Search

Purpose The purpose of this paper is to determine the prevalence of general and abdominal obesity among adolescents attending independent schools in Qatar. Design/methodology/approaches A school-based cross-sectional study was conducted in November-December 2013 in 23 secondary schools. A total of 1,161 students aged 14 to 19 year olds were randomly selected using a multistage stratified cluster random sampling technique. Body weight, height and waist circumference (WC) were measured using standard protocol. The International Obesity Task Force (IOTF) age- and sex-specific body mass index (BMI) reference were used to define overweight and obesity. Abdominal obesity (AO) was defined by waist to height ratio (WHtR ≥ 0.5) and by sex- and age-specific WC cut-off values. Findings The prevalence of overweight and obesity among the study population was 20.6 and 20.7%, respectively. The highest rate of overweight and obesity was observed among boys, and the youngest age group. The rate of obesity defined by either WC/or WHtR was higher than that assessed by BMI. The prevalence of AO assessed by WC and WHtR was 48.8 and 46.9%, respectively. The rate of AO was significantly higher (p < 0.05) among boys compared to girls for both assessment criteria. The proportion of adolescents with AO (WHtR ≥ 0.5) according to BMI was 17.3%, 80.8% and 97.1% for adolescents with normal, overweight and obesity had AO, respectively. Being male was significantly associated with higher odds of having both general obesity and AO. Originality/value The study revealed a high prevalence of general and abdominal obesity in adolescents in Qatar. Waist measures appear to be an important indicator in identifying adolescents at risk and should be included as screening tools for cardiometabolic risk.

Background The Qatar Dietary Guidelines (QDGs) were developed as part of the national strategy to prevent chronic diseases. This study aims at characterizing gaps between the QDGs and usual dietary and lifestyle patterns in Qatar, identifying demographic and socioeconomic determinants of adherence to the QDGs and investigating the association between adherence and cardiometabolic risk. Methods This study is based on the Qatar National STEPwise cross-sectional survey which was conducted on a nationally representative sample of Qatari adults, aged 18 to 64 years (n = 1109). Data collection included socio-demographic characteristics, lifestyle factors, anthropometric (weight, height and waist circumference (WC)), and blood pressure measurements. The dietary intake of participants was evaluated using a non-quantitative food frequency questionnaire (FFQ). Biochemical assessment was performed to measure the fasting levels of blood sugar, triglycerides (TG) and HDL cholesterol. The metabolic syndrome (MetS) was defined as the presence of three or more cardiometabolic risk factors. To examine adherence to the guidelines, each specifc recommendation was matched to corresponding data drawn from the survey. To investigate the association of sociodemographic, lifestyle and cardiometabolic characteristics with adherence to the QDGs, an adherence score was calculated. Results More than 83% of adults did not meet the recommendations for vegetables, fruits, whole grains, legumes and high fibre intakes, 70% were overweight or obese, 50–72% reported frequent consumption of sweetened beverages and sweets, and 47% reported frequent consumption of fast foods. Younger adults, the unemployed, the least educated and those not married had lower adherence to the QDGs. Adherence was inversely associated with elevated WC (OR: 0.88, 95% CI:0.82–0.95) and the MetS (OR:0.84,95% CI:0.74–0.96). Conclusions Building on the identified gaps and vulnerable population groups, the study findings should provide a road map for the prioritization of interventions and the development of culture- specific programs aiming at promoting adherence to dietary guidelines in Qatar, while serving as a model to other countries in the region.

Women of childbearing age are particularly vulnerable to the adverse effects of elevated blood pressure (BP), with dietary and lifestyle habits being increasingly recognized as important modifiable environmental risk factors for this condition. Using data from the National STEPwise survey conducted in Qatar in year 2012, we aimed to examine lifestyle patterns and their association with elevated BP among Qatari women of childbearing age (18–45 years). Socio-demographic, lifestyle, dietary, anthropometric and BP data were used (n = 747). Principal component factor analysis was applied to identify the patterns using the frequency of consumption of 13 foods/food groups, physical activity level, and smoking status. Multivariate logistic regression analyses were used to evaluate the association of the identified lifestyle patterns with elevated BP and to examine the socio-demographic correlates of these patterns. Three lifestyle patterns were identified: a “healthy” pattern characterized by intake of fruits, natural juices, and vegetables, a “fast food &amp, smoking” pattern characterized by fast foods, sweetened beverages, and sweets, in addition to smoking, and a “traditional sedentary” pattern which consisted of refined grains, dairy products, and meat in addition to low physical activity. The fast food &amp, smoking and the traditional &amp, sedentary patterns were associated with an approximately 2-fold increase in the risk of elevated BP in the study population. The findings of this study highlight the synergistic effect that diet, smoking and physical inactivity may have on the risk of elevated BP among Qatari women.

