The epidemiology and prevention of childhood obesity in Tehran, Iran

Childhood obesity is a recognised increasing public health problem in Iran, but no evidence for effective prevention strategies is available. The aim was to inform the development of an obesity prevention intervention for Iranian school children. A quantitative analysis was used to examine the pattern and associated factors with obesity and a qualitative study explored the beliefs of parents and school staff about the causes of childhood obesity and potential interventions. Overall 28.2% of the children were overweight or obese and there was a non-significant tendency for increased energy intake with higher weight status. Measures of body fat were highly positively correlated with blood pressure. There was generally accurate body size perception among children and no relationship between weight status and quality of life scores. Focus group participants identified a range of perceived obesity risk factors related to diet and physical activity at the micro and macro levels. In terms of interventions, the importance of macro level activities was highlighted. The study confirms that childhood obesity is an important health problem in Tehran and highlighted socio-economic variations in prevalence, which will inform the targeting of prevention interventions. Important contextual information was obtained to inform the development of a prevention intervention

Obese and female adolescents skip breakfast more than their non-obese and male peers

We examined the association between overweight/gender and skipping breakfast among adolescent students in Tehran city using a cross-sectional study and a multistage random sampling method. All educational zones in Tehran city were covered during the educational year of 2000-01. In total, 2321 students aged 11-16 years (1068 male; 1263 female) participated in the study. Weight and height were measured and body mass index (BMI; kg/m2) was calculated. Overweight, pre-obesity and obesity were defined as BMI � 85 th , 85 th to 95 th , and � 95 th percentile of age-sex-specific BMI reference values, respectively. Self-reported frequency of breakfast consumption was categorized as usual/always, often, and rarely/never (5-7, 2-4 and 0-1 times/wk, respectively). Student's t and Chi-square tests were employed to analyze the data. Statistical inferences were made at α = 0.05. In boys and girls, the mean ± standard deviation of BMI was 19.8 ± 4.0 and 20.6 ± 4.1 kg/m2, the 18.8 and 23.1 were overweight, and 7.3 and 8.3 were obese, respectively. There was a significant difference in the frequency of breakfast consumption between obese and normal male students (P < 0.001). Differences between pre-obese and normal, and obese and normal female students were also significant (P < 0.002 and P < 0.001, respectively). A significant difference was found in the frequency of breakfast consumption between male and female adolescents in all three categories (P < 0.001). These results suggest that obese and female adolescents are more likely to skip breakfast than their normal and male peers and are therefore at higher risk for growth deficits and low educational performance. Preventive/educational programs are urgently needed in this age group. © 2007 Versita Warsaw and Springer-Verlag

Opium: An emerging risk factor for gastric adenocarcinoma

Opium use has been associated with higher risk of cancers of the esophagus, bladder, larynx, and lung; however, no previous study has examined its association with gastric cancer. There is also little information on the associations between hookah (water pipe) smoking or the chewing of tobacco products and the risk of gastric cancer. In a case-control study in Golestan Province of Iran, we enrolled 309 cases of gastric adenocarcinoma (118 noncardia, 161 cardia and 30 mixed-location adenocarcinomas) and 613 matched controls. Detailed information on long-term use of opium, tobacco products and other covariates were collected using structured and validated lifestyle and food frequency questionnaires. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were obtained using conditional logistic regression models. Opium use was associated with an increased risk of gastric adenocarcinoma, with an adjusted OR (95% CI) of 3.1 (1.9-5.1), and this increased risk was apparent for both anatomic subsites (cardia and noncardia). There was a dose-response effect, and individuals with the highest cumulative opium use had the strongest association (OR: 4.5; 95% CI: 2.3-8.5). We did not find a statistically significant association between the use of any of the tobacco products and risk of gastric adenocarcinoma, overall or by anatomic subsite. We showed, for the first time, an association between opium use and gastric adenocarcinoma. Given that opium use is a traditional practice in many parts of the world, these results are of public health significance. Copyright © 2013 UICC

