Vaani P Garg1, Rajesh Vedanthan2, Farhad Islami3, Akram Pourshams4, Hossein Poutschi4, Hooman Khademi5, Mohammad Naeimi6, Akbar Fazel-Tabar Malekshah4, Elham Jafari4, Rasool Salahi6, Farin Kamangar7, Arash Etemadi8, Paul D Pharoah9, Christian C Abnet8, Paul Brennan10, Sanford M Dawsey8, Valentin Fuster11, Paolo Boffetta12, Reza Malekzadeh4. 1. Icahn School of Medicine at Mount Sinai, New York, NY, USA. 2. Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: rajesh.vedanthan@mssm.edu. 3. Icahn School of Medicine at Mount Sinai, New York, NY, USA; Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 4. Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 5. Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; International Agency for Research on Cancer, Lyon, France. 6. Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. 7. Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA. 8. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. 9. Departments of Oncology and Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. 10. International Agency for Research on Cancer, Lyon, France. 11. Icahn School of Medicine at Mount Sinai, New York, NY, USA; Centro Nacional de Investigaciones Cardiovasculares, Calle de Melchor Fernandez Almagro, Madrid, Spain. 12. Icahn School of Medicine at Mount Sinai, New York, NY, USA; International Prevention Research Institute, Lyon, France.
Abstract
BACKGROUND: Cardiovascular disease and obesity are now becoming leading causes of morbidity and mortality in low- and middle-income countries. OBJECTIVES: We investigated the relationship between prevalent heart disease (HD) and current anthropometric indices and body size perception over time from adolescence to adulthood in Iran. METHODS: We present a cross-sectional analysis of baseline data from a prospective study of adults in Golestan Province, Iran. Demographics, cardiac history, and current anthropometric indices-body mass index, waist circumference, and waist to hip ratio-were recorded. Body size perception for ages 15 years, 30 years, and at the time of interview was assessed via pictograms. Associations of these factors and temporal change in perceived body size with HD were evaluated using multivariable logistic regression models. RESULTS: Complete data were available for 50,044 participants; 6.1% of which reported having HD. Higher body mass index, waist circumference, and waist to hip ratio were associated with HD (p < 0.001). Men had a U-shaped relationship between HD and body size perception at younger ages. For change in body size perception, men and women demonstrated a U-shaped relationship with prevalent HD from adolescence to early adulthood, but a J-shaped pattern from early to late adulthood. CONCLUSIONS: HD was associated with anthropometric indices and change in body size perception over time for men and women in Iran. Due to the increasing prevalence of overweight and obesity in low- and middle-income countries, interventions focused on decreasing the cumulative burden of risk factors throughout the life course may be an important component of cardiovascular risk reduction.
BACKGROUND:Cardiovascular disease and obesity are now becoming leading causes of morbidity and mortality in low- and middle-income countries. OBJECTIVES: We investigated the relationship between prevalent heart disease (HD) and current anthropometric indices and body size perception over time from adolescence to adulthood in Iran. METHODS: We present a cross-sectional analysis of baseline data from a prospective study of adults in Golestan Province, Iran. Demographics, cardiac history, and current anthropometric indices-body mass index, waist circumference, and waist to hip ratio-were recorded. Body size perception for ages 15 years, 30 years, and at the time of interview was assessed via pictograms. Associations of these factors and temporal change in perceived body size with HD were evaluated using multivariable logistic regression models. RESULTS: Complete data were available for 50,044 participants; 6.1% of which reported having HD. Higher body mass index, waist circumference, and waist to hip ratio were associated with HD (p < 0.001). Men had a U-shaped relationship between HD and body size perception at younger ages. For change in body size perception, men and women demonstrated a U-shaped relationship with prevalent HD from adolescence to early adulthood, but a J-shaped pattern from early to late adulthood. CONCLUSIONS:HD was associated with anthropometric indices and change in body size perception over time for men and women in Iran. Due to the increasing prevalence of overweight and obesity in low- and middle-income countries, interventions focused on decreasing the cumulative burden of risk factors throughout the life course may be an important component of cardiovascular risk reduction.
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