Association of physical activity and dietary behaviours in relation to the body mass index in a national sample of Iranian children and adolescents: CASPIAN Study

OBJECTIVE: To examine the relation of dietary and physical activity (PA) patterns with the body mass index (BMI), and the associations between these patterns among children. METHODS: A representative sample of 21 111 school students aged 6-18 years was selected by multistage random cluster sampling from 23 provinces in the Islamic Republic of Iran. PA and dietary pattern were assessed by self-administered validated questionnaires. FINDINGS: Fruit and vegetables, dairy products and snacks (salty, fatty or sweet) had a similar consumption frequency of approximately twice a day. The type of fat most frequently consumed was hydrogenated solid fat (consumed by 73.8% of families). The PA level was significantly higher among boys than girls, in rural than in urban residents, and in intermediate students than high-school students. Among boys, the frequency of consumption of vegetables and plant proteins (R(2) = 0.46); and among girls, the frequency of consumption of dairy products and fruits, as well as high PA level had a significant inverse association with BMI (R(2) = 0.57). Among boys, the low frequency of consumption of fruits, the time spent on PA and the energy expenditure; and among girls, the time spent on PA and the energy expenditure, had significant relationships with overweight. When controlling for covariates, PA levels had significant relationships with the frequency of consumption of all food groups. CONCLUSION: Unhealthy lifestyles make Iranian young people prone to chronic diseases later in life. When examining their health benefits, the interrelationship of dietary and PA behaviours should be considered.     

Blood pressure and its influencing factors in a national representative sample of Iranian children and adolescents: the CASPIAN Study.

BACKGROUND: This study was performed to determine the blood pressure (BP) percentile curves by height, as well as to assess the prevalence of high BP and its influencing factors among children in the first national survey in this field in Iran. DESIGN: A multicentre national cross-sectional survey. METHODS: This study was performed in 23 provinces among a representative sample of 21,111 students aged 6-18 years. RESULTS: Age and sex-specific percentile curves of systolic and diastolic BP were obtained by height. A comparison of the values obtained corresponding to the 90th percentiles with the Second Task Force cut-offs showed that the BP values and trends were relatively similar in both studies. The overall prevalence of systolic, diastolic as well as systolic or diastolic hypertension according to the Second Task Force study 95th percentile cut-off points were 4.2, 5.4 and 7.7%, respectively, without a significant sex difference. A history of low birthweight, overweight, taller height, the consumption of solid hydrogenated fat, as well as the frequency of fast food consumption increased the risk of both systolic and diastolic hypertension. Male sex, large waist, and low education of the mother were the risks for systolic hypertension, whereas the risk of diastolic hypertension rose with living in an urban area, attending public school, low physical activity level, having a housewife mother, and a positive family history of obesity, especially in the parents. CONCLUSION: Considering the effect of modifiable environmental factors on the childrens' BP, encouraging breast feeding and a healthy lifestyle may have an important effect on public health.     

Assessment of Pubertal Development in Iranian Girls

Objective

We estimated pubertal development of 7,493 normal Iranian girls aged 6 to 20 years in a cross-sectional study.

Methods

Pubertal stages were assessed according to Tanner. The mean ages to achieve secondary sexual characteristics as well as the mean age at menarche were estimated. Weight and height were measured and body mass index (BMI) was calculated. Reference curves for different breast stages and menarche were constructed. The percentiles for attaining each stage were compared to data proposed by Tanner.

Findings

The mean age at breast bud stage (B2) was 10.10, pubic hair stage (P2) was 9.83, and menarche age was 12.55 years. The anthropometric variables were interpreted in different maturity stages. The mean age at attainment of puberty was compared with those of other populations.

Conclusion

Not only the onset of puberty in Iranian girls but also the duration of puberty is similar to data from most other countries. A lower age limit for the definition of precocious puberty than the traditional 8 years is documented for Iranian girls. However, it should be noted that considering the rate of evolution of pubertal findings is more important than the age of their appearance.     

The role of echocardiography in diagnosing space-occupying lesions of the heart

In contrast to primary cardiac tumors, which are less frequent and mostly benign in nature, the majority of intracardiac tumors are metastatic lesions. Cardiac ultrasound has evolved enormously since its emergence in the 1950s and is presently the modality of choice for imaging space-occupying lesions of the heart; it provides high quality, real-time images that are extremely valuable in the evaluation of cardiac masses. Although transthoracic echocardiography is an excellent initial diagnostic technique to evaluate and diagnose cardiac masses, transesophageal echocardiography provides superior image resolution and better visualization of cardiac masses in patients with suboptimal transthoracic echocardiography studies. Computed tomography and magnetic resonance imaging are additional tools used for cardiac imaging and may provide useful information in addition to that obtained by echocardiography, especially when the images obtained by the latter are suboptimal.     

