ReviewTrend in the prevalence of obesity and overweight among Iranian children and adolescents: A systematic review and meta-analysis
Introduction
The epidemic of non-communicable diseases (NCD) is a global problem that is expected to rise considerably in low- and middle-income countries [1], [2]. Excess weight is one of the most common risk factors for most NCDs. A growing body of evidence exists about the worldwide increase in mean body mass index (BMI) [3], as well as the prevalence of obesity and overweight [4], with substantial variation in levels and trends in different countries. Excess weight is not limited to adults, and it has become an emerging health problem in the pediatric age group, even in developing countries [5], [6].
Of special concern in this regard is the situation in the Middle East and North Africa (MENA), which is facing a double burden of nutritional disorders. The epidemiologic transition, lifestyle changes, and considerably high prevalence of obesity has led the Middle Eastern population to face the greatest global burden of NCDs, notably diabetes [7] and cardiovascular diseases [8]. As a country in this region, Iran has a high prevalence of obesity and related disorders, such as metabolic syndrome and diabetes in different age groups [9], [10], [11]. Such disorders pose high costs to the health care system. For instance, the total national cost of diagnosed diabetes mellitus in 2009 in Iran was estimated as high as U.S.$3.78 billion [12]. Therefore, prevention and early control of the risk factors associated with NCDs is a public health priority in Iran.
Childhood obesity is considered one of the major predisposing factors of most NCDs [13], [14]. Therefore, having an insight on the prevalence and trend of childhood overweight and obesity can provide evidence-based information for health policymakers at national and international levels in order to implement programs for primordial and primary prevention of NCDs.
In recent years, various prevalence rates for childhood overweight and obesity have been reported; however, as Iran is the 18th-largest country in the world, with an area of 1 648 195 km2, and a population of around 75 million, it is necessary to condense the existing information to gain a general perception on this situation among Iranian children and adolescents. As the first report of its kind in MENA, the aim of this review was to assess the trend in the prevalence of childhood obesity and overweight in Iran, using systematic review and meta-analysis.
Section snippets
Search strategy
We searched multiple international (MEDLINE through PubMed and Scopus) and Iranian scientific databases (Scientific Information Database [SID] and IranMedex) for English and Persian language studies published between October 2007 and August 2012 that contained data on the prevalence of obesity and/or overweight among Iranian children and adolescents. The literature was searched combining keywords from the following concepts: the population (children, students, and adolescents and their related
Study selection and characteristics
Our electronic search yielded 2 330 papers, of which 916 duplicate papers retrieved from more than one database were excluded. In the first (title evaluation) and second phase (abstract evaluation), 864 and 337 papers were excluded, respectively. Checking references and screening relevant studies from previous meta-analysis [16] resulted in 28 more papers being discovered. Finally, 241 papers were further assessed in full text; of these, 107 articles (49 English and 58 Persian) were included in
Discussion
This systematic review and meta-analysis has provided a precise estimate for the trend of obesity and overweight by age group and sex in Iranian children and adolescents. We documented various trends for overweight and obesity among different age groups of the Iranian pediatric population; in general, our findings revealed a higher increase in the trend of excess weight in children ages 2 to 6 and 7 to 11 y than in older age groups. This finding may suggest that younger children are getting
Conclusion
This review, which is likely the first of its kind in the MENA region, appraised and synthesized a large number of studies. By calculating a pooled average result across studies, this study provides research evidence on the trend of obesity and overweight among Iranian children. The escalating trend of excess weight among young children is alarming and provides information for policymakers and health care providers at national and regional levels for preventive programs and interventions.
Acknowledgments
This study was funded by Isfahan University of Medical Sciences.
References (134)
- et al.
National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants
Lancet
(2011) - et al.
In-school snacking, breakfast consumption, and sleeping patterns of normal and overweight Iranian high school girls: a study in urban and rural areas in Guilan
Iran. J Nutr Educ Behav
(2009) - et al.
The burden of non-communicable diseases in developing countries
Int J Equity in Health
(2005) - Department of Public Information. Non-communicable diseases deemed development challenge of “epidemic proportions” in...
- et al.
National, regional, and global trends in adult overweight and obesity prevalences
Popul Health Metr
(2012) - et al.
Childhood obesity and the metabolic syndrome in developing countries
Indian J Pediatr
(2013) Childhood overweight, obesity, and the metabolic syndrome in developing countries
Epidemiol Rev
(2007)- et al.
Global prevalence of diabetes: estimates for the year 2000 and projections for 2030
Diabetes Care
(2004) - et al.
Nutrition transition and cardiovascular disease risk factors in Middle East and North Africa countries: reviewing the evidence
Ann Nutr Metab
(2010) - et al.