Summary Background The Arab world has a set of historical, geopolitical, social, cultural, and economic characteristics and has been involved in several wars that have affected the burden of disease. Moreover, financial and human resources vary widely across the region. We aimed to examine the burden of diseases and injuries in the Arab world for 1990, 2005, and 2010 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010). Methods We divided the 22 countries of the Arab League into three categories according to their gross national income: low-income countries (LICs; Comoros, Djibouti, Mauritania, Yemen, and Somalia), middle-income countries (MICs; Algeria, Egypt, Iraq, Jordan, Lebanon, Libya, Morocco, occupied Palestinian territory, Sudan, Syria, and Tunisia), and high-income countries (HICs; Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). For the whole Arab world, each income group, and each individual country, we estimated causes of death, disability-adjusted life years (DALYs), DALY-attributable risk factors, years of life lived with disability (YLDs), years of life lost due to premature mortality (YLLs), and life expectancy by age and sex for 1990, 2005, and 2010. Findings Ischaemic heart disease was the top cause of death in the Arab world in 2010 (contributing to 14·3% of deaths), replacing lower respiratory infections, which were the leading cause of death in 1990 (11·0%). Lower respiratory infections contributed to the highest proportion of DALYs overall (6·0%), and in female indivduals (6·1%), but ischaemic heart disease was the leading cause of DALYs in male individuals (6·0%). DALYs from non-communicable diseases—especially ischaemic heart disease, mental disorders such as depression and anxiety, musculoskeletal disorders including low back pain and neck pain, diabetes, and cirrhosis—increased since 1990. Major depressive disorder was ranked first as a cause of YLDs in 1990, 2005, and 2010, and lower respiratory infections remained the leading cause of YLLs in 2010 (9·2%). The burden from HIV/AIDS also increased substantially, specifically in LICs and MICs, and road injuries continued to rank highly as a cause of death and DALYs, especially in HICs. Deaths due to suboptimal breastfeeding declined from sixth place in 1990 to tenth place in 2010, and childhood underweight declined from fifth to 11th place. Interpretation Since 1990, premature death and disability caused by communicable, newborn, nutritional, and maternal disorders (with the exception of HIV/AIDS) has decreased in the Arab world—although these disorders do still persist in LICs—whereas the burden of non-communicable diseases and injuries has increased. The changes in the burden of disease will challenge already stretched human and financial resources because many Arab countries are now dealing with both non-communicable and infectious diseases. A road map for health in the Arab world is urgently needed. Funding Bill & Melinda Gates Foundation.

This study investigated the effect of lifestyle patterns, as a combination of diet, physical activity and smoking, on Metabolic Syndrome (MetS) among Qatari women of childbearing age (n = 418), a population group particularly vulnerable to the health sequela of this syndrome. Using data from the National WHO STEPwise survey conducted in Qatar in 2012, Principal Component Factor Analysis was performed to derive lifestyle patterns with survey variables related to the frequency of consumption of 13 foods/food groups, physical activity levels, and smoking status. MetS was diagnosed using ATPIII criteria. Three lifestyle patterns were identified: ‘High Risk’ pattern, characterized by intakes of fast foods, sweets and sugar sweetened beverages, in addition to lower levels of physical activity and higher smoking prevalence; ‘Prudent’ pattern, driven mainly by higher intakes of fruits, vegetables, fish, and whole grains; and ‘Traditional’ pattern which included beans, meat, dairy products, and a low prevalence of smoking. Among these three lifestyle patterns, only the ‘High Risk’ was associated with MetS, whereby subjects belonging to the third tertile of this pattern’s score had 2.5 times the odds of MetS compared to those belonging to the first tertile. The findings of this study demonstrated the synergy among high risk behaviors among Qatari women in increasing the odds of MetS; the latter being a major risk factor for cardiovascular diseases.

