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Dept. of Basic Sciences, School of Medicine, Shahroud University of
Dept. of Statistics and Computer, University of Welfare and Rehabilitation
status and obesity in non-menopause women aged 15-49 years in Tehran,
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
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
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.
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. email@example.com
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).
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
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
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
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. firstname.lastname@example.org
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
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)
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
better predict CAD than BMI and WC.
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.
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
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
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. email@example.com
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
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.
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
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.firstname.lastname@example.org
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
activity, were analyzed by linear regression and unconditional logistic
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.
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.
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.
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
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-
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.
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.
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
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
The Effects of Socio-Economic Status on BMI, Waist:Hip
Ratio and Waist Circumference in a Group of Iranian
Shahraki M, Shahraki T, Ansari H.
Department of Nutrition, Faculty of Medicine, Zahedan University of
Medical Sciences, Zahedan, Islamic Republic of Iran.
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
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
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
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
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.
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).
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. email@example.com
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
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
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
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,
Department of Epidemiology and Biostatistics, School of Public Health,
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
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.
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.
Indian Heart J. 2008 Mar-Apr;60(2):110-2.
The Relation between Total Daily Caloric Intake and Blood
Najafian J, Nushin M.
Department of Cardiology, Isfahan University of Medical Science, Isfahan,
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
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
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,
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
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.
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.
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
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.
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,
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,
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.
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,
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
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
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.
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.
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.
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.
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