Underweight, Overweight, and Obesity among High School Students in the City of Golpayegan in 2015
 
Mosayeb Fallahi; MSc¹, Hassan Mozaffari-khosravi; PhD¹ , Davood Bahrami; MSc¹,
Maryam Lotfi-foroshani; MSc*²
 
[1] Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2 Department of Nutrition, School of Nutrition, Esfahan University of Medical Sciences.
 

 
Introduction

The prevalence of obesity and overweight in children and adults has been recently considered as an important health problem in the developing countries (De Onis and Blössner, 2000). In this regard, adolescents' overweight can be taken into account as a significant determinant of obesity and overweight in adulthood. Furthermore, a direct correlation was observed between childhood obesity and obesity in adolescence and adulthood. According to the related studies, 70-80% of overweight adolescents become obese adults and the rate of future obesity in obese children can be 2-3 times more than that in other children (Barsh et al., 2000).
Besides, overweight and obese children are more likely to be exposed to cardiovascular diseases, type II diabetes, hypertension, as well as metabolic syndromes in adulthood (Eisenmann, 2004, Golestan et al., 2008). Moreover, it seems that obesity is the result of environmental and genetic factors including bad diet, reduction of physical activities, as well as wrong lifestyles and behaviors (Garrow et al., 2000, Kral, 2001).
In this regard, Iran is known as one of the first seven countries with the highest prevalence rate of obesity and overweight, which was twice higher during 1993-1999 (Kelishadi et al., 2003). It was also reported that 8.82% of Iranian children suffered from overweight and 4.5% of them were obese. These rates were estimated to raise to 10.7% for overweight and 4.5% for obesity (Kelishadi et al., 2007, Kelishadi et al., 2014).
A research conducted among teenagers residing in the city of Tehran revealed that 10.7% of the individuals were overweight, 6.3% were fat, and 72.6% were normal (Weigley et al., 1997). According to other research in Iran, 3.4% of obesity and 11% of overweight were observed in individuals within the age range of 6-18 years. Moreover, differences among the cities were significant. Generally, obesity was reported tobe more common in northern and southern provinces of Iran, whereas, it was less common in some other geographic regions such as Sistan and Bluchestan Province (Mirzazadeh et al., 2009, Mozaffari-Khosravi et al., 2004, Shahgholian et al., 2004, Soheilifar and Emdadi, 2005).
On the other hand, malnutrition and weight loss in developing countries, including Iran, has been recognized as one of the most important health-related issues in children and adolescents. Accordingly, malnutrition was assumed to increase the incidence of infectious and chronic diseases. It was also found to damage the body functions, cause disorders, and hinder growth in adolescents; which consequently can reduce their efficiency in the domain of education (Nowrozi et al., 2011).
In a survey conducted in Birjand in 2001, the prevalence rate of malnutrition was 73.7% based on the criteria for underweight (according to Gomez criteria), was 36.5% based on the criteria for weight loss (in accordance with Waterloo criteria), and was 48.6% based on the criteria for short stature (according to Waterloo criteria) (Taheri et al., 2001). Percentiles of body mass index (BMI) were also one of the indicators used to measure overweight and obesity in adolescents (Cole et al., 2000). In this respect, percentiles smaller than five indicate malnutrition, values lower than 85-95 represent overweight, and those greater than 95 show obesity (WHO, 2000). In general, the purpose of this study was to investigate the prevalence rates of obesity, overweight, and malnutrition in 10th-grade high school students residing in Golpayegan city using the Third National Health and Nutrition Examination Survey (NHANES III) criteria published by the US Centers for Disease Control and Prevention (CDC).
Materials and Methods
In this cross-sectional study, a random cluster sampling method was performed and the sample size was obtained using the Cochran formula. This study was conducted on 800 high school students including 396 boys and 404 girls in the age range of 14-19 years, who were selected from eight schools.
Written consent forms were obtained from all the participants and the required information about their height and BMI were collected. The exclusion criteria included individuals suffering from cancer, hemophilia, thalassemia, and other disabilities. All measurements were done by the same person; the participants’ age in this study was also calculated according to their identification card. Moreover, a digital scale was used for recording their weights without shoes and clothes. It should be noted that the accuracy of the given scale was calculated using a 5-kilogram weight for 10 times weighting. The BMI was similarly calculated based on the individuals' height and weight in kilograms per square meter (kg/m²). Later, the participants were divided into four groups of underweight (less than percentile 5), normal (5-50 percentiles), overweight (85-95 percentiles), and obese (more than percentile 95) (based on the Centers for Disease Control and Prevention criteria, 2000). Finally, the data were analyzed using the SPSS (Version 16).
Results
The total number of the high school students was 800 including 396 boys and 404 girls in the age range of 14-19 years with the mean age of 15.6 ± 6.6 years. The lowest weight reported was 30 and the highest one was 121 kg, the mean weight was 56.64 ± 13.34 kg. Among the students, the lowest height was 136 cm and the highest one was 198 cm. The mean height was also equal to 164.7 ± 8.12 cm. The BMI was at least 12.5 kg/m², while the highest BMI was 38.6 kg/m² and the BMI mean was equal to 20.11 ± 4.08 kg/m². Other demographic characteristics of the participants are also listed in Table 1. Moreover, the students’ anthropometric characteristics including age and gender are presented in Table 2.      
The prevalence of underweight and obesity in boys was significantly higher than girls (Table 3). The risks of obesity and overweight were also reported higher in students whose parents were illiterate; although, no relationship was found between the risks of underweight and the levels of parental literacy (Table 4).