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Alkhatib B, Al-Shami I, Agraib LM. Habitual food consumption, eating behavior and meal-timing among Jordanian adults with elevated Blood pressure: a cross-sectional population-based study. Blood Press 2024; 33:2310257. [PMID: 38312098 DOI: 10.1080/08037051.2024.2310257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/22/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND The prevalence of elevated blood pressure (BP) has been raised worldwide. Food consumption, eating habits, and nutritional lifestyle related to meal timing, skipping meals, and meal contents have recently received more attention in studies on BP and metabolic syndrome. Purpose: This study evaluated the association between habitual food consumption, eating behavior, and meal timing with BP among Jordanian adults. METHODS A cross-sectional study included 771 Jordanian adults. A food frequency questionnaire was completed. Data about eating habits, meal timing, and emotional eating were collected. BP was measured. RESULTS The prevalence of less than recommended intake of vegetables, milk, protein, and fruits was higher in participants with elevated BP (69.2%, 90.2%, 58.9%, and 25.5%, respectively) as compared to the normal BP group (p < 0.001). Consuming vegetables and milk less than the recommended was reported to significantly increase the likelihood of elevated BP by OR= (1.60, and 2.75 (95%CI: 1.06-2.40; 1.62-4.66). Hence, consuming more than recommended fruit reduced the risk of elevated BP by OR = 0.56 (95%CI: 0.38-0.82). A 63.2% of elevated BP participants have three meals daily, a higher percentage of intake of one (23.5%) and two (45.7%) snacks. However, they had a higher percentage of morning eaters (50.7%), had lunch between 1:00-6:00 PM (92.7%), and had dinner between 6:00 and 9:00 PM (68.1%). CONCLUSIONS Although Jordanian adults with elevated BP appear to have healthy eating habits and meal timing and frequency, their habitual food consumption falls short of the daily recommendations for milk, fruits, vegetables, and protein.
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Affiliation(s)
- Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Lana M Agraib
- Department of Food Science and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jordan
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2
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Tamimi A, Al-Abbadi M, Tamimi I, Juweid M, Ahmad M, Tamimi F. The transformation of Jordan's healthcare system in an area of conflict. BMC Health Serv Res 2024; 24:1033. [PMID: 39243074 PMCID: PMC11378627 DOI: 10.1186/s12913-024-11467-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND The Jordanian healthcare system has evolved over the past decades expanding its services, technological, and educational resources. A comprehensive view of this system is lacking. The objective of this report is to describe the structure of the Jordanian healthcare system, the challenges facing it, and the current and recommended health policies. MATERIALS AND METHODS This study reviewed the current status of the Jordanian healthcare system. The following parameters were analyzed: health indicators, infrastructure, human resources, insurance system, pharmaceutical expense, health education system, and medical tourism. Data were collected from various relevant official institutions and related published literature. RESULTS Jordan has a young population with a median age of 23.8 years. Life expectancy is 78.8 years for females and 77.0 years for males. The Jordanian healthcare system is divided into three major categories: (1) Governmental Insurance (i.e., the Ministry of Health (MOH), the Royal Medical Services (RMS) and semi-governmental insurance); (2) Private Insurance; and (3) Refugee Insurance, including the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the United Nations High Commissioner for Refugees (NHUR). The Governmental Insurance covers 64.30% of the total population. Health expenditure is 6.37% of the gross domestic product (GDP). Pharmaceutical expenses make up 26.6% of the total national healthcare budget. Human resource assessment shows a high ratio of medical staff per 10.000 inhabitants, especially concerning physicians (31.7), dentists (7.9), and pharmacists (15.1). However, the ratio of nursing staff per 10.000 inhabitants is considered low (37.5). The Hospital bed/1000 population ratio is also relatively low (1.4). Healthcare accreditation is implemented through the Joint Commission International (JCI) accreditation which was achieved by 7 hospitals and by the National Health Care Accreditation Certificate (HCAC) achieved by 17 hospitals and 42 primary healthcare centers. Postgraduate medical education covers almost all medical and surgical fields. Medical tourism is currently well-established. CONCLUSIONS Assessment of the Jordanian healthcare system shows high ratios of physicians, dentists, and pharmacists but a low ratio of nursing staff per 10.000 inhabitants. The hospital bed/1000 population ratio is also relatively low. Pharmaceutical expenses are significantly high and medical tourism is well-developed.
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Affiliation(s)
- Ahmad Tamimi
- Department of Neurosurgery, Faculty of Medicine, University of Jordan, Amman, Jordan.
| | - Mousa Al-Abbadi
- Department of Pathology and Cytopathology, Faculty of Medicine, Jordan University Hospital, University of Jordan, Amman, Jordan
| | - Iskandar Tamimi
- Orthopedic Surgery Department; Regional University Hospital of Malaga, Malaga University, Malaga, Spain
| | - Malik Juweid
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, University Hospital, University of Jordan, Amman, Jordan
| | - Muayyad Ahmad
- Department of Clinical Nursing, Faculty of Nursing, University of Jordan, Amman, Jordan
| | - Faleh Tamimi
- College of Dental Medicine, Qatar University, Doha, Qatar
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Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
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4
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Alkhatib B, Agraib LM, Al-Shami I, Al-Dalaeen A. The Novelty of using Obesity Indices as Blood Pressure Predictors. Curr Hypertens Rev 2024; 20:36-43. [PMID: 38037836 DOI: 10.2174/0115734021277171231114103758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/30/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023]
Abstract
AIMS To study the association between selected obesity indices, systolic blood pressure (SBP), and diastolic blood pressure (DBP). METHODS A cross-sectional study on 491 Jordanian adults (19-65 years old). The sociodemographic data, anthropometrics, and blood pressure were measured and recorded. Obesity indices (Conicity Index (CI), Abdominal volume index (AVI), Body Roundness Index (BRI), and Weight-adjusted-waist index (WWI)) were calculated using standard validated formulas. RESULTS Based on age, the SBP had a significant moderate correlation with BRI and AVI in all age groups. In the age group 20 to 34 years, SBP had a significantly moderate correlation with CI, and DBP had a significantly moderate correlation with BRI and AVI. In the age group 35 to 44 years, DBP had a significantly moderate correlation with CI, BRI, WWI, and AVI. For the age group 45 to 65 years, the SBP had a significantly moderate correlation with all the obesity indexes, opposite to DBP. Obesity indices explain 23.6% to 24.1% of the changeability in SBP, and one unit increase in them resulted in an increase in SBP range from 0.61 ± 0.14 to 19.88 ± 4.45. For DBP, obesity indices explained 15.9% to 16.3% of the variability in DBP, and raising them by one unit led to an increase in the DBP range from 0.27 ± 0.11 to 10.08 ± 4.83. CONCLUSION All the studied obesity indices impacted SBP and DBP with the highest reported effect for AVI and BRI and a lower impact for WWI. The impact of obesity indices on DBP was affected by age group.
