Prevalence of physical inactivity in Iran: a systematic review

Socioeconomic inequalities in employees' health-enhancing physical activity: Evidence from the SHAHWAR cohort study in Iran

BACKGROUND

Increasing level of physical activity (PA) among working population is of particular importance, because of the high return of investment on employees' PA. This study was aimed to investigate socioeconomic inequalities in Health-Enhancing Physical Activity (HEPA) among employees of a Medical Sciences University in Iran.

METHODS

Data were extracted from the SHAHWAR Cohort study in Iran. Concentration index (C) and Wagstaff decomposition techniques were applied to determine socioeconomic inequality in the study outcomes and its contributors, respectively.

RESULTS

Nearly half of the university employees (44.6%) had poor HEPA, and employees with high socioeconomic status (SES) suffered more from it (C = 0.109; 95% CI: 0.075, 0.143). Also, we found while poor work-related PA (C = 0.175; 95% CI: 0.142, 0.209) and poor transport-related PA (C = 0.081, 95% CI: 0.047, 0.115) were more concentrated among high-SES employees, low-SES employees more affected by the poor PA at leisure time (C = -0.180; 95% CI: -0.213, -0.146). Shift working, and having higher SES and subjective social status were the main factors that positively contributed to the measured inequality in employees' poor HEPA by 33%, 31.7%, and 29%, respectively, whereas, having a married life had a negative contribution of -39.1%. The measured inequality in poor leisure-time PA was mainly attributable to SES, having a married life, urban residency, and female gender by 58.1%, 32.5%, 28.5%, and -32.6%, respectively. SES, urban residency, shift working, and female gender, with the contributions of 42%, 33.5%, 21.6%, and -17.3%, respectively, were the main contributors of poor work-related PA inequality. Urban residency, having a married life, SES, and subjective social status mainly contributed to the inequality of poor transport-related PA by 82.9%, -58.7%, 36.3%, and 33.5%, respectively, followed by using a personal car (12.3%) and female gender (11.3%).

CONCLUSIONS

To reduce the measured inequalities in employees' PA, workplace health promotion programs should aim to educate and support male, urban resident, high-SES, high-social-class, and non-shift work employees to increase their PA at workplace, and female, married, rural resident, and low-SES employees to increase their leisure-time PA. Active transportation can be promoted among female, married, urban resident, high-SES, and high-social-class employees and those use a personal car.

Improving Physical Fitness and Health of Office Workers in Iran

This paper reports on a study on improving the health and fitness of office workers in Iran using a comprehensive model. The research design was a randomized controlled trial involving 294 employees. The intervention was a 6-month program to promote physical activity. The primary outcome measure was their scores on the physical activity (PA) index recorded at 3 and 6 months. A statistically significantly increase in PA was found in the intervention group over the control group. In addition, the mean values of related health and physiological indices of the intervention group demonstrated a statistically significant increase compared to the control group. The conclusions of this study support research findings in multiple countries, that the physical activity and health of office workers can be improved in a short period.

Pelvic floor disorder and relevant factors in Iranian women of reproductive age: a cross-sectional study

BACKGROUND

With high severity and prevalence, pelvic floor disorder is a health issue that women face worldwide. Different demographic-obstetric factors are involved in the emergence of this dysfunction that can have many adverse effects on a woman's quality of life. Hence, this study aimed to determine the prevalence of pelvic floor disorder and its related socio-demographic and obstetric factors among Iranian women of reproductive age.

METHODS

The statistical population of this cross-sectional study included 400 woman of reproductive age (15-49 years) covered by the health centers of Tabriz, Iran in 2022. The cluster sampling method was employed to select the participants. The data collection tools were a socio-demographic and obstetric characteristics questionnaire and the PDFI-20 (Pelvic Floor Distress Inventory-20). The chi-squared test was conducted to determine the association between socio-demographic and obstetric characteristics and prevalence of pelvic floor disorder in a bivariate analysis, whereas the multivariate logistic regression test was used in a multivariate analysis.

RESULTS

The general prevalence of pelvic floor disorder was 76%. The prevalence rates of pelvic organ prolapse distress 6 (POPDI-6), colorectal-anal distress 8 (CRAD-8), and urinary distress (UDI-6) were 54.3%, 61.8%, and 49.3%, respectively. The results of the multivariate logistic regression test indicated that constipation (odds ratio = 5.62; 95% CI 1.97 to 16.03; P = 0.001) increased the risk of pelvic floor disorder.

