Wednesday, 15 October 2014

Iran: population waist

Iran's demographic waist explains some of the increase in MS in the country. #MSBlog #MSResearch

"In response to a question I received yesterday about the population waist in Iran. The following picture shows you the population demographics of Iran. As you can see there is a waist of young people driven by an increase in birth rates after the Iranian revolution. As MS typically presents between the ages of 20-40 as the 'waist' enters this age group you will see an increased number of cases presenting with MS regardless of whether or not the MS incidence is increasing or not. In fact when you account for this waist entering the at risk period of MS the incidence is going up; driven largely by MS in woman. Another fact that the Iranian MS epidemic slays is the contribution of smoking to this surge in MS in woman. Some epidemiologists suggest that 40-50% of the increased incidence of MS in woman can be explained by increased smoking rates in woman after the second world war. In Iran less that 7% or woman smoke. What is happening in Iran? I am sure the clue to the cause of MS is to be found in Iran. Despite this it is very hard if not impossible to get funding to study MS in Iran; the west has too many sanctions against the country."


"Please note the population demographics of the UK; there is no obvious waist, but its profile is worrying in that there are so many ageing people without enough young people to support them. This is called the demographic time-bomb; if you think the UK is bad you should look at Japan and China."  


12 comments:

  1. Just to clarify do you mean 'waist' or 'waste', this is what I don't understand. Waist as in a body measurement (middle) or waste as in a waste of resources, time or garbage.

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  2. Re: "Just to clarify do you mean 'waist' or 'waste'."

    WAIST as in body measurement; as you can see there is a large waist of youngish people in the Iranian population and there is no waist in the UK demographic profile.

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  3. "What is happening in Iran?"
    I've never bought the smoking hypothesis, I suspect the large increase in MS in women in Iran can be directly correlated to the massive increase in women covering themselves (thus getting less sunlight exposure and vitamin D) which was imposed by religious police after the fall of the Shah in 1979 and the takeover by the current hardline Islamic regime. Previous to this women, particularly in the cities did not cover themselves in anything like the same extent. Of course men are not subjected to the same restrictions and there is nothing like the same surge in cases in men.
    An uncomfortable truth.

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    1. Spot on MouseDoctor, I had family in Iran (left in different diasporas), and women as far as I know have always smoked , the main difference in the last 40 years is the hijab and the manteau (overcoat). The Shah banned the hijab and chador in 1936, so it would be interesting to see MS stats from 1936 to 1979. In some villages women where the chador. Not a lot of vitamin D!

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    2. I had the chance to study MS epidemiology in Tehran, I am really interested to know your opinion on other possible contributing environmental factors, like air pollutants:
      http://www.abstractstosubmit.com/msboston2014/eposter/getfile.php?d=148&t=f&

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    3. Simple, just measure the vit D levels in women. What are the results?

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  4. Also I wonder if this has anything to do with better detection of MS. Iran isn't far behind the west when it comes to medical research, though years of sanctions has not helped. Definitely not convinced about the smoking increase, most definitely convinced on lack of vitamin D. Iran has always had more incidences of MS than other ME countries but it can't just be lack of vit D caused by hijabs or there would be more MS in the Gulf where it's a lot more than just a hijab to cover women. And huge amounts of shisha (and non-shisha) smoking goes on there with women.

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    1. I'm sure better detection of MS plays a part but it doesn't explain the highly skewed incidence in females versus males. The Gulf point is interesting, I'm not sure how genetically different Iranians are to Gulf Arabs but this might play a role, also a lot of the populations of the gulf states are in fact migrant workers from countries like Pakistan etc, where the incidence of MS is lower anyway.
      For me, I think the hijab/chador issue is key and points to the need for vitamin D supplementation for Iranian women not only to try and reduce the risk of MS but also to ward off other conditions such as osteoporosis which is becoming a problem in veiled women in the UK.

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    2. Genetically very different. Depending on if they are Persian (I'm quarter) or Arabic Iranians, Kurdish, Pashtuns etc...So this may well be the difference but unless you had stats on the demos, it would be incredibly difficult to work out or get such stats!. However, interestingly my grandmother was Irani (persian), and born in Mumbai, this part of my family was ahem ... forced into exile. Before Iranis, it was the Parsis who had to flee. And guess what, they get MS more than other ethnic groups in India. Neither community have married into Indian society (well not many anyway), I'd say Parsis are 'pure' Persian. And, no they don't wear hijabs and -on the whole - refrain from smoking. Anyway sorry for the long post but it may well be ethnicity is part of the reason.

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    3. I should also say, though biological anthropology is out of favour these days, that Persians (like my grandmother) fall into the Caucasian genetics bracket. But as it is a complicated area of study (that doesnt necessarly mean 'european', I'll just direct you to wiki http://en.wikipedia.org/wiki/Persian_people

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    4. I wish I had more time to look into this - anthropology is my 'specialism' and it seems that it is Parsis in India that have the highest rates of MS, they mainly originated from near to one of the current MS hot spots in Iran. This is quite interesting article on MS in India and Parsi community http://www.hindawi.com/journals/ad/2011/937586/

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  5. And let's not ignore chronic stress. If you had to live under sanctions and a strict (tactfully describing it) Islamic regime as a woman (not as bad as many places in the gulf but still not something I'd willingly live under) the low level rumblings of war that affects much of the Middle East, feel you might possibly be stressed. Chronic stress not acute but as a constant narrative in your life. So low Vit D and chronic stress ... I think smoking may be the least of the MS risk factors.

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