The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to determine the prevalence of overweight and obesity and to examine the effects of actual weight status, perceived weight status and body satisfaction on self-esteem and depression in a high school population in Turkey.</p> <p>Methods</p> <p>A cross-sectional survey of 2101 tenth-grade Turkish adolescents aged 15–18 was conducted. Body mass index (BMI) was calculated using weight and height measures. The overweight and obesity were based on the age- and gender-spesific BMI cut-off points of the International Obesity Task Force values. Self-esteem was measured using the Rosenberg Self-Esteem Scale, and depression was measured using Children's Depression Inventory. Logistic regression analysis was used to examine relationships among the variables.</p> <p>Results</p> <p>Based on BMI cut-off points, 9.0% of the students were overweight and 1.1% were obese. Logistic regression analysis indicated that (1) being male and being from a higher socio-economical level were important in the prediction of overweight based on BMI; (2) being female and being from a higher socio-economical level were important in the prediction of perceived overweight; (3) being female was important in the prediction of body dissatisfaction; (4) body dissatisfaction was related to low self-esteem and depression, perceived overweight was related only to low self-esteem but actual overweight was not related to low self-esteem and depression in adolescents.</p> <p>Conclusion</p> <p>The results of this study suggest that school-based adolescents in urban Turkey have a lower risk of overweight and obesity than adolescents in developed countries. The findings of this study suggest that psychological well-being of adolescents is more related to body satisfaction than actual and perceived weight status is.</p

Perceptions of Local Parents and School Staff on Childhood Obesity Prevention Interventions in Iran

Background and Objectives: Childhood obesity is an increasing public health problem in Iran, and there is no evidence for effective prevention strategies to date. The aim of this qualitative study was to identify and prioritise perceived potential interventions by parents and school staff to help inform the development of an obesity prevention intervention for Iranian school children. Materials and Methods: Focus groups were held with the parents of primary school aged children and school staff working in primary schools in Tehran city. Additionally, three interviews were held with two physical education teachers and one school nurse. The participants were asked about the causes of obesity and what activities they believed would help children to maintain healthy weight. Then they were asked to prioritise the activities that would have the greatest impact on children to maintain their healthy weight. Thematic analysis was used to analyse the data. Parents were selected from a range of socio-economic backgrounds to include two groups from each of high, medium, and low socio-economic districts of Tehran. Eleven focus groups were held with a total of 85 participants. Results: Public policy interventions included the provision of valid nutrition information, physical activity promotion, and accessibility to healthy foods. School-based interventions included improving physical education, providing organised physical activity, provision of good quality education for children, parents and school staff, improving school shops, and using rewards and competitions. The findings suggest that close liaison should be established between the school, the family, and the broader community. Conclusions: This study provided important contextual data on where the emphasis should be placed in developing the childhood obesity prevention interventions for the school children in Tehran. The findings further highlight the importance of involving a wide range of stakeholders, and including multiple components to maximise the chances of success. Keywords: Child, Obesity, Prevention, Intervention, Qualitative research, Ira

Association of Sudden Death and Seizure with Left Ventricle Non-compaction in a Family

Background: Left ventricle non-compaction (LVNC) or persistence of spongy myocardium is a rare form of congenital cardiomyopathy which presents with cardiac failure, thromboembolic events, arrhythmia and sudden death. Case Presentation: We report a family with two deceased children and two alive offspring diagnosed with left ventricular (LV) non-compaction. A 9-year-old boy and a 16-year-old girl of our reported family suddenly died following exercise and emotional provocation. Both had a history of convulsion and syncope, with the latter taking anticonvulsant medication. Following their demise, the other members of the family were evaluated by echocardiography. The remaining two offsprings, one boy and one girl were diagnosed as having isolated LVNC. Conclusion: Syncope and convulsion can be first manifestations of LVNC and heralding signs for sudden death in patients with LVNC. Echocardiography can be helpful for early diagnosis