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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 10.5144/0256-4947.2006.243aasm-3-243aLettersReply to Re: Childhood obesity in Iraq: a gender perspective Lafta Riyadh K. MD, PhDCommunity Medicine, Department College Of Medicine, Mustansiriyah University, Baghdad, IraqMay-Jun 2006 26 3 243 244 Copyright © 2006, Annals of Saudi Medicine2006This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Dear Dr. Afifi: Thank you very much for your valuable notes, which mean that you have read the article thoroughly and we appreciate that very much.

In respect to your notes, let me explain the following:

It sounds as if there is a sort of misunderstanding regarding the approach of the study; we did not study obesity from a gender perspective (although we would like to do so), but rather, on the basis of some probable risk factors. Gender was used mainly for stratification in the first order and then a comparison was done between the two sexes to portray the picture clearly. The difference in prevalence of obesity between boys and girls was not significant except in one category (in 2 risk factors), and if you just take a look again you will see that we mentioned “this may be due to.....”. On the other hand we do not have to prove that girls between 10–12 years are more obese than boys of the same age group because we only said that the association (of the risk factor, not of the gender) was not significant except in boys 10–12 years and we (as you certainly noticed) did not build any inference on that finding.

The association between outdoor exercise and obesity was not significant (a finding that may disagree with other studies as you referred) could be attributed to the fact that the data were collected through interviewing the pupils themselves and there was no standard method to estimate the amount, type and duration of the exercises. Besides, for the last few years in Iraq we have not had a trend of regular exercises due to the unfavorable security situation that you are aware of.

Regarding watching TV, we mentioned that the association was not significant except in one age category and I would not say that it is protective (as you did) but simply “not significant” as the confidence interval passes zero (which is 1 in case of an odds ratio); please reread the paragraph before the last in the discussion.

We believe that the results were clear and the statistics (which were reviewed by an excellent statistician) were precise, and if we sometimes do not find what we expect then it is simply due to the fact that findings in research work do not go always by the book.

Thanks again for your correspondence and best regards.