Academic journal article Journal of Health Population and Nutrition

Gender Differences in Obesogenic Behaviour, Socioeconomic and Metabolic Factors in a Population-Based Sample of Iranians: The IHHP Study

Academic journal article Journal of Health Population and Nutrition

Gender Differences in Obesogenic Behaviour, Socioeconomic and Metabolic Factors in a Population-Based Sample of Iranians: The IHHP Study

Article excerpt


Similar to many other developing countries, the Eastern Mediterranean region has experienced a significant rise in cardiovascular diseases (CVDs) in the last two decades (1). According to the estimate of the World Health Organization (WHO), by 2010, CVDs will be the major cause of morbidity and mortality in developing countries (2). Despite the recent improvements in health services which have enhanced the longevity of cardiovascular patients, CVDs are still the leading cause of death in Iran. Changes in lifestyle of the Iranians, including their improper nutritional habits, physical inactivity, and tobacco-use, are said to be responsible for this rise (3).

It is well-documented that obesity is one of the most important and modifiable risk factors of CVDs (4). Several lifestyle behaviours and factors relating to socioeconomic status (SES) may influence this emerging health problem. This influence may differ in terms of gender. To prepare and carry on effective programmes targeting the risk factors for CVDs, reliable data on different characteristics of the population are necessary. The baseline survey of a community-based programme titled Isfahan Healthy Heart Programme (IHHP) assessed the mean levels and prevalence of risk factors for CVDs in three cities in the central part of Iran. Further, it aimed to determine the behavioural and SES factors associated with CVDs to plan necessary population-based interventions.

The present study reports the differences in the obesity indices, other risk factors for CVDs, lifestyle behaviours, and SES among Iranian men and women.



The methods of the IHHP have been previously described in details (5-6), and here we describe those in brief.

We selected 12,514 men and women, aged [greater than or equal to] 19 years, from Isfahan, Najaf-Abad, and Arak--three counties located in the central part of Iran, using multistage random-cluster sampling. Pregnant women and those who were not mentally competent were excluded from the study. Data were collected in different sessions comprising a 30-minute home-interview and physical examinations in clinics. The validated questionnaire included questions on demographic characteristics, smoking, nutrition, and physical activity-related behaviours.

Nutritional behaviours are presented as Global Dietary Index (GDI) that was calculated using a large volume of data obtained on dietary habits through a validated qualitative 48-item food-frequency questionnaire which was adapted from the validated Countrywide Integrated Non-communicable Disease Intervention (CINDI) programme (7). This questionnaire focused on total and saturated fat intake. Frequency responses were scored as 2, 1, or 0 depending on nutritional value, with higher score indicating higher total and saturated fat intakes, e.g. by questions as "How many times a week do you usually eat meat?"


Healthful nutritional behaviour was defined as having more than five times of fruits and vegetables per day (8-9). Physical activity was assessed quantitatively with a detailed questionnaire that assessed the walking or cycling time.

Smoking was defined as current smoking for those who smoke at least one cigarette a day; passive smoking for those who had involuntary inhalation by a non-smoker; and ex-smoker as those who do not actually smoke but have a history of previous regular use of tobacco (10).

Weight and height were measured with calibrated instruments and under a standard protocol (4). Body mass index (BMI) was calculated as weight (kg)/height (m)2. Waist circumference (WC) and hip circumference were measured and recorded in cm using standard WHO methods. The waist-to-hip ratio (WHR) was calculated by dividing the circumference of the waist to that of the hip.

Fasting venous blood samples were examined for total cholesterol (TC), high-density lipoprotein (HDL-C), triglycerides (TG), and fasting blood glucose (FBG). …

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