CONCLUSIONS

According to the findings, the prevalence of pelvic floor disorder is high among Iranian women of reproductive age. This condition is correlated with constipation. Therefore, screening is recommended through valid tools in addition to offering preventive measures such as preventing and curing constipation to reduce the risk of pelvic floor disorder.

Physical activity pattern in Iran: Findings from STEPS 2021

Background

Insufficient physical activity (IPA) is a significant risk factor for various non-communicable diseases. The Iran action plan is a 20% reduction in IPA. Therefore, we aimed to describe the age and sex pattern of physical activity domains, IPA, the intensity of physical activity, sedentary behavior, and their associates at Iran's national and provincial levels in 2021.

Methods

This study used the data of the STEPwise Approach to NCD Risk Factor Surveillance (STEPS) 2021 in Iran. The STEPS study used the Global Physical Activity Questionnaire (GPAQ) version two developed by WHO for the assessment of physical activity, which included work, transport, and recreational activities domains. We showed and compared demographic and clinical characteristics of participants between males and females, using t-test and Chi-square test. A logistic regression model adjusted for residential areas, years of schooling, wealth index, age, marital status, and occupation has also been implemented. The results were presented as percentages and 95% confidence intervals (CI).

Results

We included 27,874 participants with a mean (SD) age of 45.69 (15.91), among whom 12,479 (44.77%) were male. The mean prevalence of IPA for the whole population for all ages was 51.3% (50.62-51.98%). By sex, 41.93% (40.88-42.98%) and 57.87% (56.99-58.75%) of men and women had IPA, respectively. According to the physical activity domains, the age-standardized prevalence of no recreational activity was 79.40% (78.80-79.99%), no activity at work was 66.66% (65.99-67.32%), and no activity at transport was 49.40% (48.68-50.11%) for both sexes combined. Also, the overall age-standardized prevalence of sedentary behaviors was 50.82% (50.11-51.53%). Yazd province represented the highest prevalence of IPA (63.45%), while West Azerbaijan province represented the lowest prevalence (39.53%). Among both sexes, living in the urban area vs. rural area [adjusted OR: 1.44; (1.31-1.58)], married vs. single status [adjusted OR: 1.33; (1.16-1.53)], and wealth index of class 3 vs. class 1 [adjusted OR: 1.15; (1.01-1.30)] were significantly associated with a higher rate of IPA.

Conclusion

The prevalence of IPA was considerably high in Iran. To achieve the predefined goal of reducing IPA, the health system should prioritize increasing physical activity, especially in urban areas and among females.

Factors affecting the physical activity of healthcare workers of Iran University of Medical Sciences: a qualitative study

Background

Low physical activity in adulthood is a major public health challenge. The majority of adults spend many hours each week at work, and workplace thus becomes a suitable location in which to promote health and implement physical activity programs. This qualitative study was conducted to identify the barriers and facilitators of worksite physical activity from the perspective of the employees of Iran University of Medical Sciences.

Methods

In this qualitative thematic analysis, five focus group discussions were held with the participation of 68 staff members of Iran University of Medical Sciences who had been selected by purposive sampling with maximum diversity.

Results

The analysis of the data led to the identification of three general themes, including challenges and barriers, strategies, and incentives (facilitators). The four main categories of challenges and barriers included policy-making and legislation, organizational factors, structural factors, and personal factors. Most barriers identified by the participants were placed in the personal factors and organizational factors categories. The strategies for increasing physical activity were identified in the following three categories: Policy-making and legislation, organizational factors, and environmental factors. The majority of the strategies proposed were placed in the organizational factors and policy-making and legislation categories.

Conclusions

Increasing physical activity in the workplace as a strategy for the general promotion of physical activity in people requires interventions in different areas, especially with regard to organizational factors and policy-making and legislation.

The relationship between sleep quality and physical activity among patients with heart failure: a cross-sectional study

BACKGROUND

Sleep disorders are one of the most common and annoying problems among patients with heart failure, which decrease their quality of life. Participation in physical activity is one of the most effective methods to reduce sleep disorders; however, few patients participate. This study was conducted to examine the relationship between physical activities and sleep quality among heart failure patients.

