Skip to main content
SpringerLink
Log in

Socio-Behavioral Factors Associated with Overweight and Central Obesity in Tehranian Adults: a Structural Equation Model

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to test a conceptual model of associations between socio-demographic and behavioral factors and obesity in the Tehran Lipid and Glucose Study (TLGS).

Methods

Data from 2747 TLGS adult participants (58.3 % female) were analyzed. Socio-demographic and behavioral factors in the conceptual model were tested for their direct and indirect associations with overweight and central obesity, using structural equation modeling (SEM), conducted by IBM SPSS AMOS software.

Results

Overweight and central obesity were found in 61.6 and 48.1 % of respondents, respectively. Fit indices were acceptable for the conceptual model. Daily energy intake had a direct association with overweight and central obesity in both genders; however, poor dietary pattern had direct associations with overweight and central obesity only in men. In women, age, marital status, and level of education had direct associations with overweight and central obesity. In men, only age and marital status had direct associations with overweight and central obesity.

Conclusions

Age and marital status in both genders and level of education only in women were among the socio-demographic factors which were directly associated with both overweight and central obesity. Among behavioral factors, daily energy intake was the most important factor that was directly associated with both overweight and central obesity in both genders. Adherence to poor diet directly was associated with overweight and central obesity only in men. The current findings provide beneficial information for designing culturally relevant and effective interventions/strategies for prevention of overweight among Tehranian adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond). 2008;32(9):1431–7. doi:10.1038/ijo.2008.102.

    Article  CAS  Google Scholar 

  2. Barzin M, Keihani S, Hosseinpanah F, Serahati S, Ghareh S, Azizi F. Rising trends of obesity and abdominal obesity in 10 years of follow-up among Tehranian adults: Tehran Lipid and Glucose Study (TLGS). Public health nutrition. 2015;1-9. doi:10.1017/S1368980015000269.

  3. Dixon JB. The effect of obesity on health outcomes. Mol Cell Endocrinol. 2010;316(2):104–8. doi:10.1016/j.mce.2009.07.008.

    Article  CAS  PubMed  Google Scholar 

  4. Pi-Sunyer X. The medical risks of obesity. Postgrad Med. 2009;121(6):21–33. doi:10.3810/pgm.2009.11.2074.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Cameron AJ, Dunstan DW, Owen N, Zimmet PZ, Barr EL, Tonkin AM, et al. Health and mortality consequences of abdominal obesity: evidence from the AusDiab study. Med J Aust. 2009;191(4):202–8.

    PubMed  Google Scholar 

  6. Ghassemi H, Harrison G, Mohammad K. An accelerated nutrition transition in Iran. Public Health Nutr. 2002;5(1A):149–55. doi:10.1079/phn2001287.

    Article  PubMed  Google Scholar 

  7. Koohpayehzadeh J, Etemad K, Abbasi M, Meysamie A, Sheikhbahaei S, Asgari F, et al. Gender-specific changes in physical activity pattern in Iran: national surveillance of risk factors of non-communicable diseases (2007-2011). Int J Public Health. 2014;59(2):231–41. doi:10.1007/s00038-013-0529-3.

    Article  PubMed  Google Scholar 

  8. Klumbiene J, Petkeviciene J, Helasoja V, Prattala R, Kasmel A. Sociodemographic and health behaviour factors associated with obesity in adult populations in Estonia, Finland and Lithuania. Eur J Public Health. 2004;14(4):390–4. doi:10.1093/eurpub/14.4.390.

    Article  PubMed  Google Scholar 

  9. Aranceta J, Perez-Rodrigo C, Serra-Majem L, Ribas L, Quiles-Izquierdo J, Vioque J, et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO’97 Study. Eur J Clin Nutr. 2001;55(6):430–5. doi:10.1038/sj.ejcn.1601189.

