Document Type : Original Article(s)
- Firoozeh Sajjadi 1
- Noushin Mohammadifard 2
- Maryam Maghroun 3
- Fatemeh Shirani 4
- Simin Karimi 5
- Marzie Taheri 3
- Nizal Sarrafzadegan 6
1 Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3 Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
4 Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
5 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
6 Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
BACKGROUND: Lifestyle modification is the most important strategy for control of obesity and overweight. Obestatin and adiponectin are the biomarkers of obesity. Thus, this study was performed to examine the effect of educational and encouragement interventions and lifestyle modifications on obesity anthropometric as well as obestatin and adiponectin levels.METHODS: This semi-experimental study was conducted on a subsample of TABASSOM study. Participants were 41 overweight and obese children and adolescents aged 6-18 years old and 45 overweight and obese adults aged 19-65 years old. Anthropometric characteristics including height, weight, waist and hip circumferences, and body fat percentage (BFP) were measured at the first and after one year at the end of study. We implemented some educational and encouragement interventions regarding dietary modification and physical activity during the study. Obestatin and adiponectin levels were measured at the first and end of study by enzyme-linked immunosorbent assay (ELISA) method.RESULTS: The study did not show significant effect on anthropometric characteristics such as body mass index (BMI) and waist circumference (WC). BFP decreased significantly in boys, total children and adolescent group, and waist-to-hip ratio (WHR) decreased significantly only in adolescent boys after 1 year (P < 0.050).CONCLUSION: Educational and encouraging interventions and lifestyle modifications could lead to decrease of body WHR and BFP in adolescent boys. This is helpful in controlling the increasing rate of obesity.
- Calza S, Decarli A, Ferraroni M. Obesity and prevalence of chronic diseases in the 1999-2000 Italian National Health Survey. BMC Public Health 2008; 8: 140.
- Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health 2009; 9: 88.
- Sarrafzadegan N, Kelishadi R, Sadri G, Malekafzali H, Pourmoghaddas M, Heidari K, et al. Outcomes of a comprehensive healthy lifestyle program on cardiometabolic risk factors in a developing country: the Isfahan Healthy Heart Program. Arch Iran Med 2013; 16(1): 4-11.
- Kelishadi R, Mohammadifard N, Sarrazadegan N, Nouri F, Pashmi R, Bahonar A, et al. The effects of a comprehensive community trial on cardiometabolic risk factors in adolescents: Isfahan Healthy Heart Program. ARYA Atheroscler 2012; 7(4): 184-90.
- World Health Organization. Commission on Ending Childhood Obesity [Online]. [cited 2017]; Available from: URL; https://www.who.int/end-childhood-obesity/en
- Gao Y, Griffiths S, Chan EY. Community-based interventions to reduce overweight and obesity in China: A systematic review of the Chinese and English literature. J Public Health (Oxf) 2008; 30(4): 436-48.
- Sarrafzadegan N, Kelishadi R, Siadat ZD, Esmaillzadeh A, Solhpour A, Shirani S, et al. Obesity and cardiometabolic risk factors in a representative population of Iranian adolescents and adults in comparison to a Western population: The Isfahan Healthy Heart Programme. Public Health Nutr 2010; 13(3): 314-23.
- 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.
- Sarrafzadegan N, Kelishadi R, Esmaillzadeh A, Mohammadifard N, Rabiei K, Roohafza H, et al. Do lifestyle interventions work in developing countries? Findings from the Isfahan Healthy Heart Program in the Islamic Republic of Iran. Bull World Health Organ 2009; 87(1): 39-50.
- Mohammadifard N, Kelishadi R, Safavi M, Sarrafzadegan N, Sajadi F, Sadri GH, et al. Effect of a community-based intervention on nutritional behaviour in a developing country setting: The Isfahan Healthy Heart Programme. Public Health Nutr 2009; 12(9): 1422-30.
- Abolhassani S, Irani MD, Sarrafzadegan N, Rabiei K, Shahrokhi S, Pourmoghaddas Z, et al. Barriers and facilitators of weight management in overweight and obese people: Qualitative findings of TABASSOM project. Iran J Nurs Midwifery Res 2012; 17(3): 205-10.
- Abete I, Parra D, Crujeiras AB, Goyenechea E, Martinez JA. Specific insulin sensitivity and leptin responses to a nutritional treatment of obesity via a combination of energy restriction and fatty fish intake. J Hum Nutr Diet 2008; 21(6): 591-600.
- Seoane LM, Al-Massadi O, Caminos JE, Tovar SA, Dieguez C, Casanueva FF. Sensory stimuli directly acting at the central nervous system regulate gastric ghrelin secretion. An ex vivo organ culture study. Endocrinology 2007; 148(8): 3998-4006.
- Lee MJ, Fried SK. Integration of hormonal and nutrient signals that regulate leptin synthesis and secretion. Am J Physiol Endocrinol Metab 2009; 296(6): E1230-E1238.
- Zhang JV, Ren PG, Avsian-Kretchmer O, Luo CW, Rauch R, Klein C, et al. Obestatin, a peptide encoded by the ghrelin gene, opposes ghrelin's effects on food intake. Science 2005; 310(5750): 996-9.