METHODS

A convenience sample of 100 patients with heart failure referred to rehabilitation centers in southeastern Iran was used in this descriptive cross-sectional study. The Pittsburgh Sleep Quality Index and the Rapid Assessment of Physical Activity (RAPA) were used to collect data. The Spearman correlation coefficient and regression were used to analyze the data. The significance level was < 0.05.

RESULTS

The results revealed that the mean score of sleep quality was 8.74 ± 2.83, with the majority of them (84.47%) having poor sleep quality. The mean score of physical activity was 2.59 ± 1.33, and the majority of them (95.15%) had sub-optimal physical activity. There was a significant and inverse relationship between the total scores of sleep quality and physical activity, and patients' sleep quality improved while physical activity increased. Physical activity, sex, history of heart surgery, and the stage of illness were found to account for 31% of the variances in patients' sleep quality.

CONCLUSION

The results of this study showed better sleep quality among patients who were more physically active. Given that the majority of patients with heart failure suffer from sleep disorders, patients' knowledge of physical activity should be increased to improve their quality of sleep and quality of life.

Comparing the effects of text messaging and mobile social networking on physical activity and anthropometric indices of middle-aged women: a randomized controlled trial

BACKGROUND

Physical inactivity is a global health problem which is more prevalent among women. Among different age groups, middle-aged women are more vulnerable to physical inactivity as one of consequences of menopause. This study aimed to compare the effect of text messaging and that of mobile social networking on the improvement of physical activity and anthropometric indices of middle-aged women in Iran.

METHODS

This was a randomized controlled trial in which 110 overweight or obese women who were physically inactive were recruited and allocated into two groups of text messaging (n = 55) or mobile social networking (n = 55). Women in both groups received information regarding the necessity, benefits, and barriers of physical activity and how to overcome these barriers for 12 weeks. The International Physical Activity Questionnaire (IPAQ), and a demographic questionnaire were used to collect data. Anthropometric indices including weight, height, waist circumference, hip circumference, waist/hip ratio, and body fat percentage were measured at baseline, as well as 4, 8, and 12 weeks after intervention. Data were analyzed using independent t-test, Chi-square, and repeated measure test.

RESULTS

In the mobile social networking group, most women had moderate physical activity after 12 weeks (P < 0.05). The mean physical activity and energy expenditure were significantly higher in the mobile social group than those in the text messaging. In the 12th week of intervention, there was a significant reduction in the weight and BMI of the participants in the mobile social networking group compared to the text messaging group (P < 0.05). The waist and hip circumferences of women in the mobile social networking group reduced significantly after 12 weeks of intervention in comparison to the text messaging group (P = 0.001). The two groups did not show any significant difference regarding waist/hip ratio. While the body fat percentage was reduced in the mobile social networking group in the 4th, 8th, and 12th week of intervention, the differences between the two groups was not significant.

CONCLUSION

Both text messaging and mobile social networking were effective in promoting physical activity and reducing anthropometric indices except for waist/hip ratio and body fat percentages, but the effect of mobile social networking was more pronounced. Thus, mobile social networking is recommended for promoting physical activity among middle-aged women.

Socioeconomic difference in physical activity in children and their parents: The childhood and adolescence surveillance and prevention of adult noncommunicable disease study

BACKGROUND

As a health-related behavior, physical activity (PA) differs according to individual's socioeconomic status (SES). This study aimed to assess the socioeconomic difference in leisure-time PA among Iranian students and their parents at national and regional levels.

STUDY DESIGN

Nationwide cross-sectional study.

METHODS

This study was conducted as part of a national survey conducted in 2015 among 14400 Iranian students and their parents. Total PA level was measured as the average hours spent on PA per week. Nonlinear principal component analysis was used to construct the households' SES based on household's assets, type of house ownership, occupation of fathers and the educational levels of fathers and mothers. Concentration index was applied to measure the inequality in the PA level in parents and students.

RESULTS

Complete data of 13313 students and their parents were available. At the national level, students spent more hours of PA per week (3.753 h per week [h/w]) as compared to their parents. Moreover, PA h/w was higher in fathers (3.488 h/w) as compared to mothers (2.763 h/w). The lowest means of mother's and student's PA were found in the highest SES region. At national level, the concentration indices (CI) of father's and mother's PA were -0.050 (95% CI = -0.067 ~ -0.030) and -0.028 (95% CI = -0.044 ~ -0.012), respectively, indicating pro-poor inequality, but the CI value of student PA was non-significant (CI = -0.007, 95% CI = -0.023-0.008).