Smoking behavior and its influencing factors in a national-representative sample of Iranian adolescents: CASPIAN study

OBJECTIVES: To determine the national prevalence of smoking among Iranian youths and its environmental influencing factors. METHODS: This study was performed in 2003-2004 among 11,966 school students, ages 11-18 years, selected by multi-stage random cluster sampling from 20 provinces in Iran. The participants filled out self-administered anonymous questionnaires. RESULTS: The prevalence of self-reported cigarette smoking was 14.3%, with a higher prevalence in boys than in girls (18.5% vs. 10.1%, respectively, P < 0.001), and in high school than in middle school students (17.4% vs. 10.6%, respectively, P < 0.001). Overall, 42.2% of smokers were daily smoker, and the rest were occasional smoker. The mean age of the first attempt to smoke was 13.2 +/- 2.5 years with no significant gender difference but was significantly lower in daily than in occasional smokers. The place of the first attempt to smoke was mostly in friend parties (41.6%) and traditional teahouses (23.2%) for boys and the family parties (37.1%) and the traditional teahouses (27.4%) for girls. The higher school level and having a tobacco user at home significantly increased the likelihood of smoking in adolescents, with the highest odds ratio (OR) found for having a smoker sister in girls (OR = 4.5, 95%CI, 2.5, 8.2), and having a smoker brother in boys (OR = 2.4, 95%CI, 2.03, 3.05). CONCLUSION: Smoking is becoming as a major public health threat among Iranian youths. Control measures should be considered not only for cigarette smoking, but also for the socially accepted habit of water pipe use that is revived in traditional teahouses.     

Mental health problems of Iranian female adolescents and its association with pubertal development: a nationwide study

Mental health problems including emotional and behavioral problems during puberty may be under influence of different risk factors including cultures, living in urban or rural areas and ethnic factors which may vary between different countries. The main aim of this study is to investigate the profile of emotional and behavioral problems and the role of factors such as age, stage of puberty, ethnicity, rurality and living in urban area, as risk factors in Iranian girls. As a part of a large national study we evaluated the emotional and behavioral problems in different stages of puberty in a community sample of Iranian adolescent girls from public schools that were selected by clustered random sampling method. In all subjects, demographic characteristics, and pubertal stages were measured. Emotional and behavioral problems were evaluated using Strength and Difficulties Questionnaire (SDQ). The associations of age, pubertal development indices, socioeconomic and demographic factors with the behavioral problems were assessed. A total number of 4576 students enrolled the study and responded to the questions. The mean age of participants was 13.83 ± 2.19 years. The mean total score of difficulties in participants was 14.34 ± 5.81. According to these results 813 (17.8%) adolescents had total problem scores higher than Goodman's cutoff points and the most frequent problem domain was conduct problems (20.5%). According to the results the most related variable with the total difficulty score of SDQ were ethnicity, residency in urban areas and development of menstrual cycle respectively. The results of this study showed that the most correlated factors with mental health problems in Iranian girls during puberty are ethnicity, urbanity and development of menstrual cycle.     

The evaluation of prepared microgroove pattern by femtosecond laser on alumina-zirconia nano-composite for endosseous dental implant application

Ceramic dental materials, especially alumina (20 %vol)-yttrium stabilized tetragonal zirconia poly crystal (A-Y-TZP20), have been considered as alternatives to metals for endosseous dental implant application. For increasing the bone-to-implant contact as well as the speed of bone formation, a new surface modification can be effective. The aim of this study was to design microgroove patterns by femtosecond laser on A-Y-TZP20 nano-composite disks for endosseous dental implant application. The phase composition and the morphology of the A-Y-TZP20 nano-composite samples were characterized using X-ray diffraction and Scanning electron microscopy equipped with energy dispersive X-ray spectroscopy techniques. Statistical analysis was submitted to Kolmogorov-Smirnov test and Student’s t test for independent variables, with a 5 % significance level. EDAX analysis revealed a significant decrease in the relative content of contaminants like carbon (p?<?0.05) in laser surface-treated group as compared to non surface-treated group. X-ray diffraction did not show any change in the crystalline structure induced by laser processing. It was concluded that the femtosecond laser is a clean and safe method for surface modification of A-Y-TZP20.     

Factors associated with the metabolic syndrome in a national sample of youths: CASPIAN Study

Background and aimTo date, research on the influence of environmental factors on metabolic syndrome (MS) among youths is limited. This study was conducted to investigate for the first time the association of these factors with MS in a large national, representative sample of children from a non-Western population.Methods and resultsThe study population comprised of 4811 students (2248 boys and 2563 girls) aged 6–18 years, living in six different provinces in Iran. MS, defined based on criteria analogous to those of the Adult Treatment Panel III, was detected in 14.1% of participants.A birth weight of >4000 g in boys and <2500 g in girls increased the risk of having the MS [OR, 95% CI: 1.4 (1.007, 2.05) and 1.2 (1.1, 1.4), respectively]. Poorly educated parents and a positive parental history of chronic disease were other risks factors associated with MS. Low levels of physical activity significantly increased the risk of having MS [boys: 1.3 (1.1, 1.7); girls: 1.4 (1.2, 1.6)]. The risk of MS increased in-line with the consumption of solid hydrogenated fat [boys: 1.2 (1.07, 1.3); girls, 1.3 (1.1, 1.5)] and bread made with white flour [boys: 1.6 (1.3, 2.1); girls, 1.4 (1.1, 1.7)]. In contrast, an increased frequency of consumption of fruits and vegetable, as well as dairy products decreased the risk of having MS.ConclusionConsidering the effect of modifiable lifestyle habits and birth weight on MS in youths, urgent public health approaches should be directed towards primordial and primary prevention of this rapidly growing problem.