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- Strategy to Combat Obesity and to Promote Physical Activity in Arab Countries.
- Abstract Introduction
- Childhood Obesity in the Middle East: A Review.
- Abstract AIM
- Abstract BACKGROUND
- Practices in Child Growth Monitoring in the Countries of the Eastern Mediterranean Region
- Stunting is a Major Risk Factor for Overweight: Results from Na onal Surveys in 5 Arab Countries.
- Abstract 699
|Participants Residents of the GCC states participating in studies on the
prevalence of overweight and obesity, hyperglycaemia, hypertension and
hyperglycaemia, hypertension and hyperlipidaemia.
RESULTS: Forty-five studies were included in the review. Reported
prevalences of overweight and obesity in adults were 25–50% and 13–50%,
respectively. Prevalence appeared higher in women and to hold a non-
linear association with age. Current prevalence of impaired glucose
tolerance was es mated to be 10–20%. Prevalence appears to have been
increasing in recent years. Estimated prevalences of hypertension and
dyslipidaemia were few and used varied definitions of abnormality, making
review difficult, but these also appeared to be high and increasing,
CONCLUSIONS: There are high prevalences of risk factors for diabetes and
diabetic complications in the GCC region, indicative that their current
management is suboptimal. Enhanced management will be critical if
escalation of diabetes-related problems is to be averted as industrialization,
urbanization and changing population demographics continue.
Diabetes Metab Syndr Obes. 2011;4:89-97. Epub 2011 Mar 8.
Strategy to Combat Obesity and to Promote Physical
Activity in Arab Countries.
Musaiger AO, Al Hazzaa HM, Al-Qahtani A, Elati J, Ramadan J, Aboulella
NA, Mokhtar N, Kilani HA.
Obesity has become a major public health problem in the Arab countries,
creating a health and economic burden on these countries' government
services. There is an urgent need to develop a strategy for prevention and
control of obesity. The third Arab Conference on Obesity and Physical
Ac vity was held in Bahrain in January 2010, and proposed the Strategy to
Combat Obesity and Promote Physical Activity in Arab Countries. This
strategy provides useful guidelines for each Arab country to prepare its own
strategy or plan of action to prevent and control obesity. The strategy
focused on expected outcomes, objectives, indicators to measure the
objec ves, and ac on needs for 9 target areas: child-care centers for
preschool children, schools, primary health care, secondary care, food
companies, food preparation institutes, media, public benefit organizations,
and the workplace. Follow-up and future developments of this strategy
were also included.
Iranian Journal of Endocrinology & Metabolism, lume 13, Number 2 (8-
2011) 2011, 13(2): 157-164
The Comparison of Prevalence of Diabetes and
Hypertension between Rural Areas of Fars and Rural Area
of EMRO Region
Introduction: Since monitoring and evaluation of diabetes and
hypertension in individuals/the population greatly contribute to improving
both clinical care and following identification of disease in the region and
even the country, and to manage prevent and control diabetes and
hypertension and their risk factors, the goal of this study was to compare
disease status in rural areas of Fars province and rural areas of the EMRO
sec onal one that has been conducted in 2008 by randomized cluster
sampling, based on data obtained from an extensive provincial screening
plan for adults aged over 30 years in rural areas of Fars province. Based on
these data, the prevalence of diabetes, hypertension and their risk factors
were calculated and the relationship between diabetes and hypertension
was determined by risk factors including age, sex, family history, and MI
using Chi square and t-test and SPSS so ware version 17 and Minitab
version, prevalences in 15 is rural areas were compared with the ones in
EMRO region countries.
Results: The prevalence of hypertension and diabetes rural areas of Fars
province were calculated to be 21.8% and 11.14% respec vely as compared
with rural areas of EMRO region countries.The prevalence of diabetes was
also lower on the average and the prevalence of obesity (BMI>30), was less
than other countries in the region and Iran.
lower than other regional countries, raising a wareness in high rish groups
affected public commitment to basic information transmitting to high risk
classes of the society should be taken into account and commitment by the
health system administration and the government to sustain monitoring of
health, to ensure curtailing the burden of diabetes and hypertension and
associated risk factors among countries of the region.
Obes Rev. 2011 Jan;12(1):1-13. doi: 10.1111/j.1467-789X.2010.00750.x.
The Prevalence and Trends of Overweight, Obesity and
Nutrition-Related Non-Communicable Diseases in the
Arabian Gulf States.
Ng SW, Zaghloul S, Ali HI, Harrison G, Popkin BM.
Department of Nutrition, University of North Carolina, Chapel Hill, USA.
