Overweight and Obesity in the Eastern Mediterranean Region
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PARTICIPANTS: 118 obese pregnant females with a body mass index >32
undergoing CS were divided into two groups: group I (n = 78) with closed subcutaneous drainage system and group II (n = 40) without drainage system. Incision closure technique was standardized. Prophylactic antibiotics were given routinely to both groups.
breakdown in both groups together with rate of hematoma formation and occurrence of fever. Secondary outcomes were amount of fluid drained, need for redressing. RESULTS: Wound breakdown occurred in 9 cases in group I (11.5%), while it happened in 5 cases in group II (12.5%) (p > 0.05). Rela ve risk was 0.92 (95% CI 0.26-3.75). Hematoma forma on was observed in only 1 case in the nondrainage group (group II). Fever was observed in 18 cases in group I (23.1%) in the first 24 h postopera ve while in group II, 13 cases developed fever (32.5%) (p > 0.05). The need for redressing within the first 24 h was only in 2.5% of cases in group I while it was 17.9% in group II (p < 0.05).
drain as a prophylactic measure against wound breakdown in obese pregnant females undergoing CS as long as they received a prophylactic antibiotic.
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J Egypt Public Health Assoc. 2002;77(1-2):29-49. Impact of Life Style on the Nutritional Status of Medical Students at Ain Shams University. Bakr EM, Ismail NA, Mahaba HM. Department of Community, Occupational, and Environmental Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Abstract This cross sectional study was carried out to assess the nutritional status of medical students and to determine its relation to their life style. The study involved 317 students at, Am Shams University. Anthropometric measurements such as weight, height, mid-arm circumference, triceps skin fold thickness and body mass index were measured. The students completed a self-administered questionnaire including data about some life style factors and food-frequency consumption. The study revealed that 41.3% of the students were of normal weight while 9.5% of the sample were underweight, 36.9% were overweight and 12.5% were obese. The mean mid upper arm circumference (MUAC) and mid arm muscle circumference (MAMC) of males was significant higher than that of females, while the mean triceps skin fold (TSF) of females was significant higher than that of males. The food frequency questionnaire analysis showed that most of students consume all food groups items faire. There was no statistical significant difference between the body mass index (BMI) of students and different types of food consumption. About two thirds of the students used to prac ce exercise, 26.9% of the students prac ced exercise for less than 2 hours per week, while 33.9% of them for more than 2 hours. There was no statistical significant difference between the BMI of students and different types of exercise. However, there was significant higher percentage of males play sports and prac ce running (44.7% and 19.4% respec vely) compared to (11.7% and 8.1%) of females. Sixty four percent of the students usually have regular meals. About 87.2% of obese compared to 64.9% of normal weight students eat snacks between meals, the difference was statistically significant. Obese individuals eat more during watching television and during feeling of stress compared to non-obese and the difference was statistically significant. The duration of practicing exercise, sports and playing computer was significantly higher in males than females. However, the duration of watching television was significantly higher in females than males. Logistic regression analysis results showed that family history of obesity and some life style factors as duration of computer use, eating more during stress time and snacking between meals were important risk factors for obesity. We concluded that about half of medical 66
students were overweight and obese. The most important life style factors responsible for obesity were longer time spent using computer, eating more during time of stress and snacking between meals. Also, genetic factors played an important role in development of obesity. It is recommended to develop nutritional education and physical activities programs to face the problem of increasing the rate of overweight and obesity among university students.
Public Health Nutrition (2002),5:141-148. The Nutrition Transition in Egypt: Obesity, Undernutrition and The Food Consumption Context Osman M Galal a1a2
a1
School of Public Health, University of California, Box 951772, Los Angeles, CA 90095, USA a2 High Institute of Public Health, Alexandria University, Alexandria, Egypt Abstract OBJECTIVES: To describe changing food consumption patterns in Egypt over the last several decades, current levels of overweight and obesity, and current data on obesity-related morbidity.
level food consumption surveys, large recent surveys of hypertension and diabetes, and documentation of historical and policy context.
