Dietary factors and Type 2 diabetes in the Middle East : what is the evidence for an association? - A systematic review.

This review aims to search and summarise the available evidence on the association between dietary factors and type 2 diabetes mellitus (T2DM) in Middle Eastern populations, where diabetes prevalence is among the highest in the world. Electronic databases were searched; authors, libraries, and research centres in the Middle East were contacted for further studies and unpublished literature. Included studies assessed potential dietary factors for T2DM in Middle Eastern adults. Two reviewers assessed studies independently. Extensive searching yielded 17 studies which met the inclusion criteria for this review. The findings showed that whole-grain intake reduces the risk of T2DM, and potato consumption was positively correlated with T2DM. Vegetables and vegetable oil may play a protective role against T2DM. Dietary patterns that are associated with diabetes were identified, such as Fast Food and Refined Grains patterns. Two studies demonstrated that lifestyle interventions decreased the risk of T2DM. In summary, the identified studies support an association between some dietary factors and T2DM; however, many of the included studies were of poor methodological quality so the findings should be interpreted with caution. The review draws attention to major gaps in current evidence and the need for well-designed studies in this area

Current dietetic practices of obesity management in Saudi Arabia and comparison with Australian practices and best practice criteria

Objective: To describe the dietetic practices of the treatment of obesity in Saudi Arabia and compare this with best practice criteria and the practice in Australia. Methods: Anonymous questionnaires were completed by dietitians in Saudi Arabia. The topics included barriers to obesity management, demand and level of service and strategies and approaches used for weight management. Best practice scores were based on those used to assess Australian dietitians. Results: 253 dietitians participated in the survey. Of these, 175 (69 %) were involved in the management of obesity. The best practice score for Australian dietitians was slightly but significantly greater than the scores of Saudi dietitians (mean 41.6 vs 38.8; p \u3c0.001), (median 43 vs 39). There was also a significant correlation between the best practice score and years of experience (r = 0.26, p \u3c0.001). The most common assessment approaches were assessment of BMI (87%) and exercise habits (81%) while the most common strategies for obesity management were; dietary total fat reduction (92%) and increase incidental daily activity (92%). The major barrier for establishment of a weight management clinic reported by 49% of participants was inadequate resources. Conclusion: Saudi Arabian dietetic practice for the management of obesity does incorporate most best practice recommendations, but some specific elements are rarely used

Obesity, diabetes and longevity in the Gulf: is there a Gulf Metabolic Syndrome?

The Gulf is experiencing a pandemic of lifestyle-induced obesity and type 2 diabetes mellitus (T2DM), with rates exceeding 50 and 30%, respectively. It is likely that T2DM represents the tip of a very large metabolic syndrome iceberg, which precedes T2DM by many years and is associated with abnormal/ectopic fat distribution, pathological systemic oxidative stress and inflammation. However, the definitions are still evolving with the role of different fat depots being critical. Hormetic stimuli, which include exercise, calorie restriction, temperature extremes, dehydration and even some dietary components (such as plant polyphenols), may well modulate fat deposition. All induce physiological levels of oxidative stress, which results in mitochondrial biogenesis and increased anti-oxidant capacity, improving metabolic flexibility and the ability to deal with lipids. We propose that the Gulf Metabolic Syndrome results from an unusually rapid loss of hormetic stimuli within an epigenetically important time frame of 2-3 generations. Epigenetics indicates that thriftiness can be programmed by the environment and passed down through several generations. Thus this loss of hormesis can result in continuation of metabolic inflexibility, with mothers exposing the foetus to a milieu that perpetuates a stressed epigenotype. As the metabolic syndrome increases oxidative stress and reduces life expectancy, a better descriptor may therefore be the Lifestyle-Induced Metabolic Inflexibility and accelerated AGEing syndrome – LIMIT-AGE. As life expectancy in the Gulf begins to fall, with perhaps a third of this life being unhealthy – including premature loss of sexual function, it is vital to detect evidence of this condition as early in life as possible. One effective way to do this is by detecting evidence of metabolic inflexibility by studying body fat content and distribution by magnetic resonance (MR). The Gulf Metabolic Syndrome thus represents an accelerated form of the metabolic syndrome induced by the unprecedented rapidity of lifestyle change in the region, the stress of which is being passed from generation to generation and may be accumulative. The fundamental cause is probably due to a rapid increase in countrywide wealth. This has benefited most socioeconomic groups, resulting in the development of an obesogenic environment as the result of the rapid adoption of Western labour saving and stress relieving devices (e.g. cars and air conditioning), as well as the associated high calorie diet

Sugar-sweetened carbonated beverage consumption correlates with BMI, waist circumference, and poor dietary choices in school children