    Article  CAS  PubMed  Google Scholar 

  10. Janghorbani M, Amini M, Rezvanian H, Gouya MM, Delavari A, Alikhani S, et al. Association of body mass index and abdominal obesity with marital status in adults. Arch Iran Med. 2008;11(3):274–81.

    PubMed  Google Scholar 

  11. Okubo H, Sasaki S, Murakami K, Kim MK, Takahashi Y, Hosoi Y, et al. Three major dietary patterns are all independently related to the risk of obesity among 3760 Japanese women aged 18-20 years. Int J Obes (Lond). 2008;32(3):541–9. doi:10.1038/sj.ijo.0803737.

    Article  CAS  Google Scholar 

  12. Wang H, Troy LM, Rogers GT, Fox CS, McKeown NM, Meigs JB, et al. Longitudinal association between dairy consumption and changes of body weight and waist circumference: the Framingham Heart Study. Int J Obes (Lond). 2014;38(2):299–305. doi:10.1038/ijo.2013.78.

    Article  CAS  Google Scholar 

  13. Perez-Escamilla R, Obbagy JE, Altman JM, Essery EV, McGrane MM, Wong YP, et al. Dietary energy density and body weight in adults and children: a systematic review. J Acad Nutr Diet. 2012;5:671–84. doi:10.1016/j.jand.2012.01.020.

    Article  Google Scholar 

  14. Bullo M, Garcia-Aloy M, Martinez-Gonzalez MA, Corella D, Fernandez-Ballart JD, Fiol M, et al. Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk. Prev Med. 2011;53(3):155–61. doi:10.1016/j.ypmed.2011.06.008.

    Article  PubMed  Google Scholar 

  15. Must A, Tybor DJ. Physical activity and sedentary behavior: a review of longitudinal studies of weight and adiposity in youth. Int J Obes (Lond). 2005;29 Suppl 2:S84–96.

    Article  Google Scholar 

  16. May AM, Romaguera D, Travier N, Ekelund U, Bergmann MM, Kaaks R, et al. Combined impact of lifestyle factors on prospective change in body weight and waist circumference in participants of the EPIC-PANACEA study. PLoS One. 2012;7(11):e50712. doi:10.1371/journal.pone.0050712.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Jakicic JM, Otto AD. Physical activity considerations for the treatment and prevention of obesity. Am J Clin Nutr. 2005;82(1 Suppl):226S–9.

    CAS  PubMed  Google Scholar 

  18. Compernolle S, De Cocker K, Abbott G, Verloigne M, Cardon G, De Bourdeaudhuij I, et al. Do sedentary behaviors mediate associations between socio-demographic characteristics and BMI in women living in socio-economically disadvantaged neighborhoods? Int J Behav Nutr Phys Act. 2015;12:48. doi:10.1186/s12966-015-0209-1.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Nesbit KC, Kolobe TH, Sisson SB, Ghement IR. A model of environmental correlates of adolescent obesity in the United States. J Adolesc Health. 2014;55(3):394–401. doi:10.1016/j.jadohealth.2014.02.022.

    Article  PubMed  Google Scholar 

  20. Hendrie GA, Coveney J, Cox DN. Defining the complexity of childhood obesity and related behaviours within the family environment using structural equation modelling. Public Health Nutr. 2012;15(1):48–57. doi:10.1017/S1368980011001832.

    Article  PubMed  Google Scholar 

  21. Beydoun MA, Wang Y. Pathways linking socioeconomic status to obesity through depression and lifestyle factors among young US adults. J Affect Disord. 2010;123(1-3):52–63. doi:10.1016/j.jad.2009.09.021.

    Article  PubMed  Google Scholar 

  22. Borodulin K, Zimmer C, Sippola R, Makinen TE, Laatikainen T, Prattala R. Health behaviours as mediating pathways between socioeconomic position and body mass index. Int J Behav Med. 2012;19(1):14–22. doi:10.1007/s12529-010-9138-1.

