2023 Impact Factor: 1.3
2023 CiteScore: 2.2
pISSN: 2251-6085
eISSN: 2251-6093
Chairman & Editor-in-Chief:
Dariush D. Farhud, MD, Ph.D., MG.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE). 
Vol 44 No Supple 1 (2015)
Outputs of National Projects of CASPIAN-III, CASPIAN-IV and NUTRI-KAP in Iran
Original Article(s)
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Background: The goal of the current study was to investigate the association between socioeconomic status (SES) and knowledge, attitude and practice (KAP) of Iranian households toward use of iron and vitamin A&D supplements in infants and pregnant women.
Method: Overall, 14,136 Iranian households from urban and rural areas of 31 provinces were considered as the study population. A multi-stage cluster sampling technique was applied in each province and the size of clusters was 8 people. Data were collected by interviewing the qualified person and using a structure questionnaire. Socioeconomic status was considered as three levels (good, moderate or weak) based on five variables: household assets, occupation and education levels of head of family and respondent and number of family members. The percentage of KAP in households was measured by questions about essential supplementation in pregnancy and infancy.
Result: The percentage of knowledge of using vitamin A&D and the beginning time of iron intake was 67.4%, and 67.8%, respectively. More than three forth of respondents had a favorable attitude about iron intake in pregnancy and infancy. Almost 80% of households used iron and vitamin A&D for their infants and 78% of pregnant women used iron supplement. Generally, the percentage of KAP was significantly higher in urban households. There was a linear association between KAP and SES.
Conclusion: KAP in urban and rural households was not desirable; however, urban households had better status than rural ones. One of the suggested ways of ameliorating nutritional issues in pregnant women and infants aged less than two years olds is educating households about the importance of supplementation in pregnancy and infancy.
Keywords: Socioeconomic status, Knowledge, Attitude, Practice, Iron, Vitamin A-D
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Background: Disparities in health may relate to differences in nutrition. Among dietary determinants, Socioeconomic Status (SES) plays an important role. Therefore, this study was aimed to investigate the association between SES and cooking pattern and consumed food among rural and urban Iranian households.
Methods: Overall, 14,136 households were selected through single-stage cluster sampling methods from urban and rural regions of 31 provinces of Iran in 2011-2012. Demographic, SES, cooking pattern and consumed food data were obtained through valid structured questionnaires by interviewing between trained interviewers with qualified people in households. Data were analyzed using STATA software ver. 11.0 (STATA Corp, College Station, Tex.)
Results: In households with weak SES background, 70.4% of households cooked separately for any meal. The healthy cooking method for red meat and chicken, fish, celery, vegetables stew, onion and green bean was significantly higher in good SES ( P<0.001). Households with good SES had higher intake low fat dairy, liquid oil and iodized salt (P<0.001) compared with families with weak SES. Most consumed bread in three groups was Lavash (Local name).
Conclusion: Pattern of cooking and the type of consumed foods among different SES group and their relationship with each other. So based on this information will be facilitated for interventions and training for better nutrition pattern in society.
Keywords: Socioeconomic Status, KAP, Cooking pattern, Consumed food
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Background: The aim of this study was to evaluate the association of Socioeconomic Status (SES) with anthropometric measures and BP in Iranian children and adolescents.
Methods: This nationwide study was conducted in 2011-2012 among 14,880 students, aged 6-18 years, selected by multistage, cluster-sampling method from rural and urban areas of 30 provinces of Iran. Anthropometric indexes and BP were measured by standard protocols and with calibrated instruments. SES was estimated based on family assets and parents’ job and education using principle component analysis method. SES was considered as “low”, “intermediate” and “high” in the statistical analysis.
Results: Overall, 13486 children and adolescents out of 14,880 invited students (response rate 90.6%) participated in this study. They consisted of 50.8% boys, 75.6% urban residents, with a mean age of 12.47 ±3.36 years. The prevalence of overweight, obesity and abdominal obesity and also mean of all anthropometric measures increased linearly with increasing SES. Inversely, underweight decreased linearly with increasing SES. Association of BP measures with SES was not statistically significant. After adjustment for potential confounders, association of anthropometric measures and BP with SES did not change significantly.
