1
|
Mumena WA, Kutbi HA. Fruit and vegetable consumption among children in Saudi Arabia: Predictors and associations with dietary intake. J Hum Nutr Diet 2024; 37:1277-1287. [PMID: 38865290 DOI: 10.1111/jhn.13339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Data exploring factors related to the consumption of fruits and vegetables (F&V) among children in Saudi Arabia are lacking. The present study aimed to evaluate F&V consumption among Saudi children. Predictors of F&V intake and associations with dietary intake were also explored. METHODS Cross-sectional data of 424 Saudi children (6-12 years) were collected from their mothers using an online survey. Phone interviews were conducted with mothers and children to provide data on dietary intake of children. RESULTS Most children included in the study (92.2%, n = 391) consumed less than five servings of F&V per day. Region of residency (B = -0.14, SE = 0.06, 95% confidence interval [CI] = -0.25 to -0.02, p = 0.019), paternal education level (B = 0.52, SE = 0.14, 95% CI = 0.24-0.79, p < 0.001) and family monthly income (B = 0.15, SE = 0.07, 95% CI = 0.01-0.29, p = 0.034) predicted the intake of F&V. Food neophobia and food pickiness also predicted the intake of F&V (B = -0.16, SE = 0.06, 95% CI = -0.27 to -0.05, p = 0.005 and B = -0.24, SE = 0.06, 95% CI = -0.36 to -0.12, p < 0.001, respectively). Children's intake of F&V positively predicted the intake of fibre, potassium, phosphorus, magnesium, iodine and vitamin C. CONCLUSIONS Limited intake of F&V was observed among Saudi children. F&V consumption was found to be associated with a number of sociodemographic factors, including region of residency, paternal education level and family income, as well as children's food neophobia and pickiness. Children's intake of F&V predicted higher intake of fibre, potassium, phosphorus, magnesium, iodine and vitamin C, suggesting that F&V consumption may contribute to improved intake of key nutrients in children.
Collapse
Affiliation(s)
- Walaa Abdullah Mumena
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Hebah Alawi Kutbi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
2
|
Isa HM, Mohamed M, Alsaei A, Isa Z, Khedr E, Mohamed A, Jahrami H. Analysis and prediction of nutritional outcome of patients with pediatric inflammatory bowel disease from Bahrain. BMC Pediatr 2024; 24:265. [PMID: 38658864 PMCID: PMC11040799 DOI: 10.1186/s12887-024-04720-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a chronic gastrointestinal disease that causes anorexia, malabsorption, and increased energy requirements. Childhood IBD can significantly impact nutritional status and future health. OBJECTIVE This study aimed to analyze the nutritional status of patients with pediatric IBD at presentation and during follow-up and to identify predictors of nutritional outcome. METHODS This retrospective cohort study reviewed the medical records of children diagnosed with IBD in the Pediatric Department, Salmaniya Medical Complex, Bahrain, 1984 - 2023. Demographic data, clinical characteristics, and anthropometric data were collected. World Health Organization growth standards were used to interpret nutritional status. RESULTS Of the 165 patients, 99 (60%) had anthropometric data at presentation, and 130 (78.8%) had follow-up data. Most patients were males (64.6%) and had Crohn's disease (CD) (56.2%), while 43.8% had ulcerative colitis (UC). The median age at presentation was 10.9 years and the mean follow-up duration was 12.6 years. At presentation, 53.5% of the patients were malnourished, that decreased to 46.9% on follow-up. Thinness was reduced from 27.3% at presentation to 12.1% at follow-up (p = 0.003). There was an increased tendency to normal weight on follow-up (59.6%) compared to time of presentation (46.5%), p = 0.035. Overweightness showed a non-significant increase from 26.3% at presentation to 28.3% at follow-up (p = 0.791). Children with IBD were more likely to become obese when they grow up to adulthood (2.3% versus 20.5%, respectively, p < 0.001). Weight-for-age, and height-for-age at presentation were higher among CD compared to UC, but body mass index (BMI) at follow-up was higher among UC patients (p < 0.05). Thinness at follow up was associated with very early-onset disease (p = 0.02), lower weight and BMI at presentation (p < 0.001 each), younger age at follow-up (p = 0.002), pediatric age group (p = 0.023), lower hematocrit (p = 0.017), and higher C-reactive protein (p = 0.007). Overweight at follow up was associated with increased weight and BMI at presentation (p < 0.001 each), longer disease duration (p = 0.005), older age (p = 0.002), and azathioprine intake (p = 0.026). Considering follow-up duration, univariate analysis exhibited that Bahraini nationality, post-diagnosis disease duration, age at follow-up, occurrence of diarrhea, height, and BMI at presentation were factors that decreased liability to abnormal nutritional status, while CD, history of weight loss, perianal disease, and skin rash, and intake of prednisolone expressed increased liability of abnormal nutritional status (p < 0.05). CONCLUSION Pediatric IBD is associated with a high incidence of malnutrition. Thinness is more prominent at presentation, while overweight is higher on follow-up. Multiple risk factors aggravating abnormal nutritional status were highlighted. Accordingly, nutritional counseling should be prioritized in a multidisciplinary approach.
Collapse
Affiliation(s)
- Hasan M Isa
- Pediatric Department, Salmaniya Medical Complex, Manama, Bahrain
- College of Medicine and Medical Science, Arabian Gulf University, Manama, Bahrain
| | - Masooma Mohamed
- Pediatric Department, Salmaniya Medical Complex, Manama, Bahrain
| | - Ahmed Alsaei
- Pediatric Department, Salmaniya Medical Complex, Manama, Bahrain
| | - Zahra Isa
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Enjy Khedr
- Faculty of Medicine, Benha University, Benha, Egypt
| | | | - Haitham Jahrami
- College of Medicine and Medical Science, Arabian Gulf University, Manama, Bahrain.
| |
Collapse
|
3
|
Killel E, Mchau G, Mbilikila H, Azizi K, Ngasa N, Hancy A, Lukindo T, Mwiru R, Noor R, Sanga A, Codjia P, Leyna GH, Masumo RM. Dietary intake and associated risk factors among pregnant women in Mbeya, Tanzania. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002529. [PMID: 38180949 PMCID: PMC10769095 DOI: 10.1371/journal.pgph.0002529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/17/2023] [Indexed: 01/07/2024]
Abstract
Poor dietary intake among pregnant women has serious detrimental consequences for pregnancy and offspring both in developed and developing countries. This study aimed to assess dietary intake and associated risk factors among pregnant women. A cross-sectional study was conducted in Mbeya, Tanzania with a sample size of 420 pregnant women attending antenatal clinics to assess the factors associated with dietary intake. Dietary intake was assessed using a piloted questionnaire of the Prime Diet Quality Score. A tested standard questionnaire was also used to collect factors that are associated with dietary intake among pregnant women. The strengths of the associations between the dependent and independent variables were tested using the Pearson chi-square tests and the multivariate log-binomial regression method was performed to calculate the adjusted risk ratios (ARR) and 95% confidence interval (CI). The study revealed that out of 420 pregnant women who participated in this study only 12.6% and 29.3% consumed at least four servings of fruits and vegetables per week respectively. Poor dietary intakes were less likely among cohabiting pregnant women [Adjusted RR 0.22 (95% CI 0.09-0.50)] and; those who reported taking Fansidar tablets during the pregnancy [Adjusted RR 0.55 (95% CI 0.31-0.96)]. Further, we found that poor dietary intakes were more likely among pregnant women who were classified as overweight and obesity by the MUAC above 33cm [Adjusted RR 3.49 (95% CI 1.10-11.06)]. The study results affirm that cohabitation and obesity affect dietary intakes among pregnant women differently compared to married women in rural settings of Tanzania. Further research is needed to investigate the social aspects that link dietary intake outcomes for developing a tailored gestational intervention to improve maternal and birth outcomes in sub-Saharan African countries.