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Affiliation(s)
- Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Lana M Agraib
- Department of Food Science and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Anfal Al-Dalaeen
- Department of Clinical Nutrition and Dietetics, Faculty of Allied Medical Sciences, Applied Science Private University, Amman 11931, Jordan
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Alkhatib B, Agraib LM, Al-Dalaeen A, Al-Shami I. Are There Any Correlations between Vitamin D, Calcium, and Magnesium Intake and Coronary and Obesity Indices? JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:12-19. [PMID: 37159492 DOI: 10.1080/27697061.2023.2203225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The association between nutrient intake and obesity and coronary problems has received great attention. So, this study aimed to examine the association between vitamin D, calcium, and magnesium intake and obesity and coronary indices. METHODS A total of 491 male and female university employees (18-64 years) were randomly included in a cross-sectional study. Blood samples were drawn, and the lipid profile was analyzed. Different anthropometrics were measured. Obesity and coronary indices were calculated based on standard formulas. A 24-h recall was used to measure the average dietary intake of vitamin D, calcium, and magnesium. RESULTS For the total sample, vitamin D had a significantly weak correlation with the abdominal volume index (AVI) and weight-adjusted waist index (WWI). However, calcium intake had a significant moderate correlation with the AVI and a weak correlation with the conicity index (CI), body roundness index (BRI), body adiposity index (BAI), WWI, lipid accumulation product (LAP), and atherogenic index of plasma (AIP). In males, there was a significant weak correlation between calcium and magnesium intake and the CI, BAI, AVI, WWI, and BRI. Additionally, magnesium intake had a weak correlation with the LAP. In female participants, calcium and magnesium intake had a weak correlation with CI, BAI, AIP, and WWI. Additionally, calcium intake showed a moderate correlation with the AVI and BRI and a weak correlation with the LAP. CONCLUSION Magnesium intake had the greatest impact on coronary indices. Calcium intake had the greatest impact on obesity indices. Vitamin D intake had minimal effects on obesity and coronary indices.
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Affiliation(s)
- Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Science, The Hashemite University, Zarqa, Jordan
| | - Lana M Agraib
- Department of Food Science and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jordan
| | - Anfal Al-Dalaeen
- Department of Clinical Nutrition and Dietetics, Faculty of Allied Medical Sciences, Applied Science Private University, Amman, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Science, The Hashemite University, Zarqa, Jordan
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Alkhatib B, Al Hourani H, Al-Shami IK, Al-Jawaldeh A. Food consumption and adherence to dietary guidelines among Jordanian children and adolescents. F1000Res 2023; 12:1094. [PMID: 39296353 PMCID: PMC11409655 DOI: 10.12688/f1000research.138866.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 09/21/2024] Open
Abstract
Background Early-life food consumption patterns may affect children's health by increasing susceptibility to developing non-communicable chronic diseases (NCDs) in adulthood. Aims To evaluate Jordanian children and adolescents' energy and macronutrient intake and how closely they adhere to dietary recommendations. Methods This cross-sectional study used data from Jordan's Population-based Food Consumption Survey, a household population-based study conducted in Jordan between 2021 and 2022 (561 children and adolescents 8-19 years). Dietary intake was assessed using the two non-consecutive 24-hour dietary recall methods (24-h DR). The estimated food group and nutrient intakes were compared to nutritional recommendations, including MyPlate dietary guidelines. Results The prevalence of overweight/obese individuals based on body mass index (BMI) was 44%, and the average waist-to-height ratio (WHtR) was 24.7%. Compared to MyPlate dietary guidelines, children and adolescents had a higher added sugar intake (57g/day). Also, consuming vegetables, fruits, and dairy fell short of MyPlate dietary guidelines. The total discretionary calorie intake in children and adolescents was approximately one-third of the total energy intake. Conclusion The food consumption of Jordanian children and adolescents includes high intakes of discretionary calories, with a low intake of fruits, vegetables, and dairy products. The prevalence of overweight/obesity was elevated compared to international norms.
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Affiliation(s)
- Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Huda Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Islam K Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean, Committee for World Health Organization, Cairo, Egypt
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7
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Khader Y, Al Nsour M, Abu Khudair S, Saad R, Tarawneh MR, Lami F. Strengthening Primary Healthcare in Jordan for Achieving Universal Health Coverage: A Need for Family Health Team Approach. Healthcare (Basel) 2023; 11:2993. [PMID: 37998485 PMCID: PMC10671215 DOI: 10.3390/healthcare11222993] [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: 09/26/2023] [Revised: 11/04/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Achieving Universal Health Coverage (UHC) is a strategic objective of the Jordanian government and has been prioritized in its strategies and plans. However, there are several challenges affecting primary healthcare in Jordan and the health system in general that prevent Jordan from achieving UHC. This paper highlights the importance of team-based care in the form of Family Health Teams (FHTs) to realize Jordan's goal of achieving UHC. FHTs are a team-based approach that brings together diverse professionals to provide a comprehensive, efficient, patient-centered primary care system that meets the changing needs of Jordan's population and refugees. However, the implementation of FHT may encounter obstacles, including individual, organizational, institutional, and external barriers. To overcome such obstacles, several actions and processes need to be taken, including political commitment and leadership, implementing good governance and policy frameworks, allocating resources and funding, multisectoral collaboration, and engagement of communities and stakeholders. The successful implementation of FHTs requires participation from government officials, parliamentarians, civil society, and influential community, religious, and business leaders. A strategic policy framework, effective oversight, coalition building, regulation, attention to system design, and accountability are also essential. In conclusion, adopting the FHT approach in Jordan's Primary Healthcare system offers a promising path towards achieving UHC, improving healthcare access, quality, and efficiency while addressing the unique challenges faced by the country's healthcare system.