CONCLUSIONS

Given that the mother's and student's PA level was low in the high SES regions, it is suggested that focused PA planning may further increase the level of PA across higher SES regions and might be effective in reducing the PA inequality.

A national and sub-national metaregression of the trend of insufficient physical activity among Iranian adults between 2001 and 2016

Insufficient physical activity (IPA) caused approximately 5% of mortalities in 2017 in Iran, almost double its global average. Despite the relatively considerable burden, a knowledge gap exists regarding the trend of IPA in recent years. We described the trend of IPA prevalence utilizing the data from six rounds of STEPwise approach to risk factor Surveillance (STEPS) in Iran. We estimated the physical activity status of Iranian adults from 2006 to 2016 after adjusting for years of schooling, urbanization percentage, and wealth index. We used the spatiotemporal model to interpolate and extrapolate the IPA prevalence for the years in-between the series and from 2001 to 2006, respectively. We used the data of 177,910 participants from six STEPS surveys and found that the national prevalence of IPA had steadily increased over the course of 16 years and had almost doubled in this time period (23.1% in 2001 to 55.4% in 2016). The increase was persistent across all age and gender strata and in every province. Moreover, IPA was more prevalent among women than their male peers regardless of their age category or province of residence. The prevalence of IPA in Khuzestan (highest prevalence) was almost double compared to that in Lorestan (lowest prevalence) in 2016. The IPA prevalence increased considerably and almost doubled in 16 years among Iranian adults, particularly women. Policies need to target IPA as a high priority contributing to the burden of Non-communicable diseases.

Social Disparities in Post-diagnosis Health Behaviors of Iranian Breast Cancer Survivors: The Mediating Role of Psychosocial Factors as Potential Buffering Agents

Background: Breast cancer (BC) is surging as a public health issue in Iran and engagement in positive health behaviors improves the odds of survival and reduces the risk of concomitant comorbidities in BC survivors. Objectives: The primary purpose of this study was to investigate the impact of socioeconomic inequalities on leisure-time physical activity (LTPA) and fruit and vegetable (F & V) consumption among Iranian BC survivors. Another objective of this study was to examine the role of psychosocial factors, such as stress, self-efficacy, and social support as mediators between socioeconomic status (SES) and these health behaviors. Few studies have investigated social disparities in the health behaviors of cancer survivors. Likewise, the mediating role of psychosocial factors in the SES-health behavior gradient has rarely been explored in the cancer context. Psychosocial factors might have positive implications for socioeconomically disadvantaged survivors. Methods: Cross-sectional data were obtained from 196 patients with BC by a telephone-administrated questionnaire. The Behavioral Risk Factor Surveillance System (BRFSS) 2013 was partially employed to measure exercise and F & V consumption. Cross-sectional analyses (correlation and logistic regression) were conducted to assess the relationship between SES, psychosocial factors, and health behaviors (P < 0.05). Results: Regarding LTPA and F & V consumption, more than half of the survivors complied with the recommended levels, consecutively. Both education and family income exhibited a positive association with LTPA and F & V consumption. Furthermore, self-efficacy and social support showed a positive relationship with LTPA and F & V consumption. Conclusions: The SES impacted health behaviors directly and via intermediary psychosocial factors. The results can inform future studies and interventions; psychosocial factors could buffer the effects of social inequalities on health behaviors. A key policy priority should, therefore, be planning and implementing psychosocial empowerment interventions to promote exercise and a healthy diet among impoverished cancer survivors.

A Field-Based Study of the Magnitude of Risk Factors and Health Habits in Young Volunteers in the Community

Objective

A field study is more informative in terms of epidemiological data than a hospital-based study. Undiagnosed risk factors may be discovered in an asymptomatic group. This study aimed to estimate if the community was well informed about the risk factors for coronary artery disease and if that affected the prevalence and the anthropometric among those who participated in the study.

Materials and methods

A cross-sectional study was conducted, using a consecutive sampling technique. Individuals were interviewed in terms of the risk factors and clinical signs and symptoms. The anthropometric measurements were done on-site to identify asymptomatic risk factors. The survey was utilized to increase the awareness among the participants.

