majzoubeh taheri

This study aims to determine the factors affecting the tendency to lose weight (TLW) and its methods in Iranian children and adolescents.

In this cross‑sectional nationwide study 14800 students, aged 7–18 years, living in 30 provinces of Iran were selected via multistage cluster random sampling method. The dietary and physical activity habits and TLW as well as psychosocial health status, anxiety, self‑satisfaction, and change in dietary behaviors were assessed by the global school‑based student health survey (WHO‑GSHS) questionnaire. Multivariate logistic regression model was used to identify factors influencing TLW.

Overall, 14274 students (participation rate of 99%), consisting of 51% boys and 71.4% urban residents, completed the study. Of them, 37.7% (51.4% Girls and 48.6% boys) tended to lose weight. In multivariate model, the odds for TLW was 12% higher in students aged 13–18 years than those aged 6–12 years (OR = 1.12, 95% CI: 1.02 to 1.23; P < 0.001). Students with high anxiety level were 43% more likely to have TLW (OR = 1.43, 95% CI: 1.28–1.59; P < 0.001). The odds of increasing physical activity for weight loss was 22% lower in obese than in normal weight students (OR = 0.78, 95% CI: 0.66 to 0.93; P < 0.001).

TLW was significantly higher in girls, as well as in those with higher anxiety level. In addition to dietary change, increasing physical activity should be encouraged among children and adolescents with excess weight. Public education regarding proper lifestyle change for reaching healthy weight should be underscored.

The purpose of this study was to obtain the cutoff points of visceral adiposity index (VAI), a new marker of indirect evaluation of visceral fat, to assess its association with metabolic syndrome (MetS) in a population of children and adolescents.

This cross sectional study was conducted on children and adolescents aged 7-18 years attended in the fifth phase of a national school-based surveillance survey. The odds ratio (OR) of cardiometabolic risk factors across tertile categories of VAI was determined using the logistic regression models and the valid cut-off values of VAI for predicting MetS was obtained using the receiver operation characteristic (ROC) curve analysis.

A total of 3843 students (52.3% boys, 12.3 [12.2-12.4] years) were included in the analysis. The mean of VAI was significantly higher in participants who had MetS (2.60 [2.42-2.78] vs 1.22 [1.19-1.25]; P <0.001). Participants in the third tertile compared to the first tertile category of VAI had higher odds of abdominal obesity (OR: 1.77, 95% CI: 1.43-2.20), impaired fasting blood glucose (OR: 2.00, 95% CI: 1.28-3.13) and low high-density lipoprotein cholesterol (OR: 15.93, 95% CI: 12.27-20.66). The cut-off points of the VAI for predicting MetS were 1.58, 1.30 and 1.78 in total population, boys and girls, respectively.

We determined the cut-off points of VAI as an easy tool for detecting MetS in children and adolescents and demonstrated that VAI is strongly associated with MetS. Prospective longitudinal studies are suggested to show the possible efficiency of the VAI as a predictor of MetS in pediatrics.

Leisure time activities might be associated with school performance. This study aimed to investigate the association between leisure time variables, including television and computer using time, homework time and cell phone using time, with children’s school performance in a nationally representative sample of Iranian children and adolescents. In this analytical cross-sectional study as the fifth survey of a national school-based surveillance program in Iran, participants were selected by multi-stage sampling approach among 7-18-year-old students from urban and rural areas. In addition to filling questionnaires obtained from World Health Organization Global School Health Survey and conducting physical examinations, the averages of school grades were categorized into "very good" (grade 17-20 out of 20), and "not very good" (under 17 out of 20) as school performance according to qualitative evaluation scales established recently in Iranian schools. The participation rate was 99%, 14,274 students completed the study. Urban students spent more time doing homework and using screen media, and they had better school performance than rural students (P < 0.001). Girls had higher homework time and better school performance than boys (P < 0.001). Prolongedscreen time, including watchingtelevision and computer use increased the odds of lower school performance (Odds ratio = 1.11). No other media type times or homework time had a significant association with school performance. In this study, prolongedscreen time represents an inverse association with school performance. Television viewing time, computer and cell phone using time and homework time might have no separate significant effects on school performance.

