Trends of Obesity in Iranian Adults from 1990s to late 2000s; a Systematic Review and Meta-analysis.

BACKGROUND: Obesity is currently emerging as a global epidemic, affecting 10% of adultpopulation worldwide. The primary objective of the current systematic reviewis to describe the trend of overall prevalence of obesity in Iranian women andmenthrough a meta-analysis. METHODS: We searched the medical literature published from 1990 to 2007 in Medline(PubMed), EMBASE database, and the Iranian digital library. All publishedreports of research projects, papers in relevant congresses, unpublished crudedata analysis, proceedings, books and dissertations were reviewed. Data fromeligible papers that fulfilled the qualification criteria entered meta-analysis(Random Model). RESULTS: Data from 209,166 individuals were analyzed. The overall prevalence ofobesity in adults was 18.5% (95%CI: 15.1-21.8), respectively. The prevalenceof obesity in men and women was 12.9% (95%CI: 10.9-14.9) and 26.2%(95%CI: 21.3-30.5), respectively. The trend of obesity was similar in both genders;women had almost a constantly higher risk of obesity than men duringthe recent two decades. CONCLUSION: Data from 209,166 individuals were analyzed. The overall prevalence ofobesity in adults was 18.5% (95%CI: 15.1-21.8), respectively. The prevalenceof obesity in men and women was 12.9% (95%CI: 10.9-14.9) and 26.2%(95%CI: 21.3-30.5), respectively. The trend of obesity was similar in both genders;women had almost a constantly higher risk of obesity than men duringthe recent two decades.

Accuracy and coverage of reproductive health information on the Internet accessed in English and Persian from Iran.

BACKGROUND AND METHODOLOGY: The Internet is a useful resource for obtaining information. We evaluated the accuracy and coverage of reproductive health information on the Internet in English- and Persian-language sites accessed from Iran. An expert committee decided on five reproductive health topics to be evaluated and specified a checklist of content for these (36 items in total). We employed selected keywords in search engines between February and March 2006. About one of every four screened websites (n = 200) addressed at least one target topic and were subjected to in-depth assessment. Three medical doctors independently rated each of the selected websites. Accuracy and coverage percentages were calculated for each website. RESULTS: A total of 168 English- and 32 Persian-language websites were found that addressed the specified topics. The mean accuracy and coverage percentages of the 200 websites assessed were 98.8% (95%CI 98.1-99.6) and 45.2% (95%CI 41.0-49.3), respectively. Thirty-four (17%) websites, all in English, achieved a coverage percentage of 80% or more. Academic referencing was not present in 152 (76%) websites. 'Sexually transmitted diseases' and 'family planning' were the topics with highest coverage in both the English- and Persian-language websites studied. 'Reproductive system and puberty' had the least coverage in the Persian websites. The top 20 websites found for the general population on reproductive health are reported. DISCUSSION AND CONCLUSIONS: Websites providing comprehensive reproductive health information are not easy to locate from Iran; in particular, Persian-language websites and those targeting young people are scarce. However, for the websites identified the accuracy of information provided was acceptable. There is a need to identify high-quality, easily accessible websites for use by both professionals and the general public and to develop new ones.

Factor analysis of cardiovascular risk clustering in pediatric metabolic syndrome: CASPIAN study.

AIMS: To assess the results of factor analysis of coronary artery disease risk factors in a large national representative sample of children, and to compare its results on the variables measured between those with or without metabolic syndrome (MetS). METHODS: This cross-sectional multicenter population survey was conducted on 4,811 nationally representative school students aged 6-18 years. MetS was defined based on criteria analogous to the Adult Treatment Panel III. Factor analysis by principle components analysis and Varimax rotation was carried out to cluster risk factors. RESULTS: MetS was present in 14.1% of subjects (n = 678). From the nine variables assessed, factor analysis of the z scores of variables show that in all age groups, three similar factors were loaded: lipids, adiposity, and blood pressure, that accounted for 87.4-90.8% of the variance. Three factors were loaded in those with MetS (cholesterol/TG, metabolic/adiposity, and blood pressure) (65.9% of variance); and four factors (cholesterol, metabolic, adiposity, and blood pressure) were loaded among those without the MetS (75.6% of variance). We did not find a central feature that underlies all three factors among children with the MetS; however, waist circumference was the only variable that was loaded for two factors. CONCLUSION: These findings support a change in the concept of MetS from that of a single entity to one that represents several distinct but intercorrelated entities. An approach to assessing risk clustering from early life, and longitudinal studies that would elucidate how these various risk domains interact over time are needed.

Association of anthropometric indices with cardiovascular disease risk factors among children and adolescents: CASPIAN Study.