Results

In total, 193 individuals participated in this study. The mean age of the sample was 36.3 ± 12.4 years, with 53% male. Smoking was the most frequent risk factor (31.6%), followed by dyslipidemia (22.5%), hypertension (16.6%), and diabetes mellitus (14.5%). Almost half of the sample participated in sports for one to two hours per week (40%). Almost all consumed fast food at least once a week, and 16.6% consumed fast food more than four times a week. The average systolic blood pressure was 129.41 ± 22.5 mmHg and the average body mass index (BMI) 27.6 ± 7.2 kg/m2.

Conclusion

Dyslipidemia was the most prevalent risk factor. Hypertension and diabetes mellitus are on top of the risk factor pyramid in commonality. An early diagnosis is important to decrease the incidence of cardiovascular disease. The consumption of fast food and obesity are relatively high and require educational interventions and more available healthy food. Screening through social media and primary health care centers may avert a negative outcome.

Physical activity levels and related sociodemographic factors among Iranian adults: Results from a population-based national STEPS survey

Background: Physical inactivity (PA) is one of the leading modifiable risk factors for noncommunicable diseases (NCDs) worldwide. This study aimed to determine PA levels and related sociodemographic factors as risk factors for NCDs among Iranian adults.

Methods: In this cross sectional study, data were collected from the sixth nationwide STEPS survey in 31 provinces of Iran. A total of 6100 individuals aged 18-64 years were selected by a multistage cluster sampling method, and their PA levels were assessed using the Global Physical Activity Questionnaire (GPAQ). Data were analyzed using descriptive methods and analytical tests, including chi-square, ANOVA, and independent t tests in SPSS version 21 software.

Results: The prevalence of vigorous, moderate, and low levels of PA was 36.3% (95%CI:35.1-37.5), 29.2% (95%CI:28-30.3), and 34.5% (95%CI:33.3-35.7) in participants, respectively. The mean ± SD of total MET-min/week was 1842.3±2619.3. Total mean ± SD duration of PA was 98.2 ± 115 min/week (125.8±142.6 and 77.2±84.5 min/week in men and women, respectively). Transport-related PA and severe PA at work had large and small contributions to overall PA, respectively. Urbanization, sex, age, family size, and occupation status were identified as factors associated with PA levels (p<0.001).

Conclusion: This study revealed a significant prevalence of low PA among the target population and some sociodemographic characteristics identified as factors associated with PA. Identification of these factors can develop more effective interventions to promote PA.

Promoting sustainable physical activity among middle-aged Iranian women: a conceptual model-based interventional study

Background

Physical inactivity enhances the risk of adverse health conditions such as non-communicable diseases, morbidity, and mortality among middle- and older-aged population. This study is aimed to design, implement, and evaluate a conceptual model of physical activity (PA) promotion among middle-aged Iranian women (MAIW).

Methods

An interventional study was conducted with 80 women aged between 30 and 59 years in intervention and control groups during 2018–2019. The subjects referred to health centers were selected by the available convenience sampling method. Data collection tools to assess the MAIW' PA level (metabolic equivalent tasks (MET)-min/week) included face-to-face interviews, body mass index (BMI) measurements, the four-question form of PA vital signs in the framework of Iran's Package of Essential Non-communicable (IraPEN) program, and the questionnaire is based on the Health Belief Model (HBM) constructs.

Results

The intervention led to a three-fold increase in the average PA (from 280.63 to 927.70 MET-min/week) of the intervention group. Although no significant difference in the BMI between both groups was found before the intervention, this educational program decreased the mean BMI from 30.36 to 28.83 kg/m² (p = 0.01). After the intervention, the values of HBM-based perceived sensitivity/severity and self-efficacy were increased from 62.09 to 71.03% and from 27.01 to 83.15%, respectively (p < 0.0001). There were no significant differences in the cue to action and perceived benefits and barriers after the intervention.

Conclusion

The developed model by increasing the motivation of MAIW could remarkably improve the PA level with a decrease in their BMI.

Trial register Iranian Registry of Clinical Trials (IRCT): IRCT20200717048124N1 at 2020-08-05, retrospectively registered.