Collapse
Affiliation(s)
- Erick Killel
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Geofrey Mchau
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Hamida Mbilikila
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Kaunara Azizi
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Nyamizi Ngasa
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Adam Hancy
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Tedson Lukindo
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Ramadhan Mwiru
- The United Nations Children’s Fund (UNICEF), Dar es Salaam, Tanzania
| | - Ramadhan Noor
- The United Nations Children’s Fund (UNICEF), Dar es Salaam, Tanzania
| | - Abraham Sanga
- The United Nations Children’s Fund (UNICEF), Dar es Salaam, Tanzania
| | - Patrick Codjia
- The United Nations Children’s Fund (UNICEF), Dar es Salaam, Tanzania
| | - Germana H. Leyna
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ray M. Masumo
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
- Department of Statistics, University of Dar es Salaam (UDSM), Dar es Salaam, Tanzania
| |
Collapse
|
4
|
Zeidan W, Taweel H, Shalash A, Husseini A. Consumption of fruits and vegetables among adolescents in Arab Countries: a systematic review. Int J Behav Nutr Phys Act 2023; 20:3. [PMID: 36624455 PMCID: PMC9830827 DOI: 10.1186/s12966-022-01398-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 12/04/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Adolescents' consumption of fruits and vegetables is inadequate in most Arab countries, leading to a higher risk of poor health outcomes. This systematic review evaluates fruits and vegetables intake among adolescents in Arab countries, the proportion of adolescents meeting the dietary guidelines in these countries, and the dietary assessment tools used to assess fruits and vegetables intake. METHODS Four databases were searched, MEDLINE, PUBMED, EMBASE, and Web of Science. Studies were eligible if they reported fruit or vegetable consumption among adolescents aged 10 to 19 in 22 Arab countries. The risk of bias in the included studies was assessed by two reviewers independently using the risk of bias tool developed by Hoy et al. Data were extracted and synthesized into three categories; frequency of fruits and vegetables consumption, mean fruits and vegetables consumption, and percentage of adolescents meeting fruits and vegetables consumption recommendations. RESULTS The review included 44 articles utilizing 41 cross-sectional studies. Most studies were school-based, and data was collected from both males and females using self-administered questionnaires. Of those, validated questionnaires were used in 28 studies. According to the World Health Organization recommendation, most studies defined five fruits and vegetables servings as the adequacy cutoff point; other definitions were used in some studies. The reported mean consumption ranged between 6.1 times per week and 4.5 servings of fruits and vegetables per day. The proportion of those who met the recommendations of eating five servings per day ranged between 10 and 29%. Fruits were shown to have a lower daily intake than vegetables (4.2 to 53.7% for fruits and 7.8 to 66.3% for vegetables). DISCUSSION This review indicated inadequate fruits and vegetables consumption among adolescents in Arab countries and highlighted an increased risk of non-communicable diseases and malnutrition prevalence. A limitation was the incomparability of available data between countries. Further in-depth research on the core reasons behind adolescents' inadequacy in fruits and vegetables consumption is recommended.
Collapse
Affiliation(s)
- Widad Zeidan
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine.
| | - Haneen Taweel
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Aisha Shalash
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Abdullatif Husseini
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| |
Collapse
|
5
|
Al-Jawaldeh A, Taktouk M, Naalbandian S, Aguenaou H, Al Hamad N, Almamary S, Al-Tamimi HA, Alyafei SA, Barham R, Hoteit M, Hussain M, Massad H, Nasreddine L. Sugar Reduction Initiatives in the Eastern Mediterranean Region: A Systematic Review. Nutrients 2022; 15:55. [PMID: 36615712 PMCID: PMC9823488 DOI: 10.3390/nu15010055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
This systematic review aims to identify and characterize existing national sugar reduction initiatives and strategies in the Eastern Mediterranean Region. For this purpose, a systematic review of published and grey literature was performed. A comprehensive list of search terms in the title/abstract/keyword fields was used to cover the four following concepts (1) sugar, (2) reduction OR intake, (3) policy and (4) EMR countries. A total of 162 peer-reviewed documents were identified, until the 2nd of August 2022. The key characteristics of the identified national strategies/initiatives included the average sugar intake of each country's population; sugar levels in food products/beverages; implementation strategies (taxation; elimination of subsidies; marketing regulation; reformulation; consumer education; labeling; interventions in public institution settings), as well as monitoring and evaluation of program impact. Twenty-one countries (95%) implemented at least one type of sugar reduction initiatives, the most common of which was consumer education (71%). The implemented fiscal policies included sugar subsidies' elimination (fourteen countries; 67%) and taxation (thirteen countries 62%). Thirteen countries (62%) have implemented interventions in public institution settings, compared to twelve and ten countries that implemented food product reformulation and marketing regulation initiatives, respectively. Food labeling was the least implemented sugar reduction initiative (nine countries). Monitoring activities were conducted by four countries only and impact evaluations were identified in only Iran and Kingdom of Saudi Arabia (KSA). Further action is needed to ensure that countries of the region strengthen their regulatory capacities and compliance monitoring of sugar reduction policy actions.
