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Background: Childhood obesity and overweight have become major public health problems worldwide. To combat this problem, effective, sustainable, and consistent strategies are needed. In this study, the long-term effect of a school-based intervention for weight reduction was evaluated in primary school students in Tehran, Iran. Methods: This was a cluster randomized controlled trial (RCT) conducted in 12 primary schools in a low- to middle-class district in Tehran, Iran. The participants were 334 overweight or obese primary school students (girls =164) based on World Health Organization standards, equally distributed in the intervention (n=167) and comparison (n=167) groups. It was a multi-component intervention and included nutrition education and increased physical activity (PA), a lifestyle modification program for parents, and changing the food items sold in canteens of the schools. Body mass index Z-score [BMI-Z] was determined as the primary outcome and measured at baseline, three months after baseline, at post-test (after 18 weeks), and follow-up (13-month). In total, 205 students (59.5%) completed the follow-up. Analyses were carried out based on the intention-to-treat principle using linear mixed models. Results: After 13 months, the BMI Z-score decreased in both intervention and comparison groups. However, the change was more significantly observed in the intervention group (adjusted change: 0.098, 95% CI: (0.03-0.16) compared with comparison group (P=0.003(. The intervention had a more significant effect on BMI Z-score among girls (adjusted change: 0.36, 95% CI: (0.27-0.45) compared with the comparison group (P<0.001) (than among boys (adjusted change: -0.14, 95% CI: (-0.23--0.05) compared with the comparison group (P=0.002). Conclusion: The intervention was an effective way to reduce BMI in the girls and the effect lasted for a relatively long time. [ABSTRACT FROM AUTHOR]

Background: The link between food insecurity and weight disorders of children or adolescents remains controversial. Therefore, this systematic review and metaanalysis aimed to clarify the association between food insecurity and weight disorders of children and adolescents in Iran. Methods: PubMed, ISI Web of Science, Scopus, Google Scholar, Magiran, and SID databases were searched up to August 2020. Study selection, data extraction, and bias assessment in the included studies were performed by two reviewers independently. Odds ratios (ORs) were calculated using a random effects model. Results: The pooled ORs of crosssectional studies showed that food insecurity was not associated with the odds of underweight (OR 1.18, 95% CI 0.52, 2.70) with no evidence of publication bias but high heterogeneity between studies (I² = 80 %; P < 0.05). Similarly, the pooled ORs demonstrated that there was no association between food insecurity and obesity in children and adolescents of Iranian population (OR 1.29, 95% CI 0.91, 1.82) with no evidence of publication bias and heterogeneity between the studies (I² = 0.0 %; P = 0.52). Conclusions: There was no association between food insecurity and underweight or obesity in children and adolescents of Iranian population. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity can affect life in three aspects, including continuing obesity after childhood, increased risk of chronic diseases, and mortality. Over the last year, students' lifestyles have changed due to the COVID-19 pandemic. In order to plan educational interventions to improve students' health, this study aimed to investigate the prevalence of obesity among elementary students during COVID-19 pandemic in Yazd, Iran. Methods: This cross-sectional study was conducted on 583 elementary students in 4th-6th grades (aged 10-12 years) in Yazd in 2021. The participants were recruited using multistage sampling (cluster, stratified, and random) method. Data collection tools included the physical activity questionnaire for older children (PAQ-C) and a validated researcher-made questionnaire in terms of fast food and carbonated sweet beverages consumption. Body mass index (BMI) was calculated using the students' height and weight information registered in student electronic registration system (SANAD). Results: The prevalence of overweight and obesity among primary school students was 23.9% and 14.5%, respectively. Gender (P < 0.0001), type of school (P < 0.0001), mother's education level (P = 0.03), amount of carbonated sweet beverages (P < 0.0001), and level of physical activity (P = 0.04) were associated with BMI status. There was no significant association between frequency of students' consumption of fast food (P = 0.41) or soft drinks and BMI status (P = 0.48). Conclusion: During the COVID-19 outbreak, students' weight gain has been more affected by reducing physical activity than consuming high-calorie foods. Therefore, it is required to create new infrastructure and opportunities for improving physical activity among students. [ABSTRACT FROM AUTHOR]

