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      Major Dietary Patterns and Their Associations with Overweight and Obesity Among Iranian Children

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          Abstract

          Background:

          Increasing prevalence of obesity is a major health concern. Lifestyle behaviors and diet play an important role in developing childhood obesity. The aim of this study was to determine the association between major dietary patterns and overweight/obesity in a group of Iranian school-aged children.

          Methods:

          This cross-sectional study was conducted in Isfahan, Iran with 637 elementary school-aged children. A semi-quantitative food-frequency questionnaire was used to assess usual dietary intakes. Data on socio-demographic, physical activity and other lifestyle habits were collected using standard questionnaires. Obesity was determined based on national cut-offs. Factor analysis was used for identifying major dietary patterns.

          Results:

          Three major dietary patterns were extracted; “Healthy,” “Western,” and “Sweet-Dairy.” After adjusting for confounders, girls in the second quartile of healthy pattern, were more likely to be overweight (odds ratio [OR] =2.23, Confidence intervals [CI] =1.003, 4.96) compared to those in the highest quartile. Likelihood of being overweight was lower for girls in the second quartile of western dietary pattern versus the fourth quartile (OR = 0.46, CI = 0.21, 1.01). Accordingly, lower adherence to sweet and dairy pattern was associated with lower body mass index (BMI) among girls (OR = 0.42, CI = 0.21, 0.85). There was no significant relationship between western and sweet-dairy pattern with BMI among boys, however, significant association was observed between lowest and highest quartiles of healthy pattern (OR = 0.36, CI = 0.15, 0.84).

          Conclusions:

          We found significant associations between the three dietary patterns and obesity among girls. Only healthy pattern was related to weight status of schoolboys. Longitudinal studies will be needed to confirm these associations.

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          Most cited references52

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          Measurement of dietary intake in children.

          When children and adolescents are the target population in dietary surveys many different respondent and observer considerations surface. The cognitive abilities required to self-report food intake include an adequately developed concept of time, a good memory and attention span, and a knowledge of the names of foods. From the age of 8 years there is a rapid increase in the ability of children to self-report food intake. However, while cognitive abilities should be fully developed by adolescence, issues of motivation and body image may hinder willingness to report. Ten validation studies of energy intake data have demonstrated that mis-reporting, usually in the direction of under-reporting, is likely. Patterns of under-reporting vary with age, and are influenced by weight status and the dietary survey method used. Furthermore, evidence for the existence of subject-specific responding in dietary assessment challenges the assumption that repeated measurements of dietary intake will eventually obtain valid data. Unfortunately, the ability to detect mis-reporters, by comparison with presumed energy requirements, is limited unless detailed activity information is available to allow the energy intake of each subject to be evaluated individually. In addition, high variability in nutrient intakes implies that, if intakes are valid, prolonged dietary recording will be required to rank children correctly for distribution analysis. Future research should focus on refining dietary survey methods to make them more sensitive to different ages and cognitive abilities. The development of improved techniques for identification of mis-reporters and investigation of the issue of differential reporting of foods should also be given priority.
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            An accelerated nutrition transition in Iran.

            To describe the emergence of the nutrition transition, and associated morbidity shifts, in the Islamic Republic of Iran. Review and analysis of secondary data relating to the socio-political and nutritional context, demographic trends, food utilisation and consumption patterns, obesity, and diet-related morbidity. The nutrition transition in Iran is occurring rapidly, secondary to the rapid change in fertility and mortality patterns and to urbanisation. The transition is occurring against the backdrop of lack of sustained economic growth. There is considerable imbalance in food consumption with low nutrient density characterising diets at all income levels, over-consumption evident among more than a third of households, and food insecurity among 20% of the population. Obesity is an emerging problem, particularly in urban areas and for women, and both diabetes and other risk factors for heart disease are becoming significant problems.
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              The shift in stages of the nutrition transition in the developing world differs from past experiences!

              This paper explores the unique nutrition transition shifts in diet and activity patterns from the period termed the receding famine pattern to the one dominated by nutrition-related non-communicable diseases (NR-NCDs). The paper examines the speed and timing of these changes; unique components, such as the issue of finding both under- and overnutrition in the same household; potential exacerbating biological relationships that contribute to differences in the rates of change; and political issues. The focus is on lower- and middle-income countries of Asia, Africa, the Middle East and Latin America. These changes are occurring at great speed and at earlier stages of these countries' economic and social development. There are some unique issues that relate to body composition and potential genetic factors. The significance of the high number of persons exposed to heavy insults during pregnancy and infancy (foetal origins hypothesis) and the subsequent rapid shifts in energy imbalance remains to be understood. Countries that are still addressing major concerns of undernutrition are not ready to address these NR-NCDs. The developing world needs to give far greater emphasis to addressing the prevention of the adverse health consequences of this shift to the nutrition transition stage of degenerative diseases.
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                Author and article information

                Journal
                Int J Prev Med
                Int J Prev Med
                IJPVM
                International Journal of Preventive Medicine
                Medknow Publications & Media Pvt Ltd (India )
                2008-7802
                2008-8213
                April 2013
                : 4
                : 4
                : 448-458
                Affiliations
                [1 ]School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
                [2 ]Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
                [3 ]Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
                [4 ]Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
                Author notes
                Correspondence to: Dr. Zamzam Paknahad, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail: paknahad@ 123456hlth.mui.ac.ir
                Article
                IJPVM-4-448
                3650598
                23671778
                325301eb-3e48-4cf0-b58b-687a89a6f058
                Copyright: © International Journal of Preventive Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 November 2012
                : 24 January 2013
                Categories
                Original Article

                Health & Social care
                children,dietary patterns,factor analysis,obesity,overweight
                Health & Social care
                children, dietary patterns, factor analysis, obesity, overweight

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