Rabbani Bita, Chiti Hossein, Sharifi Faranak, Mazloomzadeh Saeedeh
Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
Caspian J Intern Med. 2022 Summer;13(3):555-566. doi: 10.22088/cjim.13.3.555.
Lifestyle modifications, especially improving nutritional patterns and increasing physical activity are the most important factors in preventing obesity and metabolic syndrome in children and adolescents. For this purpose, the following interventional study was designed to investigate the effects of educational programs for students, as well as the changes in diet and physical activity on obesity and components of the metabolic syndrome.
This study is part of an interventional research project (elementary school) conducted on all students of Sama schools in Zanjan and Abhar in three levels;elementary, middle and high school, including 1000 individuals in Zanjan (intervention group) and 1000 individuals (control group) in Abhar in 2011. Interventions were based on educating students, teachers and parents, changes in food services and physical activity. We primarily measured anthropometric indices, fasting blood sugar, lipid profiles and blood pressure and completed standard nutrition and physical activity questionnaires. Also, blood insulin levels were randomly measured in a number of students. Data analysis was done by SPSS software Version 16.0.
Overall, 589 individuals (252 males, 337 females) entered the case group and 803 individuals (344 males, 459 females) entered the control group. After two years of intervention, the mean waist circumference (63.8±10.9) and diastolic BP (63.8±10.4) were significantly lower, however, the mean systolic BP (10.1.0±12.5), food score (25.0±5.0) and drinking score (12.1±2.3) were higher in the intervention group (p<0.001). Comparing the components of metabolic syndrome between the second year and at the time of recruitment within the intervention group, showed that although the number of overweight/obese individuals, individuals with hypertriglyceridemia and high LDL increased, while those with abdominal obesity, high BP, hyperglycemia, and insulin resistance decreased (p<0.001). On the other hand, in the control group, the number of individuals with high BP increased significantly.
The prevalence of abdominal obesity and hypertension, which are the two major components of metabolic syndrome, are much higher in our study than the other regions of the country. However, interventions for modification of diet and increasing physical activity, are effective in lowering of their prevalence.
生活方式的改变，尤其是改善营养模式和增加体育活动，是预防儿童和青少年肥胖及代谢综合征的最重要因素。为此，设计了以下干预性研究，以调查针对学生的教育项目以及饮食和体育活动的变化对肥胖和代谢综合征各组分的影响。
本研究是一项干预性研究项目（小学）的一部分，该项目在赞詹和阿巴尔的萨马学校的所有学生中分三个级别进行；小学、初中和高中，2011年在赞詹有1000名学生（干预组），在阿巴尔有1000名学生（对照组）。干预措施基于对学生、教师和家长的教育、食品服务和体育活动的改变。我们主要测量了人体测量指标、空腹血糖、血脂谱和血压，并完成了标准的营养和体育活动问卷。此外，还随机测量了一些学生的血胰岛素水平。数据分析使用SPSS软件16.0版完成。
总体而言，589名个体（252名男性，337名女性）进入病例组，803名个体（344名男性，459名女性）进入对照组。经过两年的干预，干预组的平均腰围（63.8±10.9）和舒张压（63.8±10.4）显著降低，然而，干预组的平均收缩压（101.0±12.5）、食物评分（25.0±5.0）和饮酒评分（12.1±2.3）更高（p<0.001）。比较干预组第二年与招募时的代谢综合征各组分，结果显示，虽然超重/肥胖个体、高甘油三酯血症个体和高LDL个体的数量增加，但腹型肥胖、高血压、高血糖和胰岛素抵抗个体的数量减少（p<0.001）。另一方面，在对照组中，高血压个体的数量显著增加。
代谢综合征的两个主要组分，即腹型肥胖和高血压的患病率，在我们的研究中比该国其他地区高得多。然而，改变饮食和增加体育活动的干预措施，对于降低它们的患病率是有效的。