Trends of low physical activity among Iranian adolescents across urban and rural areas during 2006-2011

It is well documented that physical inactivity is related to weight gain and a whole host of chronic diseases. This study investigated trends of low physical activity among Iranian adolescents in urban and rural areas between 2006-2011. A total of 12,178 adolescents, aged between 15 and 19 years, participated in National Surveys of Risk Factors for Non-Communicable Diseases. Data on physical activity was obtained using the global physical activity questionnaire. A complex sample survey and multinomial logistic regression were used to model physical activity levels. The percentage of adolescents who had low levels of physical activity increased from 2006 to 2011 in both urban and rural areas. Low and moderate levels of physical activity were lower in rural girls as compared with urban girls, with a prevalence ratio of 0.59 (95% CI 0.47-0.74) and 0.59 (95% CI 0.47-0.74), respectively. The corresponding values for boys residing in rural areas compared with boys in urban areas were 0.56 (95% CI 0.43-0.75) and 0.60 (95% CI 0.48-0.74), respectively. The adolescents' lifestyles showed an increasing trend for physical inactivity in both genders; however, in rural areas, only girls had a rising affinity for a sedentary lifestyle throughout the 2006-2011 years.

Association of Meteorin-Like Hormone with insulin resistance and body composition in healthy Iranian adults

BACKGROUND AND AIMS

Sedentary behavior and/or physical inactivity are modifiable risk factors for noncommunicable diseases. Myokines are one of the mediators of physical activity health benefits. Relationship between regular physical activity (RPA) and baseline plasma Meteorin-Like Hormone (Metrnl) has not been explored in human. Hence, we compared baseline plasma Metrnl between sedentary individuals and ones with recreational physical activities, and role of Metrnl as a biological messenger between physical activity and insulin resistance and body composition was also explored.

METHODS

Forty healthy young men (aged: 21 ± 2.1 yrs; BMI: 23 ± 3.44 kg/m²) completed the study. Participants were equally assigned into two groups of control (sedentary) and case (recreational athletes). Baseline plasma Metrnl, glucose, insulin and body composition components and insulin resistance index (HOMA-IR) were assessed under resting conditions.

RESULTS

Except for baseline blood glucose, baseline plasma Metrnl, insulin, HOMA-IR and body mass index and body fat percentage were similar between two groups (P > 0.05). However, after Metrnl correction for the degree of insulin resistance index (Metrnl/HOMA-IR), recreational athletes showed a significantly greater baseline compared to sedentary subjects (P < 0.05). Baseline blood glucose showed a negative and significant correlation with baseline plasma Metrnl (P < 0.05).

CONCLUSIONS

Baseline plasma Metrnl is correlated with regular physical activity and insulin sensitivity, but not with body composition parameters. Metrnl may be one possible mediator of the beneficial effects of PA on insulin sensitivity in healthy humans. Hence, increasing awareness of the benefits of physical activity and incorporating physical activity into lifestyle are of great importance for people with non-communicable diseases.

"Playing with Little Behaviors"; Physical Activity Promotion by Gamified Education in Young Boys

Background:

Physical activity is affecting every aspect of our life. A sedentary lifestyle can be the risk factor for noncommunicable diseases (NCD) or premature death all over the world. Several studies demonstrate that school-based physical activity promotion is an important solution to make healthy behaviors, especially in children and adolescents. In this vein, the current research evaluates a model for physical activity, which is promoted through a game among high school students.

Methods:

In this study, 47 high school's 10^th-grade boys from Tehran were requited. The game scenario included the suggestion of some behaviors which can increase daily physical activity by each student, like or dislike each behavior by other students, counting likes, selecting the most-liked behaviors, and rewarding their proposers. After a week, the behavioral recall was assessed and compared with a control group who had been heard these behaviors in the class without gamification.

Results:

The participants in the game could recall physical activity behaviors significantly more than peers in the control group.

Conclusions:

The findings show gamification could significantly improve the effectiveness of education for normal behaviors in physical activity.

The Prevalence and 5-Year Incidence Rate of Low Physical Activity in an Urban Population of 10,000 in Southeastern Iran: Relationship With Other Cardiovascular Risk Factors

BACKGROUND

Because of high prevalence of coronary artery diseases (CADs) in Iran and their relationship with low physical activity (LPA), this study aimed to measure the epidemic size of LPA, its incidence rate, and its relationship with other CAD risk factors in Kerman, Iran.

METHODS

About 10,000 adults were randomly recruited through single-stage cluster sampling. Demographic characteristics, biochemical variables, smoking, opium use, mental status, and physical activities were assessed. The relationship between LPA and 7 other CAD risk factors was measured. Five-year incidence rate of LPA was calculated according to the data from the physically active participants in the first phase of the study (n = 3416) who attended the second phase after 5 years.