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Affiliation(s)
- Yousef Khader
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mohannad Al Nsour
- The Eastern Mediterranean Public Health Network, Amman 11195, Jordan; (M.A.N.); (R.S.)
| | - Sara Abu Khudair
- Global Health and Development, Faculty of Social Sciences, Tampere University, 33520 Tampere, Finland;
| | - Randa Saad
- The Eastern Mediterranean Public Health Network, Amman 11195, Jordan; (M.A.N.); (R.S.)
| | | | - Faris Lami
- Department of Family and Community Medicine, College of Medicine, University of Baghdad, Bab Al Muadham, Baghdad 00964, Iraq;
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Milhem F, Komarnytsky S. Progression to Obesity: Variations in Patterns of Metabolic Fluxes, Fat Accumulation, and Gastrointestinal Responses. Metabolites 2023; 13:1016. [PMID: 37755296 PMCID: PMC10535155 DOI: 10.3390/metabo13091016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023] Open
Abstract
Obesity is a multifactorial disorder that is remarkably heterogeneous. It presents itself in a variety of phenotypes that can be metabolically unhealthy or healthy, associate with no or multiple metabolic risk factors, gain extreme body weight (super-responders), as well as resist obesity despite the obesogenic environment (non-responders). Progression to obesity is ultimately linked to the overall net energy balance and activity of different metabolic fluxes. This is particularly evident from variations in fatty acids oxidation, metabolic fluxes through the pyruvate-phosphoenolpyruvate-oxaloacetate node, and extracellular accumulation of Krebs cycle metabolites, such as citrate. Patterns of fat accumulation with a focus on visceral and ectopic adipose tissue, microbiome composition, and the immune status of the gastrointestinal tract have emerged as the most promising targets that allow personalization of obesity and warrant further investigations into the critical issue of a wider and long-term weight control. Advances in understanding the biochemistry mechanisms underlying the heterogenous obesity phenotypes are critical to the development of targeted strategies to maintain healthy weight.
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Affiliation(s)
- Fadia Milhem
- Plants for Human Health Institute, NC State University, 600 Laureate Way, Kannapolis, NC 28081, USA;
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, 400 Dan Allen Drive, Raleigh, NC 27695, USA
- Department of Nutrition, University of Petra, 317 Airport Road, Amman 11196, Jordan
| | - Slavko Komarnytsky
- Plants for Human Health Institute, NC State University, 600 Laureate Way, Kannapolis, NC 28081, USA;
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, 400 Dan Allen Drive, Raleigh, NC 27695, USA
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Al Hourani H, Alkhatib B, Al-Shami I, Olaimat AN, Al-Holy M, Al-Awwad NJ, Abughoush M, Saleh NA, AlHalaika D, Alboqai O, Al-Jawaldeh A. Energy and macronutrient intakes in Jordan: a population study. Sci Rep 2023; 13:12736. [PMID: 37543630 PMCID: PMC10404255 DOI: 10.1038/s41598-023-39900-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 08/01/2023] [Indexed: 08/07/2023] Open
Abstract
Jordan has never conducted a nutrition survey to determine nutrient and energy intakes. The current study aimed to describe the energy and macronutrient consumed by the Jordanian population. A cross-sectional food consumption study was conducted, including a sample of Jordanians using two non-consecutive 24-h dietary recalls (24-h DR) between October 2021 and March 2022. A total of 2145 males and females aged 8 to 85 years old living in households were studied. The average of two 24-h DRs for each individual was converted into energy and nutrient intakes. After measuring weight, height, and waist circumference, the body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. The percentage of under-reporters was higher in women than men (58.2% vs. 45.9%). Adults and older adult women had the highest prevalence of obesity (29.6%), while adults and older adult men had the highest prevalence of overweight (41.4%). There is a significant increase in energy intake in children, boys, and all adults, compared to the recommended calories. The mean energy percentage (E %) of total fat was 38%, exceeding the upper limit of the Acceptable Macronutrient Distribution Range (AMDR). At the same time, the mean daily dietary fiber intake fell below the recommended levels (ranging from 13.5 g in children to 19.5 g in older adults). The study population consumes more fat and less fiber than the recommended levels. Actions must be taken across all age groups to correct the deviation of energy and macronutrient intakes from the recommended dietary allowances.
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Affiliation(s)
- Huda Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan.
| | - Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Amin N Olaimat
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Murad Al-Holy
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Narmeen Jamal Al-Awwad
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Mahmoud Abughoush
- Science of Nutrition and Dietetics Program, College of Pharmacy, Al Ain University, 64141, Abu Dhabi, United Arab Emirates
| | - Nada A Saleh
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Dima AlHalaika
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Omar Alboqai
- Department of Nutrition and Food Science, Faculty of Agriculture and Sciences, Jerash University, Jerash, Jordan
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, 7608, Egypt
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Alkhatib B, Agraib L, Hasan H, Qasrawi DM, Al-Shorman A. The Use of Herbs, Dietary Products, and Different Types of Diet for Weight Loss Purposes. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:1390-1398. [PMID: 37593514 PMCID: PMC10430400 DOI: 10.18502/ijph.v52i7.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/11/2022] [Indexed: 08/19/2023]
Abstract
Background Obesity is a global pandemic health problem. Attempting weight reduction, excess weight people commonly seek herbal products in addition to claim diets. We aimed to assess the prevalence of consuming herbal and dietary products for weight loss purposes and to assess weight reduction attitudes and beliefs among a group of excess-weight adults in Jordan. Methods A cross-sectional study was conducted on a sample of 477 Jordanian adults (81.6% females), between Feb-Apr/2021. The study data collection was completed by using a validated online structured questionnaire. Results 28.9% of the male participants reported that the most common source of diets they followed was by themselves (43.2%) and by dietitians (25%). Whereas female participants followed the weight reduction diets prescribed by dietitians, by themselves, and on the internet (31.1%; 26.5%, and 23.7; respectively, P=0.011). The majority of participants from both genders do not believe in using weight reduction herbs alone for losing weight; it must be done along with diet and exercise (P=0.018). Females who use herbs for weight reduction were more than males. In addition, green tea was the most used herb by all participants (8%). The main advisor for using weight reduction herbs and dietary products in females was the internet (30.1%) followed by their own (24.2%). However, in males, it was by their own (21.6%), then by a dietitian (12.6%), and by the internet (12.5%) (P=0.001). Moreover, a quarter of male participants and 21.6% of females did not feel that using herbs to lose weight was efficient. Conclusion The excess weight adults in Jordan seek to use diet, herbs, and dietary products for weight reduction, advised by unreliable sources. Although the majority are convinced that it is not effective alone, further studies are needed to assess the side effects and safety of such consumption among the population.
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Affiliation(s)
- Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Lana Agraib
- Department of Food and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jordan
| | | | - Dana Maher Qasrawi
- Jordan University Hospital, Internal Medicine Resident, University of Jordan, Amman, Jordan
| | - Alaa Al-Shorman
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
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Agraib LM, Al Hourani HM, Al-Shami IK, Alkhatib BM, Al-Jawaldeh A. Association between dietary fatty acid patterns and obesity indices in Jordanian adults: A cross-sectional study. Heliyon 2023; 9:e17938. [PMID: 37455990 PMCID: PMC10344746 DOI: 10.1016/j.heliyon.2023.e17938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/03/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
Background The ratios of fatty acids in different diets and their connection to chronic diseases including obesity and CVD have been researched. The current study set out to detect the dietary fatty acid patterns among Jordanian adults and their relationships with obesity indices. Methods The data of 1096 adults were extracted from a household food consumption patterns survey study. Food intake was analyzed, and fatty acid patterns were determined. After anthropometric measurements, obesity indices were calculated. Results Two fatty acid patterns were determined (High fatty acids from Protein and Olive Oil sources pattern, and the low Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) pattern), explaining an overall variance of 41.78% and 24.31%, respectively. A significant difference in obesity scores through fatty acids pattern quartiles was only seen among female participants. Q4 of the "High fatty acids from Protein and Olive Oil sources" pattern had a significantly higher means of body mass index (25.12 ± 0.46; p = 0.015), waist-to-height-ratio (0.51 ± 0.01; p = 0.002), weight-adjusted waist index (10.13 ± 0.09; p = 0.021) and body roundness index (3.61 ± 0.15; p = 0.007) compared to Q1, while Q4 of "Low EPA and DHA" pattern had significantly higher means of waist circumference (WC) (86.28 ± 1.34) and a body shape index (ABSI) (10.12 ± 0.30) in comparison to Q1 (WC = 81.55 ± 1.08 and ABSI = 9.07 ± 0.22; p = 0.025, 0.013; respectively). In females, there was a significant association between the "High fatty acids from Protein and Olive Oil sources" pattern and all the obesity indices. Conclusion Our results suggest that an increase in the high fatty acids from Protein and Olive Oil sources pattern is associated with a reduction in obesity indices, which is opposite to the low EPA and DHA pattern. This was a sex-specific association.
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Affiliation(s)
- Lana M. Agraib
- Department of Food and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jordan
| | - Huda M. Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University. Zarqa, Jordan
| | - Islam K. Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University. Zarqa, Jordan
| | - Buthaina M. Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University. Zarqa, Jordan
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo 7608, Egypt
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12
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Sawalha K, Asad R, Habash F, López-Candales A. Profiling Cardiometabolic Health in Jordan: A Call to Action to Improve Cardiovascular Health. Cureus 2023; 15:e38488. [PMID: 37273358 PMCID: PMC10237340 DOI: 10.7759/cureus.38488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 06/06/2023] Open
Abstract
Over the past decades, Jordan has witnessed unprecedented growth in the prevalence of cardiometabolic diseases, with a crude prevalence of 48.2% in 2020, up from 38% in 2009. This is slightly higher than the reported prevalence of 40% in the US population. According to the latest World Health Organization report published in 2020, Jordan's leading cause of mortality is cardiovascular diseases with a cause-specific mortality rate of 18.6%. Since the advancement of the healthcare system in Jordan took place in the early 2000s, Jordan has witnessed a major epidemiologic transition where the burden of infectious disease has decreased, but on the other hand, the burden of cardiometabolic disease has increased as well. For such a country with limited resources and healthcare infrastructure where two-thirds of its population is below the age of 30, this is alarming. This growth can be attributed to a complex interplay between genetic and lifestyle factors. Smoking, physical inactivity, obesity, and unhealthy diet are considered major public health problems in Jordan, as reported in 2007 by the Jordanian Behavioral Risk Factor Surveillance. We attempt to raise awareness through this review article, so healthcare providers in Jordan understand the magnitude of the issue, and appropriate steps are taken to reestablish screening and management guidelines pertaining to cardiometabolic diseases in Jordan.
