Overweight and Obesity in the Eastern Mediterranean Region
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current body weight. One-third (33.5%) and 26.6% of the adolescents thought that their parents and their peers, respectively, would consider them to be overweight or obese. The percentage of adolescents who reported parental or peer underestimation was higher among those classified as overweight or obese than it was among those who were of normal weight. CONCLUSION: The study shows the existence of a distorted body image as reflected by failure of many overweight or obese adolescents to perceive themselves as such. Among Bahraini adolescents weight-related beliefs and attitudes exist at two ends of the spectrum: a tolerance of obesity at one end and an exaggerated concern for its occurrence at the other.
Br J Nutr. 2003 Oct; 90(4):837-44. Relationship between Body Composition and Blood Pressure in Bahraini Adolescents. Al-Sendi AM, Shetty P, Musaiger AO, Myatt M. College of Health Science, Ministry of Health, Bahrain.
The objective of the present study was to examine the relationship between body composition and blood pressure (BP) in Bahraini adolescents. A sample of 504 Bahraini schoolchildren aged 12-17 years (249 boys and 255 girls) was selected using a mul -stage stratified sampling procedure. BP measurements were performed on the students. Anthropometric data including weight, height, waist circumference (WC), hip circumference, and triceps, subscapular and medial calf skinfold thicknesses were also collected. BMI, percentage body fat, waist:hip (WHR), and subscapular:triceps skinfold ratio were calculated. Mean systolic BP and mean diastolic BP were higher in males than in females. Weight and height in boys and weight only in girls were significantly associated with systolic BP independent of age or percentage fat. Nearly 14 % of the adolescents were classified as having high BP. BMI and percentage body fat were significantly and positively associated with the risk of having high BP in the boys and girls. Adolescents with high WHR or WC, as indicators for central obesity, tended to have higher BP values. The results from the present study indicate that obesity influences the BP of Bahraini adolescents and that simple anthropometric measurements such as WHR and WC are useful in identifying children at risk of developing high BP. These findings together with the known tracking of BP from adolescence into adulthood underline
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the importance of establishing intervention programmes in order to prevent the development of childhood and adolescent obesity.
Ann Hum Biol. 2003 Jul-Aug;30(4):367-79. Anthropometric and Body Composition Indicators of Bahraini Adolescents. Al-Sendi AM, Shetty P, Musaiger AO. College of Health Science, Ministry of Health, Bahrain.
adulthood and predisposes the individual to some chronic diseases in later life. Body composition is a good indicator for assessing obesity and nutritional status of people. AIM: To determine the anthropometric and body composition characteristics of Bahraini adolescents and to compare these measurements with previously published data on the same age group. SUBJECTS OF METHODS: Cross-sec onal data on 506 Bahraini adolescents (249 boys and 257 girls) aged 12-17 years were collected in 2000. The sample was selected from intermediate and secondary schools using a multistage stratified sampling procedure. Anthropometric measurements, including weight, height, mid upper arm circumference, waist and hip circumference, triceps, subscapular and medial calf skinfold thickness, were performed on the adolescents. Body mass index (BMI), percent body fat, arm muscle circumference (AMC), arm muscle area (AMA), arm fat area (AFA), waist/hip ratio (WHR), and subscapular/triceps skinfold ratio (STR) were also calculated.
changes in body composition during puberty was observed. The findings showed that mean BMI, skinfold thickness and percent body fat were all higher than those reported in earlier studies on Bahraini adolescents of corresponding age range, indicating an increase in fat accumulation among the adolescent population. Bahraini adolescents were found to be shorter and of similar weight or even heavier than their Western counterparts, indicating a greater trend of obesity among Bahraini adolescents. CONCLUSION: A trend of greater obesity appears to have occurred in the Bahraini adolescents during the period between 1986 and 2000. These findings have important public health implications given recent evidence
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linking childhood and adolescent obesity to increased risk of obesity and morbidity in adulthood. Therefore, programmes to prevent the development of obesity in children and adolescents should be given a high priority.
Eur J Clin Nutr. 2003 Mar;57(3):471-4. Prevalence of Overweight and Obesity among Bahraini Adolescents: A Comparison between Three Different Sets of Criteria. Al-Sendi AM, Shetty P, Musaiger AO. Food and Nutrition Division, Food and Agriculture Organisation, Rome, Italy.
overweight and obesity among Bahraini adolescents using three different sets of criteria/standards.
Bahraini students (249 males and 257 females) between 12 and 17 y of age. The sample was selected using multistage stratified random sampling technique. MEASUREMENT: Anthropometric measurements including weight, height and triceps and subscapular skinfolds were taken on the adolescents. Age was verified against school records. To minimize inter-observer error, weight and height were taken by one person while skinfold was taken by two trained persons (one for each sex).
was high, especially in girls. Obesity was highest (21% in males and 35% in females) when the WHO recommended criteria of BMI for age and skinfolds for age percen les were applied and lowest (15% in boys and 18% in girls) when the age and sex specific BMI cut-off values of Cole et al were used. Compared with those of WHO criteria, estimates of overweight and obesity prevalence obtained with Must et al and Cole et al were generally close.
in the Bahraini adolescent population than was previously reported, especially among girls. The BMI reference values of Must et al and that of
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Cole et al gave relatively similar estimates and appear to be more practical for use in surveys aimed at estimating the prevalence of overweight and obesity among adolescents than the WHO recommended composite criteria.
