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      Socio-demographic determinants of obesity indexes in Iran: findings from a nationwide STEPS survey

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          Abstract

          Background: Overweight and obesity are considered as non-communicable diseases (NCDs) risk factors with increasing prevalence worldwide. This nationwide study aimed to determine the socio-demographic determinants of obesity indexes in Iran.

          Methods: This cross-sectional study was conducted based on data from the sixth round of nationwide Stepwise approach to surveillance (STEPS) survey in the 31 provinces of Iran in 2011. A total of 9878 people aged ≥20 years were selected using a multi-stage cluster sampling method. Data were collected through three steps questionnaire including ecological, physical and biochemical measurements. We assessed body mass index (BMI), waist circumference(WC) and waist-hip ratio (WHR) as the main indicators of obesity.

          Results: In this study, the weighted prevalence of overweight and obesity were 34.5% (95% CI:33.6, 35.5) and 21.5% (95% CI: 20.7, 22.3), respectively. The mean ± standard deviation (SD)of BMI among men and women were 25.4±4.4 and 26.9±5.2 kg/m 2 respectively. Older age,living alone, having lower education level, being housewife or retired were associated with overweight and obesity (P<0.05). Urbanization was positively associated with BMI and WC.Being obese or overweight was associated with having a history of type 2 diabetes mellitus (T2DM), hypertension (HTN) and cardiovascular diseases (CVDs).

          Conclusion: The prevalence of overweight in this study was less than global rate while it was vice versa for obesity prevalence. Some socio-demographic characteristics were identified as determinants of obesity which should be considered for planning preventive and control action plans.

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          Most cited references 20

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          Prevalence of obesity, central obesity and the associated factors in urban population aged 20-70 years, in the north of Iran: a population-based study and regression approach.

          Obesity is an undesirable outcome of changing of lifestyle and behaviours. It is also reversible predisposing factor for the development of several debilitating diseases. This study was aimed to determine the prevalence rate of obesity, overweight, central obesity and their associated factors in the north of Iran. We conducted a population-based cross-sectional study with a sample of 1800 women and 1800 men with respective mean ages of 37.5 +/- 13.0 and 38.5 +/- 14.2 years of urban population aged 20-70 years living in the north of Iran. The demographic and lifestyle data, in particular, age, gender, marital status, marriage age, family history of obesity, educational level, occupation, occupational and leisure time physical activity, duration of exercise per week, parity and the number of children were collected with a designed questionnaire. Diagnosis of obesity and central obesity were confirmed by the WHO standard recommended method by determining of body mass index (BMI) and waist circumference (WC). Logistic regression model was used to estimate the adjusted odds ratio (OR) and its 95% confidence interval. Over half of the study subjects were at educational levels of high school or higher; 79.4% of population was married and 35.3% had a family history of parental obesity. The majority of subjects in particular women had none or low levels of physical activity. The overall prevalence rates of obesity and overweight were 18.8% and 34.8% respectively. The overall prevalence rate of central obesity was 28.3%. The rate of obesity in women was higher than men (P or =5 were associated with increased risk of obesity (OR = 2.2, P < 0.001 and OR = 2.43, P < 0.0001 and OR = 3.73, P < 0.0001 respectively). The results of this study indicate an increased rate of obesity and overweigh in the north population of Iran. With respect to these findings, low level of activity and education, parity, family history of obesity, marriage at earlier age and ageing are responsible for both obesity and central obesity in the north of Iran. Therefore, a community-based multiple strategies are required to combat with increasing rate of obesity and its subsequent complications such as diabetes, coronary artery disease, hypertension and osteoarthritis.
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            First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults.

            The goal was to estimate the prevalence of overweight, obesity, underweight, and abdominal obesity among the adult population of Iran. A nationwide cross-sectional survey was conducted from December 2004 to February 2005. The selection was conducted by stratified probability cluster sampling through household family members in Iran. Weight, height, and waist circumference (WC) of 89,404 men and women 15 to 65 years of age (mean, 39.2 years) were measured. The criteria for underweight, normal-weight, overweight, and Class I, II, and III obesity were BMI or=40 (kg/m(2)), respectively. Abdominal obesity was defined as WC >or=102 cm in men and >or=88 cm in women. The age-adjusted means for BMI and WC were 24.6 kg/m(2) in men and 26.5 kg/m(2) in women and 86.6 cm in men and 89.6 cm in women, respectively. The age-adjusted prevalence of overweight or obesity (BMI >or=25) was 42.8% in men and 57.0% in women; 11.1% of men and 25.2% of women were obese (BMI >or=30), while 6.3% of men and 5.2% of women were underweight. Age, low physical activity, low educational attainment, marriage, and residence in urban areas were strongly associated with obesity. Abdominal obesity was more common among women than men (54.5% vs. 12.9%) and greater with older age. Excess body weight appears to be common in Iran. More women than men present with overweight and abdominal obesity. Prevention and treatment strategies are urgently needed to address the health burden of obesity.
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              Obesity and associated lifestyle behaviours in Iran: findings from the First National Non-communicable Disease Risk Factor Surveillance Survey.

              To assess the national prevalence of overweight and obesity, as well as some associated lifestyle behaviours, for the first time in Iran. This population-based study was performed in early 2005 as part of the World Health Organization (WHO) STEPwise approach to non-communicable diseases' risk factor surveillance. Dietary and physical activity habits were assessed by WHO questionnaires. The study population comprised 89,532 subjects aged over 15 years living in the 28 provinces of Iran. Overall, 50.4% (n = 45,113) of the participants were male and 64.6% (n = 57 866) were from the urban areas. The national estimates of overweight, obesity and morbid obesity were 28.6%, 10.8% and 3.4%, respectively. 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%, respectively. 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. 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.
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                Author and article information

                Journal
                Health Promot Perspect
                Health Promot Perspect
                Health Promot Perspect
                TBZMED
                Health Promotion Perspectives
                Tabriz University of Medical Sciences
                2228-6497
                2018
                07 July 2018
                : 8
                : 3
                : 187-194
                Affiliations
                1Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                2Deputy General Director for NCDs, National Focal Person for STEPS Survey & Director for Injury Prevention, Ministry of Health and Medical Education, Tehran, Iran
                Author notes
                [* ]Corresponding Author: Ali-Asghar Kolahi, MD, MPH; Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences. 3rd Floor, No 9, Hadieh Alley, In front of Hosseinieh Ershad, Shariati Ave., Tehran, Iran. Postal code: 1546817613 Tehran, Iran. Tel: +98 21 22220980, Fax: +98 21 26411317, Email: a.kolahi@ 123456sbmu.ac.ir
                Article
                10.15171/hpp.2018.25
                6064748
                © 2018 The Author(s).

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Tables: 4, References: 26
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