Assessment of longitudinal and cross-sectional effects of age on adult obesity in an Iranian population: results of a large population-based cohort study
Vol. 23 No. 6 (2021), Research articles
Vol. 23 No. 6 (2021)

Assessment of longitudinal and cross-sectional effects of age on adult obesity in an Iranian population: results of a large population-based cohort study

Research articles
https://doi.org/10.32592/ircmj.2021.23.6.736
Published 2021-06-21
Mahsa Rafiee Alhossaini
Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, P.O Box 14115111, Tehran, Iran
Anoshirvan Kazemnejad
Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, P.O Box 14115111, Tehran, Iran
Farid Zayeri
Proteomics Research Center and Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 1971653313, Tehran, Iran
Masoumeh Sadeghi
3Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, P.O Box 58388994, Isfahan, Iran
PDF
HTML

Keywords

Adult
Age factors
Aging
Obesity

Categories

How to Cite

Rafiee Alhossaini, M., Kazemnejad, A. ., Zayeri, F. ., & Sadeghi, M. . (2021). Assessment of longitudinal and cross-sectional effects of age on adult obesity in an Iranian population: results of a large population-based cohort study. Iranian Red Crescent Medical Journal, 23(6). https://doi.org/10.32592/ircmj.2021.23.6.736
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver

Download Citation

Endnote/Zotero/Mendeley (RIS) BibTeX

Abstract

Background: The risk of obesity commonly changes with age, which is a longitudinal (aging) effect. Moreover, the individuals who enter the study at the same age have similar living conditions that may influence their obesity risk in a particular way; this is a cross-sectional effect. Both cross-sectional and longitudinal effects of age should be considered for a better understanding of the effect of age on obesity and the related factors.

Objectives: The present study aimed to (i) assess both the cross-sectional and longitudinal effects of age on obesity and (ii) determine how obesity changes with age in the target population using a Marginal Logistic Regression (MLR) model.

Methods: The current study made use of the information of individuals who had participated in the Isfahan Cohort Study. Participants were a large group of Iranian adults over 35 years of age who lived in the central region of Iran in 2001. Repeated measurements were obtained in 2001, 2007, and 2013.

Results: From 2001 to 2013, the percentage of obesity in men and women raised from 13% and 31% to 18% and 44%, respectively. Both cross-sectional and longitudinal effects of age were significantly associated with the odds ratio of obesity. There was a rise in the probability of obesity for individuals aged 35-60 years at baseline and a decline for the older ones. The odds of obesity had about a 2% increase (on average) per year, regardless of the baseline age.

Conclusion: The obtained results pointed to a difference between the cross-sectional and longitudinal effects of age on the probability of obesity in the target population. The high and rising prevalence of obesity was a serious public health issue among participants, especially women, aged 35-60 years. The assessment of changes in obesity in a population-based study provides opportunities to target subpopulations that need more care and attention in public health interventions.

