Main Article Content
Introduction: Obesity is an important health concern worldwide and is a growing problem in Iran. Adolescent obesity has a major role in development of adulthood obesity and its complications. The present study was conducted to evaluate the prevalence of overweight, obesity, and associated risk factors in female adolescents living in Tehran, Iran.
Methods: This cross-sectional study was carried out among 2,132 female adolescents aged 14-17 years in Tehran recruited between 2017 and 2018. Weight and height were measured and body mass index (BMI) was calculated. Underweight, overweight, and obesity were considered as < 5th, ? 85th, and ? 95th percentile, respectively, of CDC BMI-for age and sex criteria. Adolescents and their mothers filled in the questionnaires on physical activity, computer use, duration of breastfeeding, total sleep time, and family socioeconomic status. Statistical analysis was performed using SPSS version 22.0 software. P < 0.05 was considered statistically significant.
Results: The overall prevalence rates of overweight and obesity were 24.1% and 6.5%, respectively. The prevalences of overweight and obesity were highest in the South District (28.9% and 7.7%, respectively) and were lowest in the North District (19.1% and 5.2%, respectively). There were significant differences in physical activity level (P < 0.001), total sleep time (P < 0.001), duration of breastfeeding (P < 0.01), and daily computer use (P < 0.001) among the four groups (underweight, normal, overweight, and obese). Regarding the socioeconomic status, parental education level and economic status were significantly higher in those who had normal weight compared to other weight groups (in both, P < 0.001).
Conclusion: This study showed that overweight and obesity among female adolescents in Tehranhave become a major public health concern. Level of physical activity, computer use, sleep duration, breastfeeding duration, levels of parental education, and economic status were associated with overweight and obesity prevalence.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Revised 7/16/2018. Revision Description: Removed outdated link.
Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–781.
Smetanina N, Albaviciute E, Babinska V, Karinauskiene L, Albertsson-Wikland K, Petrauskiene A, Verkauskiene R. Prevalence of overweight/obesity in relation to dietary habits and lifestyle among 7-17 years old children and adolescents in Lithuania. BMC Public Health. 2015 Oct 1;15:1001.
Berenson GS, Srinivasan SR, Bao W, Newman 3rd WP, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998;338(23):1650–6.
Rachmi CN, Li M, Alison Baur L. Overweight and obesity in Indonesia: prevalence and risk factors-a literature review. Public Health. 2017 Jun;147:20-29.
Eckel RH, Krauss RM. American heart association call to action: obesity as a major risk factor for coronary heart disease. Circulation 1998; 97: 2099–2100.
Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, Et al. Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017 Mar 1;102(3):709-757.
Weber M, Grote V, Closa-Monasterolo R et al. Lower protein content in infant formula reduces BMI and obesity risk at school age: follow-up of a randomized trial. Am J ClinNutr. 2014; 99(5):1041-51.
Morales Camacho WJ, Molina Díaz JM, Plata Ortiz S, Plata Ortiz JE, Morales Camacho MA, Calderón BP. Childhood obesity: Aetiology, comorbidities, and treatment. Diabetes Metab Res Rev. 2019 Jul 12:e3203.
Mirzaeian S, Fakhari M, Hosseini R, hassanzadeh A, Esmaillzadeh A. Association between duration of breastfeeding and subsequent overweight and obesity in female adolescents . Iranian Journal of Nutrition Sciences & Food Technology. 2011; 6 (2).
CDC Growth Charts: United States Percentile Data Files with LMS Values [On line]; Available from: URL: http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/datafiles.htm. Accessed on December 19, 2019.
Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund UL, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Medicine & Science in Sports & Exercise. 2003 Aug 1;35(8):1381-95.
Abiri B, Vafa M, Sarbakhsh P, saleck L, Mousavi E, Amiri F, Amiri Z. The Association of Intelligence Quotient with Obesity and Some Related Factors in Children Girls. Progr Nutr [Internet]. 2018Dec.11 [cited 2019Aug.16];20(2-S):218-24.
Moayeri H, Bidad K, Aghamohammadi A, Rabbani A, Anari S, Nazemi L, Gholami N, Zadhoush S, Hatmi ZN. Overweight and obesity and their associated factors in adolescents in Tehran, Iran, 2004-2005. Eur J Pediatr. 2006 Jul;165(7):489-93.
Amini, M., Omidvar, N., & Kimiagar, M. (2007). Prevalence of overweight and obesity among junior high school students in a district of Tehran. Journal Of Research In Medical Sciences, 12(6), 315-319.
