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Balhareth A, Meertens R, Kremers S, Sleddens E. Overweight and obesity among adults in the Gulf States: A systematic literature review of correlates of weight, weight-related behaviours, and interventions. Obes Rev 2019; 20:763-793. [PMID: 30653803 PMCID: PMC6850146 DOI: 10.1111/obr.12826] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/16/2018] [Accepted: 11/27/2018] [Indexed: 12/28/2022]
Abstract
Obesity has increased to an epidemic level in the Gulf States. This systematic review is the first to explore the scientific evidence on correlates and interventions for overweight (body mass index [BMI] ≥ 25) or weight-related behaviours in the region. A systematic search of peer-reviewed articles was conducted using PubMed and PsycINFO. Ninety-one studies were eligible for this review including 84 correlate studies and seven intervention studies. Correlate studies of overweight focused on sociodemographic factors, physical activity, and dietary habits. Low physical activity, sedentary behaviour, and unhealthy dietary habits were associated with overweight. The most-reported sociodemographic correlates of overweight were increased age, being married, low education, urban residence, and unemployment. Correlate studies of physical activity and dietary behaviours mostly focused on sociodemographic variables. Being female and increased age (the latter less consistently) were associated with low physical activity. Interventions were very heterogeneous with respect to the target group, intensity, and behavioural strategies used. The effectiveness of interventions was difficult to evaluate because of the chosen study design or outcome measure, the small sample size, or high attrition rate. Few studies have investigated sociocognitive and environmental determinants of weight-related behaviours. Such information is crucial to developing health promotion initiatives that target those weight-related behaviours.
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Affiliation(s)
- Abdulaziz Balhareth
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical Center+MaastrichtThe Netherlands
- Department of Health Education and Promotion, Faculty of Public Health and Tropical MedicineJazan UniversityJazanSaudi Arabia
| | - Ree Meertens
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical Center+MaastrichtThe Netherlands
- Department of Health Promotion, CAPHRI Care and Public Health Research InstituteMaastricht University Medical Center+MaastrichtThe Netherlands
| | - Stef Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical Center+MaastrichtThe Netherlands
| | - Ester Sleddens
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical Center+MaastrichtThe Netherlands
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Alkazemi D, Zafar TA, Ebrahim M, Kubow S. Distorted weight perception correlates with disordered eating attitudes in Kuwaiti college women. Int J Eat Disord 2018; 51:449-458. [PMID: 29488236 PMCID: PMC6586007 DOI: 10.1002/eat.22852] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We investigated the presence of disordered eating attitudes and weight perception among young women at body mass index (BMI) values that correspond to underweight, normal weight, overweight, and obese weight status. METHOD Data were collected from 1,147 female undergraduate students (89% Kuwaiti nationals) recruited from Kuwait University through employment of the eating attitude test (EAT-26) together with an anonymous, self-administered questionnaire to determine the prevalence of symptomatology indicative of anorexia nervosa and bulimia nervosa. RESULTS The mean EAT-26 scores differed significantly between the weight categories. More students with overweight and obesity scored above the established EAT-26 cut off value indicating at risk of disordered eating compared to students who were at a normal weight or underweight (52.1% vs. 38.8%, respectively, X2 (1) =16.1, p < .001). Logistic regression analyses showed significantly higher odds ratios (ORs) for the groups with overweight and obesity for dieting and bulimic behaviors, while women at normal and underweight had higher ORs for restrictive oral control behaviors associated with anorexia nervosa. Distorted weight perception was found in all weight categories. DISCUSSION The high proportion of disordered eating attitudes among Kuwaiti college women could not be attributed to obesity alone as the type of disordered eating behavior varied more by weight perception than by weight status. The high levels of eating disorder related symptoms could be due to a combination of the social influences, diet, and lifestyle of college students. Such factors need to be considered by healthcare professionals as early as possible with more focused programs towards promotion of healthy weight for college students.
