IHHP Article: Obesity and associated modifiable environmental factors in Iranianadolescents: Isfahan Healthy Heart Program – Heart Health Promotion from Childhood*
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Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program – Heart Health Promotion from Childhood
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ROYA KELISHADI, MAHIN HASHEMI POUR, NIZAL SARRAF-ZADEGAN, GHOLAM HOSSEIN SADRY, REZVAN ANSARI, HASSAN ALIKHASSY, NASROLLAH BASHARDOUST

Abstract
Objective
To evaluate the prevalence of overweight and obesity among Iranian adolescents and theirrelationship with modifiable environmental factors.

Methods
The subjects of the present study were 1000 girls and 1000 boys, aged between 11 and 18 years selected by multistage random sampling, their parents (n = 2000) and their school staff (n = 500 subjects) in urban and rural areas of two provinces in Iran. Data concerning body mass index (BMI), nutrition and the physical activity of the subjects were analyzed by SPSSV10/Win software.

Results
The prevalence of 85th percentile . body mass index (BMI) < 95th percentile and BMI > 95th percentile in girls was significantly higher than boys (10.7 ± 1.1 and 2.9 ± 0.1% vs 7.4 ± 0.9 and 1.9 ± 0.1%, respectively; P < 0.05). The mean BMI value was significantly different between urban and rural areas (25.4 ± 5.2 vs 23.2 ± 7.1 kg/m2, respectively; P < 0.05). A BMI > 85th percentile was more prevalent in families with an average income than in high-income families (9.3 ± 1.7 vs 7.2 ± 1.4%, respectively; P < 0.05) and in those with lower-educated mothers (9.2 ± 2.1 vs 11.5 ± 2.4 years of mothers education, respectively). The mean total energy intake was not different between overweight or obese and normal-weight subjects
(1825 ± 90 vs 1815 ± 85 kCal, respectively; P > 0.05), but the percentage of energy derived from carbohydrates was significantly higher in the former group compared with the latter (69.4 vs 63.2%, respectively; P < 0.05). Regular extracurricular sports activities were significantly lower and the time spent watching television was significantly higher in overweight or obese than non-obese subjects (time spent watching telelvision: 300 ± 20 vs 240 ± 30 min/day, P < 0.05). A significant linear association was shown between the frequency of consumption of rice, bread, pasta, fast foods and fat/salty snacks and BMI (. = 0.05–0.06; P < 0.05). A significant correlation was shown between BMI percentiles and serum triglyceride, high-density lipoprotein–cholesterol and systolic blood pressure (Pearson’s r = 0.38, –0.32 and 0.47, respectively).

Conclusions
Enhanced efforts to prevent and control overweight from childhood is a critical national priority, even in developing countries. To be successful, social, cultural and economic influences should be considered.

Key words
adolescents, cardiovascular disease risk factors, nutrition, obesity, physical activity

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