Background The Middle East and North Africa region harbors significant proportions of stunting and wasting coupled with surging rates of non-communicable diseases (NCDs). Recent evidence identified nutrition during the first 1000 days of life as a common denominator not only for optimal growth but also for curbing the risk of NCDs later in life. The main objective of this manuscript is to describe the protocol of the first cohort in the region to investigate the association of nutrition imbalances early in life with birth outcomes, growth patterns, as well as early determinants of non-communicable diseases. More specifically the cohort aims to1) examine the effects of maternal and early child nutrition and lifestyle characteristics on birth outcomes and growth patterns and 2) develop evidence-based nutrition and lifestyle guidelines for pregnant women and young children. Methods/design A multidisciplinary team of researchers was established from governmental and private academic and health sectors in Lebanon and Qatar to launch the Mother and Infant Nutritional Assessment 3-year cohort study. Pregnant women (n = 250 from Beirut, n = 250 from Doha) in their first trimester are recruited from healthcare centers in Beirut, Lebanon and Doha, Qatar. Participants are interviewed three times during pregnancy (once every trimester) and seven times at and after delivery (when the child is 4, 6, 9, 12, 18, and 24 months old). Delivery and birth data is obtained from hospital records. Data collection includes maternal socio-demographic and lifestyle characteristics, dietary intake, anthropometric measurements, and household food security data. For biochemical assessment of various indicators of nutritional status, a blood sample is obtained from women during their first trimester. Breastfeeding and complementary feeding practices, dietary intake, as well as anthropometric measurements of children are also examined. The Delphi technique will be used for the development of the nutrition and lifestyle guidelines. Discussion The Mother and Infant Nutritional Assessment study protocol provides a model for collaborations between countries of different socio-economic levels within the same region to improve research efficiency in the field of early nutrition thus potentially leading to healthier pregnancies, mothers, infants, and children. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0864-5) contains supplementary material, which is available to authorized users.

Background and Objectives: Type 2 diabetes mellitus (T2DM) is a major health problem in Qatar. The prevalence of T2DM in the adult population of Qatar is approximately 16% (twice that in the USA) and the country is ranked sixth in the world for diabetes prevalence. The number of cases of childhood diabetes in Qatar has doubled in ten years. The rapid rise of T2DM cases is thought to be due, in part, to genetic factors that interact with lifestyle factors including, but not limited to, poor nutrition, lack of physical activity and obesity. Recent evidence suggests that lack of vitamin D and inflammation may also play a role. Methods: We examined the current knowledge from literature linking T2DM to the chronic low-grade inflammation and the possible role of vitamin D in attenuating the inflammatory factors and, thereby, preventing T2DM. Results: Low-grade inflammation resulting from imbalances in the innate immune system has been associated with an array of chronic disorders that predispose to the later development of T2DM (e.g., obesity, metabolic syndrome, and insulin resistance). As a result, inflammation may contribute to the pathogenesis of T2DM. Therefore, attenuation of this inflammatory response via modulating the innate immune system could lead to improved insulin sensitivity and delayed disease onset. Dietary supplementation with vitamin D, may present a novel strategy toward the prevention and control of T2DM at the population level due to its anti-inflammatory and antioxidant properties. Conclusion: The concept that vitamin D, via attenuating inflammation, could be employed as a novel preventative measure for T2DM, is evaluated in the context of its relevance to healthcare and public health practices. Overall, to reduce the disease risk and burden at the population level, preventative strategies can be developed to include vitamin D supplementation into the traditional intervention protocols (e.g., exercise, life-style modification, etc.).