J Biosoc Sci. 2002 Apr;34(2):277-81. Social and Lifestyle Factors Associated with Diabetes in the Adult Bahraini Population. Musaiger AO, Al-Mannai MA. Environmental and Biological Program, Bahrain Center for Studies and Research, Mananma. Abstract This paper aimed to assess the prevalence of known diabetes among Bahraini adults, and to determine associated social and lifestyle factors. A community-based survey was carried out on 514 adults aged 30-79 years. The overall prevalence of known diabetes was 9%. Using multivariate analysis, the risk of diabetes was found to be higher among older (50-79 years), female, illiterate, currently married, non-smoking people, those who did not walk regularly, overweight and obese people (BMI > or = 25), those who had a history of hypertension and those who consumed fresh vegetables more than 3 mes a week. However, only obesity was found to be significantly associated with diabetes (OR = 1.83, CI 1.48-4.15).
Saudi Med J. 2001 Sep;22(9):793-6. Blood Lipids and Body Fat in Bahraini Women. Al-Mannai A, Khalfan HA, Dickerson JW, Morgan JB. College of Medicine and Medical Sciences, Arabian Gulf University.
parameters of a representative sample from the population of overweight and obese, and average weight Bahraini women visi ng 2 health centers in Bahrain. METHODS: This study was conducted over a period of 4 months in 2 health centers in the urban city of Muharraq in Bahrain, namely Muharraq Health Center and Shaikh Salman Health Center. The association was examined between body mass index, and the distribution of body fat determined by 17
the waist hip ratio. Serum triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, as well as glucose levels were measured.
were of similar age (mean of 30.4 and 30.7 years) but differed significantly in their body mass index values; however, their mean waist hip ratio was similar (0.80 and 0.82). The type of obesity shown by these Bahraini women was not associated with an elevation of serum glucose concentrations, or with significant differences in either serum cholesterol or triglyceride concentrations. There was however, a statistically significant difference between the 2 groups with respect to the level of high-density lipoprotein cholesterol, which was lower in the obese group, compared with the lean counterparts. Furthermore, the ratio of high-density lipoprotein to low- density lipoprotein cholesterol was significantly lower in the obese subjects, compared with the controls. CONCLUSION: Obesity in a group of Bahraini women was associated with indices predisposing to coronary heart disease, and this has public health implications.
Ann Saudi Med. 2001 May-Jul;21(3-4):183-7. Obesity among Adult Bahraini Population: Impact of Physical Activity and Educational Level. Al-Mahroos F, Al-Roomi K. Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain. Abstract BACKGROUND: In the populations of the Arabian Peninsula, obesity has emerged as the leading cause of morbidity and mortality over a 25-year period of swift socioeconomic progress. The objective of this study was to determine the body weight distribution, prevalence and risk factors for the overweight and obese in the native adult Bahraini population.
community survey was conducted involving 2013 Bahraini subjects aged 40- 69. The males were aged 40-59 years, with a mean age of 49 years, while the females were aged 50-69 years, with a mean age of 59. The sample was adjusted for gender, age, and area of residence distribution. A questionnaire describing the demographic, social, educational status and 18
income status was completed. Measurements were made of height and weight, and body mass index (BMI) was calculated for each subject. WHO classifica on was used for defining overweight (BMI 25-29.9 kg/m 2) and obesity (BMI > or =30 kg/m(2)) categories. RESULTS: The age-standardized prevalence rate among native Bahraini men and women was high. Approximately 32% of women and 25% of men were obese (BMI > or =30.0 kg/m(2)). The prevalence of obesity was significantly higher among female subjects than males throughout all the age groups. Overweight and obesity were more prevalent among those with higher levels of education and people with high incomes. A significant relationship was found between obesity and education, physical inactivity and TV watching of 16 hours a week or more. Subjects' self-appraisal and their report of physicians' diagnosis of health disorders revealed a significantly higher prevalence of ill health among obese subjects. There was a progressive decrease of BMI for male and female subjects with age. Although 28% of par cipants (564) had body mass index > or =30 kg/m(2), only 42% (267) of these obese individuals rated themselves as overweight. In addition, obesity was inversely related to physical activity at work in men.
native middle-aged and elderly Bahraini population is high. We noted that the prevalence of obesity increased as the level of education increased, which reflects the perception of obesity being a sign of affluence among Bahraini population. There is a necessity to develop an action plan for controlling obesity and its metabolic consequences among the populations of the Arabian Gulf.
Ann Hum Biol. 2001 May-Jun;28(3):346-50. Weight, Height, Body Mass Index and Prevalence of Obesity among the Adult Population in Bahrain. Musaiger AO, Al-Mannai MA. Environmental and Biological Programme, Bahrain Centre for Studies and Research, Manama. amusaiger@bcsr.gov.bh Abstract PRIMARY OBJECTIVES: To determine anthropometric measurements (weight, height, body mass index, BMI), and the prevalence of overweight and obesity based on BMI.
