Overweight and Obesity in the Eastern Mediterranean Region
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- Abstract BACKGROUND
- Prevalence of and Factors Associated with Overweight and Obesity among a Group of Iraqi Women.
- Cut-Off Values for Anthropometric Variables that Confer Increased Risk of Type 2 Diabetes Mellitus and Hypertension in Iraq.
- Abstract BACKGROUND
- CONCLUSIONS
- Health-Related Quality of Life of Adolescents with Overweight or Obesity in the North of Jordan.
- Metabolic Abnormalities Associated with Obesity in Children and Adolescents in Jordan.
- Overweight and Obesity and Their Correlates among Jordanian Adolescents.
- Abstract PURPOSE
- DESIGN
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Abstract PURPOSE: The current wars in Iraq and Afghanistan have led to an increasing number of female veterans seeking medical and mental healthcare in the Department of Veterans Affairs (VA) healthcare system. To better understand gender differences in healthcare needs among recently returned veterans, we examined the prevalence of positive screenings for depression, posttraumatic stress disorder (PTSD), military sexual trauma (MST), obesity, and chronic pain among female and male veterans of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) receiving care at the VA Connecticut Healthcare System.
OEF/OIF veterans at VA Connecticut who received services in either Primary Care or the Women's Health Clinic between 2001 and 2006.
women) were examined. Female veterans were more likely to screen posi ve for MST (14% vs. 1%, p < 0.001) and depression (48% vs. 39%, p = 0.01) and less likely to screen posi ve for PTSD (21% vs. 33%, p = 0.002). There was no significant gender difference in clinically significant pain scores. Men were more likely than women to have body mass index (BMI) >30 kg/m(2) (21% vs. 13%, p = 0.008).
exist in the prevalence of positive screenings for MST, depression, obesity, and PTSD. As the VA continues to review and improve its services for women veterans, clinicians, researchers, and senior leaders should consider innovative ways to ensure that female veterans receive the health services they need within the VA system.
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Rural Remote Health. 2007 Oct-Dec;7(4):765. Epub 2007 Dec 9. Cut-Off Values for Waist Circumference in Rural Iraqi Adults for the Diagnosis of Metabolic Syndrome. Mansour AA, Al-Hassan AA, Al-Jazairi MI. Department of Medicine, Basrah College of Medicine, Iraq. aambaam@yahoo.com Abstract BACKGROUND: The determination of cutoff points for healthy waist circumference (WC) is of paramount importance for prevention, optimum management, and prognostication of obesity, the metabolic syndrome (MetS), type 2 diabetes mellitus, and coronary heart disease. The aim of this project was to establish the cutoff level for WC in rural Basrah in Iraq, one of the eastern Mediterranean and Middle East (Arab) populations. METHODS: This was a community-based, cross-sectional survey for establishing the normal value for WC among a rural district population in Basrah (Abu-Al-khasib), Iraq. A stratified sampling procedure was used for sample selection. RESULTS: The cutoff level yielding maximum sensitivity and specificity for predic ng the presence of mul ple risk factors was 97 cm in men and 99 cm in women. Sensi vity and specificity using these cutoff values were 70% and 50%, respec vely, in men and 70% and 45%, respec vely, in women. CONCLUSION: We propose the optimal cutoff point for WC for the diagnosis of MetS in the Iraqi adult rural popula on as 99 cm in women and 97 cm in men.
East Mediterr Health J. 2007 Mar-Apr;13(2):420-9. Prevalence of and Factors Associated with Overweight and Obesity among a Group of Iraqi Women. Al-Tawil NG, Abdulla MM, Abdul Ameer AJ. Department of Community Medicine, College of Medicine, AI-Nahrain University, AI-Kadhimiya, Baghdad, Iraq. altaweeln@yahoo.com Abstract We studied the prevalence and factors associated with overweight and obesity among 200 non-pregnant Iraqi women (> 18 years) a ending 2 outpatient clinics in Baghdad. The women were interviewed using a 279
questionnaire and had their body mass index (BMI) and waist-to-hip ratio (WHR) calculated. Only 24% of the women were normal weight: 39%, 25% and 12% were overweight (BMI 25-29.9 kg/m2), obese (> or =30 kg/m2) and morbidly obese (> or = 40 kg/m2) respec vely. While the mean WHR was normal, the mean waist circumference was higher than normal. Factors significantly associated with overweight and obesity were older age, history of previous laparotomy and type of clothing worn (gown) inside the home.