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Affiliation(s)
- Dalal Alkazemi
- Department of Food Science and Nutrition, College of Life SciencesKuwait University, P.O. Box 5969AdailiyaSafat13060Kuwait
| | - Tasleem A. Zafar
- Department of Food Science and Nutrition, College of Life SciencesKuwait University, P.O. Box 5969AdailiyaSafat13060Kuwait
| | - Mariam Ebrahim
- Department of Food Science and Nutrition, College of Life SciencesKuwait University, P.O. Box 5969AdailiyaSafat13060Kuwait
| | - Stan Kubow
- School of Human NutritionMcGill UniversityMontrealQuebecH9X3V9Canada
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Al-Isa AN. Comparing Socio-Demographic, Health-Related, and Biochemical Factors Associated with Metabolic Syndrome (MetS) between Adolescents from Two Arab Countries. Health (London) 2014. [DOI: 10.4236/health.2014.68098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Karageorgi S, Alsmadi O, Behbehani K. A review of adult obesity prevalence, trends, risk factors, and epidemiologic methods in Kuwait. J Obes 2013; 2013:378650. [PMID: 24455212 PMCID: PMC3877637 DOI: 10.1155/2013/378650] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/17/2013] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Kuwait is among the countries with the highest obesity rates worldwide; however, little is known about the state of obesity epidemiology research in Kuwait. In this paper, we therefore review the findings and methodology of studies on the prevalence, trends and risk factors of obesity in Kuwait. METHODS The PubMed database was searched using the keyword combination: obesity and adults and Kuwait. Out of 111 articles, 39 remained after abstract review, and 18 were selected after full-text review. RESULTS The studies were all cross-sectional and published in the last fifteen years (1997-2012). The sample size ranged from 177 to 38,611 individuals. Only 30% of studies used random sampling. The prevalence (BMI ≥ 30) in studies with a nationally representative sample ranged from 24% to 48% overall and in adults >50 years was greater than 52%. Rates were significantly higher in women than those in men. Studies that examined trends showed an increase in obesity prevalence between 1980 and 2009. Multiple risk factors including sociocultural factors were investigated in the studies; however, factors were only crudely assessed. CONCLUSION There is a need for future studies, particularly surveillance surveys and prospective cohort studies utilizing advanced methods, to monitor trends and to comprehensively assess the factors contributing to the obesity epidemic in Kuwait.
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Affiliation(s)
- Stalo Karageorgi
- Genome Centre, Dasman Diabetes Institute, P.O. Box 1180, Dasman, 15462 Kuwait City, Kuwait
- *Stalo Karageorgi:
| | - Osama Alsmadi
- Genome Centre, Dasman Diabetes Institute, P.O. Box 1180, Dasman, 15462 Kuwait City, Kuwait
| | - Kazem Behbehani
- Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait
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Al-Isa A. Prevalence of metabolic syndrome (MetS) among male Kuwaiti adolescents aged 10 - 19 years. Health (London) 2013. [DOI: 10.4236/health.2013.55124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Al-Isa AN, Akanji AO. Socio-demographic and health-related determinants of metabolic syndrome (MetS) among male Kuwaiti adolescents aged 10 - 19 years. Health (London) 2013. [DOI: 10.4236/health.2013.54095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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MacPherson MM, MacArthur L, Jadan P, Glassman L, Bouzubar FF, Hamdan E, Landry MD. A SWOT analysis of the physiotherapy profession in Kuwait. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2012; 18:37-46. [PMID: 22700480 DOI: 10.1002/pri.1527] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 04/16/2012] [Accepted: 04/18/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Since the end of the Gulf War in 1991, Kuwait has become one of the wealthiest countries in the world and one that has a highly socialized health-care system. This rapid growth and socio-economic development appears to have had a negative impact on the health of its people. As such, the profession of physiotherapy may be in a unique position to address this issue by providing health behaviour interventions and promoting healthy lifestyles. The purpose of this study was to explore the current state of physiotherapy in Kuwait and provide recommendations for future development and growth. METHOD Using a qualitative research approach, we conducted 17 key informant interviews (clinicians, administrators and other key stakeholders) in Kuwait. The strengths, weaknesses, opportunities and threats framework was then used to categorize the emerging themes and provide a basis for a strategic direction for the profession. RESULTS Informants reported that strengths included funding for services and motivation of professionals. Weaknesses included education and professional resources, marketing/advocacy, standardization and regulation of practice. Opportunities discussed were untapped demand for physiotherapy services, internal development and evolution of the physiotherapy association, along with professional collaboration. Threats addressed included low public awareness of physiotherapy, challenges with inter-professional practice/communication, and cultural perspectives of healthy lifestyles. CONCLUSIONS Our research indicates that many unique opportunities exist for physiotherapists in Kuwait. Further development and evolution of Kuwait's physiotherapy professional association could facilitate efforts to advocate for the profession, initiate standards of practice and provide enhanced opportunities for professional collaboration.