BACKGROUND: For the first time in Iran, and to the best of our knowledge in Asia, we assessed the anthropometric indices most closely correlated to cardiovascular disease (CVD) risk factors in a large nationally representative sample of children and adolescents to be used as a simple tool for identifying those at risk. METHODS: This multi-center study was performed among a representative sample of 4811 school students (2248 boys and 2563 girls) aged 6-18 years, as part of the baseline survey of a national surveillance system. Anthropometric indices and CVD risk factors were measured using standard protocols, and their correlation was analyzed by using Receiver Operator Characteristic (ROC) curves and partial correlation. RESULTS: The most prevalent CVD risk factors were low HDL-C (28%), followed by hypertriglyceridemia (20.1%), and overweight (17%). The ROC analyses showed that among boys, all anthropometric indices had the same association with CVD risk factors in 6-9.9-year-age group, while in the 10-13.9 and 14-18-year-age groups, respectively waist circumference (WC) and body mass index (BMI) were the best in distinguishing CVD risk factors. Among girls, these indices were respectively BMI and waist to stature ratio (WSR); WC and WSR; and WC. In the partial correlation analysis, in boys, the highest coefficient was found for BMI; BMI and WC; and for WC and WSR; in girls, these indices were BMI; WC and WSR; and BMI respectively. CONCLUSIONS: In the present study, BMI, WC and WSR were the most appropriate in predicting CVD risk factors. It may be clinically useful in the pediatric population to routinely measure WC and WSR in addition to BMI as a screening tool to identify high-risk youth.

Association of physical activity and the metabolic syndrome in children and adolescents: CASPIAN Study.

BACKGROUND/AIM: To determine the association of physical activity and the metabolic syndrome in a large national-representative sample of children. METHODS: This study was performed in 2003-2004 on 4,811 school students aged 6-18 years, selected by multi-stage random cluster sampling from six provinces in Iran. We assessed the level of physical activity using a standardized questionnaire, and categorized it to the tertiles. The metabolic syndrome was defined based on criteria analogous to those of the Adult Treatment Panel III. RESULTS: The participants comprised 2,248 boys and 2,563 girls with a mean age of 12.07 +/- 3.2 years. In all age groups, boys were more physically active than girls. The metabolic syndrome was detected in 14.1% of participants, and its prevalence was higher in those subjects in the 1st, 2nd and 3rd tertiles of physical activity, respectively (15.1 vs.14.2 and 13.1%, respectively, p <0.05). This difference was seen in boys, while no difference was found between girls in the 2nd and 3rd tertiles of physical activity. Physical activity was linked to a cluster of factors consisting of high-density lipoprotein-cholesterol and waist circumference, followed by triglycerides in boys, and of triglycerides, waist circumference and blood pressure in girls. In both genders, before and after adjustment for age and body mass index, low levels of physical activity significantly increased the risk of having the metabolic syndrome [in boys: OR: 1.8, 95% CI: 1.1, 2.1; and in girls, OR: 1.6 (1.1, 1.9)]. CONCLUSION: We found an association between physical activity and the metabolic syndrome, which was independent of body mass index and age. Children should be encouraged to have greater physical activity.

Blood pressure and its influencing factors in a national representative sample of Iranian children and adolescents: the CASPIAN Study.

BACKGROUND: This study was performed to determine the blood pressure (BP) percentile curves by height, as well as to assess the prevalence of high BP and its influencing factors among children in the first national survey in this field in Iran. DESIGN: A multicentre national cross-sectional survey. METHODS: This study was performed in 23 provinces among a representative sample of 21,111 students aged 6-18 years. RESULTS: Age and sex-specific percentile curves of systolic and diastolic BP were obtained by height. A comparison of the values obtained corresponding to the 90th percentiles with the Second Task Force cut-offs showed that the BP values and trends were relatively similar in both studies. The overall prevalence of systolic, diastolic as well as systolic or diastolic hypertension according to the Second Task Force study 95th percentile cut-off points were 4.2, 5.4 and 7.7%, respectively, without a significant sex difference. A history of low birthweight, overweight, taller height, the consumption of solid hydrogenated fat, as well as the frequency of fast food consumption increased the risk of both systolic and diastolic hypertension. Male sex, large waist, and low education of the mother were the risks for systolic hypertension, whereas the risk of diastolic hypertension rose with living in an urban area, attending public school, low physical activity level, having a housewife mother, and a positive family history of obesity, especially in the parents. CONCLUSION: Considering the effect of modifiable environmental factors on the childrens' BP, encouraging breast feeding and a healthy lifestyle may have an important effect on public health.

Smoking behavior and its influencing factors in a national-representative sample of Iranian adolescents: CASPIAN study.

OBJECTIVES: To determine the national prevalence of smoking among Iranian youths and its environmental influencing factors. METHODS: This study was performed in 2003-2004 among 11,966 school students, ages 11-18 years, selected by multi-stage random cluster sampling from 20 provinces in Iran. The participants filled out self-administered anonymous questionnaires. RESULTS: The prevalence of self-reported cigarette smoking was 14.3%, with a higher prevalence in boys than in girls (18.5% vs. 10.1%, respectively, P < 0.001), and in high school than in middle school students (17.4% vs. 10.6%, respectively, P < 0.001). Overall, 42.2% of smokers were daily smoker, and the rest were occasional smoker. The mean age of the first attempt to smoke was 13.2 +/- 2.5 years with no significant gender difference but was significantly lower in daily than in occasional smokers. The place of the first attempt to smoke was mostly in friend parties (41.6%) and traditional teahouses (23.2%) for boys and the family parties (37.1%) and the traditional teahouses (27.4%) for girls. The higher school level and having a tobacco user at home significantly increased the likelihood of smoking in adolescents, with the highest odds ratio (OR) found for having a smoker sister in girls (OR = 4.5, 95%CI, 2.5, 8.2), and having a smoker brother in boys (OR = 2.4, 95%CI, 2.03, 3.05). CONCLUSION: Smoking is becoming as a major public health threat among Iranian youths. Control measures should be considered not only for cigarette smoking, but also for the socially accepted habit of water pipe use that is revived in traditional teahouses.