VALIDATION OF THE ARABIC VERSION OF THE FOOD SAFETY AND HYGIENE QUESTIONNAIRE AMONG NUTRITION STUDENT

There is shortage of data on food safety knowledge and practices among Lebanese food handlers due to the lack of a reliable tool. The aim of the current study is to determine the reliability as well as the validity of an adopted Arabic version of the Osaili et al (2013) food safety questionnaire. Translation and back translation and testing equivalence were done using standard accepted procedures. A total of 110 undergraduate Nutrition and Dietetics students completed the questionnaire consisting of five subscales that covers major food safety concepts including personal hygiene, safe storage, cross contamination prevention, knowledge of health problems affecting food safety and symptoms of foodborne diseases. Construct validity was tested using knowledgeable group analysis; internal consistency was determined using Cronbach’s α and item-to-total correlation. Temporal stability was evaluated by test–retest reliability in a subgroup of 67 students. The results showed non-significant difference between scores of English and Arabic versions revealing equivalence. For the psychometric analysis, the significant statistical difference for most of food safety knowledge scores between lower and higher years of study indicates satisfactory construct validity. The test-retest reliability of the Arabic questionnaire showed a good temporal stability (ICC\u3e0.8), while the Cronbach’s α for the total scales ranged between 0.611 and 0.736 revealing an acceptable and satisfactory level of internal consistency for the items retained in the questionnaire. The translated Arabic version of the food safety questionnaire can be considered as a consistent and reliable tool, to be used as food safety knowledge assessment among food handlers

Association between Sarcopenia and Reduced Bone Mass: Is Osteosarcopenic Obesity a New Phenotype to Consider in Weight Management Settings?

Sarcopenic obesity (SO) is a frequent phenotype in people with obesity; however, it is unclear whether this links with an impaired bone status. In this study, we aimed to investigate the association between SO and low bone mass, and to assess the prevalence of a new entity that combines excessive fat deposition, reduced muscle mass and strength, and low bone mass defined as osteosarcopenic obesity (OSO). Body composition was completed by a DXA scan in 2604 participants with obesity that were categorized as with or without SO, and with low or normal bone mineral content (BMC). Participants with both SO and low BMC were defined as OSO. Among the entire sample, 901 (34.6%) participants met the criteria for SO. This group showed a reduced mean BMC (2.56 ± 0.46 vs. 2.85 ± 0.57, p < 0.01) and displayed a higher prevalence of individuals with low BMC with respect to those without SO (47.3% vs. 25.9%, p < 0.01). Logistic regression analysis showed that the presence of SO increases the odds of having low BMC by 92% [OR = 1.92; 95% CI: (1.60–2.31), p < 0.05] after adjusting for age, body weight, and body fat percentage. Finally, 426 (16.4%) out of the total sample were affected by OSO. Our findings revealed a strong association between SO and reduced bone mass in adults with obesity, and this introduces a new phenotype that combines body fat, muscle, and bone (i.e., OSO) and appears to affect 16% of this population

Development and validation of an Arabic questionnaire to assess psychosocial determinants of eating behavior among adolescents: a cross-sectional study

Background: There is a scarcity of studies that evaluate the psychosocial determinants of eating behavior among adolescents in the Eastern Mediterranean region. The availability of such data is limited by the lack of valid culturally appropriate tools. The current study aims to develop and validate an Arabic questionnaire that measures psychosocial determinants of eating behavior among adolescents. Methods: A cross-sectional study was carried out to validate a five-scale questionnaire developed to measure nutrition-related knowledge, attitude, practices, and self-efficacy and social norms. Content validity was assessed by Lawshe\u2019s method, factor analysis was used to assess construct validity, and Cronbach\u2019s \u3b1 was used to test internal consistency. Temporal stability was assessed by test\u2013retest reliability. A random sample of public and private school students participated in the validation study. Results: All the five scales demonstrated excellent content validity (content validity ratio, CVR 650.778). Factor analysis revealed several dimensions for each scale. Cronbach\u2019s \u3b1 for the identified dimensions or subscales ranged between 0.495 and 0.809 indicating acceptable internal consistency. Cronbach\u2019s \u3b1 for the total scales ranged between 0.759 and 0.836. Test\u2013retest analysis revealed good temporal stability (intraclass correlation, ICC >0.7). Conclusions: A psychometrically valid tool to measure psychosocial determinants of eating behavior was developed. This tool can serve as a potential instrument for pretest and impact evaluation of ongoing nutrition education interventions and curricula. Based on results obtained from this tool, efficacious modifications can be instilled for nutrition policies and interventions