Collapse
Affiliation(s)
- Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 7608, Egypt
| | - Mandy Taktouk
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon
| | - Sally Naalbandian
- Science and Agriculture Library, American University of Beirut, Beirut 11-0236, Lebanon
| | - Hassan Aguenaou
- Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Ibn Tofail University-CNESTEN, Kenitra 14000, Morocco
| | - Nawal Al Hamad
- The Public Authority for Food and Nutrition, Kuwait City 43600, Kuwait
| | | | - Hend Ali Al-Tamimi
- Health Promotion and Non Communicable Disease (NCD) Division, Public Health Department, Ministry of Public Health, Doha 42, Qatar
| | - Salah Abdulla Alyafei
- Health Promotion and Non Communicable Disease (NCD) Division, Public Health Department, Ministry of Public Health, Doha 42, Qatar
| | - Rawhieh Barham
- Nutrition Department, Ministry of Health, Amman 11118, Jordan
| | - Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon
- PHENOL Research Group (Public Health Nutrition Program-Lebanon), Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon
| | - Munawar Hussain
- Food Policy Program Consultant, Global Health Advocacy Incubator, Islamabad 45710, Pakistan
| | - Hanan Massad
- National Consumer Protection Association, Amman 11190, Jordan
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon
| |
Collapse
|
6
|
Fujiwara A, Omura Y, Oono F, Sugimoto M, Sasaki S, Takimoto H. A Scoping Review of Epidemiological Studies on Intake of Sugars in Geographically Dispersed Asian Countries: Comparison of Dietary Assessment Methodology. Adv Nutr 2022; 13:1947-1973. [PMID: 35641021 PMCID: PMC9526866 DOI: 10.1093/advances/nmac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/10/2022] [Accepted: 05/26/2022] [Indexed: 01/28/2023] Open
Abstract
Previous systematic reviews, which focused on sugar intake and its relation with health issues, were mainly conducted in Western countries, not Asian countries characterized by differences in dietary habits and disease prevalence. The scarcity of Asian studies may be attributed to the lack of assessment tools for estimating sugar intake. To provide an overview of the epidemiological studies on sugar intake in Asian countries, with a primary focus on dietary assessment methodology for estimating sugar intake, we conducted a scoping review of the epidemiological studies estimating sugar intake in Asian countries (the United Nations' definition) and Taiwan using PubMed and Web of Science. Study quality was evaluated based on its assessment of sugar intake in the whole diet, dietary assessment methods, and data sources used for estimating sugar content. We identified 143 studies from 136 publications from Eastern (n = 63), Southern (n = 30), South-Eastern (n = 26), and Western (n = 24) Asia. Total sugars were investigated in 95 studies, while 23-30 studies investigated sucrose, fructose, added sugars, and free sugars. The main aim of the selected studies was assessment of diet-disease relations (n = 85) and estimation of dietary intake (n = 40), and 62 studies assessed sugars as the primary exposure/outcome. A total of 120 studies assessed sugar intake in the whole diet, and 62 studies used validated FFQs or multiple-day dietary assessment methods. Only 41 studies used country-specific comprehensive food-composition databases or directly measured sugar content. Only 17 studies reported high-quality data. This review elucidated a sufficient number of epidemiological studies estimating sugar intake across Asian countries; however, most studies reported low-quality data. The results from our review showed that both feasible and validated dietary assessment methods, as well as comprehensive country-specific sugar-composition databases, are essential for producing high-quality studies with accurate sugar intake to examine its association with health outcomes.
Collapse
Affiliation(s)
- Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan,Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Yuka Omura
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Fumi Oono
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Minami Sugimoto
- Institute for Future Initiatives, University of Tokyo, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
| | | |
Collapse
|
7
|
Yilma B, Endris BS, Mengistu YG, Sisay BG, Gebreyesus SH. Inadequacy of nutrient intake among adolescent girls in south central Ethiopia. J Nutr Sci 2021; 10:e90. [PMID: 34733502 PMCID: PMC8532068 DOI: 10.1017/jns.2021.62] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/19/2021] [Accepted: 07/30/2021] [Indexed: 11/08/2022] Open
Abstract
Adolescent undernutrition is a major public health problem in Ethiopia. Inadequate dietary intake of nutrients is the major determinants of undernutrition. However, the adequacy of dietary intake among adolescents was not sufficiently explored. The present study aims to estimate the inadequacy of nutrient intake among adolescent girls in south central Ethiopia. A community-based cross-sectional study was conducted. We assess food and nutrient intake using repeated multiple-pass 24-h dietary recall. The study was conducted in Damot Gale district, Woliyta zone, Southern Ethiopia. Data were collected from 288 female adolescents. The majority of adolescent girls consumed cereals (96⋅9 %) and roots/tubers (75⋅3 %). However, only less than 1 % of them consumed flesh food. The mean energy, carbohydrate, protein and dietary fibre intake of the adolescent girls per day was 1452⋅7 ± 356⋅3 kcal, 305⋅6 ± 72⋅4 g, 35⋅7 ± 13⋅3 g and 18⋅6 ± 8⋅4 g, respectively. The median fat intake was 13⋅3 g (IQR 8⋅8, 19⋅8). The contribution of carbohydrate, protein and fat for the total energy was 80, 10 and 8 %, respectively. The prevalence of inadequate intake of protein was 60⋅9 %. The prevalence of inadequate intake of iron for early adolescents and late adolescents was 82 and 53 %, respectively. The prevalence of inadequate intake of folate was 83⋅9 % and zinc was 58 %. The prevalence of inadequate intake was greater than 90 % for vitamin B12, vitamin C and calcium. The present study found an alarmingly high prevalence of inadequate intake of some nutrients among adolescent girls of Damot Gale district.
Collapse
Affiliation(s)
- Beza Yilma
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bilal S. Endris
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yalemwork G. Mengistu
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Binyam G. Sisay
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Seifu H. Gebreyesus
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
8
|
Wadolowska L, Kostecka M, Kowalkowska J, Jeruszka-Bielak M, Tomaszewska M, Danielewicz A, Hamulka J. Sustainability of a Multi-Component Education Program (ABC of Healthy Eating) after Three Months and Nine Months: The Socioeconomic Context in Improving Nutrition Knowledge in Polish Teenagers. Nutrients 2021; 13:nu13051661. [PMID: 34068863 PMCID: PMC8153617 DOI: 10.3390/nu13051661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 11/24/2022] Open
Abstract
The study aimed to evaluate the sustainability of a multi-component education (ABC-HEat) program related to healthy nutrition and lifestyle after three months and nine months and to assess the socioeconomic context in improving teenage nutrition knowledge. The study was designed as a clustered, controlled, education-based intervention. A sample was chosen and allocated into either an educated group (under intervention) or a control group (outside of intervention). The study covered 464 11–12-year-old students (educated/control 319/145). In the educated group, data were collected three times: before education, after three months and after nine months to measure the short- and the long-term effects of education, respectively. In the control group, data were collected in parallel. Changes in nutrition knowledge score (NKS, points) by sex, residence, family affluence scale (FAS) were the main outcome measures. The increase in the NKS was significantly higher in the educated group than in the control group—three months after education on average by 1.4 to 2.7 points (all p < 0.001) in the total sample and all subgroups, and nine months after education in rural residents by 2.2 points (p < 0.001) and in the total sample by 0.4 (p < 0.05). In the educated group, the chance of no increase in the NKS was higher in urban than rural residents after three months and nine months (adjusted odds ratios [OR] and 95% Confidence Intervals [95% CI]: 3.63, 1.80–7.31 and 2.99, 1.60–5.59, respectively, both p < 0.001) using the increase in the NKS by ≥4 points as a reference. The multi-component education program improved the nutrition knowledge of teenagers in the short term regardless of socioeconomic variables, but in the long term this effect was visible only in rural residents. It suggests that a special path of nutrition education addressed to urban teens may be required.