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Al Zenki S, Al Omirah H, Al Hooti S, Al Hamad N, Jackson RT, Rao A, Al Jahmah N, Al Obaid I, Al Ghanim J, Al Somaie M, Zaghloul S, Al Othman A. High prevalence of metabolic syndrome among Kuwaiti adults--a wake-up call for public health intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:1984-96. [PMID: 22754486 PMCID: PMC3386600 DOI: 10.3390/ijerph9051984] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 05/04/2012] [Accepted: 05/15/2012] [Indexed: 01/10/2023]
Abstract
The socio-economic development which followed the discovery of oil resources brought about considerable changes in the food habits and lifestyle of the Kuwaiti population. Excessive caloric intake and decreased energy expenditure due to a sedentary lifestyle have led to a rapid increase in obesity, diabetes and other non-communicable chronic diseases in the population. In this paper, we examine the prevalence of the Metabolic Syndrome (MetS) among Kuwaiti adults (≥20 years) using data from the first national nutrition survey conducted between July 2008 and November 2009. The prevalence of MetS was 37.7% in females and 34.2% in males by NCEP criteria, whereas the values were 40.1% in females and 41.7% in males according to IDF criteria. Prevalence of MetS increased with age and was higher in females than males. The high prevalence of the MetS in Kuwaiti adults warrants urgent public health measures to prevent morbidity and mortality due to cardiovascular complications in the future.
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Affiliation(s)
- Sameer Al Zenki
- Kuwait Institute for Scientific Research, PO Box 24885, Safat 13109, Kuwait; (H.A.O.); (S.A.H.); (J.A.G.); (A.A.O.)
| | - Husam Al Omirah
- Kuwait Institute for Scientific Research, PO Box 24885, Safat 13109, Kuwait; (H.A.O.); (S.A.H.); (J.A.G.); (A.A.O.)
| | - Suad Al Hooti
- Kuwait Institute for Scientific Research, PO Box 24885, Safat 13109, Kuwait; (H.A.O.); (S.A.H.); (J.A.G.); (A.A.O.)
| | - Nawal Al Hamad
- Ministry of Health, Food and Nutrition Administration, PO Box 24225, Safat 13103, Kuwait; (N.A.H.); (M.A.S.)
| | - Robert T. Jackson
- Department of Nutrition and Food Science, University of Maryland, College Park, MD 20742, USA;
| | - Aravinda Rao
- Ministry of Health, Medical Laboratories Services, Sabah Hospital Laboratories, PO Box 24225, Safat 13103, Kuwait; (A.R.); (N.A.J.); (I.A.O.)
| | - Nasser Al Jahmah
- Ministry of Health, Medical Laboratories Services, Sabah Hospital Laboratories, PO Box 24225, Safat 13103, Kuwait; (A.R.); (N.A.J.); (I.A.O.)
| | - Ina'am Al Obaid
- Ministry of Health, Medical Laboratories Services, Sabah Hospital Laboratories, PO Box 24225, Safat 13103, Kuwait; (A.R.); (N.A.J.); (I.A.O.)
| | - Jameela Al Ghanim
- Kuwait Institute for Scientific Research, PO Box 24885, Safat 13109, Kuwait; (H.A.O.); (S.A.H.); (J.A.G.); (A.A.O.)
| | - Mona Al Somaie
- Ministry of Health, Food and Nutrition Administration, PO Box 24225, Safat 13103, Kuwait; (N.A.H.); (M.A.S.)
| | - Sahar Zaghloul
- National Nutrition Institute, 16 Kasr El Aini Street, Cairo, Egypt;
| | - Amani Al Othman
- Kuwait Institute for Scientific Research, PO Box 24885, Safat 13109, Kuwait; (H.A.O.); (S.A.H.); (J.A.G.); (A.A.O.)