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Affiliation(s)
- Khalid Sawalha
- Cardiometabolic Medicine, University of Missouri Kansas City, Kansas City, USA
| | - Reda Asad
- Endocrinology, Diabetes and Metabolism, University of Missouri Kansas City, Kansas City, USA
| | - Fuad Habash
- Cardiac Electrophysiology, Baylor Heart and Vascular Hospital, Dallas, USA
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13
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Rababah T, Al-U'datt M, Angor MM, Gammoh S, Rababah R, Magableh G, Almajwal A, AL-Rayyan Y, AL-Rayyan N. Impact of COVID-19 pandemic on obesity among adults in Jordan. Front Nutr 2023; 10:1114076. [PMID: 36742426 PMCID: PMC9896011 DOI: 10.3389/fnut.2023.1114076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023] Open
Abstract
COVID-19 is a severe acute respiratory syndrome that mainly affects the human respiratory system. Unhealthy nutritional habits and obesity are expected as consequences of protective measures including quarantine. Obesity, in its growing prevalence, is a worldwide health issue associated with worsening health conditions. This is a cross-sectional study to assess the impact of the COVID-19 pandemic on obesity among Jordanian adults and across epidemiological statuses. Participants were randomly selected, and the survey was distributed on social media networking sites. A total of 672 subjects were surveyed and participated in the study between March and June 2021 via Google Form questionnaire. The results indicated that 74.4% of participants reported that they did not do any physical activity, and 43.5% changed their lifestyle and eating habits for the worse. During the COVID-19 pandemic, almost half of the participants reported an increase in hunger, consuming 3-4 meals/day, and consuming < 1 liter of water/day. Additionally, more than half of the participants reported no change in fat, cereals, and protein consumption, 46.4 % had no change in fruit and vegetable consumption, and 50.6% increased their consumption of sweets. Our results showed a significant increase in the self-reported BMI categories during the COVID-19 pandemic for all ages (p < 0.001). Change in weight and BMI was significantly associated with marital status, education level, living place, family size, family working members, and working status. Participants across all epidemiological statuses displayed a statistically significant increase in BMI. This study was conducted to observe the impacts of the COVID-19 pandemic on health behaviors and obesity among Jordanian adults and across epidemiological statuses. We found that there were significant negative changes in the lifestyle (physical activity) and eating behaviors of Jordanians during the COVID-19 quarantine which in turn increased their body weight and changed the obesity rate.
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Affiliation(s)
- Taha Rababah
- Department of Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan,*Correspondence: Taha Rababah ✉
| | - Muhammad Al-U'datt
- Department of Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan
| | - Malak M. Angor
- Nutrition and Food Processing Department, Al-Huson College, Al-Balqa Applied University, Salt, Jordan
| | - Sana Gammoh
- Department of Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan
| | - Rana Rababah
- Department of Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan
| | - Ghazi Magableh
- Industrial Engineering Department–Yarmouk University, Yarmouk University, Irbid, Jordan
| | - Ali Almajwal
- College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Yara AL-Rayyan
- College of Agriculture and Life Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Numan AL-Rayyan
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States,National Agricultural Research Center, Al-Baqa'a, Jordan,Numan AL-Rayyan ✉
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14
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Alfaqih MA, Araidah A, Amarin Z, Saadeh R, Al-shboul O, Khanfar M, Allouh MZ. Association of vitamin D levels and polymorphisms in vitamin D receptor with type 2 diabetes mellitus. Biomed Rep 2022; 18:3. [PMID: 36544850 PMCID: PMC9755923 DOI: 10.3892/br.2022.1585] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a leading cause of death. The prevalence of T2DM in countries of the Middle East and North Africa (MENA) region, including Jordan, is among the highest worldwide. The reason(s) behind the epidemic nature of T2DM in Jordan are unknown but warrant further exploration. Studies have indicated that T2DM could be influenced by diet and/or genetic background. Evidence suggests that numerous patients with T2DM are deficient in vitamin D. The activity of vitamin D on its target tissues may be influenced by single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) gene. It was therefore hypothesized that SNPs in VDR could modify the risk of T2DM. To test this hypothesis, 125 patients with T2DM were recruited along with 125 controls. The study subjects were genotyped for variations in rs2228570, rs1544410, rs7975232, and rs731236 SNPs in the VDR. The levels of 25-hydroxyvitamin D [25(OH)D] were measured from the serum. The analysis revealed that reduced 25(OH)D and age were associated with the risk of T2DM (P<0.05). Moreover, under a dominant inheritance model, the GG genotype of rs2228570 was revealed to increase the risk of T2DM in univariate and multivariate analysis (P<0.05). Additionally, a chromosomal block containing the GAAG haplotype of VDR SNPs increased the risk of T2DM (OR=1.909; CI: 1.260-2.891; P=0.0021). Collectively, the present study revealed that low levels of serum 25(OH)D and rs2228570 of the VDR gene are associated with the risk of T2DM.
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Affiliation(s)
- Mahmoud A. Alfaqih
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Abdullah Araidah
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Zouhair Amarin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Rami Saadeh
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Othman Al-shboul
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mariam Khanfar
- Division of Biology and Biomedical Sciences, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Mohammed Z. Allouh
- Department of Anatomy, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan,Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates,Correspondence to: Professor Mohammed Z. Allouh, Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
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15
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Al-Jawaldeh A, Abbass MMS. Unhealthy Dietary Habits and Obesity: The Major Risk Factors Beyond Non-Communicable Diseases in the Eastern Mediterranean Region. Front Nutr 2022; 9:817808. [PMID: 35369054 PMCID: PMC8970016 DOI: 10.3389/fnut.2022.817808] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/11/2022] [Indexed: 12/14/2022] Open
Abstract
There are 22 countries in the Eastern Mediterranean Region (EMR) expanding from Morocco in the west to Pakistan and Afghanistan in the east, containing a population of 725,721 million in 2020. In the previous 30 years, the illness burden in the EMR has transmitted from communicable diseases to non-communicable diseases such as diabetes, cardiovascular diseases, and cancer. In 2019, cardiovascular mortality in the EMR was mostly attributed to ischemic heart disease, the first reason for mortality in 19 countries in the region. Stroke was the second reason for death in nine countries followed by diabetes, which was ranked as the second reason for death in two countries. The prominent nutrition-related NCDs risk factors in EMR include obesity, hypertension, high fasting plasma glucose, and upregulated unhealthy diet consumption. Most of the EMR population are unaware of their NCDs risk factor status. These risk factors, even if treated, are often poorly controlled, therefore, inhibiting their existence by changing the lifestyle to proper dietary habits and sufficient physical activity is mandatory. In this review, the epidemiology and nutrition-related risk factors of NCDs in the EMR will be discussed and illustrated, aiming to scale up action and support decision-makers in implementing cost effective strategies to address obesity and NCDs prevention and management in the region.
