Vitamin B12 and folate status during pregnancy among Saudi population

T2DM is a growing health problem worldwide. It is now increasingly being diagnosed earlier in life. The factors involved in such an epidemic are complex. The intrauterine environment has long been known as an important contributor to many diseases including metabolic disorders such as T2DM. Recently, there is emerging evidence for maternal micronutrients affecting vital developmental processes in utero which can adversely “programme” the offspring to develop metabolic disorders in later life. Thus, “gene-diet” interaction during foetal development is likely to be a significant contributor to the epidemic of T2DM. In particular, the intrauterine imbalance between the two related vitamins, vitamin B12 and folate, affect DNA methylation and in turn programme the foetus for the whole life. Evidence from mandatory folic acid fortification studies suggests that in the presence of adequate folate, neural tube defects due to vitamin B12 insufficiency have tripled. In India, children born to mothers with “high folate and low vitamin B12” had higher adiposity and insulin resistance. Therefore, micronutrient status during pregnancy is likely to have a significant impact on the metabolic risk of the offspring. This thesis examines whether vitamin B12 insufficiency is prevalent in pregnancy, especially in a non-vegetarian population across the world as well as the Saudi pregnant population. As estimated intake is an accepted measure for micronutrient levels, we also examined the relationship between estimated vitamin B12 and folate intake with actual levels in the blood. We have found that vitamin B12 insufficiency was not uncommon during pregnancy across the world even in the non-vegetarian population and is also common in the Saudi population. Surprisingly, vitamin B12 insufficiency was observed in 50% of the tested population even in the presence of adequate vitamin B12 intake. In addition, we have also shown for the first time in the Saudi population that maternal BMI is inversely related to vitamin B12 levels, particularly in pregnancy. Even though we have shown a similar (or worse) picture in mothers with gestational diabetes, this study needs to be replicated, as our numbers are too small. Prospective studies linking the role of vitamin B12 insufficiency especially in the presence of high folate on birth outcomes in the Saudi population as well as intervention studies investigating the role of vitamin B12 supplementation in women of childbearing age and in pregnancy are urgently needed

Variation in Macro and Trace Elements in Progression of Type 2 Diabetes

Macro elements are the minerals of which the body needs more amounts and are more important than any other elements. Trace elements constitute a minute part of the living tissues and have various metabolic characteristics and functions. Trace elements participate in tissue and cellular and subcellular functions; these include immune regulation by humoral and cellular mechanisms, nerve conduction, muscle contractions, membrane potential regulations, and mitochondrial activity and enzyme reactions. The status of micronutrients such as iron and vanadium is higher in type 2 diabetes. The calcium, magnesium, sodium, chromium, cobalt, iodine, iron, selenium, manganese, and zinc seem to be low in type 2 diabetes while elements such as potassium and copper have no effect. In this review, we emphasized the status of macro and trace elements in type 2 diabetes and its advantages or disadvantages; this helps to understand the mechanism, progression, and prevention of type 2 diabetes due to the lack and deficiency of different macro and trace elements

Nutrition and health in Arab adolescents (NaHAR) : study protocol for the determination of ethnic-specific body fat and anthropometric cut-offs to identify metabolic syndrome

