title: Prevalence of General and Abdominal Obesity in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study.
abstract: BACKGROUND
  Pediatric obesity is one of the predisposing risk factors for many non-communicable diseases.
  
  
  OBJECTIVE
  The purpose of this study was to estimate the national prevalence of general and abdominal obesity among Iranian children and adolescents.
  
  
  METHODS
  This cross-sectional nation-wide study was performed in 30 provinces in Iran among 14880 school students aged 6 - 18 years, selected by multistage random cluster sampling. The World Health Organization growth curve was used to categorize Body Mass Index (BMI). Obesity was defined as BMI equal to or higher than the age- and gender-specific 95(th) percentile; abdominal obesity was considered as waist-to-height ratio of more than 0.5.
  
  
  RESULTS
  Data of 13486 out of 14880 invited students were complete (response rate of 90.6%). They consisted of 6543 girls and 75.6% urban residents, and had a mean age of 12.45 (95% CI: 12.40 - 12.51) years. The prevalence rate of general and abdominal obesity was 11.89% (13.58% of boys vs. 10.15% of girls) and 19.12% (20.41% of boys vs. 17.79% of girls), respectively. The highest frequency of obesity was found in the middle school students (13.87% general and 20.84% abdominal obesity). The highest prevalence of general obesity was found in Boushehr (19%) followed by Guilan and Mazandaran (18.3%, 18.3%), while the lowest prevalence was observed in Hormozgan (2.6%). The highest frequency of abdominal obesity was found in Mazandaran (30.2%), Ardabil (29.2%) and Tehran (27.9%). Provinces such as Sistan-Baloochestan (8.4%), Hormozagan (7.4%), and Kerman (11.4%) had the lowest prevalence of abdominal obesity. The Southern and South Eastern provinces had the lowest prevalence of general obesity (2.6% and 5.6%) and abdominal obesity (7.4% and 8.8%). Moreover, the highest prevalence of obesity was found in North and North West Iran by maximum frequency of 18.3% general obesity and 30.2% of abdominal obesity.
  
  
  CONCLUSIONS
  The results showed a high prevalence of general and abdominal obesity among boys living in the Northern provinces of Iran. The present study provides insights that policy makers should consider action-oriented interventions for prevention and control of childhood obesity at national and sub-national level.
authors.affiliation: Department of Nutrition, Child Growth, Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Diseases, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Haleh
authors.initials: H
authors.lastname: Esmaili
authors.affiliation: Department of Nutrition, Child Growth, Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Diseases, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Bahreynian
authors.affiliation: Department of Public Health, Alborz University of Medical Sciences, Karaj, IR Iran ; Department of Epidemiology, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
authors.affiliation: Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.
authors.forename: Mohammad Esmaeel
authors.initials: ME
authors.lastname: Motlagh
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Diseases, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.affiliation: Chronic Diseases Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Diseases, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
keywords: Adolescent; Child; Iran; Obesity; Overweight; Prevalence