Collapse
Affiliation(s)
- Lidia Wadolowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland; (L.W.); (J.K.); (A.D.)
| | - Malgorzata Kostecka
- Department of Chemistry, Faculty of Food Science and Biotechnology, University of Life Sciences, 15 Akademicka Street, 20-950 Lublin, Poland
- Correspondence: ; Tel.: +48-814-456-846
| | - Joanna Kowalkowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland; (L.W.); (J.K.); (A.D.)
| | - Marta Jeruszka-Bielak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland; (M.J.-B.); (J.H.)
| | - Marzena Tomaszewska
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Anna Danielewicz
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland; (L.W.); (J.K.); (A.D.)
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland; (M.J.-B.); (J.H.)
| |
Collapse
|
9
|
The Relationship between Under-Nutrition and Hypertension among Ellisras Children and Adolescents Aged 9 to 17 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238926. [PMID: 33271742 PMCID: PMC7731383 DOI: 10.3390/ijerph17238926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 11/25/2022]
Abstract
Background: Globally, under-nutrition and hypertension in children has been associated with the risk of developing cardiovascular disease (CVD) in adulthood. The main objective of this study was to investigate the relationship between under-nutrition and hypertension, furthermore, to determine the risk of developing hypertension due to under-nutrition. Methods: The study comprised of 1701 participants (874 boys and 827 girls) between the ages of 9 and 17 years old. All anthropometric and blood pressure measurements were taken according to standard procedures. Mid-upper arm circumference (MUAC), body mass index (BMI), upper arm fat area (UFA), total upper arm area (TUAA) and upper arm muscle area (UMA) of Ellisras children were compared with the National Health and Nutrition Examination Survey III reference population. The linear regression models were used to determine the relationship between under-nutrition with hypertension for unadjusted and then adjusted for age and gender. The logistic regression model was used to determine the risk of under-nutrition on developing hypertension for unadjusted and adjusted for age and gender. Results: There was a positive significant (p < 0.0001) association between all under-nutrition variables (MUAC, BMI, UFA, TUAA and UMA) and systolic blood pressure (SBP; beta ranges between 0.84 and 2.78), and diastolic blood pressure (DBP; beta ranges between 0.3 and 1.08 before adjusting and after adjusting for age and gender (SBP, beta ranges between 0.59 and 2.00 and DBP (beta ranges between 0.24 and 0.80. Conclusion: The prevalence of under-nutrition was high while the prevalence of hypertension was low in this study. The mean under-nutrition variables (BMI, UFA, UMA and MUAC) of Ellisras children were far lower compared to the NHANES III reference population. Hypertension was significantly associated with under-nutrition in this study.
Collapse
|
10
|
Al-Jawaldeh A, Taktouk M, Nasreddine L. Food Consumption Patterns and Nutrient Intakes of Children and Adolescents in the Eastern Mediterranean Region: A Call for Policy Action. Nutrients 2020; 12:E3345. [PMID: 33143163 PMCID: PMC7693485 DOI: 10.3390/nu12113345] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022] Open
Abstract
The Eastern Mediterranean Region (EMR) has witnessed significant social and economic changes that may have influenced the diet of children and adolescents, and increased the risk for obesity and malnutrition in this age group. This review aims to characterize and assess food consumption patterns and nutrient intakes amongst school-aged children (5-10 years) and adolescents (10-19 years) in countries of the EMR. Electronic databases (MedLine, PubMed, Scopus, and Google Scholar) were searched for relevant articles published between 2005 and 2020; international organizations and governmental websites were also searched. Available studies documented low intakes of fruits, vegetables and fiber, inadequate consumption of water, milk and dairy products, coupled with high intakes of fat, saturated fat, and sugar sweetened beverages, as well as a frequent consumption of energy-dense, nutrient poor foods such as sweet and savory snacks. Micronutrient inadequacies were also observed, particularly for calcium, iron, zinc and vitamins A, D, C, and folate. Acknowledging the impact that nutrition may have on building societies and transforming the lives of children, adolescents and their families, there is a crucial need for a food system approach in developing and implementing national and regional policies and interventions aimed at improving the diet of children and adolescents.
Collapse
Affiliation(s)
- Ayoub Al-Jawaldeh
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo 7608, Egypt;
| | - Mandy Taktouk
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
| |
Collapse
|
11
|
Mirhadyan L, Moradi Latreyi S, Pasha A, Kazem Nejad Leili E. Junk Food Consumption and its Associated Factors in High School Students in Rasht in 2017. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2020. [DOI: 10.29252/jgbfnm.17.1.52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
12
|
Eid S, Saleh S, Abed-El Salam H. Assessment of the nutritional status of malnourished school-age Egyptian children. JOURNAL OF MEDICINE IN SCIENTIFIC RESEARCH 2020. [DOI: 10.4103/jmisr.jmisr_75_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
13
|
Fat Intake Reduction Strategies among Children and Adults to Eliminate Obesity and Non-Communicable Diseases in the Eastern Mediterranean Region. CHILDREN-BASEL 2018; 5:children5070089. [PMID: 29966315 PMCID: PMC6069461 DOI: 10.3390/children5070089] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 06/20/2018] [Accepted: 06/23/2018] [Indexed: 01/11/2023]
Abstract
Non-communicable diseases (NCDs) are the leading cause of mortality globally with an estimated 39.5 million deaths per year (72% of total death) in 2016, due to the four major NCDs: cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. In the Eastern Mediterranean Region (EMR), almost 68% of all deaths are attributed to NCDs commonly known as chronic or lifestyle-related diseases. Two-thirds of NCD premature deaths are linked to 4 shared modifiable behavioral risk factors: tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. These unhealthy behaviours lead to 4 key metabolic/biological changes; raised blood pressure, overweight/obesity, high blood glucose levels/diabetes, and hyperlipidemia (high levels of fat in the blood), that increase the risk of NCDs. Globally, countries are already working towards agreed global goals on maternal and infant nutrition and on the prevention of NCDs. In both fields the goals include halting the increase in overweight and obesity and reducing NCD diet-related risk factors including reducing saturated fatty acids (SFAs) and trans fatty acids (TFAs) intake. The objective of this review is to present an up-to-date overview of the current fat (SFAs and TFAs) intake reduction initiatives in countries of the Eastern Mediterranean Region (EMR) by highlighting national and regional programs, strategies and activities aiming at decreasing the intakes of dietary fat (SFA and TFA). The literature review shows that the average intake of SFA is estimated to be 10.3% of the total energy intake (EI), exceeding the WHO (World Health Organization) upper limit of 10%. The average TFA intake is estimated at 1.9% EI, which also exceeds the WHO upper limit of 1% EI. The highest SFAs intake was reported from Djibouti, Kuwait, Saudi-Arabia, Lebanon and Yemen, while the highest TFAs intakes were reported from Egypt and Pakistan. If countries of the EMR receive immediate public health attention, that toll of NCD-related morbidity and mortality would be considerably decreased through the implantation of evidence-based preventive interventions. In this context, reductions in SFAs and TFAs intakes have been highlighted as cost-effectives strategies that may hamper the growth of the NCD epidemic.