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Abstract
OBJECTIVE Abdominal obesity is a major risk factor for chronic diseases. Yet there are no waist circumference (WC) cut-offs for children in the Arabian Gulf. We developed smoothed WC percentiles for 5-19-year-old Kuwaiti children and adolescents, which could be used in clinical and public health practice. We also examined the percentages of children who had WC ≥ 90th percentile, a value commonly associated with an elevated risk of CVD. DESIGN This is a cross-sectional study that was conducted by the Kuwait National Nutrition Surveillance System. SETTING Data were collected from representative primary-, intermediate- and secondary-school children as part of the yearly nutrition and health monitoring. Least mean square regression was used to develop smoothed WC curves. SUBJECTS A total of 9593 healthy 5.0-18.9-year-old children of both sexes were studied from all areas of Kuwait. Age, gender, residency, education level, weight, height and WC were collected for all participants. RESULTS We developed the first smoothed WC curves for Kuwaiti children. Male children had higher WC than female children. WC increased with age in both genders, but larger percentages of male children had WC ≥ 90th percentile. Male children aged >10 years have higher WC percentiles than do female children at the 50th, 75th, 90th and 97th percentiles. CONCLUSIONS Male children (especially those aged >10 years) are at higher risk than female children. Few health-care professionals routinely measure WC. WC measurement should be promoted as an important tool in paediatric primary care practice. The use of these age- and gender-specific percentiles can impact public health recommendations for Kuwaiti and other Arab children from the Gulf.
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Al-Enezi SA, Alsurayei SA, Ismail AE, Aly NYA, Ismail WA, Abou-Bakr AA. Adenomatous colorectal polyps in patients referred for colonoscopy in a regional hospital in Kuwait. Saudi J Gastroenterol 2010; 16:188-93. [PMID: 20616414 PMCID: PMC3003207 DOI: 10.4103/1319-3767.65194] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/AIM Adenomatous colorectal polyps (ACPs) are known to be the precursor lesions for colorectal cancer. The aim of the study was to determine the prevalence, endoscopic and pathological features of ACPs in patients referred for colonoscopy. PATIENTS AND METHODS The endoscopic and histological reports of adult patients who underwent complete colonoscopy in the gastroenterology unit of a regional Kuwaiti hospital between January 2008 and December 2008 were retrospectively studied. The specimens of polyps were reviewed by an experienced pathologist who was blinded to the clinical or endoscopic information. Non-neoplastic polyps were not included in the analysis. RESULTS Of 530 eligible patients (mean age, 45 years; male-female ratio, 2:1), 54 (10%) had 103 ACPs. Of the patients with ACPs (mean age, 57 years), 43 (80%) were males and 36 (67%) were Kuwaitis. Histopathological examination of the most significant polyp in each patient revealed that 40 (74%) polyps were tubular adenomas (TAs); 11 (20%), tubulovillous (TV) adenomas; and 3 (6%), villous adenomas. High-grade dysplasia was noticed in 4 (10%) adenomas. Fifteen (2.8%) of the 530 patients had advanced ACPs. Logistic regression analysis of some variables and their association with ACPs found that age (P < 0.001; OR, 1.9; CI, 1.5-2.3), history of adenoma (P=0.001; OR, 6.4; CI, .2.1-19.4) and being Kuwaitis (P=0.029; OR, 2.1; CI, 1.1-4.1) to be independently associated with ACPs. CONCLUSION The most common histological type of ACPs was tubular adenoma. Advancing age, being Kuwaiti nationals and prior removal of ACPs were significantly associated with the occurrence of ACPs.
