Factors associated with obesity in Iranian elderly people: results from the national health survey

Finding a Link between Obesity and Senescence: A Systematic Review and Meta-Analysis

Background

Cell aging is associated with changes in telomeres due to DNA damage arising from chronic inflammation in obese patients. The aim of the systematic review and meta-analysis was to find the relationship between obesity and aging or senescence.

Methods

The systematic review was conducted through PRISMA guideline, beginning with literature search within 2012-2022 in several databases (PubMed, EBSCOHost, Science Direct, Scopus, and Cochrane) followed by screening process using predetermined PICO criteria. Original studies on the topic of obesity and senescence (aging), from preclinical studies to clinical research (cohort or cross-sectional studies) that were published within the last ten years. All studies were appraised using SYRCLE risk of bias tool for preclinical studies and Newcastle-Ottawa Scale (NOS) for cross-sectional and cohort studies. The data extraction on the studies' characteristic and outcome on aging or senescence were followed by quantitative analysis using MetaXL process on prevalence ratio and hazard ratio of obesity to comorbidities and mortality.

Results

Fifteen studies were enrolled. Obesity and white adipose tissue cause increased levels of pro-inflammatory and pro-senescence cytokine and macrophage whilst the aging process lowers metabolism with increased insulin resistance and linked to increased risk of obesity. Obesity occurs in 22% (95% CI 18%-26%) of elderly population with higher prevalence rate in the women population. Obesity is associated with significant increased risk of multimorbidity by 56% (OR = 1.58 [95% CI 1.48-1.96]).

Conclusion

The obesity and aging or senescence has reciprocal relationship between each other.

Food Insecurity and Malnutrition among Indian Older Adults: Findings from Longitudinal Ageing Study in India, 2017-18

The study aims to assess the prevalence of food insecurity and malnutrition and to investigate the association between food insecurity, sociodemographic characteristics, and malnutrition among Indian older adults. Data for 28,004 older adults (60 + years) was extracted from Wave-1 of the Longitudinal Aging Study in India, 2017-18. Bivariate analysis was used for prevalence estimates. Multinomial logistic regression provided relative risk ratios (RRR) to determine the association. About 45% of older adults were food insecure and nearly half were malnourished (underweight - 26.7%, overweight - 22.2%). Overweight was widespread in southern, western, and northern India, while underweight and food insecurity were widespread in central, eastern, and north-eastern India. Food insecure older adults were significantly more likely to be underweight (mild: RRR = 1.105, 95% CI = 1.038-1.176; severe: RRR = 1.327, 95% CI = 1.186-1.485). Rather than severe food insecurity, those with moderate food insecurity have the least likelihood of being overweight. Being the oldest, male, widowed, divorced/separated/deserted, having fewer years of schooling, living in a ST or SC household, and in rural areawere associated with higher risk of being underweight; while their other counterparts were of being overweight. No association was found between working status and underweight, meanwhile the non-working older adults were less likely to be overweight (RRR = 0.804, 95% CI = 0.744-0.868). Underweight is strongly linked to food insecurity. In terms of food insecurity and malnutrition, the most vulnerable categories identified include oldest old, widowed, divorced/separated/deserted, SC, ST, economically weaker, and persons without or with only a few years of formal education.

Prevalence of obesity and association between body mass index and different aspects of lifestyle in medical sciences students: A cross-sectional study

Aim

The global obesity pandemic is a major health problem with adverse effects on physical and mental health. The aim of this study was to investigate the prevalence of obesity and the association between BMI and different aspects of lifestyle.

Design

A cross-sectional study.

Methods

Data collected from 380 medical sciences students using demographic characteristics and Eating Behavior, Physical Activity and Perceived Stress Questionnaires were analysed using descriptive and inferential statistics, namely analysis of variance (ANOVA), t test, Pearson's test and multivariate linear regression model.

Results

The prevalence of obesity and overweight was 3.2% and 25.3%, respectively. There was a positive and significant statistical association between emotional eating (r = .542), extrinsic eating (r = .488) and perceived stress (r = .489) with BMI, also significant and an inverse association was obtained between emotional eating (r = -.488) and total physical activity score (r = -.394) with BMI. Factors such as sex, total physical activity score and leisure time activity, external eating behaviours, emotional eating, restricted eating and perceived stress had a significant role in explaining BMI changes.