https://doi.org/10.32592/ircmj.2021.23.6.736
PDF
HTML

References

  1. Emamian MH, Fateh M, Hosseinpoor AR, Alami A, Fotouhi A. Obesity and its socioeconomic determinants in Iran. Econ Hum Biol. 2017;26:144-50. doi: 10.1016/j.ehb.2017.03.005. [PubMed: 28395273].
  2. Seidell JC, Halberstadt J. The global burden of obesity and the challenges of prevention. Ann Nutr Metab. 2015;66(Suppl 2):7-12. doi: 10.1159/000375143. [PubMed: 26045323].
  3. Kilpi F, Webber L, Musaigner A, Aitsi-Selmi A, Marsh T, Rtveladze K, et al. Alarming predictions for obesity and non-communicable diseases in the Middle East. Public Health Nutr. 2014;17(5):1078-86. doi: 10.1017/S1368980013000840. [PubMed: 23642403].
  4. Rahmani A, Sayehmiri K, Asadollahi K, Sarokhani D, Islami F, Sarokhani M. Investigation of the prevalence of obesity in Iran: a systematic review and meta-analysis study. Acta Med Iran. 2015;53(10):596-607. [PubMed: 26615371].
  5. Azizi F, Azadbakht L, Mirmiran P. Trends in overweight, obesity and central fat accumulation among Tehranian adults between 1998–1999 and 2001–2002: Tehran lipid and glucose study. Ann Nutr Metab. 2005;49(1):3-8. doi: 10.1159/000084171. [PubMed: 15735362].
  6. Bahrami H, Sadatsafavi M, Pourshams A, Kamangar F, Nouraei M, Semnani S, et al. Obesity and hypertension in an Iranian cohort study; Iranian women experience higher rates of obesity and hypertension than American women. BMC Public Health. 2006;6(1):158. doi: 10.1186/1471-2458-6-158. [PubMed: 16784543].
  7. Bakhshi E, Etemad K, Seifi B, Mohammad K, Biglarian A, Koohpayehzadeh J. Changes in obesity odds ratio among Iranian adults, since 2000: Quadratic inference functions method. Comput Math Methods Med. 2016;2016:7101343. doi: 10.1155/2016/7101343. [PubMed: 27803729].
  8. Janghorbani M, Amini M, Willett WC, Gouya MM, Delavari A, Alikhani S, et al. First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity. 2007;15(11):2797-808. doi: 10.1038/oby.2007.332. [PubMed: 18070771].
  9. Khosravi-Boroujeni H, Sarrafzadegan N, Sadeghi M, Roohafza H, Talaei M, Ng SK, et al. Secular trend of metabolic syndrome and its components in a cohort of Iranian adults from 2001 to 2013. Metab Syndr Relat Disord. 2017;15(3):137-44. doi: 10.1089/met.2016.0073. [PubMed: 28135122].
  10. Sarrafzadegan N, Talaei M, Sadeghi M, Mohammadifard N, Lotfizadeh Dehkordi M, Esmaillzadeh A, et al. Determinants of weight change in a longitudinal study of Iranian adults: Isfahan cohort study. Arch Iran Med. 2014;17(8):539-44. [PubMed: 25065276].
  11. Djalalinia S, Saeedi Moghaddam S, Sheidaei A, Rezaei N, Naghibi Iravani SS, Modirian M, et al. Patterns of obesity and overweight in the iranian population: findings of STEPs 2016. Front Endocrinol. 2020;11:42. doi: 10.3389/fendo.2020.00042. [PubMed: 32174887].
  12. Djalalinia S, Peykari N, Qorbani M, Larijani B, Farzadfar F. Inequality of obesity and socioeconomic factors in Iran: a systematic review and meta-analyses. Med J Islam Repub Iran. 2015;29:241. [PubMed: 26793632].
  13. An R, Xiang X. Age–period–cohort analyses of obesity prevalence in US adults. Public Health. 2016;141:163-9. doi: 10.1016/j.puhe.2016.09.021. [PubMed: 27931993].
  14. Jaacks LM, Gordon-Larsen P, Mayer-Davis EJ, Adair LS, Popkin B. Age, period and cohort effects on adult body mass index and overweight from 1991 to 2009 in China: the China Health and Nutrition Survey. Int J Epidemiol. 2013;42(3):828-37. doi: 10.1093/ije/dyt052. [PubMed: 23771721].
  15. Keyes KM, Utz RL, Robinson W, Li G. What is a cohort effect? Comparison of three statistical methods for modeling cohort effects in obesity prevalence in the United States, 1971–2006. Soc Sci Med. 2010;70(7):1100-8. doi: 10.1016/j.socscimed.2009.12.018. [PubMed: 20122771].
  16. Mujahid MS, Diez Roux AV, Borrell LN, Nieto FJ. Cross‐sectional and longitudinal associations of BMI with socioeconomic characteristics. Obes Res. 2005;13(8):1412-21. doi: 10.1038/oby.2005.171. [PubMed: 16129724].
  17. Fitzmaurice GM, Laird NM, Ware JH. Applied longitudinal analysis. New Jersey: John Wiley & Sons; 2012.
  18. Diggle P, Diggle PJ, Heagerty P, Liang KY, Heagerty PJ, Zeger S. Analysis of longitudinal data. Oxford: Oxford University Press; 2002.