Wabitsch M, Moss A, Kromeyer-Hauschild K. Unexpected plateauing of childhood obesity rates in developed countries. BMC Med. 2014;12(1):17.
Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806–814.
Jaacks LM, Slining MM, Popkin BM. Recent trends in the prevalence of under- and overweight among adolescent girls in low- and middle-income countries. Pediatr Obes. 2015;10(6):428–435.
Ghassemi H, Harison G, Mohammad K (2002) An accelerated nutrition transition. Public Health Nutr 5:149–155.
Mohammadpour-Ahranjani B, Rashidi A, Karandish M, Eshraghian MR, Kalantari N (2003) Prevalence of overweight and obesity in adolescent Tehrani students, 2000–2001: an epidemic health problem. Public Health Nutr 7:645–648.
Rashidi A, Mohammadpour-Ahranjani B, Vafa MR, Karandish M (2005) National prevalence of obesity-prevalence of obesity in Iran. Obes Rev 6:191–192.
Herman KM, Sabiston CM, Mathieu ME, Tremblay A, Paradis G. Sedentary behavior in a cohort of 8- to 10-year-old children at elevated risk of obesity. Prev Med. 2014;60:115–20.
Nitzan Kaluski D, Demem Mazengia G, Shimony T, Goldsmith R, Berry EM. Prevalence and determinants of physical activity and lifestyle in relation to obesity among schoolchildren in Israel. Public Health Nutr. 2009;12(6):774–82.
Groholt EK, Stigum H, Nordhagen R. Overweight and obesity among adolescents in Norway: cultural and socio-economic differences. J Public Health (Oxf). 2008;30(3):258–65.
Lissner L, Lanfer A, Gwozdz W, Olafsdottir S, Eiben G, Moreno LA, et al. Television habits in relation to overweight, diet and taste preferences in European children: the IDEFICS study. Eur J Epidemiol. 2012;27(9):705–15.
Stubbs CO, Lee AJ (2004) The obesity epidemic: both energy intake and physical activity contribute. Med J Aust 181:489–491.
Zive MM, McKay H, Frank-Spohrer GC, Broyles SL, Nelson JA, Nader PR. Infant-feeding practices and adiposity in 4-y-old Anglo- and Mexican-Americans. Am J Clin Nutr 1992;55:1104-1108.
Bergmann KE, Bergmann RL, Von Kries R, Böhm O, Richter R, Dudenhausen JW, et al. Early determinants of childhood overweight and adiposity in a birth cohort study: role of breast-feeding. Int J Obes Relat Metab Disord 2003;27:162-172.
Elliott KG, Kjolhede CL, Gournis E, Rasmussen KM. Duration of breastfeeding associated with obesity during adolescence. Obes Res 1997;5:538-541.
Grummer-Strawn LM, Mei Z. Does breastfeeding protect against pediatric overweight? Analysis of longitudinal data from the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System. Pediatrics 2004;113:e81-86.
Ariza AJ, Chen EH, Binns HJ, Christoffel KK. Risk factors for overweight in fi ve- to six-year-old Hispanic American children: a pilot study. J Urban Health 2004;81:150-161.
Wadsworth M, Marshall S, Hardy R, Paul A. Breast feeding and obesity. Relation may be accounted for by social factors. BMJ 1999;319:1576.
Kramer MS. Do breast-feeding and delayed introduction of solid foods protect against subsequent obesity? J Pediatr 1981;98:883-887.
von Kries R, Koletzko B, Sauerwald T, von Mutius E, Barnert D, Grunert V, et al. Breast feeding and obesity: cross sectional study. BMJ 1999;319:147-150.
Strbak V, Skultetyova M, Hromadova M, Randuskova A, Macho L. Late effects of breast-feeding and early weaning: seven-year prospective study in children. Endocr Regul 1991;25:53-57.
Fallahzadeh H, Golestan M, Rezvanian T, Ghasemian Z. Breast-feeding history and overweight in 11 to 13-year-old children in Iran. World J Pediatr. 2009 Feb;5(1):36-41.
Hall B. Changing composition of human milk and early development of an appetite control. Lancet 1975;1:779-781.
Liese AD, Hirsch T, von Mutius E, Keil U, Leupold W, Weiland SK. Inverse association of overweight and breast feeding in 9 to 10-y-old children in Germany. Int J Obes Relat Metab Disord 2001;25:1644-1650.
Lucas A, Sarson DL, Blackburn AM, Adrian TE, Aynsley- Green A, Bloom SR. Breast vs. bottle: endocrine responses are different with formula feeding. Lancet 1980;1:1267-1269.