    Article  PubMed  Google Scholar 

  23. Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, et al. Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. Trials. 2009;10:5. doi:10.1186/1745-6215-10-5.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Azizi F, Rahmani M, Emami H, Mirmiran P, Hajipour R, Madjid M, et al. Cardiovascular risk factors in an Iranian urban population: Tehran lipid and glucose study (phase 1). Soz Praventivmed. 2002;47(6):408–26.

    Article  PubMed  Google Scholar 

  25. Kriska AM, Knowler WC, LaPorte RE, Drash AL, Wing RR, Blair SN, et al. Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care. 1990;13(4):401–11.

    Article  CAS  PubMed  Google Scholar 

  26. Esfahani FH, Asghari G, Mirmiran P, Azizi F. Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol/Japan Epidemiol Assoc. 2010;20(2):150–8.

    Article  Google Scholar 

  27. Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F. Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutr. 2010;13(5):654–62. doi:10.1017/s1368980009991698.

    Article  PubMed  Google Scholar 

  28. World Health Organization. Obesity and overweight. http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed April 2016.

  29. Azizi F, Khalili D, Aghajani H, Esteghamati A, Hosseinpanah F, Delavari A, et al. Appropriate waist circumference cut-off points among Iranian adults: the first report of the Iranian National Committee of Obesity. Arch Iran Med. 2010;13(3):243–4.

    PubMed  Google Scholar 

  30. Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ. Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods. 1999;4(3):272–99. doi:10.1037/1082-989X.4.3.272.

    Article  Google Scholar 

  31. Fabrigar LR, Wegener DT. Exploratory factor analysis. 1st ed. Oxford University Press; 2011.

  32. Jöreskog KG. A general approach to confirmatory maximum likelihood factor analysis. Psychometrika. 1969;34(2):183–202. doi:10.1007/bf02289343.

    Article  Google Scholar 

  33. Kline RB. Principles and practice of structural equation modeling 3rd ed. New York: The Guilford Press; 2010.

    Google Scholar 

  34. Hooper D, Coughlan JR, Mullen M. Structural equation modelling: guidelines for determining model fit. Electron J Bus Res Methods. 2008;6(1):53–60.

    Google Scholar 

  35. Kaiser HF. A second generation little jiffy. Psychometrika. 1970;35(4):401–15.

    Article  Google Scholar 

  36. Kaiser HF, Rice J. Little Jiffy, Mark IV. Educational and psychological measurement. 1974.

  37. Bakhshi E, Eshraghian MR, Mohammad K, Foroushani AR, Zeraati H, Fotouhi A, et al. Sociodemographic and smoking associated with obesity in adult women in Iran: results from the National Health Survey. J Public Health (Oxf). 2008;30(4):429–35. doi:10.1093/pubmed/fdn024.

    Article  Google Scholar 

  38. Cho YA, Shin A, Kim J. Dietary patterns are associated with body mass index in a Korean population. J Am Diet Assoc. 2011;8:1182–6. doi:10.1016/j.jada.2011.05.003.

    Article  Google Scholar 

  39. Boggs DA, Palmer JR, Spiegelman D, Stampfer MJ, Adams-Campbell LL, Rosenberg L. Dietary patterns and 14-y weight gain in African American women. Am J Clin Nutr. 2011;94(1):86–94. doi:10.3945/ajcn.111.013482.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Flores M, Macias N, Rivera M, Lozada A, Barquera S, Rivera-Dommarco J, et al. Dietary patterns in Mexican adults are associated with risk of being overweight or obese. J Nutr. 2010;140(10):1869–73. doi:10.3945/jn.110.121533.

    Article  CAS  PubMed  Google Scholar 

  41. Esmaillzadeh A, Azadbakht L. Major dietary patterns in relation to general obesity and central adiposity among Iranian women. J Nutr. 2008;138(2):358–63.

    CAS  PubMed  Google Scholar 

  42. Rezazadeh A, Rashidkhani B. The association of general and central obesity with major dietary patterns in adult women living in Tehran, Iran. ARYA Atheroscler. 2010;6(1):23–30.