RESULTS

The prevalence of low, moderate, and intense physical activity was 47.2%, 34.8%, and 18.0%, respectively. LPA rose from 45.1% to 62.2% after the age of 25 years. Women had higher LPA than men. Participants with LPA had significantly higher chance of cigarette smoking, diabetes, overweight/obesity, hypertension, and opium addiction. Five-year incidence rate of LPA was 5.1 persons/100 person-years among physically active population.

CONCLUSION

Almost half of the studied population suffering from LPA was at risk of CAD. Such risky lifestyle pattern while worsened in the last 5 years makes the emerging of CAD epidemic unavoidable, if appropriate timely interventions not being in place accordingly.

Knowledge, Attitude, and Pattern of Physical Activity in Middle School Students in Isfahan, 2015

Background:

The incidence of overweight and obesity in children has increased in recent decades. Physical activity (PA), which is a multidimensional behavior, has an important role in preventing and decreasing obesity. The aim of the study is to evaluate the knowledge, attitude, and exercise habits of middle school students and also explore the differences regarding demographic variables in Isfahan, Iran.

Materials and Methods:

One thousand seven hundred and forty-one middle school students were studied in this cross-sectional study, in 2015, Isfahan. Knowledge, attitude, and pattern of PA were evaluated by a questionnaire. Data were described using central tendency and dispersion values, as well as t-test, Chi-square, ANOVA, and linear regression tests for further analysis.

Results:

Students living in Khour and Biabanak and Tiran got the highest and lowest scores in knowledge (mean ± standard deviation: 9 ± 1.32 and 6.7 ± 2.19, respectively). Education of the father is the only variable which was associated with the knowledge about PA after adjusting for other factors. About 62.5% of the students mentioned a good attitude toward PA. About 50% of the students said that they always and often do exercise. The most favorable exercise for all the students was walking.

Conclusion:

We provide the pattern of PA among middle school students of Isfahan province, which can be used to design evidence-informed policies and interventions that aim to increase PA in students.

Prevalence of modifiable cardiovascular risk factors in Yazd inner-city municipalities

Background

Cardiovascular disease (CVD) is the leading cause of death in the world. With effective intervention and control of cardiovascular risk factors, mortality rates may be reduced. The aim of this study was to investigate the prevalence of modifiable risk factors across five municipalities in Yazd city.

Methods

Ten thousand residents of the Yazd greater area aged 20–69 years were selected using cluster random sampling method. Overall, 200 clusters were randomly selected based on the postcodes of residents who lived in the five municipalities of Yazd. Those who lived in Yazd annexed cities and rural areas were excluded. A valid questionnaire was completed and physical examination performed as done (94.9% response rate). Instances of self-reported diabetes mellitus, high blood cholesterol, tobacco smoking, and unhealthy diet were recorded. Blood pressure, height, and weight were measured and physical activity was classified by International Physical Activity Questionnaire (IPAQ). A chi-square test was used to analyze the differences in variables across municipalities. Statistical analyses were performed using SPSS V. 16.

Results

We analyzed 8749 participants’ data from Yazd city. The prevalence of diabetes mellitus, hypercholesterolemia, and hypertension were 14.1, 16.7 and 18.6%, respectively. One in every four people consumed the recommended five servings of vegetables per day. Fish consumption was less than 5% at least once a week among participants. An unhealthy diet (85.7%); low physical activity (52.2%), hypertension (36.7%) and obesity (26.3%) were the most common cardiovascular risk factors. Only 2.1% of adults had no risk factors for CVD, and almost 75% of people had more than one risk factor. The prevalence of risk factors (excluding hypertension) was significantly different across the municipalities. Residents of region three had the highest prevalence of all risk factors aside from inactivity and unhealthy diet.

Conclusion

unhealthy dietary habits and inactivity are the most common modifiable risk factors of CVD in Yazd. Spatial variations of cardiovascular risk factors observed. This geographic health inequality requires more attention from policymakers to control CVD risk factors across different municipalities accordingly. Promoting healthy lifestyle is the top priority of health intervention programs. It is recommended to increase access to sport arenas and restrict access to tobacconist in high-risk areas.

Geographical Patterning of Physical Activity Prevalence in Iran: Spatial Analysis of 4 Pooled National Health Surveys Among 119,560 Adults

BACKGROUND

To investigate the geographical distribution of physical activity (PA) prevalence among adults aged 15-64 years old across Iran provinces using geographic maps.