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Affiliation(s)
- Ayoub Al-Jawaldeh
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo, Egypt
| | - Marwa M. S. Abbass
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo, Egypt
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
- *Correspondence: Marwa M. S. Abbass
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16
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Alsughayer AM, Dabbagh TZ, Abdel-Razeq RH, Al-Jussani GN, Alhassoon S, Sughayer MA. Changing Trends in Estrogen Receptors/Progesterone Receptors/Human Epidermal Growth Factor Receptor 2 Prevalence Rates Among Jordanian Patients With Breast Cancer Over the Years. JCO Glob Oncol 2022; 8:e2100359. [PMID: 35436143 PMCID: PMC9302262 DOI: 10.1200/go.21.00359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Estrogen receptors (ERs), progesterone receptors (PRs), and human epidermal growth factor receptor 2 (HER2) are the mainstay of breast cancer management, and their prevalence rates vary among different populations possibly related to ethnic/genetic and/or socioeconomic status. In a previous study conducted at the King Hussein Cancer Center (published 2006), Jordan ER/PR/HER2 rates for patients diagnosed in 2003-2004 were 50.8%/57.5%/17.5%, respectively. The aim of this study is to revisit the prevalence rates to see if they have changed over the years with changing socioeconomic status. MATERIALS AND METHODS We retrieved clinicopathologic data of all patients (1,185) diagnosed with breast cancer during 2018. The data included age, histologic type, grade, and ER/PR/HER2 status as determined by immunohistochemistry and/or fluorescence in situ hybridization for HER2. RESULTS The mean age of patients was 52 (median = 51, range = 25-92) years, and the majority (73.2%) had invasive carcinoma of no special type. ER/PR/HER2 were 77.0%/72.4%./23.8%, respectively. Triple-negative breast cancers were 10.1%. In comparison with previous results of 2006, the changes are statistically significant. Similar changes were seen in other Middle Eastern populations. The current rates are close to those of Western populations. CONCLUSION Rates of ER/PR/HER2 expression have significantly changed and are close to those of Western populations for ER/PR. We propose that such changes are secondary to the adoption of a westernized lifestyle and socioeconomic changes.
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17
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Lobstein T, Jewell J. What is a "high" prevalence of obesity? Two rapid reviews and a proposed set of thresholds for classifying prevalence levels. Obes Rev 2022; 23:e13363. [PMID: 34585495 PMCID: PMC9285557 DOI: 10.1111/obr.13363] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/28/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022]
Abstract
Categories such as "low" and "high" have been used for several decades to describe the prevalence of stunting and wasting in populations of children aged under 5 years. They provide support for public health risk assessment and policy-making, including alerting health departments and aid agencies to national trends and local needs. In the light of the need for monitoring progress to meet globally agreed targets for overweight and obesity, the classification of their prevalence will be a valuable to aid in policy development, to target resources, and to promote public health interventions. This paper reviews the current use of categories to describe obesity prevalence in policy, advocacy, and research literature. Where prevalence categories have been formally proposed, this paper compares their application on large-scale datasets. The paper then develops a set of recommended threshold values to classify prevalence levels for overweight and obesity among children under age 5 years, children aged 5-19 years, and adults.
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Affiliation(s)
- Tim Lobstein
- Policy Section, World Obesity Federation, London, UK.,The Boden Group, University of Sydney, Sydney, New South Wales, Australia
| | - Jo Jewell
- Nutrition Section, UNICEF, New York, New York, USA
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18
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Al-Awwad NJ, Ayoub J, Barham R, Sarhan W, Al-Holy M, Abughoush M, Al-Hourani H, Olaimat A, Al-Jawaldeh A. Review of the Nutrition Situation in Jordan: Trends and Way Forward. Nutrients 2021; 14:135. [PMID: 35011008 PMCID: PMC8746685 DOI: 10.3390/nu14010135] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 01/22/2023] Open
Abstract
Jordan is witnessing an escalating pace of nutrition transition, which may be associated with an increased burden of malnutrition and related non-communicable diseases. This review analyzes the nutrition situation in Jordan by exploring specific nutrition indicators, namely infant and young child feeding, low birthweight, micronutrient deficiencies, anthropometric indicators, and food consumption patterns. Results showed that although most children were ever breastfed and early initiation of breastfeeding had a two-fold increasing trend, rates of exclusive breastfeeding below 6 months of age and continued breastfeeding until two years of age were low. Complementary feeding indicators, particularly minimum diet diversity and minimum acceptable diet standards, were suboptimal. An overall low burden of stunting, wasting, and underweight among children under 5 years and remarkable progress in optimizing iodine status among school-aged children were reported. Conversely, the burden of low birthweight and overweight/obesity exacerbated, coexisting with anemia, vitamin A deficiency, and vitamin D deficiency. Overall, fruit and vegetable consumption were inadequate. The consumption of soft drinks and salt on the other hand was higher than recommended. This review acknowledges the double burden of malnutrition in Jordan and recommends the prioritization and evaluation of interventions towards improving the population's nutritional status and achieving nutrition targets.