First nationwide study of the prevalence of the metabolic syndrome and optimal cutoff points of waist circumference in the Middle East: the national survey of risk factors for noncommunicable diseases of Iran
Diabetes Care
(2009)
Prevalence of type 2 diabetes in the Islamic Republic of Iran: systematic review and meta-analysis
East Mediterr Health J
Paediatric metabolic syndrome and associated anthropometric indices: the CASPIAN Study
Acta Paediatr
Cost-of-illness analysis of type 2 diabetes mellitus in Iran
PLoS One
Relation of childhood obesity/cardiometabolic phenotypes to adult cardiometabolic profile: the Bogalusa Heart Study
Am J Epidemiol
The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review
Obes Rev
Systematic review of psychiatric disorders among Iranian adult general population
Iran J Psychiatry
The prevalence of obesity in Iran in recent decade; a systematic review and meta-analysis study
Iran J Public Health
WHO Child Growth Standards based on length/height, weight and age
Acta Paediatr Suppl
Establishing a standard definition for child overweight and obesity worldwide: international survey
BMJ
Changes in prevalence of overweight among children and adolescents in Tehran: comparing three different definitions
RJMS
Guidelines for evaluating prevalence studies
Evid Based Ment Health
The growth pattern among elementary school students in Kermanshah, Iran
J Isfahan Med
Prevalence of obesity, overweight and underweight among elementary school children in Southern Iran, 2009
Am J Applied Sci
Prevalence of overweight, obesity and underweight among high school students in Sanandaj: 2006–2007
Iranian J Endocrinol Metab
Prevalence and risk factors of obesity and overweight among primary school children in Yazd
J Shaheed Sadoughi Uni Med Sci & Health Serv
Study of obesity levels among school students
Payesh J
Prevalence of underweight, overweight and obesity among high school girls in Isfahan
Health Syst Res
Prevalence of overweight and obesity among junior high school students in a district of Tehran
J Res Med Sci
The relationship between overweight and obesity and economical status in Tehran girls students
Res Sport Sci J
Prevalence of obesity and overweight among school children in Bandar Abbas, 2008
J Hormozgan Univ Med Sci
Prevalence of obesity and overweight among 7–14 years old students in the city of Ahwaz
Med J Ahvaz Univ Med Sci
The relationship of body mass index and blood pressure in Iranian children <7 years old
J Trop Pediatr
Prevalence of obesity among schoolchildren in Iran
Obes Rev
The relation between obesity, physical activity and socioeconomic status among girl students living in northern Tehran
Feyz J Kashan Univ Med Sci
The association between household food insecurity and childhood obesity among Iranian school-aged children in Farokhshahr
Koomesh J Semnan Univ Med Sci
Prevalence of obesity among school children in Neishabour (2005)
J Ghazvin Univ Med Sci
Pattern of fat distribution (waist to hip ratio) and its relationship with BMI among high school girls in Lahijan
Iranian J Endocrinol Metab
Obesity and related factors in 7–12 year-old elementary school students during 2009–2010 in Sari, Iran
Med Glas (Zenica)
The study of the body mass index and physical activity among 11–14 year-old adolescent boys in Khooshab
Knowledge Health J
The association of overweight and obesity with menarche age and nutritional status in girls aged 11–15 in Mashhad
Med J Mashhad Univ Med Sci
Relationship between anthropometric parameters with menarche age of school girls (11–14 years old) in Shahroud
Knowledge Health J
Comparison of body mass index and the intake of energy and some nutrients with reference values in female secondary school students in Semnan
Payesh J
The prevalence of obesity and its association with the parents obesity in primary school girls in Tehran in 2002
Tehran Univ Med J
Mohammad Pour Ahranjani B, Siassi F. Determination of the most relevant body mass index standard reference to define obese Iranian school age children
Iranian J Nutr Sci Food Tech
Obesity in Iranian children
Arch Dis Child
The prevalence of obesity and its relative factors among less than 5 years aged children, Bandar Turkmen district, Iran
J Kerman Univ Med Sci
Trends of overweight and obesity among 14–18 years old urban adolescent girls among senior high schools, Ahvaz, Iran
Iranian J Diabetes Lipid Disord
Screening cardiovascular risk factors in high risk families: a study based the partnership model among students
Iranian J Diabetes Lipid Disord
Relationship of body mass index with serum lipids in elementary school students
Indian J Pediatr
Cited by (0)
The literature search, data extraction and analysis were done by RK and BS. All authors contributed equally to development of search strategy, interpreting the results, and development of paper. The authors report no conflict of interest.