Behnam Sadeghirad

Trend in the prevalence of obesity and overweight among Iranian children and adolescents: a systematic review and meta-analysis.

OBJECTIVE Childhood obesity is an important predisposing factor for most non-communicable diseases. The aim of this review was to provide evidence on the prevalence and trends of childhood obesity and overweight in Iran. METHODS Multiple international and Iranian scientific databases were searched for relevant literatures. Two independent reviewers identified relevant papers in several steps. Separate meta-analyses (using fixed- or random-effect models) were performed to estimate the overall, age, sex, and age-sex specific prevalence of obesity and overweight. Stratified analysis based on Centers for Disease Control and Prevention, International Obesity Task Force, and World Health Organization definition criteria and study year also were performed. RESULTS We included 107 studies in the meta-analysis (49 English and 58 Persian). Based on Centers for Disease Control and Prevention definition criteria, the overall prevalence of obesity and overweight remained relatively constant in the 2000s and are estimated to be about 5.1% (95% confidence interval [CI], 4.4-5.8) and 10.8% (95% CI, 10.2-11.4), respectively. The meta-regression analysis showed that the prevalence of obesity and overweight did not vary significantly with respect to sex and age of study participants. Girls had a lower prevalence of obesity and higher prevalence of overweight than boys. CONCLUSION This review, which is the first of its kind in the Middle East and North Africa, suggests that although the trend in the prevalence of childhood obesity in Iranian children is not considerably high, but the escalating trend of excess weight among young children is alarming and should be considered by providers of interventional preventive programs at national and regional levels.

HIV prevalence amongst injecting drug users in Iran: A systematic review of studies conducted during the decade 1998-2007

BACKGROUND AND OBJECTIVES Iran is a country with low HIV prevalence in the general population and concentrated prevalence amongst injecting drug users (IDUs). Various studies have been carried out on HIV prevalence amongst IDUs in Iran and diverse results have been reported. This systematic review intended to find and collect all relevant studies, assess the quality of data and provide estimations on the national prevalence over time. METHODS A broad search strategy was used, including searching international and local databases, research reports, and extensive personal contacts. All studies of IDUs conducted between 1998 and 2007 including clear description of method and HIV testing and confirmative western blot test were entered and qualitatively assessed. HIV prevalence rates were pooled for gender and stratified into several categories. RESULTS Twenty-two studies involving 3916 IDUs were included. Half of the studies had been conducted in Tehran. Ten studies were conducted in prisons, seven in treatment centres and five in the Drop-in-centres or communities. After 2005 the pooled HIV prevalence was 18.4% [95% Confidence Interval (CI) 16.7-20.2] significantly higher than the prevalence rate before 2005 [8.7% (95% CI 7.5-10]. CONCLUSION HIV prevalence amongst IDUs has increased over time and has the potential to increase exponentially. Scaling up harm reduction measures, increasing their availability and coverage, and improving the quality of services is highly recommended in order to prevent a future catastrophic epidemic.

Islamic fasting and weight loss: a systematic review and meta-analysis

OBJECTIVE Studies on the effects of Ramadan fasting on weight changes have been contradictory. We brought together all published data to comprehensively examine the effects in a systematic review and meta-analysis. DESIGN Relevant studies were obtained through searches of PubMed and CINAHL and by independent screening of reference lists and citations without any time restriction. All searches were completed between October and November 2011. SETTING Changes in body weight during and after Ramadan were extracted from thirty-five English-language studies and were meta-analysed. Most of the studies were conducted in West Asia (n 19); the remainder were conducted in Africa (n 7), East Asia (n 3) and North America/Europe (n 4). SUBJECTS Healthy adults. RESULTS Fasting during Ramadan resulted in significant weight loss (-1·24 kg; 95% CI -1·60, -0·88 kg). However, most of the weight lost was regained within a few weeks and only a slight decrease in body weight was observed in the following weeks after Ramadan compared with that at the beginning of Ramadan. Weight loss at the end of Ramadan was significant in both genders (-1·51 kg for men and -0·92 kg for women); but again the weight loss lasted no longer than 2 weeks after Ramadan. Weight loss during Ramadan was greater among Asian populations compared with Africans and Europeans. CONCLUSIONS Weight changes during Ramadan were relatively small and mostly reversed after Ramadan, gradually returning to pre-Ramadan status. Ramadan provides an opportunity to lose weight, but structured and consistent lifestyle modifications are necessary to achieve lasting weight loss.