Oakley JR. Differences in subcutaneous fat in breast- and formula-fed infants. Arch Dis Child 1977;52:79-80.
Odeley OE, de Courten M, Pettitt DJ, Ravussin E. Fasting hyperinsulinemia is a predictor of increased body weight gain and obesity in Pima Indian children. Diabetes 1997;46:1341-1345.
Ravelli AC, van der Meulen JH, Osmond C, Barker DJ, Bleker OP. Infant feeding and adult glucose tolerance, lipid profi le, blood pressure, and obesity. Arch Dis Child 2000;82:248-252.
Kim J, Noh JW, Kim A, Kwon YD. Relationships between Sleep Patterns, Health Risk Behaviors, and Health Outcomes among School-Based Population of Adolescents: A Panel Analysis of the Korean Children and Youth Panel Survey. Int J Environ Res Public Health. 2019 Jun 27;16(13).
Martinez, S.M.; Tschann, J.M.; Butte, N.F.; Gregorich, S.E.; Penilla, C.; Flores, E.; Greenspan, L.C.; Pasch, L.A.; Deardor_, J. Short sleep duration is associated with eating more carbohydrates and less dietary fat in Mexican American children. Sleep 2017, 40, 1–7.
Nixon, G.M.; Thompson, J.M.D.; Han, D.Y.; Becroft, D.M.; Clark, P.M.; Robinson, E.; Waldie, K.E.; Wild, C.J.; Black, P.N.; Mitchell, E.A. Short sleep duration in middle childhood risk factors and consequences. Sleep 2011, 31, 71–78.
O’Brien, E.M.; Mindell, J.A. Sleep and risk-taking behavior in adolescents. Behav. Sleep Med. 2005, 3, 113–133.
Sung, V.; Beebe, D.W.; VanDyke, R.; Fenchel, M.C.; Crimmins, N.A.; Kirk, S.; Hiscock, H.; Amin, R.; Wake, M. Does sleep duration predict metabolic risk in obese adolescents attending tertiary services? A cross-sectional study. Sleep 2011, 34, 891–898.
Wheaton, A.G.; Chapman, D.P.; Croft, J.B. Self-reported sleep duration and weight-control strategies among US high school students. Sleep 2013, 36, 1139–1145.
Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med 2004;1:e62.
Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004;141:846–50.
Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet 1999;354:1435-9.
Z Shi, M McEvoy, J Luu and J Attia. Dietary fat and sleep duration in Chinese men and women. International Journal of Obesity (2008) 32, 1835–1840.
Marie-Pierre St-Onge, Andrew McReynolds, Zalak B Trivedi, Amy L Roberts, Melissa Sy, and Joy Hirsch. Sleep restriction leads to increased activation of brain regions sensitive to food stimuli. Am J Clin Nutr 2012;95:818–24.
Valdes Pizarro J, Royo-Bordonada MA. Prevalence of childhood obesity in Spain: National Health Survey 2006–2007. Nutr Hosp. 2012;27(1):154–60.
O'Dea JA, Amy NK. Perceived and desired weight, weight related eating and exercising behaviours, and advice received from parents among thin, overweight, obese or normal weight Australian children and adolescents. Int J Behav Nutr Phys Act. 2011;8:68.
Parikka S, Maki P, Levalahti E, Lehtinen-Jacks S, Martelin T, Laatikainen T. Associations between parental BMI, socioeconomic factors, family structure and overweight in Finnish children: a path model approach. BMC Public Health. 2015;15:271.
Pinard CA, Davy BM, Estabrooks PA. Beverage intake in low-income parent– child dyads. Eat Behav. 2011;12(4):313–6.
Brug J, van Stralen MM, Te Velde SJ, Chinapaw MJ, De Bourdeaudhuij I, Lien N, et al. Differences in weight status and energy-balance related behaviors among schoolchildren across Europe: the ENERGY-project. PLoS One. 2012;7(4), e34742.
Sánchez-Vaznaugh EV, Kawachi I, Subramanian SV, Sanchez BN, Acevedo-Garcia D. Do socioeconomic gradients in body mass index vary by race/ethnicity, gender, and birthplace? Am J Epidemiol. 2009;169(9): 1102–1112.
Monteiro CA, Moura EC, Conde WL, Popkin BM. Socioeconomic status and obesity in adult populations of developing countries: a review. Bull World Health Organ. 2004;82(12):940–946.
Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;337:869-873.