  19. Diouf I, Charles MA, Ducimetière P, Basdevant A, Eschwege E, Heude B. Evolution of obesity prevalence in France: an age-period-cohort analysis. Epidemiology. 2010;21(3):360-5. doi: 10.1097/EDE.0b013e3181d5bff5. [PubMed: 20375843].
  20. Sarrafzadegan N, Talaei M, Sadeghi M, Kelishadi R, Oveisgharan S, Mohammadifard N, et al. The Isfahan cohort study: rationale, methods and main findings. J Hum Hypertension. 2011;25(9):545. doi: 10.1038/jhh.2010.99. [PubMed: 21107436].
  21. Sarraf-Zadegan N, Sadri G, Malek-Afzali H, Baghaei M, Mohammadi-Fard N, Shahrokhi S, et al. Isfahan healthy heart programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience. Acta Cardiol. 2003;58(4):309-20. doi: 10.2143/AC.58.4.2005288. [PubMed: 12948036].
  22. Sarrafzadegan N, Baghaei A, Sadri G, Kelishadi R, Malekafzali H, Boshtam M, et al. Isfahan healthy heart program: evaluation of comprehensive, community-based interventions for non-communicable disease prevention. Prev Control. 2006;2(2):73-84. doi: 10.1016/j.precon.2006.10.003.
  23. Sarrafzadegan N, Hassannejad R, Roohafza H, Sadeghi M, Talaei M, Oveisgharan S, et al. A 10-year Isfahan cohort on cardiovascular disease as a master plan for a multi-generation non-communicable disease longitudinal study: methodology and challenges. J Hum Hypertens. 2019;33(11):807-16. doi: 10.1038/s41371-018-0126-2. [PubMed: 30385824].
  24. Sadeghi M, Talaei M, Gharipour M, Oveisgharan S, Nezafati P, Dianatkhah M, et al. Anthropometric indices predicting incident hypertension in an Iranian population: the Isfahan cohort study. Anatol J Cardiol. 2019;22(1):33-43. doi: 10.14744/AnatolJCardiol.2019.10594. [PubMed: 31264654].
  25. World Health Organization. Noncommunicable diseases country profiles. Geneva: World Health Organization; 2018.
  26. Fitzmaurice G, Davidian M, Verbeke G, Molenberghs G. Longitudinal data analysis. Florid: CRC Press; 2008.
  27. Blüher[S1]  M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019;15(5):288-98. doi: 10.1038/s41574-019-0176-8. [PubMed: 30814686].
  28. Asgari F, Biglarian A, Seifi B, Bakhshi A, Miri HH, Bakhshi E. Using quadratic inference functions to determine the factors associated with obesity: findings from the STEPS Survey in Iran. Ann Epidemiol. 2013;23(9):534-8. doi: 10.1016/j.annepidem.2013.07.006. [PubMed: 23958406].
  29. Bakhshi E, Seifi B, Biglarian A, Mohammad K. Factors associated with obesity in Iranian elderly people: results from the national health survey. BMC Res Notes. 2011;4(1):538. doi: 10.1186/1756-0500-4-538. [PubMed: 22168800].
  30. Hickson M. Malnutrition and ageing. Postgrad Med J. 2006;82(963):2-8. doi: 10.1136/pgmj.2005.037564. [PubMed: 16397072].
  31. Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019;15(5):288-98. doi: 10.1038/s41574-019-0176-8. [PubMed: 30814686].
  32. Rashidy‐Pour A, Malek M, Eskandarian R, Ghorbani R. Obesity in the Iranian population. Obes Rev. 2009;10(1):2-6. doi: 10.1111/j.1467-789X.2008.00536.x. [PubMed: 19021868].
  33. Azizi F, Allahverdian S, Mirmiran P, Rahmani M, Mohammadi F. Dietary factors and body mass index in a group of Iranian adolescents: Tehran lipid and glucose study-2. Int J Vitam Nutr Res. 2001;71(2):123-7. doi: 10.1024/0300-9831.71.2.123. [PubMed: 11339109].
  34. Kelishadi R, Alikhani S, Delavari A, Alaedini F, Safaie A, Hojatzadeh E. Obesity and associated lifestyle behaviours in Iran: findings from the first national non-communicable disease risk factor surveillance survey. Public Health Nutr. 2008;11(3):246-51. doi: 10.1017/S1368980007000262. [PubMed: 17625028].
  35. Hajian-Tilaki K, Heidari B. Association of educational level with risk of obesity and abdominal obesity in Iranian adults. J Public Health. 2010;32(2):202-9. doi: 10.1093/pubmed/fdp083. [PubMed: 19689983].
  36. Sassi F, Devaux M, Church J, Cecchini M, Borgonovi F. Education and obesity in four OECD countries. New York: OECD Publishing; 2009.
  37. Kim YJ. The long-run effect of education on obesity in the US. Econ Hum Biol. 2016;21:100-9. doi: 10.1016/j.ehb.2015.12.003. [PubMed: 26828291].

Most read articles by the same author(s)