Arch Med Res. 2007 Feb;38(2):253-8. Cut-Off Values for Anthropometric Variables that Confer Increased Risk of Type 2 Diabetes Mellitus and Hypertension in Iraq. Mansour AA, Al-Jazairi MI. Department of Medicine, Basrah College of Medicine, Basrah, Iraq
. aambaam@yahoo.com Abstract BACKGROUND: Body mass index (BMI) is often used to reflect total body fat amount (general obesity), whereas waist circumference (WC), waist-to- hip ratio (WHpR) or waist-to height ratio (WHtR) is used as a surrogate of body fat centralization (central obesity). The purpose of the present study was to identify cut-offs for BMI and upper-body adiposity (WC, WHpR, and WHtR) that, associated with increased risk of type 2 DM and hypertension in Iraqi adults, would be consistent with overweight and central adiposity.
establishing cut-off values for BMI and upper-body adiposity (WC, WHpR or WHtR) associated with increased risk of type 2 DM and hypertension from one district in Southern Iraq, Basrah (Abu-Al-khasib). The total number of persons involved was 12,986 (6693 men and 6293 women), aged 45.6 +/- 15.7 years. RESULTS: The cut-off point in men associated with increased risk of type 2 DM and hypertension were BMI 25.4 and 24.9, WC 90 and 95 cm, WHpR 0.92 for both and WHtR 0.52 and 0.55, respec vely. For women, the cut-off point associated with increased risk of type 2 DM and hypertension were BMI 26.1 and 26.5, WC 91 and 95 cm, WHpR 0.91 for both, and for WHtR 0.56 and 0.59, respec vely. The best index for associa on with type 2 DM was WHpR with cut-off point of 0.92 for men and 0.91 for women. For
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hypertension, the best index is WHtR (with cut-off point of 0.55 for men and 0.59 for women), whereas the least reliable index was the BMI for both type 2 DM and hypertension.
strongest associa on with type 2 DM and WHtR for hypertension.
Ann Saudi Med. 2005 Sep-Oct;25(5):389-93. Childhood Obesity in Iraq: Prevalence and Possible Risk Factors. Lafta RK, Kadhim MJ. Community Medicine Department, College Of Medicine, Mustansiriyah University Baghdad, Iraq .
BACKGROUND: Childhood obesity is increasing in prevalence in developing countries. We conducted this study to assess the prevalence of overweight and obesity in primary school children age 7 to 13 years in central Iraq and to identify possible risk factors. METHODS: The study was conducted in Babil governorate from October through March 2002. Eight thousand three hundred pupils (4100 girls and 4200 boys) randomly chosen primary schools were included in the study. BMI was measured and compared to standard tables. Information on possible risk factors was collected by questionnaire.
respectively. Significant associations were found between overweight and age, residency (urban-rural), birth rank, breast-feeding and certain dietary and lifestyle practices. CONCLUSION: The prevalence of obesity and overweight is relatively high in children in central Iraq. Modern dietary habits are an important influence in the development of childhood obesity that should be watched carefully and controlled.
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JORDAN
Int J Pediatr Obes. 2011 Aug;6(3-4):215-22. Epub 2011 May 24. Metabolic Abnormalities Associated with Obesity in Children and Adolescents in Jordan. Khader YS, Batieha A, Jaddou H, Batieha Z, El-Khateeb M, Ajlouni K. Department of Community Medicine, Public Health and Family Medicine Faculty of Medicine/Jordan University of Science & Technology , Irbid , Jordan. yousef.k@excite.com
Abstract Objective. To estimate the prevalence of overweight and obesity among Jordanian children and adolescents and to determine their association with metabolic abnormalities. Methods. In a national population-based household survey, a systematic sample of households was selected. All members aged ?7 years in the selected households were invited to par cipate in the study. Of the respondents, 1,034 subjects were 18 years old or younger. Anthropometric and biochemical measurements were obtained. Overweight and obesity were defined according to age and sex specific cut-off points of BMI defined by the International Obesity Task Force criteria proposed by Cole et al. The metabolic abnormalities were defined for subjects, based on their age, according to the definition of Cook et al. and International Diabetes Federation (IDF) criteria. Results. The overall prevalence of overweight and obesity among children were 6.0% and 5.5%, respec vely. Among adolescents, the overall prevalence rates of overweight and obesity were 13.7% and 10.0%, respec vely. A er adjus ng for gender and age, overweight was significantly associated with increased odds of having high triglycerides (Odds ra o [OR] = 1.7), low HDL- cholesterol (OR = 1.9), and at least one metabolic abnormality (OR = 2.2). Obesity was significantly associated with increased odds of individual metabolic abnormalities and their clustering. Conclusions. A relatively high proportion of Jordanian children and adolescents had overweight or obesity. Overweight and obesity in children and adolescents were associated with increased odds of metabolic abnormalities and their clustering. Programs addressing eating behavior and physical activity of children and adolescents to maintain a healthy weight are needed in Jordan.