Conclusion

There is a need to develop interventions to improve dietary behaviours, management stress and access to sports facilities by health-promoting activities and the provision of online health resources.

Application of the Marginal Beta-Binomial Model in Estimation the Overall Odds of Obesity Among Iranian Adults: Meta-Analysis Method

CONTEXT

To obtain accurate and reliable estimation of overall obesity odds ratio (OR) a statistical method is needed to be designed to account for heterogeneity among studies. The marginal beta-binomial model is a new method with attractive features that make it robust for meta-analysis.

OBJECTIVES

The aim of this study is the estimation of overall obesity OR among Iranian adults with particularly attention to age, sex, place of residence, and smoking status.

DATA SOURCES

We systematically reviewed all studies regarding obesity in Iranian adults in national and international journals that are published between 1990 and 2017, including PubMed, Scopus, SID, Google Scholar, Magiran, and IranMedex. The R software was used for data analysis and obtaining overall obesity OR using the marginal beta-binomial model.

RESULTS

A total of 18 studies, with a sample size of 258283, were included in our analysis. Results showed that increasing age, female sex, and residence in urban areas increases the odds of obesity. Using the age group 20 - 30 years as the reference, the overall obesity ORs for 30 - 40, 40 - 50, 50 - 60, and 60+ years were 2.13, 3.33, 3.15, and 2.33, respectively. The overall obesity OR for women was 2.35, compared with men. The estimated odds of obesity were 53% higher for urban adults. Smoking has a negative effect on obesity; the OR of obesity for smokers was 0.48 compared with non-smokers.

CONCLUSION

Consistent results in our research can be used as a basis to reinforce health programs for prevention and treatment of obesity in Iran.

Pickle Consumption is Associated with Body Mass Index and Blood Pressure among Iranian Female College Students: a Cross-Sectional Study

Pickle is consumed in high amount among Iranians. Pickle consumption may be related to body mass index (BMI) and blood pressure (BP) but limited evidence exist in this regard. The aim of current study was to determine the association between pickle consumption and risk of overweight, central obesity and BP among Isfahanian female youths. A cross-sectional study was conducted on 289 female students aged 18–27 years randomly selected from students of Isfahan University of Medical Sciences, Isfahan, Iran. Diet was assessed by a validated and reliable food-frequency questionnaire. Mean pickle consumption was 15.1 ± 2.2 g/day. Individuals in the highest tertile of pickle consumption had a significantly higher BMI, systolic and diastolic BP (p = 0.001, 0.03, and 0.03, respectively), whereas we did not observe significant association for waist circumference (p = 0.21). Total energy intake (p = 0.02) and consumption of carbohydrate (p = 0.01), protein (p = 0.03), and fat (p = 0.05) in the upper tertile was higher than lower tertiles. There was a significant association between pickle consumption and obesity and BP among Iranian female youths. Further prospective studies are needed to confirm this association.

The Isfahan Comprehensive Elderly Study: Objectives, research design, methodology, and preliminary results

BACKGROUND

This paper presents the objectives, research design, methodology, and primary findings of the Isfahan Comprehensive Elderly Study (ICES).

MATERIALS AND METHODS

In this cross-sectional study, 603 elderly persons (aged 60 and over) were selected by multistage cluster sampling method from Isfahan, Iran, in 2016 comprehensive questionnaires along with a detailed interview were used to collect information on personal, family, socioeconomic, health and social services characteristics, life styles, physical illnesses and chronic diseases, mental, emotional and cognition disorders, quality of life, disabilities, sleep quality, social supports, life satisfaction, self-efficacy, and of participants.

RESULTS

The mean ± standard deviation (SD) age of participants was 69.66 ± 6.31 years, consisting of 50.75% females. About 23% of elderly persons were at the risk of malnutrition and 4.5% were current smoker. Severe and mild depression were documented in 9.3% and 30.2% among included study subjects, respectively. About half of the participants had hypertension, and 26.8% suffered from cardiovascular disease. The mean ± SD of total score of Geriatric Depression Scale, Perceived Stress Scale, Older People's Quality of Life, Physical Activity Scale for the Elderly and Pittsburg Sleep Quality Index was 8.84 ± 6.79, 14.76 ± 5.92, 133.99 ± 10.55, 142.04 ± 120.53, and 6.17 ± 3.44, respectively. Elderly males had significantly higher life satisfaction and self-efficacy and better cognitive function than females (P < 0.01).