Metabolic syndrome (MetS) is one of the common metabolic disorders seen in children and adolescents. This study aims to assess the rate of the MetS and its associated factors in a nationally-representative sample of Iranian pediatric age groups. This nationwide cross- sectional study was designed in 2015 in 30 provinces of Iran. Participants consisted of 4,200 school students, aged 7-18 years, studied in a national school-based surveillance program (CASPIAN-V). Physical examination and laboratory tests were performed using standard protocols. Blood samples were drawn from 3834 students for biochemical tests. The participation rate for blood sampling was 91.5%. MetS was significantly more prevalent among students in urban than in rural areas (5.7% vs. 4.8%, P value < 0.01). MetS was more prevalent in students with obese parents than in those with non-obese parents (6.4% vs. 4.5%, P value < 0.05). Significant association existed between moderate level of healthy nutritional behaviors and MetS after controlling for potential confounders (odds ratio [OR]: 0.62, 95% CI: 0.40-0.98). Students with high unhealthy nutritional behaviors showed an increased risk of MetS in crude (OR: 1.6, 95% CI: 1.05-2.44) and adjusted model (OR: 1.65, 95% CI: 1.05-2.63). High rate of MetS and associated risk factors was observed in Iranian pediatric age groups, with higher rates among boys. These findings provide useful information for effective preventive strategies based on diet, exercise, and lifestyle modification rather than therapeutic modalities.

This study presents the prevalence of cardiometabolic risk factors in a nationally representative sample of Iranian children and adolescents.
This multi-centric study was conducted in 2015 among 4200 students aged 7–18 years. They were selected by multistage cluster sampling from 30 provinces of Iran. Anthropometric indices, biochemical and clinical parameters were measured.
The mean of weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG) was higher in boys than in girls (P We found considerably high prevalence of some cardiometabolic risk factors including overweight and obesity, low HDL-C and hypertriglyceridemia in Iranian children and adolescents. The current findings underscore the necessity of intensifying health interventions for primordial and primary prevention of non-communicable diseases from early life.

The prevalence of glomerular hyperfltration and chronic kidney disease is increasing worldwide in parallel with obesity hypertension epidemic. The effect of increases in glomerular fltrations (GFR) in children with metabolic syndrome has not been studied. The purpose of the present study is to investigate the relationship between GFR and cardiometabolic risk factors in a large sample of pediatric population.
In this nationwide survey, 3800 participants were selected by cluster random sampling from 30 provinces in Iran. Anthropometric measures, biochemical, and clinical parameters were measured. We also measured estimated GFR (eGFR) using the recently modifed Schwartz equations and other known cardiometabolic risk factors such as elevated total cholesterol, high low‑density lipoprotein cholesterol (LDL‑C), and obesity.
The response rate was 91.5% (n = 3843). The mean and standard deviation (SD) (Mean ± SD) of eGFR for girls, boys, and total population were 96.71 ± 19.46, 96.49 ± 21.69, and 96.59 ± 20 ml/min/1.73 m2, respectively. Overall, 38.7% of the participants did not have any cardiometabolic risk factor. In multivariate models, the risk of elevated systolic blood pressure (BP) (odds ratio [OR]: 1.48; 95% confdence interval [CI]: 1.08–2.02), elevated diastolic BP (OR: 1.48; 95% CI: 1.08–2.02), elevated LDL‑C (OR: 1.35; 95% CI: 1.07–1.70), and obesity (OR: 1.70; 95%CI: 1.24–2.33) were signifcantly higher in participants with higher eGFR level than those with the lower level but not with low level of high‑density lipoprotein cholesterol (OR: 0.72; 95% CI: 0.60–0.88).
This study demonstrates an association between glomerular hyperfltration and obesity‑related hypertension in a large sample of the Iranian pediatric population, independently of other classical risk factors.

This paper presents the methodology and early findings of the fifth survey of a school-based surveillance program in Iran.
This nationwide study was conducted in 2015 as the fifth survey of a surveillance program entitled “Childhood and Adolescence Surveillance and PreventIon of Adult Noncommunicable disease” (CASPIAN-V) study. The protocol was mainly based on the World Health Organization-Global School student Health Survey. We studied 14400 students, aged 7-18 years, and their parents living in 30 provinces in Iran. Fasting blood was obtained from a sub-sample of 4200 randomly selected students.
The participation rate for the whole study and for blood sampling were 99% and 91.5%, respectively. The mean (SD) age of participants was 12.3 (3.2) years, consisting of 49.4% girls and 71.4% urban residents. Overall, 16.1% were underweight (17.4% of boys and 14.8% of girls), and 20.8% had excess weight consisting of 9.4% (8.7% of boys and 10.2% of girls) of overweight and 11.4% (12.5% of boys and 10.3% of girls) of obesity. Abdominal obesity was documented in 21.1% of students (21.6% of boys and 20.5% of girls). Low HDL-C was the most prevalent abnormality of the lipid profile (29.5%) followed by high serum triglycerides (27.7%). Of students, 59.9% consumed whole wheat bread; and 57% reported that they never or rarely added salt to table. The reported daily consumption of fresh fruits, vegetables, and milk was about 60%, 32%and 40%, respectively. 13.7% of participants had at least 30-min daily leisure-time physical activity.
The current findings provide an overview of the current health status and lifestyle habits of children and adolescents. This surveillance program would help planning preventive programs at individual and community levels.

