Trend of Stunting, Overweight and Obesity among Children Under Five Years in a Rural Area in Northern Iran, 1998-2013: Results of Three Cross-Sectional Studies.
BACKGROUND
Obesity is a common health problem in the world and the purpose of this study was to identify the trend of overweight, obesity and stunting among children under five from 1998 to 2013 that was carried out in three stages in the villages of Golestan province in the northern Iran (south east of the Caspian Sea).


METHODS
Three cross-sectional studies with sample sizes of 7575, including 2339, 2749 and 2487 cases were carried out in 1998, 2004 and 2013, respectively. Among 118 villages, 20 were chosen by random sampling and all of the under-five-children in these villages were assessed. For all subjects, a questionnaire was completed and anthropometric indices were measured. Z-score was used for body index classification with following categories: Z≤ 2SD=Normal or under-nutrition; >2SD Z ≤3SD = Overweight and Z>3SD = Obesity. P-value under 0.05 indicated significance.


RESULTS
In 1998, 2004 and 2013, the prevalence of overweight was 8.5% (95% CI; 7.3-9.6), 3.3% (95% CI; 2.7-4.0) and 5.2% (95% CI; 4.2-6.1), that of obesity was 4.6%(95% CI; 3.8-3.5), 1.2% (95% CI; 0.8-1.6) and 3.5% (95% CI; 2.8-4.3), and that of stunting was 32.8% (95% CI; 31.0-34.6), 13.4% (95% CI; 12.2-14.6) and 15.7% (95% CI;14.3-17.2), respectively. In boys, the mean of height was significantly different in all age groups while the mean of weight was significant only at ages 13-24, 37-48 and 49-60 months (P < 0.005 for all). In girls, the mean of height significantly different from 36 months age (P < 0.01) whereas weight difference was significant only at age of 37-48 months (P = 0.002).


CONCLUSIONS
A heterogenic trend was seen in stunting, overweight and obesity. Although short stature was the main cause of obesity in 1998, extra weight was its major cause in 2013. Renewed increase of obesity among children under-five is considerable in the northern Iran.
Assistant Prof. in Nutrition and Faculty member of Golestan University of Medical Sciences, Gorgan, Iran.
Gholamreza
G
Veghari
Associate Prof. in Biostatistics and Faculty member of Golestan University of Medical Sciences, Gorgan, Iran.
Mohammadali
M
Vakili
D017677:Age Distribution; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology*; D012424:Rural Population; D017678:Sex Distribution