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      Which modifiable, non-modifiable, and socioeconomic factors have more effect on cardiovascular risk factors in overweight and obese women?

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          Abstract

          Background:

          The aim of the present study was to assess which modifiable, non-modifiable, and socioeconomic factors are good predictors for cardiovascular risk in overweight and obese Iranian women.

          Materials and Methods:

          This clinical cross-sectional study was conducted on 811 overweight and obese women of age 20–60 years in Islamic Republic of Iran. In this study, the dependent variables were fasting blood sugar (FBS) and lipid profile, and the independent variables were educational level, waist to hip ratio (WHR), body mass index (BMI), waist circumference (WC), age, fasting glycemia, and diabetes.

          Results:

          Univariate analysis showed that the significant factors associated with FBS were age, BMI, education, and WHR, but the effect of age was more than that of others. For total cholesterol (TC), only glycemia had a significant effect [ P = 0.004, odds ratio (OR) 1.9 vs. others independent variables’ ORs]. Having diabetes, BMI ≥30 kg/m 2, and education ≤12 years were the significant factors associated with triglyceride (TG), but the effect of diabetes was more than that of others (OR: 2.7, 2.2, and 1.9 for diabetes, BMI, and education, respectively). The effect of age was more than that of other independent factors on low density lipoprotein-cholesterol (LDL-C). There was not any significant association between independent variables and high density lipoprotein-cholesterol (HDL-C) in multiple logistic regression models.

          Conclusion:

          Based on the obtained results, in clinic, for overweight and obese women, age, glycemia, and having diabetes can be considered as predictors for FBS, and LDL-C, TC, and TG, respectively.

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          Most cited references25

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          Waist circumference, waist-hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults.

          To compare body mass index (BMI), waist circumference and waist-hip ratio (WHR) as indices of obesity and assess the respective associations with type 2 diabetes, hypertension and dyslipidaemia. A national sample of 11 247 Australians aged > or =25 years was examined in 2000 in a cross-sectional survey. The examination included a fasting blood sample, standard 2-h 75-g oral glucose tolerance test, blood pressure measurements and questionnaires to assess treatment for dyslipidaemia and hypertension. BMI, waist circumference and WHR were measured to assess overweight and obesity. The prevalence of obesity amongst Australian adults defined by BMI, waist circumference and WHR was 20.8, 30.5 and 15.8% respectively. The unadjusted odds ratio for the fourth vs. first quartile of each obesity measurement showed that WHR had the strongest relationship with type 2 diabetes, dyslipidaemia (women only) and hypertension. Following adjustment for age, however, there was little difference between the three measures of obesity, with the possible exceptions of hypertension in women, where BMI had a stronger association, and dyslipidaemia in women and type 2 diabetes in men, where WHR was marginally superior. Waist circumference, BMI and WHR identified different proportions of the population, as measured by both prevalence of obesity and cardiovascular disease (CVD) risk factors. Whilst WHR had the strongest correlations with CVD risk factors before adjustment for age, the three obesity measures performed similarly after adjustment for age. Given the difficulty of using age-adjusted associations in the clinical setting, these results suggest that given appropriate cut-off points, WHR is the most useful measure of obesity to use to identify individuals with CVD risk factors.
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            Food intake patterns may explain the high prevalence of cardiovascular risk factors among Iranian women.

            Some cardiovascular risk factors are more prevalent in Middle Eastern countries than in other parts of the world. Lifestyle-related factors, including diet, might account for this discrepancy. We aimed to identify the association between food intake patterns and cardiovascular risk factors among Iranian adult women. We studied 486 apparently healthy Iranian women aged 40-60 y. We used a Willett-format FFQ for collecting dietary data. Fasting plasma glucose (FPG) concentrations, lipid profiles, and blood pressure were measured. Diabetes was defined as FPG > or = 6.93 mmol/L; dyslipidemia was based on Adult Treatment Panel III and hypertension on Joint National Committee VI recommendations. The presence of at least 1 risk factor and at least 2 risk factors of the 3 major risk factors for cardiovascular disease (hypertension, dyslipidemia, and diabetes) was also evaluated. We identified 3 major eating patterns (healthy, Western, and Iranian). After controlling for potential confounders, subjects in the top quintile of the healthy dietary pattern were less likely to have dyslipidemia [odds ratio (OR), 0.36; 95% CI, 0.19-0.53], hypertension (OR, 0.33; 95% CI, 0.17-0.60), at least 1 (OR, 0.30; 95% CI, 0.18-0.58), and at least 2 risk factors (OR, 0.39; 95% CI, 0.20-0.77) compared with the lowest quintile. In contrast, those with greater adherence to the Western dietary pattern had greater odds for cardiovascular risk factors (OR, 2.59-3.11; P < 0.05). The Iranian dietary pattern was significantly associated with dyslipidemia (OR, 1.73; 95% CI, 1.02-2.99) and at least 1 risk factor (OR, 1.89; 95% CI, 1.05-3.20). The major dietary patterns and diabetes were not associated. Eating patterns of this Middle Eastern population might explain the higher prevalence of some cardiovascular risk factors in this region. However, our findings need to be confirmed in other Middle Eastern countries.
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              Weight Control Practices of U.S. Adolescents and Adults

              To estimate the prevalence of various weight-loss practices in U.S. adolescents and adults. The Youth Risk Behavior Survey, a self-administered survey of a random sample of high school students in 1990 and the Behavioral Risk Factor Surveillance System, a random-digit dial survey in 1989. Thirty-eight states and the District of Columbia. High school students (n = 11,467) and adults 18 years and older (n = 60,861). Among high school students, 44% of female students and 15% of male students reported that they were trying to lose weight. An additional 26% of female students and 15% of male students reported that they were trying to keep from gaining more weight. Students reported that they had used the following weight control methods in the 7 days preceding the survey: exercise (51% of female students and 30% of male students); skipping meals (49% and 18%, respectively); taking diet pills (4% and 2%, respectively); and vomiting (3% and 1%, respectively). Among adults, 38% of women and 24% of men reported that they were trying to lose weight, whereas 28% of each sex reported that they were trying to maintain their weight. Attempts to lose or maintain weight are very prevalent among both adolescents and adults, especially among females.
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                Author and article information

                Journal
                J Res Med Sci
                J Res Med Sci
                JRMS
                Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences
                Medknow Publications & Media Pvt Ltd (India )
                1735-1995
                1735-7136
                July 2012
                : 17
                : 7
                : 676-680
                Affiliations
                [1]Department of Nutrition, Zahedan University of Medical Sciences, Zahedan, Iran
                [1 ]Department of Pediatrics, Faculty of Medicine and Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
                [2 ]Department of Nutrition, Faculty of Health and Nutrition, Tehran University of Medical Sciences, Tehran, Iran
                [3 ]Department of Nutrition, Ph.D student of epidemiology,Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                Address for correspondence: Prof. Shahraki Touran, Department of Pediatrics, Faculty of Medicine and Children and Adolescent Health Research Center Zahedan University of Medical Sciences, Zahedan, Iran. E-mail: dr_tshahraki@ 123456yahoo.com
                Article
                JRMS-17-676
                3685786
                23798930
                71e83a8c-bf70-494b-9857-d05adf38ba40
                Copyright: © Journal of Research in Medical Sciences

                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
                : 02 January 2012
                : 26 April 2012
                : 28 June 2012
                Categories
                Original Article

                Medicine
                non-modifiable,modifiable,iran,cardiovascular risk factors,socioeconomic,women
                Medicine
                non-modifiable, modifiable, iran, cardiovascular risk factors, socioeconomic, women

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