CONCLUSION

The findings of current study provided a comprehensive overview of the current health status and lifestyle of older adults in Isfahan city. The ICES could help policy makers to design appropriate prevention and interventional programs and policies to cover the specific needs of the elderly population.

Changes in Obesity Odds Ratio among Iranian Adults, since 2000: Quadratic Inference Functions Method

Background. Monitoring changes in obesity prevalence by risk factors is relevant to public health programs that focus on reducing or preventing obesity. The purpose of this paper was to study trends in obesity odds ratios (ORs) for individuals aged 20 years and older in Iran by using a new statistical methodology. Methods. Data collected by the National Surveys in Iran, from 2000 through 2011. Since responses of the member of each cluster are correlated, the quadratic inference functions (QIF) method was used to model the relationship between the odds of obesity and risk factors. Results. During the study period, the prevalence rate of obesity increased from 12% to 22%. By using QIF method and a model selection criterion for performing stepwise regression analysis, we found that while obesity prevalence generally increased in both sexes, all ages, all employment, residence, and smoking levels, it seems to have changes in obesity ORs since 2000. Conclusions. Because obesity is one of the main risk factors for many diseases, awareness of the differences by factors allows development of targets for prevention and early intervention.

Assessing factors related to waist circumference and obesity: application of a latent variable model

Background. Because the use of BMI (Body Mass Index) alone as a measure of adiposity has been criticized, in the present study our aim was to fit a latent variable model to simultaneously examine the factors that affect waist circumference (continuous outcome) and obesity (binary outcome) among Iranian adults. Methods. Data included 18,990 Iranian individuals aged 20–65 years that are derived from the third National Survey of Noncommunicable Diseases Risk Factors in Iran. Using latent variable model, we estimated the relation of two correlated responses (waist circumference and obesity) with independent variables including age, gender, PR (Place of Residence), PA (physical activity), smoking status, SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), CHOL (cholesterol), FBG (Fasting Blood Glucose), diabetes, and FHD (family history of diabetes). Results. All variables were related to both obesity and waist circumference (WC). Older age, female sex, being an urban resident, physical inactivity, nonsmoking, hypertension, hypercholesterolemia, hyperglycemia, diabetes, and having family history of diabetes were significant risk factors that increased WC and obesity. Conclusions. Findings from this study of Iranian adult settings offer more insights into factors associated with high WC and high prevalence of obesity in this population.

Functional Capacity of Oldest Old Living in a Long-stay Institution in Rio De Janeiro, Brazil

[Purpose] A significant increase in the number of oldest old has occurred worldwide. The aim of this study was to characterize the functional capacity of the oldest old residents in a long-stay institution in Rio de Janeiro, Brazil. [Subjects and Methods] All participants were evaluated according to the following metrics: anthropometry, body composition (bioelectrical impedance), handgrip strength, balance (Berg scale and stabilometry), ankle mobility (electrogoniometry), physical capacity (six-minute walk test), quality of life (WHOQOL-OLD), and dietary habits (questionnaire). [Results] Twenty elderly subjects with a mean age of 85.75 ± 5.22 years and a mean fat percentage of 39.02 ± 5.49% participated in the study. The group at risk of falls (n = 8) had a lower handgrip strength and walked a shorter distance over the course of six minutes compared with the group not at risk of falls. The obese group (n = 15) had higher values for stabilometric variables than the nonobese group. There was a positive and significant correlation between ankle joint mobility and physical capacity (r = 0.47). [Conclusion] High values for obesity and low values for handgrip strength and physical capacity were associated with worse body balance. Low values for ankle mobility were also associated with worse physical capacity in this population.