    PubMed  PubMed Central  Google Scholar 

  43. Tataranni PA, Harper IT, Snitker S, Del Parigi A, Vozarova B, Bunt J, et al. Body weight gain in free-living Pima Indians: effect of energy intake vs expenditure. Int J Obes Relat Metab Disord. 2003;27(12):1578–83. doi:10.1038/sj.ijo.0802469.

    Article  CAS  PubMed  Google Scholar 

  44. Hajian-Tilaki KO, Heidari B. Prevalence of obesity, central obesity and the associated factors in urban population aged 20-70 years, in the north of Iran: a population-based study and regression approach. Obes Rev. 2007;8(1):3–10. doi:10.1111/j.1467-789X.2006.00235.x.

    Article  CAS  PubMed  Google Scholar 

  45. Kelishadi R, Alikhani S, Delavari A, Alaedini F, Safaie A, Hojatzadeh E. Obesity and associated lifestyle behaviours in Iran: findings from the First National Non-communicable Disease Risk Factor Surveillance Survey. Public Health Nutr. 2008;11(3):246–51. doi:10.1017/S1368980007000262.

    Article  PubMed  Google Scholar 

  46. Sarma S, Zaric GS, Campbell MK, Gilliland J. The effect of physical activity on adult obesity: evidence from the Canadian NPHS panel. Econ Hum Biol. 2014;14:1–21. doi:10.1016/j.ehb.2014.03.002.

    Article  PubMed  Google Scholar 

  47. Luke A, Cooper RS. Physical activity does not influence obesity risk: time to clarify the public health message. Int J Epidemiol. 2013;42(6):1831–6. doi:10.1093/ije/dyt159.

    Article  PubMed  Google Scholar 

  48. World Health Organization. Global recommendations on physical activity for health. 2010.

  49. Esteghamati A, Khalilzadeh O, Rashidi A, Kamgar M, Meysamie A, Abbasi M. Physical activity in Iran: results of the third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007). J Phys Act Health. 2011;8(1):27–35.

    Article  PubMed  Google Scholar 

  50. Momenan AA, Delshad M, Mirmiran P, Ghanbarian A, Azizi F. Leisure time physical activity and its determinants among adults in Tehran: Tehran Lipid and Glucose Study. Int J Prev Med. 2011;2(4):243–51.

    PubMed  PubMed Central  Google Scholar 

  51. Afghan M, Ghasemi A, Azizi F. Seven-year changes of leisure-time and occupational physical activity among Iranian Adults (Tehran Lipid and Glucose Study). Iranian J Public Health. 2016;45(1):41–7.

    Google Scholar 

Download references

Acknowledgments

We would like to express our appreciation to the participants of the TLGS. The authors also wish to acknowledge Ms. Niloofar Shiva for critical editing of English grammar and syntax of the manuscript.

Author information

Authors and Affiliations

  1. Research Center for Social Determinants of Endocrine Health and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Sara Jalali-Farahani, Parisa Amiri & Mehrdad Karimi

  2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mehrdad Karimi & Safoora Gharibzadeh

  3. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Safoora Gharibzadeh & Fereidoun Azizi

  4. Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran, Iran

    Parvin Mirmiran

Authors
  1. Sara Jalali-Farahani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Parisa Amiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mehrdad Karimi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Safoora Gharibzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Parvin Mirmiran
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fereidoun Azizi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Parvin Mirmiran.

Ethics declarations

Conflict of Interest

No financial disclosures were reported by the authors of this paper.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jalali-Farahani, S., Amiri, P., Karimi, M. et al. Socio-Behavioral Factors Associated with Overweight and Central Obesity in Tehranian Adults: a Structural Equation Model. Int.J. Behav. Med. 24, 110–119 (2017). https://doi.org/10.1007/s12529-016-9574-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-016-9574-7

Keywords

Search

Navigation