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Affiliation(s)
- Narmeen Jamal Al-Awwad
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
| | - Jennifer Ayoub
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut 1107 2020, Lebanon;
| | - Rawhieh Barham
- Nutrition Department, Ministry of Health, Amman 11118, Jordan;
| | - Wafaa Sarhan
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Murad Al-Holy
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
| | - Mahmoud Abughoush
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
- Science of Nutrition and Dietetics Program, College of Pharmacy, Al Ain University, Abu Dhabi 64141, United Arab Emirates
| | - Huda Al-Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
| | - Amin Olaimat
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo 7608, Egypt
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19
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Alkhalidy H, Orabi A, Alnaser K, Al-Shami I, Alzboun T, Obeidat MD, Liu D. Obesity Measures as Predictors of Type 2 Diabetes and Cardiovascular Diseases among the Jordanian Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12187. [PMID: 34831943 PMCID: PMC8618033 DOI: 10.3390/ijerph182212187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 12/23/2022]
Abstract
Obesity is strongly associated with cardiovascular diseases (CVD) and type 2 diabetes (T2D). This study aimed to use obesity measures, body mass index (BMI) and waist circumference (WC) to predict the CVD and T2D risk and to determine the best predictor of these diseases among Jordanian adults. A cross-sectional study was conducted at the governmental and military hospitals across Jordan. The study participants were healthy or previously diagnosed with CVD or T2D. The continuous variables were compared using ANOVA, and the categorical variables were compared using the X2 test. The multivariate logistic regression was used to predict CVD and T2D risk through their association with BMI and WC. The final sample consisted of 6000 Jordanian adults with a mean age of 41.5 ± 14.7 years, 73.6% females. The BMI (OR = 1.7, CI: 1.30-2.30, p < 0.001) was associated with a higher risk of T2D compared to WC (OR = 1.3, CI: 1.04-1.52, p = 0.016). However, our results showed that BMI was not associated with CVD risk, while the WC was significantly and positively associated with CVD risk (OR = 1.9, CI: 1.47-2.47, p < 0.001). In conclusion, an elevated BMI predicts a higher risk of T2D, while WC is more efficient in predicting CVD risk. Our results can be used to construct a population-specific intervention to reduce the risk of CVD and T2D among adults in Jordan and other countries with similar backgrounds.
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Affiliation(s)
- Hana Alkhalidy
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan; (A.O.); (K.A.); (T.A.)
| | - Aliaa Orabi
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan; (A.O.); (K.A.); (T.A.)
| | - Khadeejah Alnaser
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan; (A.O.); (K.A.); (T.A.)
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan;
| | - Tamara Alzboun
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan; (A.O.); (K.A.); (T.A.)
| | - Mohammad D. Obeidat
- Department of Animal Production, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Dongmin Liu
- Department of Human Nutrition, Foods and Exercise, College of Agriculture and Life Sciences, Virginia Tech, Blacksburg, VA 24061, USA;
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20
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Bustami M, Matalka KZ, Mallah E, Abu-Qatouseh L, Abu Dayyih W, Hussein N, Abu Safieh N, Elyyan Y, Hussein N, Arafat T. The Prevalence of Overweight and Obesity Among Women in Jordan: A Risk Factor for Developing Chronic Diseases. J Multidiscip Healthc 2021; 14:1533-1541. [PMID: 34188480 PMCID: PMC8235929 DOI: 10.2147/jmdh.s313172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/01/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The study aimed to investigate the prevalence of obesity among Jordanian women and its association with a wide range of chronic diseases. Methods Subjects were enrolled in the present cross-sectional study based on a random drop-off technique at the Obstetrics and Gynecology clinics at Jordan University Hospital. Initially, any female 18 years of age and older was asked to enroll in the study. Relevant data were gathered using a questionnaire composed of 30 questions, and body mass index (BMI) was determined from each participant’s weight and height. The following variables were collected: socio-demographic, chronic diseases, and health status. Each variable’s frequencies were reported, and the 95% confidence interval (95% CI) for each variable was calculated. For association analysis, Chi-square analysis was performed with an odds ratio (OR) and 95% CI. Multinomial logistic regression analysis was applied to a combination of independent variables and a dependent condition with covariate factors. Results The age-standardized prevalence of overweight/obese Jordanian women was 70.6% (95% CI 66.0–74.8%). On the other hand, the age-standardized prevalence of only obese women was 36.4 (95% Cl 31.9–41.2%). Furthermore, the association between age and overweight/obesity was significant (p<0.0001). The percentage of overweight and obesity started to be significant in the 30–39 year age group. Moreover, the OR for obesity ranged from 2.7 to 7.0 (p<0.05–0.01) for those women with only elementary education. Besides, high parity was significantly associated with obesity and elementary education. For chronic conditions, the percentages of hypertension, diabetes, hypertriglyceridemia, osteoporosis, and rheumatoid arthritis were significantly correlated with increased BMI in Jordanian women. With age adjustment, however, only hypertension was associated with obese level 3 with OR of 7.2 and 95% CI of 2.1–25.1 (p<0.01). Conclusion There is a high prevalence of overweight/obesity among women in Jordan, which was related to high parity and low education level. This high prevalence of obesity increased the incidence of chronic diseases, such as hypertension. Therefore, community-based multiple strategies are required to combat obesity in Jordanian women.
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Affiliation(s)
- Mona Bustami
- Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, 11196, Jordan
| | - Khalid Z Matalka
- Faculty of Health Sciences, American University of Madaba, Madaba, Jordan
| | - Eyad Mallah
- Department of Pharmaceutical Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, 11196, Jordan
| | - Luay Abu-Qatouseh
- Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, 11196, Jordan
| | - Wael Abu Dayyih
- Department of Pharmaceutical Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, 11196, Jordan
| | - Nour Hussein
- School of Medicine, University of Jordan, Amman, Jordan
| | | | - Yousef Elyyan
- Obstetrics and Gynecology, Jordan University Hospital, Amman, Jordan
| | | | - Tawfiq Arafat
- Jordan Center for Pharmaceutical Research, Amman, Jordan
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Pengpid S, Peltzer K. Underweight and overweight/obesity among adults in Afghanistan: prevalence and correlates from a national survey in 2018. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:25. [PMID: 34090532 PMCID: PMC8180065 DOI: 10.1186/s41043-021-00251-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The study aimed to estimate the prevalence and correlates of underweight and overweight/obesity among adults in Afghanistan. METHODS National cross-sectional survey data of 3779 persons aged 18-69 years were analysed. Multinomial logistic regression was used to estimate factors associated with underweight and overweight/obesity relative to normal weight. RESULTS In all, 7.8% of the study sample was underweight (BMI < 18.5 kg/m2), 49.5% had normal weight (BMI 18.5-24.9 kg/m2), 25.5% overweight (25.0-29.9 kg/m2), and 17.2% obesity. In adjusted multinomial logistic regression, factors negatively associated with underweight were male sex (adjusted relative risk ratio (ARRR): 0.30, 95% confidence interval (CI): 0.15-0.58) and hypertension (ARRR: 0.51, 95% CI: 0.27-0.95) and factors positively associated with underweight were sedentary behaviour (ARRR: 1.85, 95% CI: 1.11-3.10) and current tobacco use (ARRR: 2.58, 95% CI: 1.08-6.16). Factors positively associated with overweight/obesity were aged 30-44 years (ARRR: 2.00, CI: 1.51-2.66) and aged 45-69 years (ARRR: 1.58, CI: 1.09-2.31) (compared to 18-29 years) (ARRR: 1.28, CI: 1.14-2.18), hypertension (ARRR: 2.74, CI: 1.89-3.96), and type 2 diabetes (ARRR: 1.82, CI: 1.13-2.94), and high physical activity (ARRR: 0.70, CI: 0.50-0.98) was negatively associated with overweight/obesity. CONCLUSION Almost one in ten adult respondents were underweight and more than two in five were overweight/obese, confirming a dual burden of malnutrition in Afghanistan.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
- Department of Research Administration and Development, University of Limpopo, Turfloop, Mankweng, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa.