Background: The prevalence of obesity in children is increasing in the world and it has become one of the major health problems. Parents are the first people who have the opportunity to shape child's eating experiences and habits, including food preferences, attitudes, and eating patterns. This study was conducted to determine the moderating role of parental feeding styles in relation to family psychosocial and social risk factors and childhood obesity in primary school children in 2018-2019 academic year in Shiraz, Iran. Methods: In this study, 298 children aged 6 to 11 years from primary schools in Shiraz were selected using multistage cluster sampling method. Their parents completed the stress-anxiety-depression scale tool and parenting feeding styles questionnaire. The data were analyzed using simultaneous multiple regression analysis, cluster analysis, and two-way analysis of variance (ANOVA). Results: The results showed that there was a statistically significant correlation between the identified risk factors and child's body mass index (BMI), as well as the variable effect of feeding styles on the child's BMI. The interaction of risk factors on feeding styles indicated that the effect of adjusting feeding styles on childhood obesity was significant due to risk factors. Conclusion: These findings support the moderating role of parental feeding styles in the development or prevention of childhood obesity. [ABSTRACT FROM AUTHOR]

Background: Childhood/adolescence under- and over-nutrition are among the major public concerns worldwide. This study aimed to determine the prevalence of underweight, overweight, and obesity among children living in Yazd, Iran using different criteria. Methods: This community-based cross-sectional study was conducted among children and adolescents aged 6-18 years. Body weight, height, waist, and hip circumference were measured. Furthermore, the body mass index (BMI) and waist to hip ratio were calculated. Afterwards, BMI was classified according to four criteria including the US center for disease control and prevention (CDC), world health organization (WHO), the international obesity task force (IOTF), and Iranian national cut-points. Results: The mean age of the included children was 11.32 ± 3.89 years. Overall, the highest rate of underweight was estimated by IOTF %16.9 and the lowest rate was estimated by the national criteria %1.2. Furthermore, the highest and the lowest rates for overweight were obtained by CDC2000%19.0 and WHO criteria %12.2, respectively. The highest and lowest rates for obesity were obtained by the national %22.3 and the CDC2000 criteria %11.3, respectively. The selected criteria were significantly different in estimating underweight, overweight, and obesity (P < 0.05). Conclusions: All the mentioned criteria showed high rate of overweight and obesity among children and adolescents in Yazd. Furthermore, the highest rate of obesity was detected by national criteria. The national distribution of BMI in Iranian children is skewed to overweight and obesity. [ABSTRACT FROM AUTHOR]

Background: The prevalence of obesity in children is increasing in the world and it has become one of the major health problems. Parents are the first people who have the opportunity to shape child's eating experiences and habits, including food preferences, attitudes, and eating patterns. This study was conducted to determine the moderating role of parental feeding styles in relation to family psychosocial and social risk factors and childhood obesity in primary school children in 2018-2019 academic year in Shiraz, Iran. Methods: In this study, 298 children aged 6 to 11 years from primary schools in Shiraz were selected using multistage cluster sampling method. Their parents completed the stress-anxiety-depression scale tool and parenting feeding styles questionnaire. The data were analyzed using simultaneous multiple regression analysis, cluster analysis, and two-way analysis of variance (ANOVA). Results: The results showed that there was a statistically significant correlation between the identified risk factors and child's body mass index (BMI), as well as the variable effect of feeding styles on the child's BMI. The interaction of risk factors on feeding styles indicated that the effect of adjusting feeding styles on childhood obesity was significant due to risk factors. Conclusion: These findings support the moderating role of parental feeding styles in the development or prevention of childhood obesity. [ABSTRACT FROM AUTHOR]