Collapse
|
14
|
Musaiger AO, Awadhalla MS, Al-Mannai M, AlSawad M, Asokan GV. Dietary habits and sedentary behaviors among health science university students in Bahrain. Int J Adolesc Med Health 2017; 29:/j/ijamh.2017.29.issue-2/ijamh-2015-0038/ijamh-2015-0038.xml. [PMID: 26251982 DOI: 10.1515/ijamh-2015-0038] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/02/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the dietary patterns and sedentary behaviors among university students in Bahrain. MATERIALS AND METHODS A cross-sectional study was carried out with students of the College of Health Sciences in Bahrain using a self-reported questionnaire. All the students enrolled in this college were included in this study (642 students; 90 males and 552 females). The mean age of the sample was 20.1±2.0 years. A pre-tested questionnaire was used to collect information on the students' breakfast intake, snacking, food frequency intake, and sedentary habits. RESULTS More than 50% of the students did not consume breakfast on a daily basis. A statistically significant difference (p<0.003) was found between males (19%) and females (35%) in relation to the intake of an afternoon snack. There were no significant gender differences regarding frequency of food intake, except for carbonated beverages (p<0.001) and nuts (p<0.047) consumption. Females were more likely than males to spend time watching television, use the Internet, use a mobile phone and sleep; however, the only significant difference found was for Internet use (p<0.003). Being physically active on a daily basis was more prevalent among males (41.6%) than females (16%) (p<0.001). Females (42.9%) were more prone to sleep for less time (<7 h) than males (34.4%)(p<0.08). CONCLUSION The findings indicated that a high percentage of health science students in Bahrain had unhealthy dietary habits and sedentary behaviors. Thus, an intervention program to promote healthy dietary patterns and lifestyle habits among university students is highly recommended.
Collapse
Affiliation(s)
| | | | | | | | - G V Asokan
- College of Health Sciences, University of
| |
Collapse
|
15
|
Koo HC, Poh BK, Ruzita AT. Intervention on whole grain with healthy balanced diet to manage childhood obesity (GReat-Child™trial): study protocol for a quasi-experimental trial. SPRINGERPLUS 2016; 5:840. [PMID: 27386289 PMCID: PMC4917502 DOI: 10.1186/s40064-016-2431-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 05/26/2016] [Indexed: 11/21/2022]
Abstract
Background The rapid increase in childhood obesity is a serious public health problem, and has led to the development of many interventions. However, no intervention has emphasized whole grains as a strategy to manage childhood obesity. Therefore, this article describes the protocol of a 12-week multi-component, family-based intervention on whole grain, using a healthy balanced diet for managing childhood obesity. Methods The GReat-Child trial utilize a quasi-experimental method in which two schools in Kuala Lumpur are assigned to intervention and control groups. The eligibility criteria are overweight/obese children, aged 9 through 11 years, who has no serious co-morbidities. The children who report consuming whole-grain foods in their 3-day diet-recall during the screening will be excluded. The study sample is characterized by anthropometric measurements (weight, height, percentage of body fat and waist circumference), whole grain and nutrient intakes (3-day 24-h diet recalls), and their knowledge, attitudes and practices towards whole grain. The 12-week intervention is comprised of three components addressing behaviour, personal and environmental factors, based on social cognitive theory: (1) individual diet counselling for the parents; (2) six 30-min nutrition education classes and (3) school delivery of whole-grain foods; The control school does not receive any interventions, however, for ethical purposes, a health talk is conducted after the entire GReat-Child Trial is completed. Conclusion The GReat-Child trial represents a novel approach to examining the effectiveness of the intervention of whole grain in a healthy balanced diet on managing childhood obesity. We anticipate that this trial will reveal not only whether whole grain intervention will be effective in managing childhood obesity, but also provide greater insights into the acceptance of whole grain among Malaysian children.
Collapse
Affiliation(s)
- H C Koo
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia ; Department of Healthcare Professional, Faculty of Health and Life Sciences, Management & Science University, Shah Alam, Malaysia
| | - B K Poh
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Abd Talib Ruzita
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| |
Collapse
|
16
|
Souza RAG, Yokoo EM, Sichieri R, Pereira RA. Energy and macronutrient intakes in Brazil: results of the first nationwide individual dietary survey. Public Health Nutr 2015; 18:3086-95. [PMID: 25905449 PMCID: PMC10271863 DOI: 10.1017/s1368980015000750] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 01/12/2015] [Accepted: 02/03/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To characterize energy and macronutrient intakes in Brazil and to describe the top food items contributing to energy and macronutrient intakes. DESIGN Two non-consecutive 24 h dietary records were collected and energy and macronutrient data were adjusted for usual intake distribution. Descriptive statistics and ANOVA with the Bonferroni post hoc test were analysed using SAS version 9·1. Means and standard deviations were estimated for sex, age and income strata. SETTING Nationwide cross-sectional survey, 2008-2009. SUBJECTS Nationally representative sample of individuals ≥10 years old (n32 749), excluding pregnant and lactating women (n 1254). RESULTS The average energy intake was 7958 kJ/d (1902 kcal/d) and mean energy density was 6·82 kJ/g (1·63 kcal/g). Added sugar represented 13 % of total energy intake and animal protein represented 10 %. The mean contribution of total fat to energy intake was 27 %, while the mean saturated fat contribution was 9 %. Compared with the lowest quartile of income, individuals in the highest income quartile had greater mean intakes of energy, added sugar, alcohol, animal protein, total fat, saturated fat, monounsaturated fat and trans fat. Rice, beans, beef, bread and coffee were among the top five foods contributing most to the intakes of energy, carbohydrates, protein, fat and fibre. CONCLUSIONS In general, Brazilians' dietary intake is compatible with a high risk of obesity and non-communicable chronic diseases, being characterized by high intakes of added sugar and saturated fat. Income may be a major determinant of diet nutritional characteristics.
Collapse
Affiliation(s)
- Rita AG Souza
- Institute of Community Health, Federal University of Mato Grosso, Cuiabá, MT, Brazil
| | - Edna M Yokoo
- Department of Epidemiology and Biostatistics, Fluminense Federal University, Niterói, RJ, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rosangela A Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Av Carlos Chagas Filho 373, CCS–Bloco J–2º andar, Cidade Universitária, Rio de Janeiro – RJ, CEP 21941-902, Brazil
| |
Collapse
|
17
|
Alhamad N, Almalt E, Alamir N, Subhakaran M. An overview of salt intake reduction efforts in the Gulf Cooperation Council countries. Cardiovasc Diagn Ther 2015; 5:172-7. [PMID: 26090327 DOI: 10.3978/j.issn.2223-3652.2015.04.06] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 04/14/2015] [Indexed: 11/14/2022]
Abstract
Globally, morbidity and mortality from non-communicable diseases (NCDs) are increasing steadily and at an alarming rate. High blood pressure is a major risk factor for cardiovascular disease (CVD) and salt reduction is an effective measure to decrease mortality rates. In the Eastern Mediterranean region, current salt intake is high, with an average intake of >12 g per person per day. Reducing the intake of salt has been identified as a priority intervention to reduce NCDs. Countries of the Gulf Cooperation Council (GCC) are showing a willingness to comply with the World Health Organization (WHO) recommendations and an eagerness to reduce the burden of NCDs. However, they face some challenges, including lack of political commitment, lack of experience, and shortage of qualified human resources. Salt intake reduction efforts vary in the GCC region, from achieving 20% salt reduction in bread, to the very early stages of planning.
