Factors Associated with Tendency for Weight Loss in a Representative Sample of Children and Adolescents: The CASPIAN‑V Study
Abstract
Background: This study aims to determine the factors affecting the tendency to lose weight (TLW)
and its methods in Iranian children and adolescents.
Methods: 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.
Results: 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).
Conclusions: 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.
Keywords
Full Text:
PDFReferences
Kelishadi R. Childhood overweight, obesity, and the
metabolic syndrome in developing countries. Epidemiol Rev
;29:62‑76.
Mehrkash M, Kelishadi R, Mohammadian S, Mousavinasab F,
Qorbani M, Hashemi ME, et al. Obesity and metabolic syndrome
among a representative sample of Iranian adolescents. Southeast
Asian J Trop Med Public Health 2012;43:756‑63.
Kushner RF, Ryan DH. Assessment and lifestyle management of patients with obesity: Clinical recommendations from systematic
reviews. JAMA 2014;312:943‑52.
Brown CL, Skelton JA, Perrin EM, Skinner AC. Behaviors
and motivations for weight loss in children and adolescents.
Obesity (Silver Spring, Md) 2016;24:446‑52.
Resnicow K, Davis R, Zhang N, Strecher V, Tolsma D,
Calvi J, et al. Tailoring a fruit and vegetable intervention on
ethnic identity: Results of a randomized study. Health Psychol
;28:394‑403.
Armstrong MJ, Mottershead TA, Ronksley PE, Sigal RJ,
Campbell TS, Hemmelgarn BR. Motivational interviewing
to improve weight loss in overweight and/or obese patients:
A systematic review and meta‑analysis of randomized controlled
trials. Obes Rev 2011;12:709‑23.
DiLillo V, West DS. Motivational interviewing for weight loss.
Psychiatr Clin North Am 2011;34:861‑9.
Pietrabissa G, Manzoni GM, Corti S, Vegliante N, Molinari E,
Castelnuovo G. Addressing motivation in globesity treatment:
A new challenge for clinical psychology. Front Psychol
;3:317.
Ceccarini M, Borrello M, Pietrabissa G, Manzoni GM,
Castelnuovo G. Assessing motivation and readiness to change for
weight management and control: An in‑depth evaluation of three
sets of instruments. Front Psychol 2015;6:511
Teixeira PJ, Going SB, Sardinha LB, Lohman TG. A review of
psychosocial pre‑treatment predictors of weight control. Obes
Rev 2005;6:43‑65.
Lowry R, Galuska DA, Fulton JE, Wechsler H, Kann L,
Collins JL. Physical activity, food choice, and weight
management goals and practices among US college students. Am
J Prev Med 2000;18:18‑27.
Djalalinia S, Kelishadi R, Qorbani M, Peykari N, Kasaeian A,
Nasli‑Esfahani E, et al. A systematic review on the prevalence
of overweight and obesity, in Iranian children and adolescents.
Iran J Pediatr 2016;26:e2599.
Kelishadi R, Haghdoost AA, Sadeghirad B, Khajehkazemi R.
Trend in the prevalence of obesity and overweight among
Iranian children and adolescents: A systematic review and
meta‑analysis. Nutrition (Burbank, Los Angeles County, Calif)
;30:393‑400.
Motlagh ME, Ziaodini H, Qorbani M, Taheri M, Aminaei T,
Goodarzi A, et al. Methodology and early findings of the fifth
survey of childhood and adolescence surveillance and prevention
of adult noncommunicable disease: The CASPIAN‑V study. Int J
Prev Med 2017;8:4.
Kelishadi R, Motlagh ME, Roomizadeh P, Abtahi SH,
Qorbani M, Taslimi M, et al. First report on path analysis for
cardiometabolic components in a nationally representative
sample of pediatric population in the Middle East and North
Africa (MENA): The CASPIAN‑III Study. Ann Nutr Metab
;62:257‑65.
Physical status: The use and interpretation of anthropometry.
Report of a WHO Expert Committee. World Health Organization
technical report series. 1995;854:1‑452. Epub 1995/01/01.
PubMed PMID: 8594834.
WHO Child Growth Standards based on length/height, weight
and age. Acta paediatrica (Oslo, Norway: 1992) Supplement.
;450:76‑85. Epub 2006/07/05. PubMed PMID: 16817681.
Ojala K, Vereecken C, Valimaa R, Currie C, Villberg J,
Tynjala J, et al. Attempts to lose weight among overweight and
non‑overweight adolescents: A cross‑national survey. Int J Behav
Nutr Phys Act 2007;4:50.
Taveras EM, Hohman KH, Price SN, Rifas‑Shiman SL,
Mitchell K, Gortmaker SL, et al. Correlates of participation in
a pediatric primary care‑based obesity prevention intervention.
Obesity (Silver Spring, Md) 2011;19:449‑52.