METHODS

Data from 4 consecutive national surveys conducted between 2007 and 2010 were pooled to determine the geographical distribution. Prevalence of low PA with 95% confidence interval was estimated by sociodemographic subpopulations over provinces using complex survey design.

RESULTS

In total, 119,560 participants (49.9% females) were included in the analyses. The mean (SD) age of participants was 39.5 (14.3) years. The prevalence of the low PA in the pooled 2007-2010 was 35.8% (95% confidence interval, 34.1-37.6). The 3 provinces with the highest prevalence of low PA were Sistan and Baluchestan, Yazd, and Hormozgan. The results of hot spot analysis showed that the Kerman province was a hot spot, and Ilam, Kermanshah, Hamedan, and Markazi were cold spots for low PA. Ilam, Kohgiluyeh and Boyer-Ahmad, and Mazandaran had the highest total PA volume (metabolic equivalent minutes per week). Hot spot analysis showed that Ilam and Khuzestan provinces were hot spots for the total PA volume.

CONCLUSIONS

The regions with low and high PA are predominately situated in the near center/southeast and west, respectively.

Comparison of the clinical phenotype of systemic sclerosis patients in Iran and France in two university centers

OBJECTIVES

Systemic sclerosis is a severe and rare chronic auto-immune multisystem disorder characterized by vasculopathy and skin stiffness. Ethnic and geographical origin can influence the outcomes. In this study, we compared the phenotypic characteristics of Iranian and French patients.

METHODS

This cross-sectional study was performed on 200 Iranian and 268 French systemic sclerosis patients. Iranian patients collected from the Iranian systemic sclerosis cohort of the Rheumatology Research Center, Shariati hospital, Tehran University of Medical Sciences. The French population was monocentric, and it was constituted by the patients included locally in the EUSTAR database in December 2016.

RESULTS

The mean age at onset was significantly lower in Iranian patients (35.58 ± 11.68 vs 47.06 ± 13.54, p-value < 0.001). The female-to-male ratio was approximately 5.2:1 and was not different in the two populations. The prevalence of diffuse cutaneous systemic sclerosis was significantly higher in Iranian patients (60.2% vs 42.85%, p-value < 0.001). Calcinosis cutis and joint synovitis were more prevalent in French patients (p-value = 0.013, <0.001). The positivity of anti-topoisomerase antibody was higher in Iranian patients, whereas the anti-centromere antibody predominated in French cases (p-value < 0.001). Restrictive pattern of pulmonary function test was more common in Iranian patients (p-value < 0.001), while estimated pulmonary arterial pressure by echocardiography was higher in French patients (p-value < 0.001).

CONCLUSION

It seems that systemic sclerosis occurred in younger ages among Iranian female with the predominance of diffuse cutaneous subtype. In addition, lung interstitial disease appeared to be more prevalent and severe in Iranians than French patients.

The First Step of Health Policy-Making for Lifestyle Modifications at Middle Age: Problem Identification in 40- to 60-Year-Old Population, Northern Iran

Background

The purpose of this study was to determine the current situation of lifestyle behaviors and related outcomes, as the first step to make proper local health policies for improvement of health lifestyle behaviors.

Materials and Methods

This analytic research has been conducted as a cross-sectional study on the middle-aged (40-60 years old) population of Amirkola, Northern Iran. The Persian translation of the Health-Promoting Lifestyle Profile II questionnaire and the International Physical Activity Questionnaire were used for data collection. Also, anthropometric variables, blood pressure, fasting blood sugar, and serum lipids profile were examined.

Results

Three hundred one individuals have been enrolled in the study. Results showed that 10.6% of the participants had unhealthy lifestyle behaviors in the subdomain of spiritual growth; 46.8% in the subdomain of health responsibility; and 48.2% in the subdomains of stress management, physical activity, and nutrition; men had more physical activity than women (p < 0.001). Totally, 189 persons (63.9%) had serum cholesterol greater than or equal to 200 mg/dL; seventy-five individuals (25%) had high blood pressure. One hundred twenty-six persons (81.8%) of women and 103 (70.1%) of men were overweight or obese.

Conclusions

Health lifestyle behaviors in 40- to 60-year-old population need a proper intervention to improve the current situation.