Collapse
Affiliation(s)
- Nawal Alhamad
- Food and Nutrition Administration, Ministry Of Health, Kuwait
| | - Elsayed Almalt
- Food and Nutrition Administration, Ministry Of Health, Kuwait
| | - Najeeba Alamir
- Food and Nutrition Administration, Ministry Of Health, Kuwait
| | | |
Collapse
|
18
|
Ochola S, Masibo PK. Dietary intake of schoolchildren and adolescents in developing countries. ANNALS OF NUTRITION AND METABOLISM 2014; 64 Suppl 2:24-40. [PMID: 25341871 DOI: 10.1159/000365125] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
School age and adolescence is a dynamic period of growth and development forming a strong foundation for good health and productive adult life. Appropriate dietary intake is critical for forming good eating habits and provides the much needed nutrients for growth, long-term health, cognition and educational achievements. A large proportion of the population globally is in the school age or adolescence, with more than three quarters of these groups living in developing countries. An up-to-date review and discussion of the dietary intake of schoolchildren and adolescents in developing countries is suitable to provide recent data on patterns of dietary intake, adequacy of nutrient intake and their implications for public health and nutrition issues of concern. This review is based on literature published from 2000 to 2014 on dietary intake of schoolchildren and adolescents aged 6-19 years. A total of 50 studies from 42 countries reporting on dietary intake of schoolchildren and adolescents were included. The dietary intake of schoolchildren and adolescents in developing countries is limited in diversity, mainly comprising plant-based food sources, but with limited intake of fruits and vegetables. There is a low energy intake and insufficient micronutrient intake. At the same time, the available data indicate an emerging trend of consumption of high-energy snacks and beverages, particularly in urban areas. The existence of a negative and positive energy balance in the same population points to the dual burden of malnutrition and highlights the emerging nutrition transition in developing countries. This observation is important for planning public health nutrition approaches that address the concerns of the two ends of the nutrition divide.
Collapse
Affiliation(s)
- Sophie Ochola
- Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya
| | | |
Collapse
|
19
|
Salameh P, Jomaa L, Issa C, Farhat G, Salamé J, Zeidan N, Baldi I. Assessment of Dietary Intake Patterns and Their Correlates among University Students in Lebanon. Front Public Health 2014; 2:185. [PMID: 25374885 PMCID: PMC4204443 DOI: 10.3389/fpubh.2014.00185] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 09/25/2014] [Indexed: 01/19/2023] Open
Abstract
Introduction: Unhealthy dietary habits are major risk factors for chronic diseases, particularly if adopted during early years of adulthood. Limited studies have explored the food consumption patterns among young adults in Lebanon. Our study aimed to examine common dietary patterns and their correlates among a large sample of university student population in Lebanon, focusing on correlation with gender and body mass index (BMI). Methods: A cross-sectional study was carried out on 3384 students, using a proportionate cluster sample of Lebanese students from both public and private universities. A self-administered food frequency questionnaire was used to assess dietary intake of university students. Factor analysis of food items and groups, cluster analysis of dietary patterns, and multivariate regressions were carried out. Results: Three dietary patterns were identified among university youth namely a vegetarian/low calorie dietary pattern (characterized mainly by consumption of plant-based food while avoiding “western” food, composite dishes, and bread); a mixed dietary pattern (characterized by high consumption of plant-based food, followed by composite dishes, bread, and a low consumption of western type food); and finally, a westernized dietary pattern (characterized by high consumption of white bread and western food, and a strong avoidance of plant food and composite dishes). We observed significant differences between males and females in terms of their reported food intake and dietary patterns. Females were particularly more prone to adopt the vegetarian/low calorie diet than males (ORa = 1.69; p < 0.001), while males were more likely to adopt a westernized diet (ORa = 1.51; p < 0.001), seemingly in private universities (p = 0.053). Students with high income and obese students (BMI ≥ 30 kg/m2) were more likely to consume vegetarian/low calorie diets (p < 0.05). Conclusion: Male university students reported a higher consumption of the westernized dietary pattern as compared to female university students in Lebanon, while the latter reported a higher adoption of a vegetarian diet. Health promotion programs are needed to address the dietary intakes and lifestyle behaviors of young adults in Lebanon to help prevent obesity and other associated comorbidities.
Collapse
Affiliation(s)
- Pascale Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University , Hadath , Lebanon
| | - Lamis Jomaa
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut , Beirut , Lebanon
| | - Carine Issa
- Faculty of Public Health, Lebanese University , Fanar , Lebanon
| | - Ghada Farhat
- Faculty of Health Sciences, University of Balamand , Beirut , Lebanon
| | - Joseph Salamé
- Charité - Universitätsmedizin University Hospital , Berlin , Germany
| | - Nina Zeidan
- Faculty of Public Health, Lebanese University , Fanar , Lebanon
| | - Isabelle Baldi
- Laboratoire Santé Travail Environnement, Université Bordeaux Segalen , Bordeaux , France
| | | |
Collapse
|
20
|
He C, Perez-Cueto FJA, Mikkelsen BE. Do attitudes, intentions and actions of school food coordinators regarding public organic food procurement policy improve the eating environment at school? Results from the iPOPY study. Public Health Nutr 2014; 17:1299-307. [PMID: 23721629 PMCID: PMC10282236 DOI: 10.1017/s1368980013001511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 02/27/2013] [Accepted: 04/24/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study investigates whether public organic food procurement policies have the potential to induce changes in the school food service environment. DESIGN A comparative cross-national survey was conducted in public primary and/or secondary schools in Finland, Germany and Italy. The school food coordinators completed a web-based questionnaire on their attitudes, intentions and actions towards organic school food provision. SETTING In Germany, 122 out of 2050 schools in the state of Hesse responded. In Finland, 250 out of 998 schools across the country responded. In Italy, 215 out of 940 schools from eight provinces responded. SUBJECTS School food coordinators in the sample of schools in the three countries. RESULTS The German and Finnish school food coordinators separately most agreed with the promotion of healthy eating habits (P < 0·001) and organic food (P < 0·001) by schools. The Finnish schools were most likely to adopt a food and nutrition policy (P < 0·001), a health-promoting school policy according to WHO principles (P < 0·001), to have a playground (P < 0·001), to involve physical activity themes in teaching (P = 0·012) and to have a canteen (P < 0·001). The Italian schools were most likely to involve the food and nutrition policy in pedagogical activities (P = 0·004), to serve nutritional school meals (P < 0·001) and to recommend children to eat healthily (P < 0·001). In the three countries, the non-organic schools were less likely to adopt a food and nutrition policy (P < 0·001), a WHO health-promoting policy (P < 0·001) and have a canteen (P = 0·017) than the organic schools. CONCLUSIONS The study suggests that there is a gap in the effects of public organic food procurement policy on building a healthier school food environment.
