title: Heart Disease Is Associated With Anthropometric Indices and Change in Body Size Perception Over the Life Course: The Golestan Cohort Study.
abstract: BACKGROUND
  Cardiovascular disease and obesity are now becoming leading causes of morbidity and mortality in low- and middle-income countries.
  
  
  OBJECTIVE
  We investigated the relationship between prevalent heart disease (HD) and current anthropometric indices and body size perception over time from adolescence to adulthood in Iran.
  
  
  METHODS
  We present a cross-sectional analysis of baseline data from a prospective study of adults in Golestan Province, Iran. Demographics, cardiac history, and current anthropometric indices-body mass index, waist circumference, and waist to hip ratio-were recorded. Body size perception for ages 15 years, 30 years, and at the time of interview was assessed via pictograms. Associations of these factors and temporal change in perceived body size with HD were evaluated using multivariable logistic regression models.
  
  
  RESULTS
  Complete data were available for 50,044 participants; 6.1% of which reported having HD. Higher body mass index, waist circumference, and waist to hip ratio were associated with HD (p < 0.001). Men had a U-shaped relationship between HD and body size perception at younger ages. For change in body size perception, men and women demonstrated a U-shaped relationship with prevalent HD from adolescence to early adulthood, but a J-shaped pattern from early to late adulthood.
  
  
  CONCLUSIONS
  HD was associated with anthropometric indices and change in body size perception over time for men and women in Iran. Due to the increasing prevalence of overweight and obesity in low- and middle-income countries, interventions focused on decreasing the cumulative burden of risk factors throughout the life course may be an important component of cardiovascular risk reduction.
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Vaani P
authors.initials: VP
authors.lastname: Garg
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: rajesh.vedanthan@mssm.edu.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Vedanthan
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA; Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Islami
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Akram
authors.initials: A
authors.lastname: Pourshams
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Poutschi
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; International Agency for Research on Cancer, Lyon, France.
authors.forename: Hooman
authors.initials: H
authors.lastname: Khademi
authors.affiliation: Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Naeimi
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Akbar Fazel-Tabar
authors.initials: AF
authors.lastname: Malekshah
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Jafari
authors.affiliation: Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Rasool
authors.initials: R
authors.lastname: Salahi
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA.
authors.forename: Farin
authors.initials: F
authors.lastname: Kamangar
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Arash
authors.initials: A
authors.lastname: Etemadi
authors.affiliation: Departments of Oncology and Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Pharoah
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Sanford M
authors.initials: SM
authors.lastname: Dawsey
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA; Centro Nacional de Investigaciones Cardiovasculares, Calle de Melchor Fernandez Almagro, Madrid, Spain.
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuster
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA; International Prevention Research Institute, Lyon, France.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D006331:Heart Diseases / Q000523:psychology*; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012649:Self Concept; D017678:Sex Distribution; D012858:Size Perception; D055105:Waist Circumference; D055815:Young Adult