- Meier U, Gressner AM. Endocrine regulation of energy metabolism: Review of pathobiochemical and clinical chemical aspects of leptin, ghrelin, adiponectin, and resistin. Clin Chem 2004; 50(9): 1511-25.
- Zhang MY, Li F, Wang JP. Correlation analysis of serum obestatin expression with insulin resistance in childhood obesity. Genet Mol Res 2017; 16(2).
- Goodson JM, Kantarci A, Hartman ML, Denis GV, Stephens D, Hasturk H, et al. Metabolic disease risk in children by salivary biomarker analysis. PLoS One 2014; 9(6): e98799.
- Reinehr T, de Sousa G, Roth CL. Obestatin and ghrelin levels in obese children and adolescents before and after reduction of overweight. Clin Endocrinol (Oxf) 2008; 68(2): 304-10.
- Zou CC, Liang L, Wang CL, Fu JF, Zhao ZY. The change in ghrelin and obestatin levels in obese children after weight reduction. Acta Paediatr 2009; 98(1): 159-65.
- NHLBI Obesity Education Initiative. The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults [Online]. [cited 2000]; Available from: URL:
- Golshiri P, Yarmohammadi P, Sarrafzadegan N, Shahrokhi S, Yazadani M, Pourmoghaddas M. Developing and validating questionnaires to assess knowledge, attitude, and performance toward obesity among Iranian adults and adolescents: Tabassom study. ARYA Atheroscler 2012; 7(Special Issue): S119-S124.
- World Health Organization, Pan American Health Organization. Maintenance manual for laboratory equipment. 2nd ed. Geneva, Switzerland: World Health Organization; 2008.
- Kishida K, Funahashi T, Shimomura I. Adiponectin as a routine clinical biomarker. Best Pract Res Clin Endocrinol Metab 2014; 28(1): 119-30.
- Kishida K, Funahashi T, Matsuzawa Y, Shimomura I. Visceral adiposity as a target for the management of the metabolic syndrome. Ann Med 2012; 44(3): 233-41.
- Goldstein BJ, Scalia R. Adiponectin: A novel adipokine linking adipocytes and vascular function. J Clin Endocrinol Metab 2004; 89(6): 2563-8.
- Smith J, Al-Amri M, Sniderman A, Cianflone K. Leptin and adiponectin in relation to body fat percentage, waist to hip ratio and the apoB/apoA1 ratio in Asian Indian and Caucasian men and women. Nutr Metab (Lond) 2006; 3: 18.
- Kamada Y, Matsumoto H, Tamura S, Fukushima J, Kiso S, Fukui K, et al. Hypoadiponectinemia accelerates hepatic tumor formation in a nonalcoholic steatohepatitis mouse model. J Hepatol 2007; 47(4): 556-64.
- Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M, Marfella R, et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: A randomized trial. JAMA 2003; 289(14): 1799-804.
- Coughlin CC, Finck BN, Eagon JC, Halpin VJ, Magkos F, Mohammed BS, et al. Effect of marked weight loss on adiponectin gene expression and plasma concentrations. Obesity (Silver Spring) 2007; 15(3): 640-5.
- Ghanbari-Niaki A, Saghebjoo M, Rahbarizadeh F, Hedayati M, Rajabi H. A single circuit-resistance exercise has no effect on plasma obestatin levels in female college students. Peptides 2008; 29(3): 487-90.
- Beasley JM, Ange BA, Anderson CA, Miller Iii ER, Holbrook JT, Appel LJ. Characteristics associated with fasting appetite hormones (obestatin, ghrelin, and leptin). Obesity (Silver Spring) 2009; 17(2): 349-54.
- Lippl F, Erdmann J, Lichter N, Tholl S, Wagenpfeil S, Adam O, et al. Relation of plasma obestatin levels to bmi, gender, age and insulin. Horm Metab Res 2008; 40(11): 806-12.
- Hirose H, Yamamoto Y, Seino-Yoshihara Y, Kawabe H, Saito I. Serum high-molecular-weight adiponectin as a marker for the evaluation and care of subjects with metabolic syndrome and related disorders. J Atheroscler Thromb 2010; 17(12): 1201-11.
- Salmon J, Ball K, Crawford D, Booth M, Telford A, Hume C, et al. Reducing sedentary behaviour and increasing physical activity among 10-year-old children: Overview and process evaluation of the 'Switch-Play' intervention. Health Promot Int 2005; 20(1): 7-17.
- Sarrafzadegan N, Rabiei K, Nouri F, Mohammadifard N, Moattar F, Roohafza H, et al. Parental perceptions of weight status of their children. ARYA Atheroscler 2013; 9(1): 61-9.
- Sahota P, Rudolf MC, Dixey R, Hill AJ, Barth JH, Cade J. Randomised controlled trial of primary school based intervention to reduce risk factors for obesity. BMJ 2001; 323(7320): 1029-32.
- United States, Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. Burlington, MA: Jones and Bartlett Publishers; 2000.