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Overweight and Obesity among Adults in Iraq: Prevalence and Correlates from a National Survey in 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084198. [PMID: 33921006 PMCID: PMC8071354 DOI: 10.3390/ijerph18084198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/22/2022]
Abstract
This study aimed to estimate the prevalence and correlates of overweight and obesity among adults in Iraq. Data from a 2015 nationally representative cross-sectional survey of 3916 persons 18 years or older (M (median) age = 40 years, IQR (interquartile range) age = 29–52 years; men: M = 41 years, IQR = 29–54 years; women: M = 40 years, IQR = 30–51 years) who responded to a questionnaire, and physical and biochemical measures were analysed. Multinomial logistic regression was utilised to predict the determinants of overweight and obesity relative to under or normal weight. The results indicate that 3.6% of the participants were underweight (body mass index (BMI) <18.5 kg/m2), 30.8% had normal weight (BMI 18.5–24.9 kg/m2), 31.8% were overweight (25.0–29.9 kg/m2), and 33.9% had obesity (BMI ≥30.0 kg/m2). In the adjusted multinomial logistic regression, being aged 40–49 years (compared to 18–39 years old) (adjusted relative risk ratio (ARRR): 4.47, confidence interval (CI): 3.39–5.91), living in an urban residence (ARRR: 1.28, CI: 1.14–2.18), and having hypertension (ARRR: 3.13, CI: 2.36–4.17) were positively associated with obesity. Being male (ARRR: 0.47, CI: 0.33–0.68), having more than primary education (ARRR: 0.69, CI: 0.50–0.94), and having a larger household size (five members or more) (ARRR: 0.45, CI: 0.33–0.60) were negatively associated with obesity. Approximately two in three adult participants were overweight/obese, and sociodemographic and health risk factors were found that can be utilised in targeting interventions.
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Al-Domi H, Al-Dalaeen A, Al-Rosan S, Batarseh N, Nawaiseh H. Healthy nutritional behavior during COVID-19 lockdown: A cross-sectional study. Clin Nutr ESPEN 2021; 42:132-137. [PMID: 33745566 PMCID: PMC7901367 DOI: 10.1016/j.clnesp.2021.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/06/2021] [Accepted: 02/14/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Ongoing outbreak of the novel coronavirus infectious disease 2019 (COVID- 19) constitutes a major global pandemic health care system challenge. Shortly following the disease outbreak, like SARS-CoV virus, all affected countries are implementing various preventive and control measures to mitigate the spread of the disease. Optimizing public health system during COVID-19 pandemic requires not only advanced medical and biological sciences knowledge, but also all human sciences related to social, as well as nutritional behavior, and lifestyle practices. AIM To investigate the effect of COVID-19- quarantine on healthy nutritional behavior and lifestyle practices among Jordanian population. METHODS A cross-sectional study among Jordanian population was conducted using an online questionnaire between March and April 2020. Participants were kindly requested to answer a standardized and validated structured questionnaire. Demographic information (age, gender, place of residence, and occupation), anthropometric data (reported weight and height); nutritional behavior information (number of meals per day, snakes, water intake), and physical activity behavior were requested. RESULTS A total of 4473 respondents were included in the study; obese (n = 1135), normal body weight (n = 1561), and underweight (n = 116). During COVID-19 quarantine, a significant increase in body weight (12.9% underweight, 28.5% normal body weight, 36.4% overweight' and 41.1% of obese (p < 0.001) was reported. Moreover, the number of snacks between meals (p < 0.001), number of main meals (p < 0.001), and the smoking rate was also increased significantly; however, there was no significant difference regarding physical activity among various weight status groups (p < 0.05). CONCLUSIONS In this study, we have provided evidence, for the first time, that there were significant negative changes in healthy nutritional behavior among Jordanians during COVID-19 quarantine who encountered significantly increased body weight, appetite, and smoking. Hence, future larger cross-sectional studies are warranted.
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Affiliation(s)
- Hayder Al-Domi
- Department of Food Technology and Nutrition, School of Agriculture, The University of Jordan, Amman 11492, Jordan.
| | - Anfal Al-Dalaeen
- Department of Food Technology and Nutrition, School of Agriculture, The University of Jordan, Amman 11492, Jordan.
| | - Sara Al-Rosan
- Department of Food Technology and Nutrition, School of Agriculture, The University of Jordan, Amman 11492, Jordan.
| | - Nour Batarseh
- Department of Food Technology and Nutrition, School of Agriculture, The University of Jordan, Amman 11492, Jordan.
| | - Hala Nawaiseh
- Department of Food Technology and Nutrition, School of Agriculture, The University of Jordan, Amman 11492, Jordan.
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