Background: This study aims to provide a comprehensive review of the prevalence of underweight among Iranian children, identify key influencing factors, analyze temporal trends, and examine related health outcomes.
Materials and Methods: This overview searched major databases, including PubMed, Scopus, Web of Science, SID, Magiran, CIVILICA, and Google Scholar, up to April 2025, using terms such as "underweight," "malnutrition," and "Iranian children." It included original studies, reviews, and systematic reviews in English and Persian focused on prevalence, risk factors, and outcomes. Study quality was assessed using the Newcastle-Ottawa Scale and AMSTAR tools.
Results: Underweight prevalence among Iranian children remains a significant public health issue, averaging 19% in ages 6 to 14 and 8.4% to 11% in children under five, with notable regional disparities (24% in central vs. 5% in western areas). Key risk factors include low socioeconomic status, limited parental education—especially maternal—low birth weight, and geographic/climatic challenges. Despite a decline from the late 1990s to mid-2010s, recent increases post-COVID-19 reflect ongoing economic difficulties. Health risks include infections, developmental delays, and mortality, exacerbated by rising urban childhood obesity. Compared globally, Iran’s under-five rates are below average but remain high in older children. Targeted, region-specific strategies such as enhancing maternal education, expanding nutrition programs, and boosting social support are essential to reduce disparities and improve child nutrition outcomes.
Conclusion: Underweight prevalence among Iranian children aged 6 to 14 and under five remains a major challenge influenced by economic disparities, regional inequalities, and maternal education. The COVID-19 pandemic and rising urban childhood obesity add complexity to the issue. Targeted policies, improved education, economic support, healthcare access, and continuous monitoring are essential to improve child health outcomes.