<p>Abstract</p> <p>Background</p> <p>The prevalence of obesity and overweight is increasing globally. Frequently coexisting with under-nutrition in developing countries, obesity is a major contributor to chronic disease, and will become a serious healthcare burden especially in countries with a larger percentage of youthful population. 35% of the population of Saudi Arabia are under the age of 16, and adult dietary preferences are often established during early childhood years. Our objective was to examine the dietary habits in relation to body-mass-index (BMI) and waist circumference (W_C), together with exercise and sleep patterns in a cohort of male and female Saudi school children, in order to ascertain whether dietary patterns are associated with obesity phenotypes in this population.</p> <p>Methods</p> <p>5033 boys and 4400 girls aged 10 to 19 years old participated in a designed Food Frequency Questionnaire. BMI and W_C measurements were obtained and correlated with dietary intake.</p> <p>Results</p> <p>The overall prevalence of overweight and obesity was 12.2% and 27.0% respectively, with boys having higher obesity rates than girls (P ≤ 0.001). W_C and BMI was positively correlated with sugar-sweetened carbonated beverage (SSCB) intake in boys only. The association between male BMI and SSCB consumption was significant in a multivariate regression model (P < 0.0001). SSCB intake was positively associated with poor dietary choices in both males and females. Fast food meal intake, savory snacks, iced desserts and total sugar consumption correlated with SSCB intake in both boys (r = 0.39, 0.13, 0.10 and 0.52 respectively, P < 0.001) and girls (r = 0.45, 0.23, 0.16 and 0.55 respectively, P < 0.001). Older children reported eating significantly less fruit and vegetables than younger children; and less eggs, fish and cereals. Conversely, consumption of SSCB and sugar-sweetened hot beverages were higher in older versus younger children (P < 0.001). BMI and W_C were negatively correlated with hours of night-time sleep and exercise in boys, but only with night time sleep in girls, who also showed the lowest frequency of exercise.</p> <p>Conclusions</p> <p>A higher intake of SSCB is associated with poor dietary choices. Male SSCB intake correlates with a higher W_C and BMI. Limiting exposure to SSCB could therefore have a large public health impact.</p

Food habits, nutritional status and disease patterns in Saudi Arabia

SIGLEAvailable from British Library Document Supply Centre- DSC:DX170321 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Food Habits, Nutritional Status and Disease Patterns in Saudi Arabia.

This is a descriptive study to investigate the Saudi population's food habits, changes in food practices that have taken place as a result of the economic upheaval, and correlate these food habits with nutritional and health status and disease. This will serve as a useful tool in establishing associations between food habit and some diseases. It would also be helpful in setting up nutrient requirements for the people and contribute to efforts of health authorities in improving the people's nutritional status and general health. A total of 714 patients and 291 sitters between birth to 90 years of age, both male and female were surveyed. Anthropometric measurements were recorded and food habits were investigated using a questionnaire. Personal data information concerning socioeconomic status (SES) of both patients and sitters were also noted. Patients were also surveyed for their food intake using a diet history, 24-hour recall, and one-day diet record. Their disease diagnosis and biochemical status were extracted from medical records. SES and anthropometric measurements of patients were compared with sitters using t-tests. Anthropometric measurements of patients and sitters were compared with the US NCHS standards using contingency table analyses. Correlation between patients' SES, food habit and disease was tested using chi-square tests. Patients' nutrient intakes of calories, protein, vitamins and minerals were compared with the US recommended dietary allowances (RDA). Biochemcial measures of albumin and hemoglobin were compared with standards. The Saudis surveyed were middle-class. The middle and high classes attended parties and ate outside more frequently than the low class group. Use of fat increased with increasing social position. Lamb, chicken, and liver were used by all. Beef, shrimps and cold cuts were consumed more by the high social group. Raw vegetables, are eaten more by the high SES than the lower SES group. Fresh fruits, mostly dates, are eaten by all socioeconomic groups. . Arabic bread and rice formed the bulk of starches. Milk and laban (buttermilk) were consumed daily, tea is drunk three times a day, and arabic coffee (more by the high SES) three times a day. Sweets were consumed after meals and "junk" foods were eaten (more by the high SES group). Socioeconomic status was found to be significantly correlated with having neoplasms (cancers), pregnancy (obesity and gestational diabetes), and circulatory diseases. This was attributable to "lifestyle factors". Correlational analysis between cancers and food/food habit showed a strong positive association with animal fat. Circulatory diseases were positively correlated with "attendance at parties", raw vegetables, sweet biscuits, chocolates, and cold cuts. Coffee consumption was negatively correlated with cardiovascular disease. High consumption of sweets and carbohydrate-rich foods were positively correlated with pregnancy-related diseases. No food/food habits were positively associated with endocrine disorders. Negative correlations were found with olive oil, candies and cakes, laban, tea with sugar, and chocolates. It is possible that diet instructions being done in hospitals have some success so patients try to stay away from offending foods. Weight for height measurements from birth up to 14 years were not significantly different from the NCHS standard, except for the girls aged GT 10 - LE 14 years and adult men. Teen-age boys aged GT 14-LE 18 had normal weight for height. From 18 years of age, the men had weights for height that were significantly lower than standard. The women's weights were within normal range after age 14 years. Height for age of children up to 14 years except GT 10 -LE 14 females were within NCHS standard. After 14 years, height for age were significantly lower than standard. All nutrients except energy for the adult males met the RDA's. Another exception was significantly lower intakes of iron by the LE 1 age group which be attributed to the lower- iron content of milk and and reserve stores, and inadequate suplements. Weight for height for the male adults that was significantly lower than standard was a reflection of low energy intakes for this same group. There were no differences between hemoglobin and serum albumin values of patients and the standard for all age and sex groups. The result of this study could be utilized to improve educational materials for teaching patients. Also, more reliable and valid methods of collecting and analyzing data for nutritional assessments in the Saudi culture may evolve