The projection of burden of disease in Islamic Republic of Iran to 2025.

Objective Iran as a developing country is in the transition phase, which might have a big impact on the Burden of Disease and Injury (BOD). This study aims to estimate Burden of Disease and Injury (BOD) in Iran up to 2025 due to four broad cause groups using Disability-Adjusted Life Year (DALY). Methods The impacts of demographic and epidemiological changes on BOD (DemBOD and EpiBOD) were assessed separately. We estimated DemBOD in nine scenarios, using different projections for life expectancy and total fertility rate. EpiBOD was modeled in two scenarios as a proportion of DemBOD, based on the extracted parameters from an international study. Findings The BOD is projected to increase from 14.3 million in 2003 to 19.4 million in 2025 (95% uncertainty interval: 16.8, 21.9), which shows an overall increase of 35.3%. Non-communicable diseases (12.7 million DALY, 66.0%), injuries (4.6 million DALY, 24.0%), and communicable diseases, except HIV/AIDS (1.8 million DALY, 9%) will be the leading causes of losing healthy life. Under the most likely scenario, the maximum increase in disease burden due to DemBOD is projected to be observed in HIV/AIDS and Non-communicable diseases (63.9 and 62.4%, respectively) and due to EpiBOD in HIV/AIDS (319.5%). Conclusion It seems that in the following decades, BOD will have a sharp increase in Iran, mainly due to DemBOD. It seems that communicable diseases (except HIV/AIDS) will have less contribution, and especially non-communicable diseases will play a more significant role.

Prevalence of Overweight and Obesity among Aboriginal Populations in Canada: A Systematic Review and Meta-analysis

ABSTRACT Previous studies on overweight and obesity among indigenous peoples in Canada have been inconclusive. A systematic review was conducted on the prevalence of overweight and obesity among Canadian indigenous populations. Major bibliographic databases were searched for relevant studies published between January 1990 and June 2013. We reviewed 594 abstracts and included 41 studies in the meta-analyses. Using the heterogeneity test (Cochrane Q) results, the overall prevalence was estimated using fixed- or random-effects model. Nonadults (<18 years) had a pooled prevalence of overweight and obesity at 29.8% (95% CI: 25.2–34.4) and 26.5% (95% CI: 21.8–31.3), respectively. The pooled prevalence of overweight and obesity among adults were 29.7% (95% CI: 28.2–31.2) and 36.6% (95% CI: 32.9–40.2), respectively. Adult males had higher overweight prevalence than females (34.6% vs. 26.6%), but lower obesity prevalence (31.6% vs. 40.6%). Nonadult girls had higher prevalence than boys [overweight: 27.6%; 95% CI: 22.6–32.7 vs. 24.7%; 95% CI: 19.0–30.5; obesity: 28.6%; 95% CI: 20.3–36.9 vs. 25.1%; 95% CI: 13.8–36.4]. Nonadult Inuit had the highest overweight and lowest obesity prevalence. Although Inuit adult had the lowest prevalence of overweight (28.7%; 95% CI: 27.3–30.2) and obesity (32.3%; 95% CI: 25.5–39.1), it was relatively high. This study highlights the need for nutritional intervention programs for obesity prevention among indigenous populations in Canada.

Consistent Condom Use with Paying and Nonpaying Partners among Female Sex Workers in Iran: Findings of a National Biobehavioral Survey

Objectives: Little is known about the dynamics of condom use among female sex workers (FSWs) in Iran. We investigated the correlates of consistent condom use (CCU) among FSWs, using data from a national biobehavioral surveillance survey in 2010. Methods: A total of 872 FSWs were recruited using a facility-based sampling strategy from 21 sites in 13 cities in Iran. Data were collected through face-to-face interviews using a standardized questionnaire. Results: Overall, 33.6% and 17.3% of FSWs reported CCU with paying and nonpaying sex partners, respectively. Consistent condom use with paying partners was significantly associated with temporary marriage, accessing family planning services and history of working in brothels. Conversely, temporary marriage or married status, condom rupture/slippage, and HIV seropositivity remained independently significantly associated with CCU with nonpaying sex partners. Conclusion: Our findings indicated the urgent need for scaling up condom promotion interventions catered toward FSWs and their sex partners to practice safe sex consistently.