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Alfawaz HA, Wani K, Alrakayan H, Alnaami AM, Al-Daghri NM. Awareness, Knowledge and Attitude towards 'Superfood' Kale and Its Health Benefits among Arab Adults. Nutrients 2022; 14:nu14020245. [PMID: 35057426 PMCID: PMC8782012 DOI: 10.3390/nu14020245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 02/01/2023] Open
Abstract
This cross-sectional online survey aimed to determine the awareness of Arab adults on the benefits of consuming nutrient-dense foods, such as kale. A total of 1200 respondents completed the survey. The questionnaire included questions related to socio-economic information, e.g., whether the participants have consumed kale, if they observed any health effects, and 13 other questions to test their knowledge on this superfood. Only 276 (23%) of the participants had previously consumed kale, with 64.5% reporting favorable health outcomes, the most common of which was weight reduction, and only 17.8% reporting side effects, such as constipation and gastrointestinal irritation. From the 13 kale knowledge questions, the average total knowledge score, scaled from 0 to 10, was 3.5 and 3.7 for males and females, respectively. The regression analysis revealed that age, income, and educational status were significant contributors for predicting better knowledge scores, as older individuals with a higher income and higher education scored higher (odds ratio of 2.96, 2.00 and 4.58, respectively). To summarize, there is a dearth of awareness about kale and its health benefits in Saudi Arabia. Kale should be promoted as a super food in all segments, particularly among the younger, lower-income, and less-educated sections of the population.
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Affiliation(s)
- Hanan A. Alfawaz
- Department of Food Science & Nutrition, College of Food Science & Agriculture, King Saud University, Riyadh 11495, Saudi Arabia; (H.A.A.); (H.A.)
| | - Kaiser Wani
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.)
| | - Haya Alrakayan
- Department of Food Science & Nutrition, College of Food Science & Agriculture, King Saud University, Riyadh 11495, Saudi Arabia; (H.A.A.); (H.A.)
| | - Abdullah M. Alnaami
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.)
| | - Nasser M. Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.)
- Correspondence: ; Tel.: +966-(11)-467-5939
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Oussalah A, Levy J, Berthezène C, Alpers DH, Guéant JL. Health outcomes associated with vegetarian diets: An umbrella review of systematic reviews and meta-analyses. Clin Nutr 2020; 39:3283-3307. [PMID: 32204974 DOI: 10.1016/j.clnu.2020.02.037] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/22/2020] [Accepted: 02/28/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Several meta-analyses evaluated the association between vegetarian diets and health outcomes. To integrate the large amount of the available evidence, we performed an umbrella review of published meta-analyses that investigated the association between vegetarian diets and health outcomes. METHODS We performed an umbrella review of the evidence across meta-analyses of observational and interventional studies. PubMed, Embase, Cochrane Database of Systematic Reviews, and ISI Web of Knowledge. Additional articles were retrieved from primary search references. Meta-analyses of observational or interventional studies that assessed at least one health outcome in association with vegetarian diets. We estimated pooled effect sizes (ESs) using four different random-effect models: DerSimonian and Laird, maximum likelihood, empirical Bayes, and restricted maximum likelihood. We assessed heterogeneity using I2 statistics and publication bias using funnel plots, radial plots, normal Q-Q plots, and the Rosenthal's fail-safe N test. RESULTS The umbrella review identified 20 meta-analyses of observational and interventional research with 34 health outcomes. The majority of the meta-analyses (80%) were classified as moderate or high-quality reviews, based on the AMSTAR2 criteria. By comparison with omnivorous diets, vegetarian diets were associated with a significantly lower concentration of blood total cholesterol (pooled ES = -0.549 mmol/L; 95% CI: -0.773 to -0.325; P < 0.001), LDL-cholesterol (pooled ES = -0.467 mmol/L; 95% CI: -0.600 to -0.335); P < 0.001), and HDL-cholesterol (pooled ES = -0.082 mmol/L; 95% CI: -0.095 to -0.069; P < 0.001). In comparison to omnivorous diets, vegetarian diets were associated with a reduced risk of negative health outcomes with a pooled ES of 0.886 (95% CI: 0.848 to 0.926; P < 0.001). In comparison to omnivores, Seventh-day Adventists (SDA) vegetarians had a significantly reduced risk of negative health outcomes with a pooled ES of 0.721 (95% CI: 0.625 to 0.832; P < 0.001). Non-SDA vegetarians had no significant reduction of negative health outcomes when compared to omnivores (pooled ES = 0.973; 95% CI: 0.873 to 1.083; P = 0.51). Vegetarian diets were associated with harmful outcomes on one-carbon metabolism markers (lower concentrations of vitamin B12 and higher concentrations of homocysteine), in comparison to omnivorous diets. CONCLUSIONS Vegetarian diets are associated with beneficial effects on the blood lipid profile and a reduced risk of negative health outcomes, including diabetes, ischemic heart disease, and cancer risk. Among vegetarians, SDA vegetarians could represent a subgroup with a further reduced risk of negative health outcomes. Vegetarian diets have adverse outcomes on one-carbon metabolism. The effect of vegetarian diets among pregnant and lactating women requires specific attention. Well-designed prospective studies are warranted to evaluate the consequences of the prevalence of vitamin B12 deficiency during pregnancy and infancy on later life and of trace element deficits on cancer risks. PROSPERO REGISTRATION NUMBER CRD42018092470.