Collapse
Affiliation(s)
- Chen He
- Research Group for Meal Science & Public Health Nutrition, Aalborg University Copenhagen, A.C. Meyers Vaenge 15, Copenhagen 2450, 2750 Ballerup, Denmark
| | - Federico JA Perez-Cueto
- Research Group for Meal Science & Public Health Nutrition, Aalborg University Copenhagen, A.C. Meyers Vaenge 15, Copenhagen 2450, 2750 Ballerup, Denmark
| | - Bent E Mikkelsen
- Research Group for Meal Science & Public Health Nutrition, Aalborg University Copenhagen, A.C. Meyers Vaenge 15, Copenhagen 2450, 2750 Ballerup, Denmark
| |
Collapse
|
21
|
Rendo-Urteaga T, Puchau B, Chueca M, Oyarzabal M, Azcona-Sanjulián MC, Martínez JA, Marti A. Total antioxidant capacity and oxidative stress after a 10-week dietary intervention program in obese children. Eur J Pediatr 2014; 173:609-16. [PMID: 24310523 DOI: 10.1007/s00431-013-2229-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 11/15/2013] [Accepted: 11/26/2013] [Indexed: 12/25/2022]
Abstract
UNLABELLED Dietary and serum total antioxidant capacity (TAC) are considered appropriate tools for investigating the potential health effects of dietary antioxidants consumed in mixed diets. The aim was to analyze the impact of a dietary intervention on macronutrient intakes and to evaluate the improvement on oxidative status after weight loss (WL) by measuring dietary and serum TAC, and urinary F2-isoprostane levels as markers of oxidative stress. Forty-four overweight/obese children (mean age 11.5 years) were enrolled to undergo a 10-week WL program. They were dichotomized at the median of body mass index-standard deviation score (BMI-SDS) change, as high (HR) and low responders (LR) after intervention. Subjects were prescribed with a fixed full-day meal diet, calculated according to their basal metabolic rate and physical activity levels. A validated food-frequency questionnaire was used to retrospectively calculate TAC and daily nutrient intake. The HR subjects were able to reduce anthropometric indices and to improve lipid and glucose profile. They also significantly diminished fat intake (p = 0.013). Moreover, baseline serum TAC values did significantly predict the reduction in urinary F2 isoprostane (B = -0.236 (-0.393 to -0.078); p = 0.014) in the HR group after the WL program. Notably, changes in dietary TAC after the treatment were associated with a decrease in body weight after the 10-week intervention (B = -2.815 (-5.313 to -0.318), p = 0.029) in the HR group. The -ΔSerumTAC/ΔDietaryTAC and the -ΔF2Isoprostane/ΔDietaryTAC ratios revealed that the relationships between oxidative markers and antioxidants dietary intake were more favorable in the HR than in the LR group. CONCLUSION Our study showed that a 10-week WL program was able to reduce adiposity indices in obese children. Moreover, after the intervention changes in dietary TAC and WL were significantly associated. Our result suggests that specific food with a high TAC content (such as fruits, vegetables, and legumes) could be recommended to improve WL.
Collapse
Affiliation(s)
- T Rendo-Urteaga
- Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea s/n, CP31008, Pamplona, Navarra, Spain
| | | | | | | | | | | | | |
Collapse
|
22
|
Ortiz-Espejo M, Pérez-Navero JL, Muñoz-Villanueva MC, Mercedes GC. Nutritional assessment in neonatal and prepubertal children with a history of extrauterine growth restriction. Early Hum Dev 2013; 89:763-8. [PMID: 23827379 DOI: 10.1016/j.earlhumdev.2013.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 05/02/2013] [Accepted: 06/09/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND Nutritional deficit during perinatal stage may induce significant alterations in adipose tissue and increase the risk of obesity, metabolic syndrome and cardiovascular disease in children with a history of extrauterine growth restriction (EUGR). AIMS To describe the nutritional status in neonatal and prepubertal with a history of EUGR and establish an association between EUGR and later conditions. STUDY DESIGN Descriptive, analytical, observational case-control study. SUBJECTS The study included a sample of 38 prepubertal children with a history of EUGR, and 123 gender-and-age matched controls. OUTCOME MEASURES The EUGR group was asked to answer a food frequency questionnaire. Analysis of body composition in both groups included anthropometric measurements, assessment of blood pressure and biochemical markers. RESULTS Newborns with EUGR received parenteral feeding with a standard nutritional regime and long-chain fatty acid support for 41 ± 23 days; enteral feeding with a special formula for premature infants was initiated at 7 ± 11 days of life. At the prepubertal stage, daily fiber and fatty acid intake in children who had experienced EUGR in the neonatal stage was below the recommended intake. In the EUGR group, the intake of vegetables, fruits and olive oil was below dietary recommendations, while the intake of butchery, fatty meats, pastries and snacks was above the recommendations for the Spanish population. CONCLUSIONS Appropriate nutrition education strategies should be developed for children with a history of EUGR to prevent later associated pathologies, as neonatal nutritional support and feeding during childhood are associated with an increase in diseases in this risk group.
Collapse
Affiliation(s)
- María Ortiz-Espejo
- Unit of Metabolism and Pediatric Investigation, Department of Pediatrics, University Reina Sofia Hospital, Avda Menéndez Pidal s/n., 14004 Córdoba, Spain
| | | | | | | |
Collapse
|
23
|
Ortiz-Espejo M, Gil-Campos M, Mesa MD, García-Rodríguez CE, Muñoz-Villanueva MC, Pérez-Navero JL. Alterations in the antioxidant defense system in prepubertal children with a history of extrauterine growth restriction. Eur J Nutr 2013; 53:607-15. [PMID: 23925485 DOI: 10.1007/s00394-013-0569-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 07/24/2013] [Indexed: 01/24/2023]
Abstract
PURPOSE The role of oxidative stress is well known in the pathogenesis of acquired malnutrition. Intrauterine growth restriction has been associated with an imbalance in oxidative stress/antioxidant system. Therefore, early postnatal environment and, consequently, extrauterine growth restriction might be associated with alterations in the antioxidant defense system, even in the prepubertal stage. METHODS This is a descriptive, analytical, and observational case-control study. The study included two groups; 38 Caucasian prepubertal children born prematurely and with a history of extrauterine growth restriction as the case group, and 123 gender- and age-matched controls. Plasma exogenous antioxidant (retinol, β-carotene, and α-tocopherol) concentrations were measured by HPLC; antioxidant enzyme activities of catalase, glutathione reductase, glutathione peroxidase, and superoxide dismutase were determined in lysed erythrocytes by spectrophotometric techniques. RESULTS Catalase and glutathione peroxidase concentrations were significantly lower in extrauterine growth restriction children than in controls (P < 0.001). Lower plasma retinol concentrations were found in the case group (P = 0.029), while concentrations of β-carotene and α-tocopherol were higher (P < 0.001) in extrauterine growth restriction prepubertal children as compared with controls. After correction by gestational age, birth weight, and length, statistically significant differences were also found, except for retinol. CONCLUSIONS Prepubertal children with a history of extrauterine growth restriction present alterations in their antioxidant defense system. Knowing these alterations may be important in establishing pharmacological and nutritional treatments as this situation might be associated with higher metabolic disorders in adulthood.