Results and conclusions: The nutrition transition in Egypt has occured in the context of abundant dietary energy availability, urbanisation and moderate fat intakes. The prevalence of obesity in adults is very high, particularly among women. The prevalences of diabetes mellitus and of hypertension parallel that of obesity, and both are very high. Little information is available on physical activity, but it is likely that a large proportion of the population is quite sedentary, particularly in the cities. At the same time, rates of early childhood malnutrition remain stubbornly stable and relatively high. Public awareness of the increasing prevalence of obesity and of diet-related chronic disease is increasing, and attention has turned to documenting the problem(s).
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East Mediterr Health J. 2001 Jul-Sep;7(4-5):716-24. Central Obesity in Elderly Individuals in South-Western Saudi Arabia: Prevalence and Associated Morbidity. Abolfotouh MA, Daffallah AA, Khan MY, Khattab MS, Abdulmoneim I. Department of Family Health, High Institute of Public Health, University of Alexandria, Alexandria, Egypt. mabolfotouh@yahoo.com Abstract Central obesity in all individuals aged 65 years and over (n = 810) in the catchment areas of three primary health care centres in Abha was determined from the waist circumference (WC) and waist-to-hip ratio (WHR). The age-adjusted prevalence of central obesity was 32.4% and 43.5% based on the WC and WHR indicators respec vely. WC was significantly associated with the risk of diabetes and hypertension, while WHR was significantly associated with the risk of diabetes only. These findings suggest that reducing the prevalence of central obesity in old age would decrease the risk of diabetes and hypertension. WC is a powerful independent predictor mainly of hypertension risk, while WHC is a good predictor of the risk of diabetes.
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Obes Surg. 2001 Jun;11(3):271-5. Laparoscopic Vertical Banded Gastroplasty: Early Experience. el Fiky KA. Surgical Department, Faculty of Medicine, Ain Shams University, Abbasia Square, Cairo, Egypt. khaled_fiky@hotmail.com Abstract BACKGROUND: The tremendous development of laparoscopic surgery in the last decade is being applied to bariatric surgery. Laparoscopic vertical banded gastroplasty (LVBG) is technically feasible by laparoscopy.
LVBG. The technical difficulties are discussed. RESULTS: Opera ng me ranged from 105 to 420 minutes. 11 pa ents have lost 45-55% of their original weight. Inser ng an esophageal bougie no. 11 from the beginning of the opera on and using the laparoscopic set- up described, made the procedure shorter, safer and easier for patients and surgeon.
surgeon who is experienced in the handling and control of laparoscopic instruments and hand-eye coordination. The early results are satisfactory. Preoperative counseling is an integral step for the operation. 69
Obes Surg. 2001 Feb;11(1):70-5. Egyptian Experience in Laparoscopic Adjustable Gastric Banding (Technique, Complications And Intermediate Results). Nowara HA. Cairo University, Egypt. surgery@mail.com
morbid obesity. The purpose of this study is to present an Egyptian experience of laparoscopic adjustable silicone gastric banding (LASGB) as a safe and effective treatment. METHODS: 108 morbidly obese pa ents having body mass index (BMI) > 40 kg/m2 were studied. 26 pa ents had a BMI > 50 kg/m2 and < 60 kg/m2, while 21 pa ents had a BMI > or = 60 kg/m2. The procedure was performed through a 4 or 5 trocar technique. RESULTS: Mean age was 32.3 years. Mean BMI was 48.9 kg/m2. All except two procedures were completed by laparoscopy. Mean hospital stay was 2.2 days. Mean BMI a er 12 months was 37.2 kg/m2 and a er 24 months was 34.3 kg/m2. Mean follow-up was 2.1 years and included 87 pa ents (81%). Complica ons included: gastric perfora on (1), pleural injury (1), liver injury (1), port complica ons (6), periband sepsis (1) and slippage (3). There were no mortalities in this series.
morbid obesity in Egyptian patients.
