Background Preventing overweight in childhood and subsequent stages of life is still a global challenge. Despite numerous relevant lifestyle interventions, data on their impact on different BMI change pathways over time is rare. The present study aimed to investigate the effect of a multi-setting lifestyle intervention on BMI trajectories from childhood to young adulthood. Methods A multi-setting lifestyle intervention at the school, family, and community levels have been conducted in the Tehran Lipid and Glucose Study framework. A total of 2145 children (4–18 years, 49% boys, and 18% intervention) were recruited for the baseline assessment and were followed through five follow-up examinations during a median of 16.1 years. Using a group-based trajectory model, BMI trajectories from childhood to young adulthood were identified, and their association with the implemented intervention was assessed. Results Four trajectory groups of BMI from childhood to young adulthood were identified, including Normal weight (41%), Young adulthood overweight (36%), Early childhood increasing overweight and adulthood obesity (19%), and Early childhood increasing obesity (4%). Only Young adulthood overweight and Early childhood increasing obesity were affected by the intervention and were concomitant with lower BMI levels than the control group, with the highest estimated effect in the latter (β=-0.52 and p = 0.018; β=-1.48 and p < 0.001, respectively). Conclusion The current findings indicate the highest effectiveness of a practical, healthy lifestyle intervention on those whose obesity started in the early years of life or youth. Our results could help policymakers and planners design more targeted lifestyle modification and weight control interventions. Trial registration This study is registered at Iran Registry for Clinical Trials, a WHO primary registry (http://irct.ir). The Iran Registry for Clinical Trials ID and date are IRCTID:IRCT138705301058N1, 29/10/2008.
Background The aim of the present study was to validate the Lifestyle Behavior Checklist (LBC) questionnaire, to measure Iranian parents' perceptions of their children's weight-related behaviors and their self-efficacy in dealing with those behaviors. Methods The LBC was translated into Farsi. Face and content validity of the questionnaire was evaluated by an expert panel. A total of 213 mothers of 3–12-year-old children responded to the questionnaire. Criterion validity of the questionnaire was evaluated through comparing its result with a parenting style questionnaire. Principal component analysis (PCA) and confirmatory factor analyses (CFA) were used to evaluate construct validity of the questionnaire. Reproducibility was measured by twice administration of LBC, one month apart and using Spearman's rho correlation test. The questionnaire's internal consistency was assessed by calculating Cronbach's α. Results LBC Problem scale was significantly correlated with authoritarian parenting style score, while the Confidence scale was significantly correlated with authoritative and negatively with permissive and authoritarian parenting styles. PCA suggested a six-factor construct, including, fussy eating, food-related problem behaviors, overeating behaviors, low interest in physical activity, poor self-image and sedentary behaviors. The results of CFA indicated acceptable fit indices for the proposed models. Both, Problem scale (Cronbach's α = 0.8) and Confidence scale (Cronbach's α = 0.95) had high internal consistency. Spearman correlation coefficients indicated acceptable reproducibility for both the Problem scale (r = 0.74) and the Confidence scale (r = 0.70). Conclusions The Farsi version of LBC questionnaire is reliable and reasonably valid to measure Iranian mothers' perception of their children's weight-related problem behavior.
Background The effect of thyroid dysfunctions on the female reproductive system is well recognized. Although many studies pointed out the possible effect of female reproductive status alteration on thyroid function, there are too many contradictions to come up with an exact conclusion. This study aimed to investigate the associations of parity, abortion, and menopause status with the prevalence and incidence of thyroid dysfunctions. Methods From the Tehran Thyroid Study (TTS) population, 2191 euthyroid female participants at baseline were selected and followed up in three-year intervals. Multivariable Cox proportional hazard model was used to determine associations between the incidence of thyroid dysfunctions with parity, abortion, and menopause status; age, smoking, body mass index, and thyroid peroxidase antibodies positivity were adjusted. Results At the baseline, multiple parities were significantly associated with overt hypothyroidism (OR, 95% CI: 1.12, 1.0-1.26) and subclinical hyperthyroidism (OR, 95% CI: 1.11, 1.03–1.21). Likewise, multiple abortions were associated with overt hyperthyroidism (OR, 95% CI: 2.09, 1.02–4.26). Multiple parities (≥ 4) significantly increased the risk of incident subclinical and clinical hypothyroidism. Moreover, the incidence of overt hypothyroidism significantly decreased in mothers with a history of abortion. No significant associations between menopause status with the prevalence and incidence of hypothyroidism or hyperthyroidism were observed. Conclusions There are relationships between parity and abortion with thyroid function. Understanding the exact mechanism requires more information at the cellular and molecular level on signaling cascades alterations during pregnancy.
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