[Inefficient education and process of obesity in Tehranian adolescents: a qualitative study]

This study aimed to determine inefficiencies in current educational programs for promoting of healthy lifestyles and prevention of obesity from the perspective of adolescents and mothers. This was a qualitative study conducted based on a grounded theory approach. To collect data, 23 personal interviews and 12 semi-structured focus group discussions were conducted with overweight/obese adolescents and mothers who had at least one overweight/obese child. To maximize the variation of participants' experiences with different socio-economic backgrounds, two demographically diverse areas from the north and south of Tehran were selected and followed with theoretical sampling. All the interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously, using the Strauss and Corbin analysis method. In the current study, inefficient education was explored using two main themes including "Single dimensional curriculum of schools" and "Inefficient public education". The single dimensional curriculum of schools was found to be characterized by "lesson-based curriculum" and "burdensome educational programs" and the inefficient public education was characterized by "inappropriate content", "lack of comprehensive educational program", "inappropriate ways of messaging" and "contradictory messages". Based on the findings of this study, "single dimensional curriculum of schools" and "Inefficient public education" were the main correlates of inefficient education in our society, which led to obesity-related behaviors and consequently excessive weight gain in Tehranian adolescents. The results of this study may be effective in prioritizing and designing health promotion programs aimed at promoting healthy lifestyles and prevention of obesity in children and adolescents

Childhood obesity in the Middle East: a review

Accurate and comprehensive data on the extent of the problem of childhood obesity is lacking in countries of the Middle East. This review, based on a Medline search, summarizes the prevalence of obesity among children and adolescents in the region during 1990-2007. The highest rates of obesity and overweight were reported from Bahrain and the lowest from the Islamic Republic of Iran. Studies from Saudi Arabia, Islamic Republic of Iran and Kuwait showed an upwards trend in childhood obesity compared with a decade ago. Lack of uniformity in reference standards and reporting systems renders comparisons difficult. Nevertheless, the high prevalence of childhood obesity in the Middle East should stimulate policy-makers in the region to set up effective national and regional surveillance systems

[Mothers' perceptions on familial correlates of overweight and obesity related behaviors in adolescents: a qualitative study]

There is convincing evidence that family environment plays an important role in influencing the obesity related-behaviors in adolescents. Considering the necessity of understanding the familial correlates of obesity in adolescents, and the lack of related studies in Iran, this study aimed to explore mothers' perceptions and experiences regarding these associated factors of overweight and obesity related behaviors in adolescents. A grounded theory approach was used for analyzing the participants' experiences, and their perceptions. To collect data, 6 semi-structured focus group discussions were conducted with 25 mothers who had at least one overweight or obese child. Based on open sampling, with the aim of maximal variation of the participants' experiences, two demographically diverse areas from the north and south of Tehran were selected and then followed with theoretical sampling. All the focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously using the Strauss and Corbin analysis method. Five main familial correlates of overweight and obesity in adolescents emerged from data: 1] Parents with inadequate knowledge, 2] Parents' modeling of unhealthy behaviors, 3] Dissimilarity of members, 4] Maternal employment and 5] Children's studies being the top priority for parents. Conclusion: Findings demonstrate familial correlates of overweight and obesity in adolescents as perceived by mothers, correlates that must be addressed by effective interventions for tackling overweight and obesity in adolescents

[Predicting of changes in obesity indices regarding to dietary patterns in longitudinal Tehran lipid and glucose study]

This study aimed at investigating the association between obesity indices [Body Mass Index [BMI], Waist Circumference [WC], Waist to Hip Ratio [WHR]] and dietary patterns derived from Reduced Rank Regression [RRR] analysis among Tehranian adults in a cohort study. Over a duration of 6 years, 141 adults were examined before and after 6 years for obesity indices. Dietary intakes were recorded at baseline by two 24 hour dietary recalls. RRR analysis derived five patterns with respect to total fat, polyunsaturated-to-saturated fat ratio, cholesterol, fiber and calcium intakes. The calculated factor scores were categorized in quintiles and changes in obesity indices were scrutinized within these quintiles. The first pattern [traditional] showed high loadings on refined carbohydrates, whole grain, vegetables, red and processed meat, saturated and trans fat, egg, showing significant high positive correlation with fat, cholesterol and calcium intakes [r=0.478, 0.626, and 0.486, respectively; p<0.001]. All obesity indices had an increasing trend across quintiles of pattern score [p<0.05 for BMI and WHR, p<0.001 for WC]. The fifth pattern [egg] had high loading for eggs, salty snacks, and fruits, and negative loadings for red and processed meat, saturated and trans fat, plant oil, and dairy products, indicating increasing trends for WC [p<0.001] and WHR [p<0.05] after adjustment for potential confounders. Other patterns showed non-significant trends for obesity indices. RRR analyses were indicative of two dominant dietary patterns correlated with increase in obesity indices in Tehran

Personal barriers to life style modification in overweight/obese adolescents: a qualitative study

Existing data show a rising prevalence of overweight and obesity among Iranian adolescents. Considering the lack of related studies from Iran, the current study investigates personal barriers to life style Modification among overweight/obese adolescents. This is a qualitative study, conducted according to the grounded theory approach. Participants were 35 school children [19 girls and 16 boys], aged 15-17 years, who were either overweight or obese. To collect data, 5 semi-structured focus group discussions and 10 in-depth interviews were conducted. To obtain views across a range of socioeconomic backgrounds, two demographically diverse areas in Tehran were selected, and in each area, participants were recruited from schools. All interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously according to the Strauss and Corbin analysis method. Based on data analysis, positive perception of conditions, priority of studying, lack of willingness, negative experiences, low self-esteem, and perceived lack of control were the major personal barriers to adolescents' healthy lifestyles. Study results demonstrated the main personal barriers for a healthy life style as perceived by adolescents, barriers that any effective interventions require to address for tackling overweight and obesity in adolescents