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Affiliation(s)
- Saleh A. Al-Enezi
- Department of Medicine, Farwaniya Hospital, Ministry of Health, Kuwait,Address for correspondence: Dr. Saleh A. Al-Enezi, Department of Medicine, Farwaniya Hospital, Ministry of Health, PO Box 18373, Postal Code 81004, Kuwait. E-mail:
| | | | - Ali E. Ismail
- Department of Medicine, Farwaniya Hospital, Ministry of Health, Kuwait,Department of Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nasser Yehia A. Aly
- Department of Infection Control, Farwaniya Hospital, Ministry of Health, Kuwait,Department of Tropical Medicine and Hygiene, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Waleed A. Ismail
- Department of Medicine, Farwaniya Hospital, Ministry of Health, Kuwait,Department of Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Amany A. Abou-Bakr
- Department of Pathology, Farwaniya Hospital, Ministry of Health, Kuwait,Department of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
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Prevalence of the metabolic syndrome among female Kuwaiti adolescents using two different criteria. Br J Nutr 2009; 103:77-81. [PMID: 19664298 DOI: 10.1017/s0007114509991425] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Overweight and obesity are highly prevalent in Kuwait and they are associated with the metabolic syndrome (MS). The present study aims to assess the prevalence of the MS among Kuwaiti female adolescents aged 10-19 years. A cross-sectional random sample of 431, apparently healthy, Kuwaiti female adolescents drawn from several randomly selected schools was studied for the prevalence of the MS using the International Diabetes Federation (IDF) and the National Cholesterol Education Program Third Adult Treatment Panel (ATP III) modified for age diagnostic criteria. Clinical assessment included measurements of waist circumference, blood pressure, fasting blood glucose, HDL and TAG. Whichever criteria are used, the prevalence of the MS among female Kuwaiti adolescents was found to be high, which indicates an urgent need for intervention programmes to prevent increased CVD and type 2 diabetes mellitus. The IDF criteria tend to give higher values for the prevalence of the MS in comparison with the modified ATP III criteria (14.8 v. 9.1 %). There have been no diagnostic criteria specific for the MS for the Gulf Arab population as yet.
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Kelishadi R, Alikhani S, Delavari A, Alaedini F, Safaie A, Hojatzadeh E. Obesity and associated lifestyle behaviours in Iran: findings from the First National Non-communicable Disease Risk Factor Surveillance Survey. Public Health Nutr 2007; 11:246-51. [PMID: 17625028 DOI: 10.1017/s1368980007000262] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the national prevalence of overweight and obesity, as well as some associated lifestyle behaviours, for the first time in Iran. DESIGN AND SETTINGS This population-based study was performed in early 2005 as part of the World Health Organization (WHO) STEPwise approach to non-communicable diseases' risk factor surveillance. Dietary and physical activity habits were assessed by WHO questionnaires. SUBJECTS The study population comprised 89,532 subjects aged over 15 years living in the 28 provinces of Iran. RESULTS Overall, 50.4% (n = 45,113) of the participants were male and 64.6% (n = 57 866) were from the urban areas. The national estimates of overweight, obesity and morbid obesity were 28.6%, 10.8% and 3.4%, respectively. Body mass index (BMI) > or = 25 kg m-2 in men, women, urban residents and rural residents were found in 37%, 48%, 46.7% and 35.5%, respectively. Abdominal obesity was present in 43.4% of women, 9.7% of men, 28.5% of the urban residents and 23% of the rural residents. Overweight as well as generalised and abdominal obesity were more prevalent in the 45-64-year age group. Although there was no significant difference in frequency of consumption of the food groups in subjects with different BMI categories, various kinds of physical activities showed a steady decline with increasing BMI. CONCLUSIONS The findings of the present study provide alarming evidence for health professionals and policy makers about the very high prevalence of generalised and abdominal obesity in Iran. The unhealthy lifestyle habits, notably sedentary lifestyles in our community, are the major contributing factors for this emerging public health problem.
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Affiliation(s)
- Roya Kelishadi
- Isfahan Cardiovascular Research Center, WHO - Collaborating Center in the EMR, Isfahan University of Medical Sciences, PO Box 81465-1148, Isfahan, Iran.