Background and Objectives: Vitamin D is thought to modulate cardiometabolic disease risk through effects on an array of disease-associated pathways, such as glucose and lipid metabolism and inflammation. Although vitamin D insufficiency is thought to play a role in the susceptibility to cardiometabolic disease, the association between the two conditions is yet to be investigated in both men and women from the general population. Methods: Subjects (n= 1,928, age range 16-79 yrs) from Canada were examined. Plasma 25-hydroxyvitamin D [25(OH)D] by month of clinic visit were plotted for men and women to examine the monthly fluctuation patterns. Linear regression models adjusted for sex, waist circumference, physical activity, hormone use, and season of clinic visit examined the linear associations between 25(OH)D and cardiometabolic biomarkers [glucose, insulin, HOMA-IR, triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total:HDL-C ratio, apolipoprotein(apo)A1, apoB] and biomarkers of inflammation [C reactive protein (CRP), fibrinogen, and homocysteine]. Analyses were repeated separately for men and women. Results: Monthly variation in 25(OH)D was noted for both men and women, with mean levels fluctuating more widely throughout the year in men (50 to 80 nmol/L) than in women (60 to 75 nmol/L). Significant inverse associations with 25(OH)D were noted for insulin (β= -0.16, p=0 .003), HOMA-IR (β= -0.18, p= 0.002), triglycerides (β= -0.21, p= 0.004), total cholesterol (β= -0.31, p= 0.046), LDL-C (β= 0.09, p= 0.02), and total:HDL-C ratio (β= -0.09, p= 0.004). When the population was stratified by sex, significant inverse associations with 25(OH)D were observed for insulin (β= -0.21, p= 0.002), HOMA-IR (β= -0.24, p= 0.002), and triglycerides (β= -0.26, p= 0.01) among men, and insulin (β= 0.13, p= 0.05), HOMA-IR (β= -0.14, p= 0.03), total cholesterol (β= -0.34, p= 0.05), LDL-C (β= -0.10, p= 0.02), and total:HDL-C ratio (β= -0.10, p= 0.001) among women. Conclusions: Plasma 25(OH)D levels vary month-to-month, and fluctuate more widely in men than in women. Vitamin D may modulate multiple processes related to the cardiometabolic biomarkers and disease risk and may, thereby, play a role in disease prevention.

Background and Objectives: Obesity is associated with a state of chronic inflammation and increased cardiometabolic disease risk. The present study examined the relationship between body mass index (BMI) and cardiometabolic and inflammatory biomarkers among normal weight, overweight, and obese subjects. Methods: Subjects (n = 1,805, aged 18 to 79 years) from Canada were examined for associations between BMI, cardiometabolic markers [apolipoprotein (Apo) A1, ApoB, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol, total:HDL-C ratio, triglycerides, and glycosylated hemoglobin (HbA1c)], inflammatory factors [C-reactive protein (CRP), fibrinogen, and homocysteine), and 25-hydroxyvitamin D [25(OH)D]. Bootstrap weights for variance and sampling weights for point estimates were applied to account for the complex survey design. Linear regression models adjusted for age, sex, physical activity, smoking status, and ethnicity (in addition to season of clinic visit for vitamin D analyses only) were used to examine the association between cardiometabolic markers, inflammatory factors, and BMI in adults. Results: All biomarkers were significantly associated with BMI (P≤0.001). ApoA1 (β= 0.31, P

Background and Objectives: The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and certain sub-populations appear especially vulnerable to developing the disease. In Qatar, the prevalence of T2DM in the adult population is approximately twice that in the USA. Qatar is ranked sixth in the world for diabetes prevalence. Risk of disease in the country is increasing with an apparent doubling of incidence in children from 1997 to 2007. To reduce T2DM risk and progression, preventative strategies need to be implemented on a population-wide scale with minimal cost and effort and without adverse effect. Our objective was to examine the utility of micronutrients in the prevention of type 2 diabetes and its complications and to evaluate the pathway(s) through which these dietary factors exert their effect. Methods: We searched the available literature linking oxidation, inflammatory signaling pathways, and micronutrient intake to T2DM. Results: The rise of T2DM rates is thought to be due, in part, to genetic factors that interact with lifestyle factors including, but not limited to, poor nutrition, lack of physical activity and obesity. However, chronic low-grade inflammation resulting from oxidative stress and imbalances in the innate immune system has been also linked to the pathogenesis of T2DM. Reducing inflammation via modulation of oxidative stress and the innate immune response could lead to a status of improved insulin sensitivity and delayed disease onset. Dietary supplementation with anti-inflammatory and antioxidant micronutrients might present a feasible strategy toward the prevention of T2DM at the population level, particularly in vulnerable sub-populations. Conclusion: Several lines of evidence support the concept of employing micronutrients as a preventative measure for T2DM via attenuating inflammation and modulating oxidative stress. This approach may be introduced as part of a population-based strategy to curb the rising incidence of T2DM in Qatar and facilitate developing public health policies and actions for disease prevention and control.