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Obes Surg. 2000 Dec;10(6):525-9. Bariatric Re-Operations: Are They Preventable? Gawdat K. Ain-Shams School of Medicine, Cairo, Egypt. kgawdat@eis.egnet.net
and every procedure appears to have advantages, drawbacks and failures. Re-operation is a part of bariatric surgery practice that is necessary in the event of failure. We analyzed the reasons for failure in the bariatric re- operation group.
a bariatric re-opera on. Of 203 bariatric operations performed in our ins tu on, 12 pa ents had a re-opera on (5.9%), and 5 pa ents had their primary procedure performed elsewhere. Mean age was 36.5 +/- 11 years, mean original weight 151.3 +/- 44.3 kg, mean BMI 58.4 +/- 16.9 kg/m2 and mean excess body weight (EBW) 94.4 +/- 43.5 kg. Mean height was 161 +/- 7.7 cm, and 15 pa ents were female (88.2%). The primary bariatric opera on was ver cal banded gastroplasty (VBG) in 15 pa ents (88.2%), Roux-en-Y gastric bypass (RYGBP) in 1 pa ent (5.9%), and gastric banding in 1 pa ent (5.9%). Dura on since the primary surgery was a mean of 15.6 months (range 1-72 months).
food intolerance (53%). 11 pa ents had VBG converted to RYGBP, 1 pa ent had a gastric banding converted to a BPD, 4 pa ents had their VBG converted to a gastro-gastrostomy, and 1 pa ent had a RYGBP staple dehiscence re-stapled.
super-obese patients, older patients, and sweets-consuming individuals undergo RYGBP or BPD as the primary operation rather than VBG or gastric banding. The use of staplers transecting and separating the gastric pouch from the remaining stomach can decrease staple dehiscence.
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J Egypt Public Health Assoc. 2000;75(5-6):437-59. Nutritional Status of Institutionalized and Free-Living Elderly in Alexandria. Shabayek MM, Saleh SI. Department of Nutrition, (CLFF) Agriculture Research Center.
Because of an increase in the number of elderly and the problems of nutrition associated with them, it is of interest to study the nutritional status of elderly persons in Alexandria City. The purpose of this study was to assess the nutritional status of elderly population and to compare between the nutritional status of those institutionalized and those living free. The study was conducted on 240 elderly persons (120 ins tu onalized and 120 free living) selected randomly from institutions and from different sites. The basic data, weight, height, body mass index (BMI) of each were recorded. Dietary intake study was done by using 24 hours recall for 3 consecutive days and food frequency were used to obtain the best estimate of food intake. Energy and nutrient intakes were obtained and compared with the recommended dietary allowance (RDAs). The main findings of the study revealed that the mean age of the institutionalized elderly was greater than those living free. Percent of obesity among females was 71.7% among free living and 45% among ins tu onalized. Under-nutrition was present in 11.7% and 8.3% of ins tu onalized males and females respectively. Food habits showed that institutionalized subjects consume more amounts of many food items than free-living. Total daily energy intake was found to be below the recommendation for all subjects, with higher intake among institutionalized than free living. Nutrient intakes among institutionalized and free living elderly were inadequate except thiamin, riboflavin, vitamin C and iron. The nutrients least adequately supplied in the diets of elderly are vitamin A and calcium along with energy deficits. In conclusion both institutionalized and free living are at risk for developing nutrient deficiencies. Deficient energy, calcium and vitamin A are common problems among most subjects. The composition of the diet among free living subjects seem to be also poor in some micronutrients. We recommended a nutrition intervention program and nutrition education to improve nutritional status of elderly people.
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IRAN Kajbaf et al. Italian Journal of Pediatrics 2011, 37:1 Relationship between Obesity and Asthma Symptoms among Children in Ahvaz, Iran: A Cross Sectional Study Tahereh Ziaei Kajbaf1*, Shideh Asar2†, Mohammad Reza Alipoor3† Abstract Background: Obesity has been identified as a risk factor for higher prevalence of asthma and asthma-related symptoms in children. The objective of this study was to evaluate the relationship between the prevalence of asthma symptoms and obesity among school-age children in the city of Ahvaz, Iran.
study through cluster sampling. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to identify the children who were currently suffering from asthma. Height and weight were measured and body mass index (BMI) was calculated in kg/m2. Overweight was defined as BMI greater than the age- and sex-specific 85th percen le, and obesity as BMI greater than the 95th percen le. We determined the relationship between obesity and asthma symptoms by chi- square tests.