Etiology of Obesity Over the Life Span: Ecological and Genetic Highlights from Asian Countries

Obesity is a worldwide pandemic, and the prevalence rate has doubled since the 1980s. Asian countries are also experiencing the global epidemic of obesity with its related health consequences. The prevalence of overweight and obesity are increasing at an alarming rate across all age groups in Asia. These increases are mainly attributed to rapid economic growth, which leads to socio-economic, nutrition and lifestyle transitions, resulting in a positive energy balance. In addition, fat mass and obesity-associated gene variants, copy number variants in chromosomes and epigenetic modifications have shown positive associations with the risk of obesity among Asians. In this review highlights of prevalence and related ecological and genetic factors that could influence the rapid rise in obesity among Asian populations are discussed.

Cohort profile: the Amirkola Health and Ageing Project (AHAP)

This is the first comprehensive cohort study of the health of older people ever conducted in Iran. The aim of this project is to investigate the health status of older people in Amirkola in the northern part of Iran, near the Caspian Sea. The Amirkola Health and Ageing Project (AHAP) is mainly concerned with geriatric medical problems, such as falling, bone fragility and fractures, cognitive impairment and dementia, poor mobility and functional dependence. It is planned that all participants will be re-examined after 2 years. Data are collected via questionnaire, examinations and venepuncture. AHAP started in April 2011 and 1616 participants had been seen by 18 July 2012, the end of the baseline stage of this study. The participation rate was 72.3%. The prevalence of self-reported hypertension (41.2%) and diabetes mellitus (23.3%) are high. Only 14.4% of older people considered their health as excellent or good in comparison with others at this age. The prevalence of osteoporosis (T score≤-2.5) was 57.4% in women and 16.1% in men, and 38.2 % of older people were vitamin D deficient (<20 ng/ml). Researchers interested in using the information are invited to contact the principal investigator Seyed Reza Hosseini (hosseinim46@yahoo.com).

Inequality in School Readiness and Autism among 6-Year-Old Children across Iranian Provinces: National Health Assessment Survey Results

OBJECTIVE

To assess the national inequality of school readiness and autism among 6-year-old Iranian children before school entry using a national health assessment survey.

METHODS

In a cross-sectional nationwide survey, all Iranian children entering public and private elementary schools were asked to participate in a mandatory national screening program in Iran in 2009 in two levels of screening and diagnostic levels.

FINDINGS

The study population consisted of 955388 children (48.5% girls and 76.1% urban residents). Of the whole children, 3.1% of the 6-year-old children had impaired vision. In addition, 1.2, 1.8, 1.4, 7.6, 0.08, 10, 10.9, 56.7, 0.7, 0.8 and 0.6 percent had color blindness, hearing impaired, speech disorder, school readiness, autism, height to age retardation, body mass index extremes, decayed teeth, disease with special needs, spinal disorders, and hypertension, respectively. The distribution of these disorders was unequally distributed across provinces.

CONCLUSION

Our results confirmed that there is an inequality in distribution of school readiness and autism in 6-year-old children across Iranian provinces. The observed burden of these distributions among young children needs a comprehensive national policy with evidence-based province programs to identify the reason for different inequality among provinces.

Prevalence study of clinical disorders in 6-year-old children across Iranian provinces: Findings of Iranian national health assessment survey

OBJECTIVE

To assess the national prevalence of clinical disorders in 6-year-old Iranian children before school entry using a national health assessment survey.

MATERIALS AND METHODS

In a cross-sectional nationwide survey, all Iranian children entering public and private elementary schools were asked to participate in a mandatory national screening program in Iran in 2009 in two levels of screening and diagnostic levels.

RESULTS

The study population consisted of 955388 children (48.5% girls and 76.1% urban). Of the whole children, 3.1% of the 6-year-old children had impaired vision. In addition, 1.2, 1.8, 1.4, 10, 10.9, 56.7, 0.7, 0.8 and 0.6% had color blindness, hearing impaired, speech disorder, height to age retardation, body mass index extremes, decayed teeth, having disease with special needs, spinal disorders, and hypertension, respectively. The distribution of these disorders was unequally distributed across provinces.

CONCLUSIONS

Our results confirmed that the prevalence of clinical disorders among 6-year-old children across Iranian provinces was not similar. The observed burden of these distributions among young children needs a comprehensive national policy with evidence-based province programs to identify the reason for different distribution among provinces.