Conclusion: We found that obesity, overweight and abdominal obesity was prevalent in high SES group and underweight in low SES group. Our findings serve as confirmatory evidence that contrary to developed countries, in developing countries childhood obesity is more prevalent in families with higher SES.
Keywords: Anthropometric measures, Blood pressure, Socio-economic status, Children and adolescents, Iran
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Background: This study was aimed to investigate the association of consuming white rice and potato, as well as the bread type with anthropometric measures and blood pressure (BP) in a national sample of Iranian children and adolescents.
Methods: This nationwide study was conducted in 2011-2012 among 14,880 students, aged 6-18 years, selected by multistage cluster sampling from 30 provinces of Iran. Weight, height, waist circumference (WC), hip circumference (HC), waist -to-hip ratio (WHR), waist-to- height ratio (WHtR), as well as systolic and diastolic blood pressure (SBP, DBP) were measured. The self-reported frequency consumption of white rice and potato (daily or non-daily), as well as consumed bread type were asked.
Results: The mean (SD) age of participants was 12.47 (3.36). They were consisted of 50.76% girls and 75.57% urban residents. The intake of white rice had significant positive association with anthropometric indices and SBP levels (P-value<0.05). In crude and adjusted models, white rice consumption was significantly associated with BMI (0.29(0.06-0.51 and 0.19(0.02-0.35)). Likewise, significant association existed between the type of the bread and anthropometric indices (except for WHR). Potato consumption was significantly associated with anthropometric indices (except for WHR and WHtR) and BP levels. In adjusted model, potato consumption had significant positive association with BMI. For every increase in the frequency of daily consumption of white rice, 0.19 units were added to BMI.
Conclusion: White rice consumption increases the risk of general and abdominal obesity in children and adolescents. Consequently, for prevention and control of obesity, the consumption of refined grains should be limited by moderating nutrition policies.
Keywords: Grains, High blood pressure, Obesity, Anthropometric indices, Iran
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Background: Among chronic non-communicable diseases (CNCDs), the occurrence of cardiovascular diseases and diabetes is more prominent. CNCDs origin in early life; with sedentary habits, notably prolonged screen time (ST), leisure time spent on watching TV and working computer, suggested as one of their risk factors. We aimed to investigate the relationship between ST and cardiometabolic risk factors in a nationally representative sample of Iranian children and adolescents.
Methods: In this analytical cross-sectional study, 5,625 school students aged 10-18 were studied in the third national survey of a school-based surveillance program. For ensuring representativeness of sample, subjects were selected using multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran (2009-10). ST was assessed through validated self-administered questionnaire, and cardiometabolic factors were determined. In addition, metabolic syndrome components were defined based on the Adult Treatment Panel III criteria modified for the pediatric age group. In addition, high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), and generalized obesity were assessed as other cardiometabolic risk factors.
Results: Mean age was 14.73±2.41. While, positive significant association was found between ST and abdominal obesity, blood pressure, levels of LDL-C and triglycerides (P <0.05), it was reversely correlated with HDL-C level (P <0.05). However, there was positive but not statistically significant association between ST and odds of metabolic syndrome (P =0.32).
Conclusion: The association between ST and some metabolic syndrome components, reducing ST should be considered as one of the preventive strategies among children and adolescents.
Keywords: Metabolic syndrome, Screen time, Physical activity, Children, Adolescent, Cardiometabolic risk factors, Iran
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Background: Iran is a vast country with great variability in ethnicity and geographical regions as well as higher diversity in socioeconomic and demographic factors in different provinces. All these differences could influence the growth indicators of children and may result in a substantial inequality in the distribution of growth indexes across Iranian provinces. This study aimed to determine the distribution of growth disorders of Iranian children according to the geographical and climatic conditions.
Methods: In this nationwide cross-sectional study, students aged 6-18 years, living in urban and rural areas of 30 provinces in Iran, were studied. The prevalence of underweight, overweight, obesity, abdominal obesity and short stature were determined in different geographical regions of Iran using the geographic information system (GIS) and ArcGIS software.