Decayed teeth are one of the diseases of civilization. Intraoral factors which interact with the others such as heredity, cultural and social factors are involved in the initiation of the disease. Among social factors, health care is particularly important. The aim of the present study was to evaluate DMFT, dmft and gingivitis in the first-year students of elementary, guidance and high schools in rural and urban areas in 23 provinces of Iran. This descriptive nationwide study was conducted in 2009‒2010 as part of the routine examination of first-year students of elementary, guidance and high schools in 23 provinces in Iran. This examination was performed across the country by physicians and medical personnel in relation to DMFT and dmft and gingival inflammation. Data were recorded in students’ health records and frequencies were extracted and reported. The results showed first-year elementary students had the highest caries rate with 45.56%. Caries rates were 40.99% and 35.8% in rural and urban areas, respectively. First-year students of elementary, guidance and high schools in Kashan and Shiraz had the highest and lowest caries rates with 62% and 13%, respectively. Under the limitations of the present study, the highest caries rate was reported in elementary students in Kashan. The highest rates of tooth extractions, tooth restorations and gingival inflammation were reported in elementary, high school and guidance school students, respectively.

Ambiguous genitalia is a hereditary disorder that usually requires early attention and detection. The discovery of ambiguous genitalia in a neonate is situation that could be difficult to manage, not only because of complications such as salt-losing, but also due to the importance of sex determination before psychological gender could be established. Awareness of the prevalence of ambiguous genitalia can affect the attitude and consideration of physicians and related medical personnel about disease in different communities. So in this study, the prevalence of ambiguous genitalia and undescended testes (UDT) in Iran was reported.

This national study was conducted in 2009-2010 as part of the routine screening examinations at school entry in Iran. The physical examinations were performed for students at entry to three school levels by physicians and medical personnel. Execution and conduction of this program was the duty of the University of Medical Sciences in each province.

On average, the prevalence of ambiguous genitalia was 0.04% at national level (0.03%, 0.05%, and 0.03% at 6, 12, and 15 year olds, respectively). The prevalence of ambiguous genitalia was not significantly different according to age group and living area. The average of UDT) prevalence in the whole country was 0.13%. The prevalence of UDT was higher at elementary school level than in the other two levels.

Although the prevalence of genitalia abnormalities was not high in the school students in Iran, given the importance of the issue and in order to find the ambiguous genitalia or UDT, medical examinations and parental notification should be taken seriously at an earlier age.

Anemia is one of the most popular hygiene problems in the world which is accompanied by disturbance of growth and development، reduction of intelligence quotient، and education problems specially for children and teens. The present study aimed to determine the prevalence of anemia in students and to indentify the stricken and endangered people in Iran. In this cross-sectional descriptive study، through students examination program، all of the first grade students in three school levels in all over the country were examined in aspect of different disturbances including anemia. Clinical signs of anemia in physical examination were considered as evidence of being anemic. Data collecting was done using registered information in students'' health identity document (ID) cards. The prevalence of anemia was 4. 5% for students، 5. 5% for girls، 3. 5% for boys، 4. 6% in urban areas، and 4. 1% in rural areas. Prevalence of anemia for the first grade students of primary، secondary، and high school was 4. 8%، 4. 5%، and 4. 1%، respectively. Prevalence of anemia in students، especially in first grade of primary school، is worrying; this shows the importance of exact recognition and identification of endangered persons with wide- spread، steady and high-sensitive screening programs. Planning and performing suitable programs for prevention and treatment of disease in society and schools is essential، too.

To assess the national prevalence of clinical disorders in 6-year-old Iranian children before school entry using a national health assessment survey. In a cross-sectional nationwide survey, all Iranian children entering public and private elementary schools were asked to participate in a mandatory national screening program in Iran in 2009 in two levels of screening and diagnostic levels. The study population consisted of 955388 children (48.5% girls and 76.1% urban). Of the whole children, 3.1% of the 6-year-old children had impaired vision. In addition, 1.2, 1.8, 1.4, 10, 10.9, 56.7, 0.7, 0.8 and 0.6% had color blindness, hearing impaired, speech disorder, height to age retardation, body mass index extremes, decayed teeth, having disease with special needs, spinal disorders, and hypertension, respectively. The distribution of these disorders was unequally distributed across provinces. Our results confirmed that the prevalence of clinical disorders among 6-year-old children across Iranian provinces was not similar. The observed burden of these distributions among young children needs a comprehensive national policy with evidence-based province programs to identify the reason for different distribution among provinces.