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Affiliation(s)
- Abderrahim Oussalah
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, F-54000, Nancy, France; Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000, Nancy, France; Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, F-54000, Nancy, France.
| | - Julien Levy
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, F-54000, Nancy, France
| | - Clémence Berthezène
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, F-54000, Nancy, France
| | - David H Alpers
- Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, 63130, USA
| | - Jean-Louis Guéant
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, F-54000, Nancy, France; Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000, Nancy, France; Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, F-54000, Nancy, France.
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Alpers DH, Young GP, Tran CD, Mortimer EK, Gopalsamy GL, Krebs NF, Manary MJ, Ramakrishna BS, Binder HJ, Brown IL, Miller LV. Drug-development concepts as guides for optimizing clinical trials of supplemental zinc for populations at risk of deficiency or diarrhea. Nutr Rev 2017; 75:147-162. [PMID: 28399577 DOI: 10.1093/nutrit/nuw065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Studies on the efficacy of zinc supplementation for treatment or prevention of diarrhea have shown an inconsistent effect in populations at risk for zinc deficiency. Unlike drugs, which have no preexisting presence in the body, endogenous zinc must be assessed pharmacokinetically by isotope tracer studies. Although such methods have produced much data, very few studies have estimated the dose and the timing of dosing of zinc supplementation. This review examines drug kinetics used to establish the best dose, the timing of such doses, and the mechanism of action through pharmacodynamic markers and applies them, where possible, to zinc supplements. The findings reveal that little is known, especially in children at highest risk of zinc deficiency. Key data missing to inform proper dosing, whether for treatment of disease or for preventive nutrient supplementation, are noted. Addressing these uncertainties could improve study design, leading to future studies of zinc supplements that might be of greater benefit.
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Affiliation(s)
- David H Alpers
- School of Medicine, Washington University, St Louis, Missouri, USA
| | - Graeme P Young
- School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Cuong D Tran
- CSIRO Health and Biosecurity, Adelaide, South Australia, Australia.,School of Medicine, Faculty of Health Sciences, The University of Adelaide, South Australia, Australia
| | - Elissa K Mortimer
- School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Geetha L Gopalsamy
- School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia.,CSIRO Health and Biosecurity, Adelaide, South Australia, Australia
| | - Nancy F Krebs
- Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Mark J Manary
- School of Medicine, Washington University, St Louis, Missouri, USA
| | | | - Henry J Binder
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Ian L Brown
- School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Leland V Miller
- Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado, USA
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The Prevalence of Micronutrient Deficiencies and Inadequacies in the Middle East and Approaches to Interventions. Nutrients 2017; 9:nu9030229. [PMID: 28273802 PMCID: PMC5372892 DOI: 10.3390/nu9030229] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 02/28/2017] [Indexed: 12/28/2022] Open
Abstract
Micronutrient deficiencies and inadequacies constitute a global health issue, particularly among countries in the Middle East. The objective of this review is to identify micronutrient deficits in the Middle East and to consider current and new approaches to address this problem. Based on the availability of more recent data, this review is primarily focused on countries that are in advanced nutrition transition. Prominent deficits in folate, iron, and vitamin D are noted among children/adolescents, women of childbearing age, pregnant women, and the elderly. Reports indicate that food fortification in the region is sporadic and ineffective, and the use of dietary supplements is low. Nutrition monitoring in the region is limited, and gaps in relevant information present challenges for implementing new policies and approaches to address the problem. Government-sponsored initiatives are necessary to assess current dietary intakes/patterns, support nutrition education, and to reduce food insecurity, especially among vulnerable population groups. Public-private partnerships should be considered in targeting micronutrient fortification programs and supplementation recommendations as approaches to help alleviate the burden of micronutrient deficiencies and inadequacies in the Middle East.