Do Lifestyle Interventions before Gastric Bypass Prevent Weight Regain after Surgery? A Five-Year Longitudinal Study

It is unclear whether weight loss (WL) achieved by means of lifestyle interventions (LSIs) before bariatric surgery (BS) can improve long-term WL outcomes after surgery. We aimed to assess the impact of a structured LSI on WL% after gastric bypass (GBP). Two groups of patients were selected from a large cohort of participants with obesity who underwent GBP surgery at Santa Maria Nuova Hospital (Reggio Emilia, Italy). The groups were categorized as those who have or have not received LSI prior to GBP. The LSI group included 91 participants (cases) compared to 123 participants (controls) in the non-LSI group. WL% was measured at follow-up times of 1, 3, 6, 12, 24, 36, 48, and 60 months. The LSI group achieved a clinically significant WL% (-7.5%) before BS, and at the time of surgery, the two groups had similar body weights and demographic statuses. At all points, until the 24-month follow-up, the two groups displayed similar WLs%. With regard to the longer follow-ups, the LSI group maintained weight loss until the last timepoint (60 months), whereas the non-LSI group experienced weight regain at 36, 48, and 60 months. In a real-world context, a structured behavioral LSI prior to GBP seems to prevent longer-term weight regain

Personalized physical activity programs for the management of knee osteoarthritis in individuals with obesity: a patient-centered approach

Physical activity (PA) plays a vital role in knee osteoarthritis (KOA) management. However, engaging individuals with KOA in regular exercise is challenging, especially when they are affected by obesity. The aim of the current review is to elucidate how to increase adherence to exercise in this population. When implementing a PA program with patients with KOA and obesity, a specific multi-step approach can be adopted. In phase I (the baseline assessment), the patients' eligibility for exercise is ascertained and a physical fitness assessment, sarcopenic obesity screening and quantification of the pain experienced are undertaken. Phase II adopts a patient-centered approach in implementing a PA program that combines an active lifestyle (>6000 steps/day) with land- or water-based exercise programs performed over eight to twelve weeks, with a frequency of three to five sessions per week, each lasting 60 min. In phase III, several strategies can be used to increase the patients' adherence to higher levels of PA, including the following: (i) personalizing PA goal-setting and real-time monitoring; (ii) enhancing physical fitness and the management of sarcopenic obesity; (iii) building a sustainable environment and a supportive social network for an active lifestyle; and (iv) reducing pain, which can ameliorate the clinical severity of KOA and help with weight management in this population

