The prevalence of obesity and overweight among Iranian population: an umbrella systematic review and meta-analysis

Dehghani, Azadeh; Molani-Gol, Roghayeh; Mohammadi-Narab, Maryam; Norouzy, Abdolreza; Abolhassani, Mohammad Hassan; Tabatabaee Jabali, Seyed Mohammad; Pazouki, Abdolreza; Soheilipour, Fahimeh; Mohammadi-Nasrabadi, Fatemeh

doi:10.1186/s12889-024-20860-8

Table听4 Summary of results and quality of evidence assessment using the GRADE and Credibility Assessment approach

From: The prevalence of obesity and overweight among Iranian population: an umbrella systematic review and meta-analysis

Outcome measures	Summary of findings		Quality of evidence assessment (GRADE)						Credibility Assessment
听	*No. of patients/ number of meta-analyses (included studies)**	Effect size (95% CI)	Risk of bias^a	Inconsistency^b	Indirectness^c	Imprecision^d	Publication bias^e	Quality of evidence^f	Evidence class^g
Overall prevalence of overweight	11,204,070/14	18.38% (10.267, 26.496)	Not serious	serious	Not serious	Not serious	Not serious	Moderate	III
Overall prevalence of obesity	14,345,043/15	10.91% (9.654, 12.177)	Not serious	serious	Not serious	Not serious	serious	Low	III
Prevalence overweight among children and adolescents	8,255,303/10	12.43% (10.184, 14.683)	Not serious	serious	Not serious	Not serious	serious	Low	III
Prevalence of obesity among children and adolescents	11,143,533/14	6.51% (5.866, 7.157)	Not serious	serious	Not serious	Not serious	serious	Low	III
Prevalence of overweight among adults	4,338,046/8	27.39% (14.878, 39.914)	Not serious	serious	Not serious	Not serious	Not serious	Moderate	III
Prevalence of obesity among adults	868,685/12	17.20% (13.483, 20.919)	Not serious	serious	Not serious	Not serious	Not serious	Moderate	IV

^*By considering overlap among the studies
^aRisk of bias based on the AMSTAR results
^bDowngraded if there was a substantial unexplained heterogeneity (I²鈥�&驳迟;鈥�50%, P鈥�<鈥�0.10) that was unexplained by meta-regression or subgroup analyses
^cDowngraded if there were factors present relating to the participants, interventions, or outcomes that limited the generalizability of the results
^dDowngraded if optimal information size was not met, or the 95%CI include the null value lower and upper bounds of the 95%CI were鈥�<鈥�0.95 and鈥�>鈥�1.05, respectively
^eDowngraded if there was an evidence of publication bias using funnel plot
^fSince all included studies were meta-analyses, the certainty of the evidence was graded as high for all outcomes by default and then downgraded based on prespecified criteria. Quality was graded as high, moderate, low, very low
^g Class I: (convincing evidence),鈥�>鈥�1000 cases (or鈥�>鈥�20 000 participants for continuous outcomes); statistical significance at P鈥�&濒迟;鈥�10^鈭�6 (random effects); no evidence of small study effects and excess significance bias; 95% prediction interval excluded null value; no large heterogeneity (I2鈥�<鈥�50%)
Class II: (highly suggestive evidence),鈥�>鈥�1000 cases (or鈥�>鈥�20 000 participants for continuous outcomes), statistical significance at P鈥�&濒迟;鈥�10^鈭�6 (random effects), and largest study with 95% confidence interval excluding null value
Class III: (suggestive evidence),鈥�>鈥�1000 cases (or鈥�>鈥�20 000 participants for continuous outcomes) and statistical significance at P鈥�&濒迟;鈥�0.001
Class IV: (weak evidence), Remaining significant associations with P鈥�&濒迟;鈥�0.05
NS: non-significant, P鈥�&驳迟;鈥�0.05

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Table听4 Summary of results and quality of evidence assessment using the GRADE and Credibility Assessment approach

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