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Dashti HM, Mathew TC, Khadada M, Al-Mousawi M, Talib H, Asfar SK, Behbahani AI, Al-Zaid NS. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol Cell Biochem 2007; 302:249-56. [PMID: 17447017 DOI: 10.1007/s11010-007-9448-z] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Accepted: 03/07/2007] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Obesity is closely linked to the incidence of type II diabetes. It is found that effective management of body weight and changes to nutritional habits especially with regard to the carbohydrate content and glycemic index of the diet have beneficial effects in obese subjects with glucose intolerance. Previously we have shown that ketogenic diet is quite effective in reducing body weight. Furthermore, it favorably alters the cardiac risk factors even in hyperlipidemic obese subjects. In this study the effect of ketogenic diet in obese subjects with high blood glucose level is compared to those with normal blood glucose level for a period of 56 weeks. MATERIALS AND METHODS A total of 64 healthy obese subjects with body mass index (BMI) greater than 30, having high blood glucose level and those subjects with normal blood glucose level were selected in this study. The body weight, body mass index, blood glucose level, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, urea and creatinine were determined before and at 8, 16, 24, 48, and 56 weeks after the administration of the ketogenic diet. RESULTS The body weight, body mass index, the level of blood glucose, total cholesterol, LDL-cholesterol, triglycerides, and urea showed a significant decrease from week 1 to week 56 (P < 0.0001), whereas the level of HDL-cholesterol increased significantly (P < 0.0001). Interestingly these changes were more significant in subjects with high blood glucose level as compared to those with normal blood glucose level. The changes in the level of creatinine were not statistically significant. CONCLUSION This study shows the beneficial effects of ketogenic diet in obese diabetic subjects following its long-term administration. Furthermore, it demonstrates that in addition to its therapeutic value, low carbohydrate diet is safe to use for a longer period of time in obese diabetic subjects.
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Affiliation(s)
- Hussein M Dashti
- Department of Surgery, Faculty of Medicine, Kuwait University, PO Box 24923, 13110 Safat, Kuwait.
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Mojiminiyi OA, Abdella NA, Al Arouj M, Ben Nakhi A. Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes. Int J Obes (Lond) 2006; 31:213-20. [PMID: 16755284 DOI: 10.1038/sj.ijo.0803355] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Obesity and the metabolic syndrome have emerged as clinical and public health crises in many populations, but not all obese patients have the syndrome. As adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism, we postulate that estimation of adipokines may be useful addition to the criteria used to identify obese individuals with the metabolic syndrome. OBJECTIVE To evaluate the determinants and associations of plasma adiponectin in relation to the metabolic syndrome in patients with Type 2 diabetes. DESIGN Cross-sectional study. SETTING General Teaching Hospital. PATIENTS One hundred and thirty five (57 M, 78 F) patients with Type 2 diabetes mellitus. MEASUREMENTS Adiponectin, leptin, high-sensitivity C-reactive protein (hs-CRP), fasting plasma insulin, glucose, glycated hemoglobin and full lipid profile. Patients were classified on the basis of the degree of adiposity, insulin resistance (IR) (homeostasis model assessment of insulin resistance (HOMA-IR)) and the number of the American Heart Association and the National Heart, Lung and Blood Institute criteria of the metabolic syndrome. RESULTS Adiponectin levels were inversely correlated with age, indices of obesity, IR and hs-CRP. Overweight/obese and non-obese insulin-sensitive patients had significantly higher (P<0.05) adiponectin levels than those with IR despite similar body mass index and waist circumference. Therefore, within each category of obesity stratification, lower adiponectin levels were associated with IR. Adiponectin showed stepwise decrease with increasing number of the criteria for diagnosis of the metabolic syndrome. Using multiple logistic regression, the odds ratio of the metabolic syndrome as predicted by adiponectin was 0.73 (95% confidence interval 0.53-0.96; P=0.04). At cutoff point of 18 ng/ml, the diagnostic sensitivity and specificity of adiponectin for the metabolic syndrome were 83 and 65%, respectively, in male patients and 92 and 41%, respectively, in female patients. Receiver operating characteristic analysis showed that adiponectin had significantly higher area under the curve compared with leptin, leptin:adiponectin ratio and triglycerides for the detection of the metabolic syndrome. CONCLUSIONS In patients with Type 2 diabetes, adiponectin concentrations are closely related to IR and the components of the metabolic syndrome. Adiponectin concentration may be a useful addition to the criteria used for identifying obese subjects with the metabolic syndrome.
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Affiliation(s)
- O A Mojiminiyi
- Department of Pathology, Faculty of Medicine Kuwait University, Safat, Kuwait.
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