Food Habits, Nutritional Status and Disease Patterns in Saudi Arabia.

This is a descriptive study to investigate the Saudi population's food habits, changes in food practices that have taken place as a result of the economic upheaval, and correlate these food habits with nutritional and health status and disease. This will serve as a useful tool in establishing associations between food habit and some diseases. It would also be helpful in setting up nutrient requirements for the people and contribute to efforts of health authorities in improving the people's nutritional status and general health. A total of 714 patients and 291 sitters between birth to 90 years of age, both male and female were surveyed. Anthropometric measurements were recorded and food habits were investigated using a questionnaire. Personal data information concerning socioeconomic status (SES) of both patients and sitters were also noted. Patients were also surveyed for their food intake using a diet history, 24-hour recall, and one-day diet record. Their disease diagnosis and biochemical status were extracted from medical records. SES and anthropometric measurements of patients were compared with sitters using t-tests. Anthropometric measurements of patients and sitters were compared with the US NCHS standards using contingency table analyses. Correlation between patients' SES, food habit and disease was tested using chi-square tests. Patients' nutrient intakes of calories, protein, vitamins and minerals were compared with the US recommended dietary allowances (RDA). Biochemcial measures of albumin and hemoglobin were compared with standards. The Saudis surveyed were middle-class. The middle and high classes attended parties and ate outside more frequently than the low class group. Use of fat increased with increasing social position. Lamb, chicken, and liver were used by all. Beef, shrimps and cold cuts were consumed more by the high social group. Raw vegetables, are eaten more by the high SES than the lower SES group. Fresh fruits, mostly dates, are eaten by all socioeconomic groups. . Arabic bread and rice formed the bulk of starches. Milk and laban (buttermilk) were consumed daily, tea is drunk three times a day, and arabic coffee (more by the high SES) three times a day. Sweets were consumed after meals and "junk" foods were eaten (more by the high SES group). Socioeconomic status was found to be significantly correlated with having neoplasms (cancers), pregnancy (obesity and gestational diabetes), and circulatory diseases. This was attributable to "lifestyle factors". Correlational analysis between cancers and food/food habit showed a strong positive association with animal fat. Circulatory diseases were positively correlated with "attendance at parties", raw vegetables, sweet biscuits, chocolates, and cold cuts. Coffee consumption was negatively correlated with cardiovascular disease. High consumption of sweets and carbohydrate-rich foods were positively correlated with pregnancy-related diseases. No food/food habits were positively associated with endocrine disorders. Negative correlations were found with olive oil, candies and cakes, laban, tea with sugar, and chocolates. It is possible that diet instructions being done in hospitals have some success so patients try to stay away from offending foods. Weight for height measurements from birth up to 14 years were not significantly different from the NCHS standard, except for the girls aged GT 10 - LE 14 years and adult men. Teen-age boys aged GT 14-LE 18 had normal weight for height. From 18 years of age, the men had weights for height that were significantly lower than standard. The women's weights were within normal range after age 14 years. Height for age of children up to 14 years except GT 10 -LE 14 females were within NCHS standard. After 14 years, height for age were significantly lower than standard. All nutrients except energy for the adult males met the RDA's. Another exception was significantly lower intakes of iron by the LE 1 age group which be attributed to the lower- iron content of milk and and reserve stores, and inadequate suplements. Weight for height for the male adults that was significantly lower than standard was a reflection of low energy intakes for this same group. There were no differences between hemoglobin and serum albumin values of patients and the standard for all age and sex groups. The result of this study could be utilized to improve educational materials for teaching patients. Also, more reliable and valid methods of collecting and analyzing data for nutritional assessments in the Saudi culture may evolve