overweight was 21.56%, 8.7%, 6.87%, and 9.5%, respec vely. The current prevalence of wheezing among obese and overweight children was 68.75% and 37%, respec vely, and there was a sta s cal associa on between obesity and the prevalence of current wheezing (p < 0.001), night cough (p
overweight were not associated with eczema and allergic rhinoconjunctivitis, so it seems that the pathophysiology of asthma in obese and overweight children is not related to allergy.
both overweight and obesity in both sexes among school-age children. 73
Journal of Isfahan Medical School, Special Issue on Health Promotion Prevalence of Obesity and Some Related Factors in 30- 70 Year- Old Population of Semnan Province, Iran Ali Rashidy Pour, Mojtaba Malek, Rahimeh Eskandarian, Raheb Ghorbani Abstract BACKGROUND: Nowadays, obesity is one of the most common diseases and its prevalence has been increased in recent years. As obesity is a risk factor for many diseases, we aimed to determine the prevalence of obesity, central obesity, and some related factors in Semnan province, Iran. METHODS: This epidemiologic cross-sec onal study was conducted on 3799 of 30-70 years old persons in Semnan, Iran. Mul stage cluster sampling was performed and subjects were selected from the affiliated cities of Semnan province. Data was collected using a specific questionnaire. Body weight, height, and waist circumference (WC) were measured. Body mass index (BMI) and waist to hip ra o (WHR) were calculated, too. 25≤BMI. From this Link: h p://www.journals.mui.ac.ir/index.php/jims1/ar cle/viewAr cle/3365 JRMS, 2011;16(6):821-827 Prevalence of Underweight, Overweight and Obesity in Preschool Children of Tehran, Iran Abbasali Gaeini1, Majid Kashef2, Ali Samadi1, Aliasghar Fallahi1 Abstract BACKGROUND: It is reported that prevalence of overweight and obesity have increased in all age groups, but little is known about prevalence of overweight and obesity in preschool children. Therefore, the purpose of this study was to survey the prevalence of underweight, overweight and obesity in 3-6 year-old Tehranian children in 2009-2010.
boys and 378 girls) preschool children aged 3-6. Subjects were selected through stra fied sampling from 5 geographic regions of Tehran (east, west, north, south, and center). Body weight and height were measured directly. Underweight, overweight and obesity was defined as body
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mass index (BMI) ≤ 5th percen le (underweight), 5th to 85th percen le (normal weight), 85th to 95th percen le (overweight), and > 95th percentile (obesity); based on recommendation of Centers for Disease Control (CDC) in 2000. RESULTS: Findings showed that the prevalence of underweight, overweight and obesity was 4.77%, 9.81% and 4.77% in boys and 4.77%, 10.31% and 4.49% in girls, respec vely.
overweight and obesity in Tehranian preschool children that is a serious problem. This result can be used in clinical setting and preventive programs.
R. Kordi, A.H. Memari Sports Medicine Research Centre, Tehran University of Medical Sciences, Tehran, Iran Abstract INTRODUCTION: Childhood obesity is a major issue and puts children at risk of physical and psychological health complications. Some studies have evaluated obesity in autism in different countries. However there is few data on the rate of obesity in high-function autism (HFA). AIM: To evaluate the weight status of children with HFA in Iran METHODS: This cross-sectional survey was carried out in autism specific schools of Tehran in 2010. In total 113 children with HFA ages 6–15 were evaluated. They were classified according to WHO references (2007) for body mass index (BMI) for age and sex as obese, overweight, healthy weight and underweight. We then examined the associations of weight status of these children with some variables and comorbodities. RESULTS: The prevalence of obesity in children with HFA was 27.0%, overweight 13.0% and underweight 7.0%. There was a significant correla on between age and BMI (r = 0.26, Pvalue < 0.01). Underweight was associated with neurologic comorbidi es (p < 0.05). The rate of obesity has not correlated with some other medical and psychiatric comorbidities, as well as sex, and parents’ weight status. 75
CONCLUSIONS: Prevalence of obesity in autistic children with high intelligence profile is high and at the same levels of both normal children and children with autistic spectrum disorders.