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METHODS AND PROCEDURES: A cross-sec onal survey of 514 Bahraini na ve adults aged 30-79 years was selected from households using clustering sampling technique.
shorter but heavier, and have higher mean BMI than their Western counterparts, suggesting a trend to obesity. The overall prevalence of overweight and obesity was 35.2% and 21.2% for men, while that for women was 31% and 48.7%, respec vely.
Arabian Gulf countries, as obesity is a major public health problem among the adult population. Anthropometrics provided in this study can be used as baseline data for the adult population of Bahrain.
Ecology of Food and Nutrition, Volume 39, Issue 2, 2000, Pages 121 - 133 Lifestyle and Social Factors Associated with Obesity among the Bahraini Adult Population Abdulrahman O. Musaiger a ; Abdul-hai A. Al-Awadi b ; Mariam A. Al-Mannai c a
Research, Manama, Bahrain b Salmaniya Medical Complex, Ministry of Health, Bahrain c College of Science, Bahrain University, Bahrain Abstract A cross-sec onal survey on 514 Bahraini na ves aged 30-79 years was carried out to study the lifestyle and social factors associated with obesity. Body mass index, BMI (weight, kg/high, m 2 ) was used to determine obesity among the study population. Obesity was considered when the subject had BMI equal to or greater than 25. The overall prevalence of obesity was 56% in men and 79.6% in women. Age, sex, educa on, smoking and history of diabetes and hypertension, watching television and frequency of fruit intake had a significant association with obesity. When a multiple logistic regression was used to estimate the risk of occurrence of obesity, it was found that the risk of obesity is greater in subjects who were females, educated, currently married, watching television daily, non-smokers, consuming fresh fruit more than three times a week and having a history of diabetes and hypertension. Lifestyle, dietary habits and social factors should be considered, therefore, in any health programme to prevent and control obesity in this community. 20
Ann Hum Biol. 2000 Sep-Oct;27(5):507-15. Anthropometry of Adolescent Girls in Bahrain, Including Body Fat Distribution. Musaiger AO, Al-Ansari M, Al-Mannai M. Environmental and Biological Programme, Bahrain
Center for Studies and Research, Manama. Abstract PRIMARY OBJECTIVE: To determine anthropometric measurements of adolescent Bahraini girls, including obesity and fat composition. METHODS AND PROCEDURES: A cross-sec onal sample of 584 Bahraini girls aged 12-19 years, were selected from schools using multistage stratified sampling procedure. Fifteen anthropometric measurements were taken (weight, height, circumferences for upper arm, upper forearm, upper chest, chest, waist, hip, thigh and medial calf, triceps, biceps, subscapular and suprailiac). Body mass index (BMI), waist/hip ratio, sum of skinfold thickness and % body fat were also computed.
increase in all anthropometric measurements with increase in age. The mean weights for girls was higher than those reported in 1986 for the same age group, but no difference was observed in the mean heights, indicating a trend toward overweight. Using the 85th and 95th cen les of the Na onal Health and Nutrition Examination Survey I (NHANESI) BMI distribution to define respectively overweight and obesity, the prevalence of overweight was 38.5% and of obesity was 6.3%. The means for BMI, waist/hip ra o, sum of skinfold thickness and % body fat were higher than those reported in many developed and developing countries. CONCLUSIONS: Bahraini adolescent girls have a higher proportion of body fat than their counterparts in many Western countries. This may contribute to some chronic diseases in adulthood. An intervention program, therefore, is urgently needed to reduce overweight and obesity at childhood and adolescent stages.
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Int J Obes Relat Metab Disord. 2000 Sep;24(9):1093-6. Profile of Body Composi on of School Children (6-18y) in Bahrain. Musaiger AO, Gregory WB. Environmental and Biological Programme, Bahrain
Center for Studies and Research, Manama. Abstract OBJECTIVE: To study the body composition of Bahraini school children. DESIGN: Cross-sectional national school survey. SUBJECTS: School children aged 6-18y. The sample comprised 818 boys and 775 girls. MEASUREMENTS: Weight, height, arm circumference and skinfold thickness were measured. Sum of skinfold thickness, body mass index (BMI), mid arm circumference, percentage body fat, fat weight and lean body weight were then calculated to determine body composition. RESULTS: A significant difference in the sum of skinfold thickness was observed between boys and girls. The girls have almost 50% extra skinfold thickness than boys at all ages. Similar trends were found in BMI, except at ages 9 and 18y. The percentage of body fat was higher in girls than boys. The mean BMI for Bahraini girls aged 13y and above exceeds that of their American counterparts, indicating a trend towards fat accumulation in the Bahraini girls.
children in Bahrain as well as being usable as reference data for similar countries in the region. The high proportion of body fat among Bahraini school children, especially girls, urges an intervention program to prevent and control obesity in this age group.
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