Elsevier

Nutrition

Volume 30, Issue 4, April 2014, Pages 393-400
Nutrition

Review
Trend in the prevalence of obesity and overweight among Iranian children and adolescents: A systematic review and meta-analysis

https://doi.org/10.1016/j.nut.2013.08.011Get rights and content

Abstract

Objective

Childhood obesity is an important predisposing factor for most non-communicable diseases. The aim of this review was to provide evidence on the prevalence and trends of childhood obesity and overweight in Iran.

Methods

Multiple international and Iranian scientific databases were searched for relevant literatures. Two independent reviewers identified relevant papers in several steps. Separate meta-analyses (using fixed- or random-effect models) were performed to estimate the overall, age, sex, and age–sex specific prevalence of obesity and overweight. Stratified analysis based on Centers for Disease Control and Prevention, International Obesity Task Force, and World Health Organization definition criteria and study year also were performed.

Results

We included 107 studies in the meta-analysis (49 English and 58 Persian). Based on Centers for Disease Control and Prevention definition criteria, the overall prevalence of obesity and overweight remained relatively constant in the 2000s and are estimated to be about 5.1% (95% confidence interval [CI], 4.4–5.8) and 10.8% (95% CI, 10.2–11.4), respectively. The meta-regression analysis showed that the prevalence of obesity and overweight did not vary significantly with respect to sex and age of study participants. Girls had a lower prevalence of obesity and higher prevalence of overweight than boys.

Conclusion

This review, which is the first of its kind in the Middle East and North Africa, suggests that although the trend in the prevalence of childhood obesity in Iranian children is not considerably high, but the escalating trend of excess weight among young children is alarming and should be considered by providers of interventional preventive programs at national and regional levels.

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.

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  • 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.

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