Overweight and Obesity among Preschool Children from Fars Province of Iran: Prevalence and Associated Factors

BACKGROUND

The global prevalence of overweight and obesity had risen in recent decades, and obesity is taken into consideration as a public health concern and a major risk factor of common chronic disease. The objective of the present study was to estimate the prevalence of overweight and obesity and to identify its underlying factors among children 2-6 yr of age in Fars Province, southern Iran.

METHODS

A total of 8911 children, aged 2-6 yr age, were selected thorough multi-stage sampling in 30 cities of Fars Province in 2012-13. Overweight and obesity status was assessed through comparison by standard BMI for age and for sex percentiles (NCHS/CDC). In addition, socio-demographic measures obtained from structured questionnaire were compared between normal and overweight plus obese (ow/ob) groups. We used backward stepwise Logistic Regression, Chi-square and Independent sample t-test to relate the underlying factors to the nutritional indices.

RESULTS

The prevalence of overweight and obesity was 5.7% (95% CI: 5.2%, 6.1%) and 5.2% (95% CI: 4.7%, 5.6%), respectively. The ow/ob was significantly correlated with male sex, urbanization, type of father's occupation, universal education of mothers, the higher birth weight, low access to household facilities, and not using health-care services (P<0.05). Besides, the logistic regression analysis showed urbanization (OR=1.46, CI: 1.26, 1.70), second sibling (OR=1.183, CI: 1.00, 1.39), and less access to a variety of food groups (OR=1.32, CI: 1.05, 1.65) as ow/ob risk factors.

CONCLUSIONS

The rate of overweight and obesity in the study population is at an alarming level. Therefore, a preventive program is needed to control ow/ob since early childhood considering the underlying factors for each region and individual groups.

Prevalence and determinants of under-nutrition among children under six: a cross-sectional survey in Fars province, Iran

BACKGROUND

Childhood malnutrition as a major public health problem among children in developing countries can affect physical and intellectual growth and is also considered as a main cause of child morbidity and mortality. The objective of this study was to estimate the prevalence of under-nutrition and identify determinants of malnutrition among children under 6 years of age in Fars province, Iran.

METHODS

This survey was conducted by house to house visit through multi-stage sampling in 30 cities of Fars province, during December 2012 to January 2013. A total of 15408 children, aged 0-6 years old, were studied for nutritional assessment in terms of underweight, stunting, and wasting. Also, socio-demographic measures were obtained from structured questionnaire. Backward stepwise logistic regression was used to relate underlying factors to the odds of under-nutrition indices.

RESULTS

The rates of stunting, underweight, and wasting were 9.53, 9.66, and 8.19%, respectively. Male children were more stunted compared to females (OR= 1.41, CI: 1.26-1.58). Also, stunting was significantly associated with lower family income (OR= 3.21, CI: 1.17-8.85) and lower maternal education (OR= 0.80, CI: 0.64-0.98). Living in urban areas, and poor water supply were identified as significant risk factors of all three types of childhood under-nutrition. Moreover, Khamse and Arab ethnic groups were more vulnerable to under-nutrition. There was a suggestion that non-access to health services were associated with wasting (OR= 1.87, CI: 1.39-2.52) and also large family size was related to underweight (OR= 1.35, CI: 1.10-1.65).

CONCLUSION

The prevalence of under-nutrition in the study population was categorized in low levels. However, planning the public preventive strategies can help to control childhood under-nutrition according to underlying factors of malnutrition in the study population including gender, settlement area, family size, ethnicity, family income, maternal education, health services, and also safe water supply.

To assess the effects of nutritional intervention based on advocacy approach on malnutrition status among school-aged children in Shiraz

BACKGROUND

The present study was carried out to assess the effects of community nutrition intervention based on advocacy approach on malnutrition status among school-aged children in Shiraz, Iran.

MATERIALS AND METHODS

This case-control nutritional intervention has been done between 2008 and 2009 on 2897 primary and secondary school boys and girls (7-13 years old) based on advocacy approach in Shiraz, Iran. The project provided nutritious snacks in public schools over a 2-year period along with advocacy oriented actions in order to implement and promote nutritional intervention. For evaluation of effectiveness of the intervention growth monitoring indices of pre- and post-intervention were statistically compared.

RESULTS

The frequency of subjects with body mass index lower than 5% decreased significantly after intervention among girls (P = 0.02). However, there were no significant changes among boys or total population. The mean of all anthropometric indices changed significantly after intervention both among girls and boys as well as in total population. The pre- and post-test education assessment in both groups showed that the student's average knowledge score has been significantly increased from 12.5 ± 3.2 to 16.8 ± 4.3 (P < 0.0001).

CONCLUSION

This study demonstrates the potential success and scalability of school feeding programs in Iran. Community nutrition intervention based on the advocacy process model is effective on reducing the prevalence of underweight specifically among female school aged children.

Mercury exposure among residents of a building block in Shiraz, Iran

Exposure to mercury can cause serious multiorgan damage affecting the central nervous system, kidneys, liver, lungs, spleen, bone marrow, and skin. At the end of the summer of 1999, the accidental leakage of 4 liters of mercury from a container into the waterway canals resulted in mass exposure to elemental mercury among the residents of a building block of a residential area of the city of Shiraz, in the south of Iran. One hundred and eleven individuals who experienced exposure to elemental mercury were investigated. Twenty-four-hour measurement of the urine mercury level-revealed a toxic level of more than 20 microg/L in 6 children and 3 adults (including a pregnant woman). Despite normal physical and laboratory (CBC, renal and liver function tests, and urinalysis) findings, dimercaprol was prescribed. One month later during the course of the follow-up the urine mercury level in 6 patients, including the pregnant woman from the same family, was found to be again at a toxic level. The pregnant mother from the same family aborted her fetus; however, due to the lack of equipment for measuring the serum mercury level, it was not possible to confirm the relation between the mercury toxicity and the abortion. This family had kept mercury in their kitchen against health workers' instructions. The attractive physical and chemical properties of mercury could explain the continuity of exposure and poisoning in these 6 cases. It is concluded that prophylactic therapy in the presence of toxic levels of mercury, despite the presence of an asymptomatic state in exposed residents, is effective in preventing the development of signs and symptoms, though instruction of high-risk cases is the best way to combat it.