conducted with 51 adolescents (27 girls and 24 boys), aged 15-17 years, who were either overweight or obese. Qualitative content analysis of the data was conducted manually and differences in coding were resolved via discussion by four independent reviewers.
data analysis. Positive perception of condition, priority of studying, lack of willingness, unsatisfactory results, low self-esteem, and perceived lack of control were the major personal barriers while lack of family and cultural support, inadequate education and scarcity of resources were the common environmental barriers to adolescents' healthy lifestyles. CONCLUSIONS: Findings demonstrated the main personal and environmental barriers for a healthy life style as perceived by adolescents. Understanding these barriers might contribute to existing literature by providing evidence from a different culture, and help to design effective preventive strategies, and implement appropriate interventions.
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J Pediatr (Rio J). 2011 Mar-Apr;87(2):169-74. Mothers' Perception of Obesity in Schoolchildren: A Survey and the Impact of an Educational Intervention. [Article in English, Portuguese] Pakpour AH, Yekaninejad MS, Chen H. Qazvin
University of
Medical Sciences, Qazvin, Iran.
pakpour_amir@yahoo.com Abstract OBJECTIVES: To investigate mothers' awareness of their children's weight problem, and to evaluate the impact of an educational intervention on improving mothers' recognition of obesity in their children.
chosen. Obese children were selected, and 300 mothers par cipated in the study. A questionnaire was completed by the mothers, who were then randomly divided into two groups. One group received education on obesity, whereas the other group did not receive any interven on. A er 2 months, the same questionnaire was completed by both groups. A multiple logistic regression was performed.
occupation, as well as family income, had significant effects on mothers' accuracy in identifying obesity in their children. The educational intervention significantly improved mothers' ability to identify obesity in their children compared with those without any interven on (OR = 15.23; 95%CI 5.95-38.96). CONCLUSIONS: In Iran, a large proportion of mothers do not have general knowledge on healthy body weight for children, thus failing to recognize that their children are obese. Educational interventions could reduce the rate of such mistake and subsequently alter parental care. 89
Acta Diabetol. 2011 Mar;48(1):79-88. Epub 2010 Nov 3. The Relationship Between Uric Acid and Metabolic Syndrome in Normal Glucose Tolerance and Normal Fasting Glucose Subjects. Meshkani R, Zargari M, Larijani B. Department of Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran. rmeshkani@tums.ac.ir Abstract Elevated serum uric acid (SUA) concentrations have been suggested to associate with metabolic syndrome (MetS) and its components. However, limited information is available regarding the relationship between SUA and MetS in subjects with normal glucose levels. A total of 501 subjects with normal fasting glucose and normal glucose tolerance were included in the study. Anthropometrical and biochemical parameters were examined using standard methods. The updated NECP criteria were used to define the MetS. Values of SUA above the sex-specific percen le 75 were used to define hyperuricemia. The prevalence of general and abdominal obesity, hypertension, hypertriglyceridemia, low-HDL, smokers, MetS and insulin resistance was significantly greater in the fourth SUA quartile. Multiple regression indicated that SUA was independently predicted by BMI, triglyceride and 2 h glucose in women, and BMI, triglyceride, 2 h glucose and cholesterol in men. Logistic regression analysis showed that the obesity, hypertriglyceridemia, MetS and insulin resistance were independent determinants of hyperuricemia in women. In men, hyperuricemia was associated with the obesity, hypertriglyceridemia and hypercholesterolemia. Factor analysis yielded three factors interpreted as weight/waist, blood pressure and lipid/glucose. Including SUA in the model did not affect total variance of factor analysis. Our results indicate that SUA is associated with MetS and its components even in subjects with normal glucose levels. General obesity was the major determinant of hyperuricemia in this population. The data from this study do not show the contribution of SUA as an additional component of the MetS.
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