Strauss RS. Self‑reported weight status and dieting in a
cross‑sectional sample of young adolescents: National Health
and Nutrition Examination Survey III. Arch Pediatr Adolesc Med
;153:741‑7.
Chung AE, Perrin EM, Skinner AC. Accuracy of child and
adolescent weight perceptions and their relationships to dieting
and exercise behaviors: A NHANES study. Acad Pediatr
;13:371‑8.
Martin MA, Frisco ML, May AL. Gender and race/ethnic
differences in inaccurate weight perceptions among U.S.
adolescents. Womens Health Issues 2009;19:292‑9.
Al Sabbah H, Vereecken C, Abdeen Z, Kelly C, Ojala K,
Nemeth A, et al. Weight control behaviors among
overweight, normal weight and underweight adolescents in
Palestine: Findings from the national study of Palestinian
schoolchildren (HBSC‑WBG2004). Int J Eat Disord
;43:326‑36.
Drewnowski A, Kurth CL, Krahn DD. Body weight and dieting
in adolescence: Impact of socioeconomic status. Int J Eat Disord
;16:61‑5.
Canpolat BI, Orsel S, Akdemir A, Ozbay MH. The relationship
between dieting and body image, body ideal, self‑perception,
and body mass index in Turkish adolescents. Int J Eat Disord
;37:150‑5.
Emmons L. Predisposing factors differentiating adolescent dieters
and nondieters. J Am Diet Assoc 1994;94:725‑8, 31; quiz 9‑30.
Andriani H, Liao CY, Kuo HW. Parental weight changes as
key predictors of child weight changes. BMC Public Health
;15:645.
Bahreynian M, Qorbani M, Motlagh ME, Heshmat R, Ardalan G,
Kelishadi R. Association of perceived weight status versus body
mass index on adherence to weight‑modifying plan among
Iranian children and adolescents: The CASPIAN‑IV study.
Indian Pediatr 2015;52:857‑63.
Kelishadi R, Marashinia F, Heshmat R, Motlagh ME, Qorbani M,
Taslimi M, et al. First report on body image and weight control
in a nationally representative sample of a pediatric population in
the Middle East and North Africa: The CASPIAN‑III study. Arch
Med Sci 2013;9:210‑7.
Brener ND, Eaton DK, Lowry R, McManus T. The association
between weight perception and BMI among high school students.
Obes Res 2004;12:1866‑74.
Berge JM, Maclehose R, Loth KA, Eisenberg M,
Bucchianeri MM, Neumark‑Sztainer D. Parent conversations
about healthful eating and weight: Associations with
adolescent disordered eating behaviors. JAMA Pediatr
;167:746‑53.
Boutelle K, Neumark‑Sztainer D, Story M, Resnick M. Weight
control behaviors among obese, overweight, and nonoverweight
adolescents. J Pediatr Psychol 2002;27:531‑40.
Loth K, Wall M, Larson N, Neumark‑Sztainer D. Disordered
eating and psychological well‑being in overweight and
nonoverweight adolescents: Secular trends from 1999 to 2010.
Int J Eat Disord 2015;48:323‑7.
Epstein LH, Smith JA, Vara LS, Rodefer JS. Behavioral
economic analysis of activity choice in obese children. Health
Psychol 1991;10:311‑6.
McWhorter JW, Wallmann HW, Alpert PT. The obese child:
Motivation as a tool for exercise. J Pediatr Health Care
;17:11‑7.
Neumark‑Sztainer D, Wall M, Story M, Standish AR. Dieting
and unhealthy weight control behaviors during adolescence:
Associations with 10‑year changes in body mass index. J Adolesc
Health 2012;50:80‑6.
Crespo CJ, Smit E, Troiano RP, Bartlett SJ, Macera CA,
Andersen RE. Television watching, energy intake, and obesity
in US children: Results from the third National Health and
Nutrition Examination Survey, 1988‑1994. Arch Pediatr Adolesc
Med 2001;155:360‑5.
Chen HY, Lemon SC, Pagoto SL, Barton BA, Lapane KL,
Goldberg RJ. Personal and parental weight misperception
and self‑reported attempted weight loss in US children and
adolescents, National Health and Nutrition Examination Survey,
‑2008 and 2009‑2010. Prev Chronic Dis 2014;11:E132.
Edwards NM, Pettingell S, Borowsky IW. Where perception
meets reality: Self‑perception of weight in overweight
adolescents. Pediatrics 2010;125:e452‑8.
Niemeier BS, Hektner JM, Enger KB. Parent participation in
weight‑related health interventions for children and adolescents:
A systematic review and meta‑analysis. Prev Med 2012;55:3‑13.
Jalali MS, Sharafi‑Avarzaman Z, Rahmandad H, Ammerman AS.
Social influence in childhood obesity interventions: A systematic
review. Obes Rev 2016;17:820‑32.
Kelman HC. Compliance, identification, and internalization:
Three processes of attitude change. J Conflict Resolut
;2:51‑60.