OBJECTIVEThe purpose of this study was to provide the first national estimate on the prevalence of the metabolic syndrome and its components and the first ethnic-specific cutoff point for waist circumference in the Eastern Mediterranean Region.RESEARCH DESIGN AND METHODSThis national survey was conducted in 2007 on 3,024 Iranians aged 25–64 years living in urban and rural areas of all 30 provinces in Iran. The metabolic syndrome was defined by different criteria, namely the definition of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), the International Diabetes Federation (IDF) criteria, and the modified definition of the NCEP/ATP III (ATP III/American Heart Association [AHA]/National Heart, Lung, and Blood Institute [NHLBI]).RESULTSThe age-standardized prevalence of the metabolic syndrome was about 34.7% (95% CI 33.1–36.2) based on the ATP III criteria, 37.4% (35.9–39.0%) based on the IDF definition, and 41.6% (40.1–43.2%) based on the ATP III/AHA/NHLBI criteria. By all definitions, the prevalence of the metabolic syndrome was higher in women, in urban areas, and in the 55- to 64-year age-group compared with the prevalence in men, in rural areas, and in other age-groups, respectively. The metabolic syndrome was estimated to affect >11 million Iranians. The optimal cutoff point of waist circumference for predicting at least two other components of the metabolic syndrome as defined by the IDF was 89 cm for men and 91 cm for women.CONCLUSIONSThe high prevalence of the metabolic syndrome with its considerable burden on the middle-aged population mandates the implementation of national policies for its prevention, notably by tackling obesity. The waist circumference cutoff points obtained can be used in the region.

Objective To examine the relation of dietary and physical activity (PA) patterns with the body mass index (BMI), and the associations between these patterns among children. Methods A representative sample of 21 111 school students aged 6-18 years was selected by multistage random cluster sampling from 23 provinces in the Islamic Republic of Iran. PA and dietary pattern were assessed by self-administered validated questionnaires. Findings Fruit and vegetables, dairy products and snacks (salty, fatty or sweet) had a similar consumption frequency of approximately twice a day. The type of fat most frequently consumed was hydrogenated solid fat (consumed by 73.8% of families). The PA level was significantly higher among boys than girls, in rural than in urban residents, and in intermediate students than high-school students. Among boys, the frequency of consumption of vegetables and plant proteins (R² = 0.46); and among girls, the frequency of consumption of dairy products and fruits, as well as high PA level had a significant inverse association with BMI (R² = 0.57). Among boys, the low frequency of consumption of fruits, the time spent on PA and the energy expenditure; and among girls, the time spent on PA and the energy expenditure, had significant relationships with overweight. When controlling for covariates, PA levels had significant relationships with the frequency of consumption of all food groups. Conclusion Unhealthy lifestyles make Iranian young people prone to chronic diseases later in life. When examining their health benefits, the interrelationship of dietary and PA behaviours should be considered. Voir page 24 le résumé en français. En la página 25 figura un resumen en español. IntroductionAccording to WHO estimates, by 2020, noncommunicable diseases (NCD) will account for approximately three quarters of all deaths in the developing world.1 Interest in childhood precursors to chronic diseases is increasing because the behavioural and biological risk fact t tors for chronic diseases persist from childhood into adulthood.2-4 Declining levels of physical activity (PA) as well as nutrition transition (i.e. the trend towards increased consumption of a diet high in saturated fat, sugar and refined foods, and low in fibre) among commut t nities are thought to be partly responsible for the rising rate of such risk factors worldwide. In this regard, a potential emerging public health concern in developing countries is likely to be the increasing incidence of childhood overweight, which in the future is likely to create an enormous public health burden. 8In recent years, in addition to problems in adults, the epidemiologit t cal transition has made Iranian young people prone to chronic diseases in later life. The project team obtained written informed consent from parents and oral assent from students. They selected school students by multistage random cluster sampling. Schools were stratified according to location (urban or rural), and the socioeconomic characteristics of their catchment area, taking into consi...