The prevalence of adolescent obesity in the Middle-East is considered among the highest in the world. Obesity in adolescents is associated with several cardiometabolic abnormalities, the constellation of which is referred to as the metabolic syndrome (MetS). This multi-country cross-sectional study aims to determine the optimal cut-off values for body fat (BF); body mass index (BMI) z-score; waist circumference (WC) percentile, and mid-upper arm circumference (MUAC) for the prediction of MetS among adolescents from Kingdom of Saudi-Arabia (KSA), Kuwait, Jordan, Lebanon and Syria. A secondary objective is to examine the validity of Bioelectrical Impendence Vector Analysis (BIVA) in estimating BF against the deuterium dilution technique (DDL). In each country, a sample of 210 adolescents will be recruited. Data collection will include demographics, socioeconomic, lifestyle and dietary data using a multi-component questionnaire; anthropometric measurements will be obtained and body composition will be assessed using the DDL and BIVA; blood pressure and biochemical assessment will be performed for the identification of the MetS. Receiver operating characteristic analyses will be undertaken to determine optimal cut-off values of BMI, WC, MUAC and BF in identifying those with MetS. Odds ratios (OR) and their respective 95% confidence interval (CI) for the association of the anthropometric measurements with MetS will be computed based on multiple logistic regression analysis models. The Bland and Altman approach will be adopted to compare BIVA against the reference DDL method for the determination of body composition parameters. This study responds to the need for ethnic-specific anthropometric cut-offs for the identification of excess adiposity and associated cardiometabolic risks in the adolescent population. The adoption of the generated cut-offs may assist policy makers, public health professionals and clinical practitioners in providing ethnic-specific preventive and curative strategies tailored to adolescents in the region

Nutrition and Health in Arab Adolescents (NaHAR): Study protocol for the determination of ethnic-specific body fat and anthropometric cut-offs to identify metabolic syndrome.

The prevalence of adolescent obesity in the Middle-East is considered among the highest in the world. Obesity in adolescents is associated with several cardiometabolic abnormalities, the constellation of which is referred to as the metabolic syndrome (MetS). This multi-country cross-sectional study aims to determine the optimal cut-off values for body fat (BF); body mass index (BMI) z-score; waist circumference (WC) percentile, and mid-upper arm circumference (MUAC) for the prediction of MetS among adolescents from Kingdom of Saudi-Arabia (KSA), Kuwait, Jordan, Lebanon and Syria. A secondary objective is to examine the validity of Bioelectrical Impendence Vector Analysis (BIVA) in estimating BF against the deuterium dilution technique (DDL). In each country, a sample of 210 adolescents will be recruited. Data collection will include demographics, socioeconomic, lifestyle and dietary data using a multi-component questionnaire; anthropometric measurements will be obtained and body composition will be assessed using the DDL and BIVA; blood pressure and biochemical assessment will be performed for the identification of the MetS. Receiver operating characteristic analyses will be undertaken to determine optimal cut-off values of BMI, WC, MUAC and BF in identifying those with MetS. Odds ratios (OR) and their respective 95% confidence interval (CI) for the association of the anthropometric measurements with MetS will be computed based on multiple logistic regression analysis models. The Bland and Altman approach will be adopted to compare BIVA against the reference DDL method for the determination of body composition parameters. This study responds to the need for ethnic-specific anthropometric cut-offs for the identification of excess adiposity and associated cardiometabolic risks in the adolescent population. The adoption of the generated cut-offs may assist policy makers, public health professionals and clinical practitioners in providing ethnic-specific preventive and curative strategies tailored to adolescents in the region

Prevalence of metabolic syndrome in Saudi Arabia - a cross sectional study

Abstract Background The evaluation of metabolic syndrome in a society predisposed to the diabetes mellitus epidemic opens a new avenue to understanding this rapidly growing global metabolic problem. Although Saudi Arabia reports one of the highest prevalence levels of obesity and diabetes, a very limited number of epidemiological studies have examined the prevalence of metabolic syndrome. Therefore, the main aim of the current study was to estimate the prevalence of metabolic syndrome and its risk factors among the adult Saudi population in comparison to other countries. Methods A total of 12,126 Saudi subjects were randomly recruited from the 13 administrative regions, and evaluated for metabolic syndrome and its risk factors. This exercise was carried out by trained physicians, through clinical evaluations and overnight fasting blood glucose and lipid profile measurements. Both the International Diabetes Federation (IDF) and modified National Cholesterol Education Program and Adult Treatment Panel III (NCEP ATP III) Criteria were employed, and subjects with metabolic syndrome were identified using country-specific waist circumference cutoff values. Results The prevalence of metabolic syndrome in Saudi Arabia was found to be 39.8% (34.4% in men and 29.2% in women) and 31.6% (45.0% in men and 35.4% in women), according to the NCEP ATP III and IDF criteria, respectively. Metabolic syndrome was also observed to be more prevalent among men and older subjects. The most frequently observed component of metabolic syndrome was found to be low levels of high-density lipoprotein (HDL), followed by abdominal obesity. The most significant risk factors in the studied cohort included age ≥ 45, smoking history, low educational level, and living in urban areas. Conclusions This study shows a high prevalence of metabolic syndrome in Saudi Arabia, and thereby warrants urgent implementation of preventive health care strategies to reduce both morbidity and mortality related to this medical problem