Nutr Metab Cardiovasc Dis. 2011 Jul;21(7):499-503. Epub 2010 Mar 12. Comparison of the Effects of Cows' Milk, Fortified Soy Milk, and Calcium Supplement on Weight and Fat Loss in Premenopausal Overweight and Obese Women. Faghih Sh, Abadi AR, Hedayati M, Kimiagar SM. Department of Nutrition, Faculty of Nutrition Sciences and Food Technology, Arghavan Ave,
Farahzadi Bulv,
Tehran, Iran.
shivafaghih@gmail.com Abstract BACKGROUND AND AIMS: Recent studies suggest that calcium metabolism and perhaps other components of dairy products may contribute to shifting the energy balance and thus play a role in weight regulation. We compared the effects of cows' milk, calcium fortified soy milk and calcium supplement on weight and body fat reduction in premenopausal overweight and obese women.
METHODS AND RESULTS: In this clinical trial, 100 healthy overweight or obese premenopausal women were randomized to one of the following dietary regimens for 8 weeks: (1) a control diet providing a 500kcal/day deficit, with 500-600mg/day dietary calcium; (2) a calcium-supplemented diet iden cal to the control diet with 800mg/day of calcium as calcium carbonate; (3) a milk diet providing a 500kcal/day deficit and containing three servings of low-fat milk; (4) a soy milk diet providing a 500kcal/day deficit and containing three servings of calcium fortified soy milk. At baseline and a er 8 weeks, weight, waist circumference, and hip circumference were measured. Three 24-h dietary records and physical activity records were also taken. Comparing the mean differences in weight, waist circumference, body mass index (BMI) and waist-to-hip ratio (WHR) using repeated measure of variance analysis showed that changes in waist circumference and WHR were significant among the four groups (p=0.029 and p=0.015, respec vely). A er adjustment for baseline values, changes in weight and BMI were also significant (p=0.017 and p=0.019, respec vely). Weight reductions in high milk, soy milk, calcium supplement and control groups were 4.43±1.93(kg), 3.46±1.28(kg), 3.89±2.40(kg) and 2.87±1.55(kg), 76
respectively. The greatest changes were seen in the high dairy group in all variables. CONCLUSION: Increasing low fat milk consumption significantly reduces the general and central obesity beyond a low calorie diet.
Gynecol Endocrinol. 2011 Jul 14. [Epub ahead of print] Pioglitazone Reduces Central Obesity in Polycystic Ovary Syndrome Women. Asadipooya K, Kalantar-Hormozi M, Nabipour I. Department of Internal Medicine, The Persian Gulf Tropical Medicine Research center, Bushehr University of Medical Sciences, Bushehr, Iran. Abstract OBJECTIVE: Based on the role of polycystic ovary syndrome as a cause of metabolic syndrome with chronic anovulation, obesity, hyperinsulinemia and hyperandrogenism, development of effective treatment for its obesity is a priority. MATERIALS/METHODS: We designed a study, involving 52 pa ents of 19- 36 years of age, to test the pioglitazone in women with polycys c ovary syndrome. Subjects were assigned to receive pioglitazone for 3 months. Body mass index, waist circumference and hip circumference were measured before and a er 3 months of pioglitazone prescrip on.
during the study period. Waist circumference, hip circumference and waist to height ratio decreased significantly. Body weight and body mass index increased. No significant improvement was seen in acne, acanthosis, hirsutism and menstrual irregularities.
patients with polycystic ovary syndrome but other clinical consequences of the syndrome may not improve with the drug.