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Child Care Health Dev. 2011 May 27. doi: 10.1111/j.1365- 2214.2011.01248.x. [Epub ahead of print] Health-Related Quality of Life of Adolescents with Overweight or Obesity in the North of Jordan. Al-Akour NA, Khader YS, Khassawneh MY, Bawadi H. Maternal-Child Health Nursing, School of Nursing, Jordan
University of Science and Technology (JUST) Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan
University of Science and Technology (JUST) Pediatric Department, Faculty of Medicine, Jordan University of Science and Technology (JUST), and Department of Nutrition and Food Technology, Jordan
University of Science and Technology, Irbid, Jordan .
Previous studies showed that overweight and obesity in children Background and adolescents are associated with impaired health-related quality of life (QOL). The objective of this study was to describe health- related QOL among This is a Jordanian adolescents who were overweight or obese. Methods cross-sectional study conducted among Jordanian students aged between 13 and 18 years in three educa onal directorates in Irbid City in the north of Jordan. Using simple random sampling, two male schools and two female schools were selected from the list of each directorate to represent all schools in north of Jordan. In each selected school, all adolescents aged 13-18 years were visited in their classes and were invited to par cipate in the study. Of the total number of 1561 subjects, 1433 (91.8%) agreed to par cipate in the study. The short-form 15-item Pediatric Quality of Life Inventory version 4.00 was used to measure health-related QOL among participants. Body mass index (BMI) was calculated and interpreted according to the BMI-for-age growth charts of the This study Center for Disease Control and Prevention guidelines. Results included 707 boys and 726 girls; 17.6% of par cipants were overweight and 7.8% were obese. For boys and girls, adolescents who were overweight or obese had significantly lower average scores for psychosocial health summary scale and physical functioning scale. Female gender, age of 16-18 years, fathers' educa on of high school or less and unemployed fathers (for social functioning and physical functioning) were significantly associated with decreased average scores of all scales and subscales of Pediatric Quality of Life Inventory. Compared with healthy adolescents, 283
adolescents who were overweight Conclusions or obese reported significantly lower health-related QOL in all domains. Girls reported greater effect of overweight and obesity on their health-related QOL.
Int J Pediatr Obes. 2011 May 24. [Epub ahead of print] Metabolic Abnormalities Associated with Obesity in Children and Adolescents in Jordan. Khader YS, Batieha A, Jaddou H, Batieha Z, El-Khateeb M, Ajlouni K. Department of Community Medicine, Public Health and Family Medicine Faculty of Medicine/ Jordan University of Science & Technology , Irbid , Jordan . yousef.k@excite.com Abstract Abstract Objective. To estimate the prevalence of overweight and obesity among Jordanian children and adolescents and to determine their association with metabolic abnormalities. Methods. In a national population-based household survey, a systematic sample of households was selected. All members aged ≥7 years in the selected households were invited to par cipate in the study. Of the respondents, 1,034 subjects were 18 years old or younger. Anthropometric and biochemical measurements were obtained. Overweight and obesity were defined according to age and sex specific cut-off points of BMI defined by the International Obesity Task Force criteria proposed by Cole et al. The metabolic abnormalities were defined for subjects, based on their age, according to the definition of Cook et al. and International Diabetes Federation (IDF) criteria. Results. The overall prevalence of overweight and obesity among children were 6.0% and 5.5%, respectively. Among adolescents, the overall prevalence rates of overweight and obesity were 13.7% and 10.0%, respec vely. A er adjus ng for gender and age, overweight was significantly associated with increased odds of having high triglycerides (Odds ra o [OR] = 1.7), low HDL- cholesterol (OR = 1.9), and at least one metabolic abnormality (OR = 2.2). Obesity was significantly associated with increased odds of individual metabolic abnormalities and their clustering. Conclusions. A relatively high proportion of Jordanian children and adolescents had overweight or obesity. Overweight and obesity in children and adolescents were associated with increased odds of metabolic abnormalities and their clustering. Programs addressing eating behavior and physical activity of children and adolescents to maintain a healthy weight are needed in Jordan.