Results: Overall, 13486 children with mean age of 12.5 (CI: 12.3 - 12.6) years were studied. The prevalence of overweight and obesity as well as underweight ranged between 5-15%, in most provinces. Underweight was more prevalent in very hot and hot regions than in cold regions. The prevalence of overweight and obesity was higher in regions with cold and rainy weather. The prevalence of short stature in most of the provinces ranged between 5-15%.
Conclusion: The findings provide geographic disparities of growth disorders among Iranian pediatrics population. They could be used as baseline information for planning further studies to determine the causal pathway for reported wide range of reported growth disorders and their association with different geographical and climatic regions.
Keywords: Obesity, Overweight, Underweight, Short stature, Children, Adolescents, Iran
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Background: This study aims to assess the pattern of meal frequency consumption of Iranian children and adolescents at national and subnational levels according to the socioeconomic status (SES) of the living region.
Methods: This multi-centric study was conducted in 2011-2012 among 14,880 students, aged 6-18 years, who were selected by multistage random cluster sampling from 30 provinces. Meal frequency was assessed by the World Health Organization Global School-based student Health Survey (WHO- GSHS) questionnaire. Data were compared at national and sub-national levels according to the SES of the living region.
Results: Overall, 13486 students completed this study (participation rate: 90.6%). The frequency of breakfast, lunch, and dinner skipping was 32.08% (95% CI: 30.99, 33.2), 8.58% (95% CI: 7.71, 9.54), and 10.90% (95% CI: 10.21, 11.62), respectively. The frequency of consuming 1 meal, 2 meals, and 3 meals a day was 9.60% (95%CI: 8.94, 10.31), 29.28% (95% CI: 28.31, 30.26), and 61.12 % (95% CI: 59.89, 62.34), respectively. The mean number of days per week of breakfast consumption was 5.14 (95% CI: 5.08, 5.20), the corresponding figure was 6.39 (95%CI: 6.35, 6.42), and 6.24 (95%CI: 6.21, 6.28) for lunch and dinner, respectively. These frequencies had no significant difference according to the SES of the living region.
Conclusion: Most Iranian children and adolescents consumed all three main meals, however irrespective of SES; in general skipping breakfast was more frequent than skipping lunch and dinner. Regular meal intake, notably breakfast, should be considered in health promoting programs for all children and adolescents.
Keywords: Meal frequency, Skipping meals, Children and adolescents, Prevention, Health promotion, Iran
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Background: This study aimed to assess the frequency of consuming different types of snacks among Iranian students according to socio-economic status (SES) of their living region.
Methods: Data were obtained from the fourth national school-based surveillance survey entitled CASPIAN-IV study. Overall, 14880 school students, aged 6-18 years, were selected through multistage, cluster sampling from rural and urban areas of the of 30 provinces of Iran. The World Health Organization Global School Student Health Survey (WHO-GSHS) was used. Data were compared at national/sub-national levels by survey data analysis methods.
Results: The participation rate was 90.6%, 13486 students (49.2% girls), mean (SD) age of 12.50 (3.36) years completed the study. At national level, fresh fruits were the most common used category of healthy snacks (55.74%, 95% CI: 54.51, 56.96). Boys had more daily consumption of milk (48.65% vs. 43.27%), and girls had more daily consumption of fresh fruits (58.07% vs. 53.47%). Urban residents had lower consumption of vegetables (30.53% vs. 37.55%), dried fruits (18.29% vs. 23.02%), and fresh fruits (45.33% vs. 50.09%) than their rural counterparts. Among unhealthy snacks, sweets had the highest daily consumption (34.15%, 95% CI: 33.04, 35.28). Boys had higher consumption of sweetened beverages (22.57% vs. 17.6%) and fast foods (3.51% vs. 2.17%). At national level, except than salty snacks (16.24% rural vs.11.83% urban), consumption of other junk snacks had no significant difference between urban and rural residents.
Conclusion: Differences in the frequency of consuming healthy and unhealthy snacks according to the SES of the living region, and the choice differences between genders should be considered in planning national health programs.
Keywords: Snack, Healthy snack, Junk food, Socio-economic status, Iran