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Eur J Clin Invest. 2011 Mar 28. doi: 10.1111/j.1365-2362.2011.02516.x. [Epub ahead of print] 8q24.3 and 11q25 Chromosomal Loci Associa on with Low HDL-C in Metabolic Syndrome. Daneshpour MS, Rebai A, Houshmand M, Alfadhli S, Zeinali S, Hedayati M, Zarkesh M, Azizi F. Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti MC, Tehran, Iran Department of Medical Genetics, National Institute for Genetic Engineering and Biotechnology, Tehran, Iran Centre of Biotechnology of Sfax, Sfax, Tunisia Faculty of Allied Health Sciences, Department of Medical Laboratory Sciences, Kuwait University, Kuwait Biotechnology Research Centre, Pasteur Institute of Iran, Teheran, Iran Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti MC, Tehran, Iran.
Eur J Clin Invest 2011 ABSTRACT: Background High-density lipoprotein cholesterol (HDL-C) levels are low in Iranians. Low HDL-C is the most frequent phenotype in metabolic syndrome (MetS) among the Iranian popula on (32%). This has been claimed to be related to gene c factors. Materials and methods To investigate possible genes linked to this disorder, 12 microsatellite markers were selected. They were used in 107 families with MetS and low HDL-C to analyse relevant association and linkage signals. Result Family-based association tests under the biallelic mode gave many positive association signals. Higher association - after correction for multiple testing - was found to be linked with marker D8S1743 and D11S1304 (P < 0·003). The obtained results suggested evidence for association with regions on chromosome 8, 11 and to a lesser degree on chromosome 16. Nonparametric linkage analysis performed by Merlin software gave no significant correlation for any of the chromosomal regions. By considering only families with positive Nonparametric Logarithm of odds (LOD) scores, higher association can clearly be visible with D16S3096 and D11S934. Conclusions These results suggest that 8q22- 24; 11q23-25 and 16q23-24 regions are very likely to contain genes that control HDL-C level in Iranian families with metabolic syndrome.
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J Endocrinol Invest. 2011 Jul 27. [Epub ahead of print] Decreased Plasma Levels of Ceruloplasmin after Diet- Induced Weight Loss in Obese Women. Tajik N, Golpaie A, Keshavarz SA, Djalali M, Sehat M, Masoudkabir F, Ahmadivand Z, Fatehi F, Zare M, Yazdani T. Nutrition and Biochemistry Dept., School of public Health, Tehran University of Medical Sciences, Tehran, Iran.
factor for cardiovascular disease and also to be associated with obesity. However, it is not known whether weight loss could decrease the plasma Cp levels.
AIM: To investigate the effect of diet-induced weight loss on plasma Cp in obese women. Subjects and Methods. Sixty-seven healthy obese women (age=33.4±8.7 years, BMI=36.0±4.8 Kg/m2) were entered into a medically supervised program aimed at reducing body weight by 10% or more. Weight loss was achieved through a diet providing a daily energy deficit of 500-1000 kilocalories/day. In addi on, all pa ents were prescribed to use 50 grams of a fiber supplement per day. For all subjects, assessment of dietary intake, anthropometric indices and plasma levels of C-reactive protein (CRP) and Cp was performed at the first visit and repeated at 12th week of follow-up. RESULTS: By completing the program, weight (delta= -9.5%, p < 0.0001), body mass index (delta= -9.7%, p < 0.0001), waist-circumference (delta= - 6.1%, p < 0.0001), and triceps skinfold thickness (delta= -14.9%, p < 0.0001) significantly decreased. Plasma Cp significantly decreased a er 12 weeks of dietary interven on (33.6±5.6 mg/dL vs. 25.15±5.8 mg/dL, p < 0.0001). Percent change in Cp was correlated with percent change in waist- circumference (r = 446, p = 0.015).
induced by restriction of energy intake is associated with decreased serum concentrations of Cp in obese women which in turn might have reduced the subjects' risk of developing cardiovascular disease. 79
J Nutr Educ Behav. 2011 Jun 7. [Epub ahead of print] Which Food Patterns are Predictors of Obesity in Tehranian Adults? Hosseini-Esfahani F, Djazaieri SA, Mirmiran P, Mehrabi Y, Azizi F. Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Abstract OBJECTIVES: To determine whether changes in food patterns over a period of 6 years were related to obesity in Tehranian adults. DESIGN: Data on dietary intake, using the food frequency questionnaire, and anthropometry were obtained in 2 periods of the survey (1999-2001 and 2005-2007).
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