OBJECTIVE -Despite concerns regarding a diabetes epidemic in the Middle East, internationally published data on national estimates of prevalent type 2 diabetes in Iran do not exist. With this article, we document a dramatically high prevalence of diabetes in Iran. RESULTS -We found that 7.7% of adults aged 25-64 years, or 2 million adults, have diabetes, among whom one-half are undiagnosed. An additional 16.8%, or 4.4 million, of Iranian adults have impaired fasting glucose. RESEARCH DESIGN AND METHODSCONCLUSIONS -The high prevalence of diabetes in working-age adults is an ominous sign for this developing nation. As the relatively young Iranian population ages in the future and urbanization continues or accelerates, the prevalence of diabetes will likely escalate. Diabetes Care 31:96-98, 2008T he Middle East is expected to bear one of the world's greatest increases in the absolute burden of diabetes in the coming decades. Most of this increase is anticipated to affect the economically productive 45-to 64-year-old age segment in contrast with most developed countries, where the increase in diabetic patients will occur in those aged Ն65 years (1). Although national estimates of the diabetes burden in Iran do not exist, the most recent study reported a high prevalence of diabetes in the highly urbanized population of Tehran, Iran's capital. (2) Here, we report the diabetesrelated results of the national Survey of Risk Factors of Non-Communicable Diseases (SURFNCD) of Iran. As a population-based sample of over 89,000 Iranians, this study provides an opportunity to estimate the national prevalence and burden of impaired fasting glucose (IFG) and diabetes. As such, it provides a valuable basis for public health planning.RESEARCH DESIGN AND METHODS -The first Iran SUR-FNCD, a nationally representative crosssectional health survey, was conducted in January and February 2005 using guidelines of the stepwise approach to noncommunicable disease risk factor surveillance of the World Health Organization (3,4). In brief, a multistage probability cluster sampling scheme was used to randomly sample 89,400 adults aged 15-64 years from the urban and rural noninstitutionalized population of all 28 provinces of Iran.Participants were interviewed and examined to determine demographic characteristics and medical conditions, including history of diabetes. Participants who reported a history of physician-or health care professional-diagnosed diabetes were classified to have known diabetes. Subsequently, all participants aged 25-64 years (70,981 individuals) were asked to attend a health facility or laboratory for collection of blood samples following a 12-h fast. The departments of laboratory and medical diagnoses of each corresponding medical university in the provinces selected the laboratories based on standard instructions. The laboratories measured fasting plasma glucose (FPG) with coefficients of variation Ͻ3%. Of the 89,440 respondents, 18,459 individuals were aged Ͻ25 years, and of the remaining 70,981 individuals, 53,508 (75.4...

Background Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. Methods Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. Findings In 2017, there were 1•8 million (95% UI 1•8-1•9) incident cases of colorectal cancer globally, with an agestandardised incidence rate of 23•2 (22•7-23•7) per 100 000 person-years that increased by 9•5% (4•5-13•5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300-915 700) deaths in 2017, with an agestandardised death rate of 11•5 (11•3-11•8) per 100 000 person-years, which decreased between 1990 and 2017 (-13•5% [-18•4 to-10•0]). Colorectal cancer was also responsible for 19•0 million (18•5-19•5) DALYs globally in 2017, with an age-standardised rate of 235•7 (229•7-242•0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (-14•5% [-20•4 to-10•3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80-84 years, with the highest rates observed in the oldest age group (≥95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20•5% [12•9-28•9]), alcohol use (15•2% [12•1-18•3]), and diet low in milk (14•3% [5•1-24•8]). Interpretation There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burden. Funding Bill & Melinda Gates Found...

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Emerging Non-communicable diseases burden move United Nation to call for 25% reduction by 2025 in premature mortality from non-communicable diseases (NCDs). The World Health Organization (WHO) developed global action plan for prevention and control NCDs, but the countries’ contexts, priorities, and health care system might be different. Therefore, WHO expects from countries to meet national commitments to achieve the 25 by 25 goal through adapted targets and action plan.In this regards, sustainable high-level political statement plays a key role in rules and regulation support, and multi-sectoral collaborations to NCDs’ prevention and control by considering the sustainable development goals and universal health coverage factors.Therefore, Iran established the national authority’s structure as Iranian Non Communicable Diseases Committee (INCDC) and developed NCDs’ national action plan through multi-sectoral approach and collaboration researchers and policy makers. Translation Iran’s expertise could be benefit to mobilizing leadership in other countries for practical action to save the millions of peoples.

The findings of this study warrant the necessity of paying special attention to monitoring of the time trends in child obesity based on uniform definitions, as well as to design programmes to prevent and control associated factors.

Establishment of a uniform set of criteria for the MetS in children is needed. Routine WC measurement in the paediatric population may be clinically useful.