Weight disorders and anthropometric indices according to socioeconomic status of living place in Iranian children and adolescents: The CASPIAN-IV study.
BACKGROUND
Excess weight in children and adolescents is a multi-factorial phenomenon and associated with earlier risk of obesity-related diseases. This study aims to assess the prevalence of weight disorders and the mean values of anthropometric indices according to regional, socioeconomic, and urban-rural variations among Iranian children and adolescents.


METHODS
This nationwide study was performed in 2011-2012 among a representative multi-stage cluster sample of 14,880 Iranian students aged 6-8 years. The World Health Organization (WHO) reference curves were used to define weight disorders. Abdominal obesity was defined as the waist-to-height ratio (WHtR) of more than 0.5. Iran was classified into four regions according to the socioeconomic status (SES).


RESULTS
The mean (95% confidence interval) of body mass index (BMI), waist circumference (WC), and hip circumference (HC) was 18.8 (18.7, 18.9) kg/m(2), 67.0 (66.7, 67.3) cm, and 80.8 (80.3, 81.2) cm, respectively. The prevalence of underweight was 12.2%. A total of 9.7%, 11.9%, and 19.1% of students overweight, obese, and abdominally obese, respectively. The highest mean of BMI, WC, wrist circumference, HC, and WHtR were related to the second high SES (North-northeast) area (19.2 [18.8, 19.5], 68.3 [67.3, 69.4], 14.8 [14.7, 15.0], 82.6 [81.1, 84.0], and 0.464 [0.460, 0.468]). In contrast, the lowest SES (Southeast) region had the lowest mean of these anthropometric indices (17.6 [17.1, 18.2], 63.2 [61.7, 64.8], 14.5 [14.2, 14.8], 76.9 [74.9, 79.0], and 0.439 [0.434, 0.444]).


CONCLUSIONS
We found considerable differences in the prevalence of anthropometric measures throughout the country by SES of the region. Health policy making and implementing health strategies should consider SES of regions.
Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Maryam
M
Bahreynian
Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Roya
R
Kelishadi
Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
Mostafa
M
Qorbani
Department of Pediatrics, Ahvaz University of Medical Sciences, Ahvaz, Iran.
Mohammad Esmaeil
ME
Motlagh
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Amir
A
Kasaeian
Department of School Health, Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran.
Gelayol
G
Ardalan
Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran.
Tahereh Arefi
TA
Rad
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Fereshteh
F
Najafi
Department of Medical Emergency, Qom University of Medical Sciences, Qom, Iran.
Hamid
H
Asayesh
Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Ramin
R
Heshmat
Anthropometric measures; obesity; socioeconomic status; underweight