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Metab Syndr Relat Disord. 2011 Apr;9(2):151-6. Epub 2010 Dec 29. Factor Analysis of Cardiometabolic Risk Factors Clustering in Children and Adolescents. Khader YS, Batieha A, Jaddou H, Batieha Z, El-Khateeb M, Ajlouni K. Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan. yousef.k@excite.com
metabolic syndrome components in children and adolescents is scarce. This study was conducted to explore the factor structure of the central metabolic syndrome variables in Jordanian children and adolescents using exploratory factor analysis.
identified in a national population-based household survey in Jordan. Their anthropometric and laboratory measurements were obtained. Factor analysis was performed on standardized variables to produce the minimum number of factors that retains as much of the total variance in the original data as possible. RESULTS: Factor analysis showed that one common factor is not sufficient to underlie metabolic syndrome. Four factors were extracted in the exploratory factor analysis-adiposity factor, blood pressure factor, lipids factor, and blood glucose factor. The cumulative percent of variance accounted for by the four factors together was 78.7% in male children, 86.9% in female children, 82.5% in male adolescents, and 83.4% in female adolescents. The adiposity factor accounted for the largest proportion of the total variance in the four groups. CONCLUSIONS: The factor analysis of cardiovascular risk clustering in Jordanian children and adolescents suggests that multiple factors account for the clustering of the metabolic syndrome components. Obesity accounts for the maximum variance in clustering and appears to be a more powerful correlate of cardiovascular risk in children and adolescents.
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Health Educ Behav. 2011 Feb;38(1):91-8. Epub 2010 Dec 17. Obesity and Body Size Preferences of Jordanian Women. Madanat H, Hawks SR, Angeles HN. San Diego State University, San Diego, CA, USA. hmadanat@mail.sdsu.edu
The nutrition transition is associated with increased obesity rates and increased desire to be thin. This study evaluates the relationship between actual body size and desired body size among a representative sample of 800 Jordanian women. Using Stunkard's body silhouettes, women were asked to identify their current and ideal body sizes, healthy body size, and their perception of the body size preferred by men. Body mass index (BMI) calcula ons indicate that 53.8% of the women were overweight or obese. Their mean current body size was 5, which is consistent with the mean BMI of 26 in the sample. Although 66% of the women were dissa sfied with their body size, the desired weight loss was not extreme. Pearson correla on was posi ve (.858, p <.0001) between measured BMI and body silhouettes chosen as an indicator of current body size. Jordanian women seemed pulled between the traditional and Westernized body preferences. Possible cultural explanations are explored.
J Nurs Scholarsh. 2010 Dec;42(4):387-94. doi: 10.1111/j.1547- 5069.2010.01367.x. Epub 2010 Oct 7. Overweight and Obesity and Their Correlates among Jordanian Adolescents. Hamaideh SH, Al-Khateeb RY, Al-Rawashdeh AB. Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan. shaher29@hu.edu.jo Abstract PURPOSE: To provide current estimates of the prevalence of overweight and obesity among Jordanian adolescents 14 to 17 years of age living in Irbid Governorate, and to determine the factors that are associated with overweight and obesity. DESIGN: Descriptive correlational cross-sectional design was used. 286
METHODS: Body mass index, perceived stress, dietary habits, physical ac vity, and demographics of 824 Jordanian adolescents living in Irbid were measured through a multistage cluster sampling method.
6.3%, respec vely. The prevalence of overweight and obesity among boys was 17.2% and 5.7%, respec vely, and among girls was 21.0% and 7.0%, respectively. Both overweight and obesity rates were higher among girls. Physical activity, mother's educational level, and number of family members were negatively correlated with overweight and obesity. On the other hand, eating breakfast regularly, mother's weight, consumption of fried food, and perceived stress level were positively correlated with overweight and obesity.
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