Conceptualization of the NaHAR study, a multi-country study conducted in the Middle-East for determination of ethnic-specific cut-off values for body fat and anthropometric indicators in adolescents.

Abbreviations: BIVA: Bioelectrical Impendence Vector Analysis; BMI: Body mass index; DDL: Deuterium dilution technique; IDF: International Diabetes Federation; NaHAR: Nutrition and Health in Arab Adolescents; WC: Waist circumference; WHtR: Waist-to-height ratio.</p

Scoring^b'*' and classification of the Tanner stage.

Scoringb'*' and classification of the Tanner stage.</p

Inclusion and exclusion criteria.

The prevalence of adolescent obesity in the Middle-East is considered among the highest in the world. Obesity in adolescents is associated with several cardiometabolic abnormalities, the constellation of which is referred to as the metabolic syndrome (MetS). This multi-country cross-sectional study aims to determine the optimal cut-off values for body fat (BF); body mass index (BMI) z-score; waist circumference (WC) percentile, and mid-upper arm circumference (MUAC) for the prediction of MetS among adolescents from Kingdom of Saudi-Arabia (KSA), Kuwait, Jordan, Lebanon and Syria. A secondary objective is to examine the validity of Bioelectrical Impendence Vector Analysis (BIVA) in estimating BF against the deuterium dilution technique (DDL). In each country, a sample of 210 adolescents will be recruited. Data collection will include demographics, socioeconomic, lifestyle and dietary data using a multi-component questionnaire; anthropometric measurements will be obtained and body composition will be assessed using the DDL and BIVA; blood pressure and biochemical assessment will be performed for the identification of the MetS. Receiver operating characteristic analyses will be undertaken to determine optimal cut-off values of BMI, WC, MUAC and BF in identifying those with MetS. Odds ratios (OR) and their respective 95% confidence interval (CI) for the association of the anthropometric measurements with MetS will be computed based on multiple logistic regression analysis models. The Bland and Altman approach will be adopted to compare BIVA against the reference DDL method for the determination of body composition parameters. This study responds to the need for ethnic-specific anthropometric cut-offs for the identification of excess adiposity and associated cardiometabolic risks in the adolescent population. The adoption of the generated cut-offs may assist policy makers, public health professionals and clinical practitioners in providing ethnic-specific preventive and curative strategies tailored to adolescents in the region.</div

Sleep duration and quality associated with obesity among Arab children

The link between sleep duration and obesity has been well established in adults, but several epidemiological studies revealed inconsistent findings in adolescents and younger children. This study aimed to investigate the relationship between sleep length and obesity in Saudi students. A total of 5,877 Saudi students, boys (55.2%) and girls (44.8%), aged between 10 and 19 years were randomly selected from elementary, intermediate, and secondary schools in different regions of Riyadh. A questionnaire on sleep behaviors was given. Anthropometry included BMI and waist and hip circumferences. Sleeping <= 7 h significantly increased the risk of obesity in both boys and girls (all age categories) (odds ratio = 1.25-1.38, 95% confidence intervals = 1.02-1.89). Overall prevalence of overweight and obese were higher among those sleeping intermittently (18.68%) than those sleeping continuously (14.5%) (P = 0.024). Short sleep duration and poor sleep quality are significantly associated with obesity among Arab youth. Further studies need to employ more objective measures of sleep, such as actigraphy, and examine the mechanism of these associations