Collapse
Affiliation(s)
- M Ortiz-Espejo
- Unit of Metabolism and Pediatric Investigation, Department of Pediatrics, University Reina Sofia Hospital, Avda Menéndez Pidal s/n, 14004, Córdoba, Spain
| | | | | | | | | | | |
Collapse
|
24
|
Abstract
OBJECTIVE To examine how the dietary patterns of children at various time points throughout childhood relate to estimated nutrient intakes. DESIGN FFQ at 3, 4, 7 and 9 years of age were completed by mothers. Dietary patterns were identified cross-sectionally using principal component analysis; ‘processed’, ‘health conscious’ and ‘traditional’ patterns were consistently obtained. Correlations between pattern scores and nutrient intakes and proportions of variance in nutrients explained by the patterns were calculated. SETTING Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK. SUBJECTS Children provided data between 3 and 9 years of age (n 8010 to 10,023). RESULTS Dietary patterns explained substantial proportions of the variance of the absolute intake for most nutrients (>25% at 3 years of age, >40% other ages). After energy adjustment, protein, fibre, K, Mg, Fe, Zn, folate, thiamin and vitamin B6 continued to be well explained. Strong correlations were observed between the ‘processed’ pattern and macronutrients including energy (r=0.481-0.619), total fat (r=0.529-0.662) and total sugar (r=0.475-0.693). However correlations with most micronutrients were reversed after energy adjustment, suggesting that the ‘processed’ pattern is energy-dense but nutrient-poor. The ‘health conscious’ and ‘traditional’ patterns were strongly positively correlated with protein, fibre and most micronutrients, whether energy adjusted or not. Higher scores on these patterns were associated with a better nutrient profile. CONCLUSIONS Dietary patterns explain a reasonable amount of the variation in the nutrient content of diets. Higher scores on the ‘health conscious’ and ‘traditional’ dietary patterns were related to better nutrient profiles; conversely, with higher scores on the ‘processed’ pattern the nutrient profile was poorer.
Collapse
|
25
|
Balthazar EA, de Oliveira MRM. Differences in dietary pattern between obese and eutrophic children. BMC Res Notes 2011; 4:567. [PMID: 22206728 PMCID: PMC3339399 DOI: 10.1186/1756-0500-4-567] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 12/29/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Excessive consumption of energy is a decisive factor of obesity, but a simple quantitative assessment of consumption between obese and eutrophic individuals not always explains the problem, raising questions about the importance of the qualitative aspects of food. Therefore, the purpose of this study was to evaluate the differences in nutrient composition and meal patterns between eutrophic and obese schoolchildren. METHODS The diet of 83 children (42 obese and 41 eutrophic), aged between 7 and 11 years of age, was assessed by two non-consecutive dietary recalls. After the software analysis of macro and micronutrients composition, the different types and amount of legumes, fruits and vegetables were analyzed to verify the dietary patterns. RESULTS No differences were verified in energy consumption between the groups (eutrophic = 1934.2 ± 672.7 kcal, obese = 1835.8 ± 621.2 kcal). In general, children showed consumption within the recommended ranges of carbohydrates, lipids and proteins. The average consumption of fiber was higher in the eutrophic group (20.7 g) when compared to the obese group (14.8 g). The dietary fiber was strongly correlated with the number of servings of beans (r = 0.77), when compared to fruits (r = 0.44) and leafy vegetables (r = 0.13). It was also observed that the higher the consumption of fiber and beans, the lower the proportion of dietary fat (r = -0.22) in the diet. Generally, there was a low consumption of fiber (20.7 g = eutrophic group/14.8 g = obese group), beans (1.1 portions in the eutrophic and obese groups), fruits (0.7 portions eutrophic group and 0.6 obese group) and vegetables (1.3 eutrophic group and 1.1 obese group). CONCLUSIONS It is concluded that the obesity was more related to a dietary pattern of low intake of dietary fiber than excessive energy consumption and macronutrients imbalance.
Collapse
Affiliation(s)
- Emilia A Balthazar
- Food and Nutrition Department, School of Pharmaceutical Sciences at the São Paulo State University (UNESP), road Araraquara-Jau km1, CP 502, 14801-902, Araraquara, SP - Brasil
| | - Maria RM de Oliveira
- Food and Nutrition Department, School of Pharmaceutical Sciences at the São Paulo State University (UNESP), road Araraquara-Jau km1, CP 502, 14801-902, Araraquara, SP - Brasil
- Education department, Biosciences Institute, São Paulo State University (UNESP), District Rubião junior, CP 510, 18618-000, Botucatu, SP - Brasil
| |
Collapse
|
26
|
Musaiger AO, Hassan AS, Obeid O. The paradox of nutrition-related diseases in the Arab countries: the need for action. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:3637-71. [PMID: 22016708 PMCID: PMC3194109 DOI: 10.3390/ijerph8093637] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 08/25/2011] [Accepted: 08/29/2011] [Indexed: 02/06/2023]
Abstract
The aim of this review was to highlight the current situation of nutrition-related diseases in the Arab countries, and factors associated with prevalence of these diseases. PubMed and Google Scholar were searched for data relating to such nutrition-related diseases published between January 1990 and May 2011. The picture of nutritional status in the Arab countries has changed drastically over the past 30 years as a result of changes in the social and economic situation. Two contrasting nutrition-related diseases exist, those associated with inadequate intake of nutrients and unhealthy dietary habits such as growth retardation among young children and micronutrient deficiencies; and those associated with changes in lifestyle such as cardiovascular disease, cancer, osteoporosis, diabetes and obesity (diet-related non-communicable diseases). Factors contributing to nutritional problems vary from country to country, depending on socio-economic status. In general, unsound dietary habits, poor sanitation, poverty, ignorance and lack of access to safe water and health services are mainly responsible for under-nutrition. Changes in lifestyle and dietary habits as well as inactivity are associated with the occurrence of diet-related non-communicable diseases. Programs to prevent and control nutrition-related diseases are insufficient and ineffective, due mainly to a focus on curative care at the expense of preventive health care services, lack of epidemiological studies, lack of nutritional surveillance, inadequate nutrition information and lack of assessment of the cost-effectiveness of nutrition intervention programs.
Collapse
Affiliation(s)
- Abdulrahman O. Musaiger
- Nutrition and Health Studies Unit, Deanship of Scientific Research, University of Bahrain, Sakhair, Zallaq Street, Bahrain
- Arab Center for Nutrition, Street 1535, Muharraq, Bahrain
| | - Abdelmonem S. Hassan
- Department of Health Sciences, Qatar University, University Avenue, Qatar; E-Mail:
| | - Omar Obeid
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Bliss Street, Lebanon; E-Mail:
| |
Collapse
|