HEALTH-RELATED QUALITY OF LIFE IN TREATMENT-SEEKING ARAB PATIENTSWITH OBESITY

Background & Aim: Health-Related Quality of Life (HRQoL) is an important outcome that reflectsthe impact of chronic diseases on patients’ wellbeing. There is a paucity of studies on HRQoL and obesity in Arab-speaking countries. Therefore we aimed to investigate this outcome in this population. METHODS: The HRQoL was assessed by the validated Arabic version of the ORWELL 97 questionnaire in 116 seeking-treatment patients with obesity referred to the Nutritional and Weight management outpatient clinic of Beirut Arab University (BAU) in Lebanon, matched by age and gender to 116 normal-weight participants. RESULTS: Patients with obesity displayed higher total ORWELL 97 scores when compared with normal-weight controls (52.16 ± 33.34 vs. 13.04 ± 11.36, p \u3c 0.001), and linear regression analysis showed that the increase of Body Mass Index (BMI) among patients with obesity is associated with an increase of ORWELL 97 scores (β= 1.790, 95% CI= 0.808 - 2.772, p \u3c 0.001). Moreover, the logistic regression analysis showed that regardless the class of obesity, the only one-unit increase in BMI may increase the odds of scoring above 71.75 increased by nearly 11% (OR, 95% CI= 1.110, 1.003 - 1.229, p=0.04), which is considered indicative of a clinically significant impairment of HRQoL, especially in those with lower social status (i.e. lower education and unemployed). CONCLUSIONS: Our findings are considered new in an Arab population, and showed that obesity impairs HRQoL in treatment-seeking patients, where higher BMI is associated with more impairment in HRQoL. Moreover, interestingly an only one-unit increase in BMI dramatically increases the risk of HRQoL impairment to become clinically significant. Future studies are needed on larger scale in different Arab countries, to identify factors that are mostly associated with HRQoL, and to detect also changes in the latter in association with obesity treatment

Revising BMI Cut-Off Points for Obesity in a Weight Management Setting in Lebanon

Obesity is defined by the World Health Organization (WHO) as a body mass index (BMI) ≥ 30 Kg/m2. This study aimed to test the validity of this BMI cut-off point for adiposity in a weight management clinical setting in Lebanon. This cross-sectional study of 442 adults of mixed gender, categorized by the WHO BMI classification, included: 66 individuals of normal weight, 110 who were overweight and 266 with obesity. The clinical sample was referred to the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (BAU) in Lebanon. All participants underwent anthropometric evaluation. The gold standard for defining obesity was based on the National Institutes of Health (NIH)/WHO guidelines for total body fat percentage (BF%). The best sensitivity and specificity were attained to predict obesity, according to the receiver operating characteristic curve (ROC) analysis. The BMI cut-off point for predicting obesity in the clinical sample was nearly 31.5 Kg/m2, and more than 90% of individuals with obesity and cardiometabolic disease were above this cut-off point. In conclusion, this new BMI cut-off point, an obesity definition higher than suggested in Western populations, was demonstrated to have clinical usefulness. Obesity guidelines in Lebanon, therefore, need revising

Development and validation of an Arabic questionnaire to assess psychosocial determinants of eating behavior among adolescents: a cross-sectional study

Abstract Background There is a scarcity of studies that evaluate the psychosocial determinants of eating behavior among adolescents in the Eastern Mediterranean region. The availability of such data is limited by the lack of valid culturally appropriate tools. The current study aims to develop and validate an Arabic questionnaire that measures psychosocial determinants of eating behavior among adolescents. Methods A cross-sectional study was carried out to validate a five-scale questionnaire developed to measure nutrition-related knowledge, attitude, practices, and self-efficacy and social norms. Content validity was assessed by Lawshe’s method, factor analysis was used to assess construct validity, and Cronbach’s α was used to test internal consistency. Temporal stability was assessed by test–retest reliability. A random sample of public and private school students participated in the validation study. Results All the five scales demonstrated excellent content validity (content validity ratio, CVR ≥0.778). Factor analysis revealed several dimensions for each scale. Cronbach’s α for the identified dimensions or subscales ranged between 0.495 and 0.809 indicating acceptable internal consistency. Cronbach’s α for the total scales ranged between 0.759 and 0.836. Test–retest analysis revealed good temporal stability (intraclass correlation, ICC >0.7). Conclusions A psychometrically valid tool to measure psychosocial determinants of eating behavior was developed. This tool can serve as a potential instrument for pretest and impact evaluation of ongoing nutrition education interventions and curricula. Based on results obtained from this tool, efficacious modifications can be instilled for nutrition policies and interventions