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Lovern D, Marbois B. Does menaquinone participate in brain astrocyte electron transport? Med Hypotheses 2013; 81:587-91. [PMID: 23910074 DOI: 10.1016/j.mehy.2013.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 06/25/2013] [Accepted: 07/03/2013] [Indexed: 02/03/2023]
Abstract
UNLABELLED Quinone compounds act as membrane resident carriers of electrons between components of the electron transport chain in the periplasmic space of prokaryotes and in the mitochondria of eukaryotes. Vitamin K is a quinone compound in the human body in a storage form as menaquinone (MK); distribution includes regulated amounts in mitochondrial membranes. The human brain, which has low amounts of typical vitamin K dependent function (e.g., gamma carboxylase) has relatively high levels of MK, and different regions of brain have different amounts. Coenzyme Q (Q), is a quinone synthesized de novo, and the levels of synthesis decline with age. The levels of MK are dependent on dietary intake and generally increase with age. MK has a characterized role in the transfer of electrons to fumarate in prokaryotes. A newly recognized fumarate cycle has been identified in brain astrocytes. The MK precursor menadione has been shown to donate electrons directly to mitochondrial complex III. HYPOTHESIS Vitamin K compounds function in the electron transport chain of human brain astrocytes.
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Affiliation(s)
- Douglas Lovern
- BioMérieux, 100 Rodolphe Dr., Durham, NC 27712, United States
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Cangoz S, Chang YY, Chempakaseril SJ, Guduru RC, Huynh LM, John JS, John ST, Joseph ME, Judge R, Kimmey R, Kudratov K, Lee PJ, Madhani IC, Shim PJ, Singh S, Singh S, Ruchalski C, Raffa RB. Vitamin D and type 2 diabetes mellitus. J Clin Pharm Ther 2012; 38:81-4. [PMID: 23216626 DOI: 10.1111/jcpt.12026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 10/25/2012] [Indexed: 01/20/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE The deleterious effect of vitamin D deficiency on bone health has long been known. More recent studies suggest a deleterious effect of low vitamin D (hypovitaminosis D) on general health. And specific studies propose an association between hypovitaminosis D and the aetiology and progression of type 2 diabetes (T2DM). Given a commonly assumed lack of toxicity of vitamin D, routine measurement of plasma vitamin D and supplementation is rapidly becoming accepted general practice. COMMENT Authoritative practice guidelines have raised the level of vitamin D that is to be considered minimal for optimum health. This recommendation was based on a wealth of information and definitive evidence for skeletal benefits of vitamin D, but there was a lack of compelling evidence that hypovitaminosis D is causally related to extra-skeletal health outcomes such as diabetes. Hence, vitamin D supplementation for the purpose of achieving a level consistent with good health is evidence based, but measurement and supplementation for the purpose of preventing or treating T2DM is not. WHAT IS NEW AND CONCLUSION Although the maintenance of adequate vitamin D levels is desirable for all patients, we conclude that routine measurement of vitamin D level in every patient or initiating high-dose supplementation for the purpose of preventing or treating T2DM is not evidence based.
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Affiliation(s)
- S Cangoz
- School of Pharmacy, Temple University, Philadelphia, PA, USA
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