This paper reviews studies on the prevalence of overweight, obesity and
related nutrition-related non-communicable diseases in Bahrain, Kuwait,
Qatar, Oman, Saudi Arabia and the UAE. Obesity is common among women;
while men have an equal or higher overweight prevalence. Among adults,
overweight plus obesity rates are especially high in Kuwait, Qatar and Saudi
Arabia, and especially among 30-60 year olds (70-85% among men; 75-88%
among women), with lower levels among younger and elderly adults. The
rate of increase in obesity was pronounced in Saudi Arabia and Kuwait.
Prevalence of obesity is high among Kuwaiti and Saudi pre-schoolers (8-9%),
while adolescent overweight and obesity are among the highest in the
world, with Kuwait having the worst es mates (40-46%); however,
comparison of child data is difficult because of differing standards. Among
nutrition-related non-communicable diseases, hypertension and diabetes
levels are very high and increase with age, with the UAE performing the
worst because of a rapid rate of increase between 1995 and 2000.
Additional monitoring of the prevalence of metabolic syndrome and
cancers is necessary. Nationally representative longitudinal surveys with
individual, household and community-level information are needed to
determine the importance of various factors that contribute to these
Springer Series on Epidemiology and Public Health, 2011, Volume 2, Part 1,
127-152, DOI: 10.1007/978-1-4419-6039-9_8
Prevalence and Etiology: Middle East and North Africa
Hafez Elzein and Sima Hamadeh
The increasing prevalence of obesity at an alarming rate in many parts of
the world probably has multiple underlying etiologies. Obesity is generally
attributed to a combination of genetic and/or environmental factors. In
children, genetic, prenatal and perinatal factors have a great effect on
individual predisposition, practices and behaviors, contributing to a long-
term positive energy balance.
East Mediterr Health J. 2010 Sep;16(9):1009-17.
Childhood Obesity in the Middle East: A Review.
Mirmiran P, Sherafat-Kazemzadeh R, Jalali-Farahani S, Azizi F.
Accurate and comprehensive data on the extent of the problem of
childhood obesity is lacking in countries of the Middle East. This review,
based on a Medline search, summarizes the prevalence of obesity among
children and adolescents in the region during 1990-2007. The highest rates
of obesity and overweight were reported from Bahrain and the lowest from
the Islamic Republic of Iran. Studies from Saudi Arabia, Islamic Republic of
Iran and Kuwait showed an upwards trend in childhood obesity compared
with a decade ago. Lack of uniformity in reference standards and reporting
systems renders comparisons difficult. Nevertheless, the I high prevalence
of childhood obesity in the Middle East should stimulate policy-makers in
the region to set up effective national and regional surveillance systems.
Diabet Med. 2010 May;27(5):593-7.
Gender Differences In Prevalence of the Metabolic
Syndrome in Gulf Cooperation Council Countries: A
Mabry RM, Reeves MM, Eakin EG, Owen N.
AIMS: To systematically review studies documenting the prevalence of the
metabolic syndrome among men and women in Member States of the Gulf
Cooperative Council (GCC; Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and
the United Arab Emirates)-countries in which obesity, Type 2 diabetes and
related metabolic and cardiovascular diseases are highly prevalent.
term 'metabolic syndrome' and the country name of each GCC Member
State. The search was limited to studies published in the English language.
The metabolic syndrome was defined according to the Third Adult
Treatment Panel (ATPIII) of the National Cholesterol Education Program
(NCEP) and/or International Diabetes Federation (IDF) definitions. The
methodological quality of each study was evaluated based on four criteria:
a national-level population sample; equal gender representation;
robustness of the sample size; an explicit sampling methodology.
relevant studies. Only four were considered high quality and found that, for
men, the prevalence of the metabolic syndrome ranged from 20.7% to
37.2% (ATPIII deﬁni on) and from 29.6% to 36.2% (IDF deﬁni on); and, for
women, from 32.1% to 42.7% (ATPIII deﬁni on) and from 36.1% to 45.9%
CONCLUSIONS: Overall, the prevalence of the metabolic syndrome in the
GCC states is some 10-15% higher than in most developed countries, with
generally higher prevalence rates for women. Preventive strategies will
require identifying socio-demographic and environmental correlates
(particularly those influencing women) and addressing modifiable risk
behaviors, including lack of physical activity, prolonged sitting time and
Ann Nutr Metab. 2010;57(3-4):193-203. Epub 2010 Nov 18.
Nutrition Transition and Cardiovascular Disease Risk
Factors in Middle East and North Africa Countries:
Reviewing the Evidence.
Mehio Sibai A, Nasreddine L, Mokdad AH, Adra N, Tabet M, Hwalla N.
Department of Epidemiology and Population Health, American University of
AIM: To examine the burden of cardiovascular disease (CVD) risk factors in
Middle East and North Africa countries and their associations with dietary
behaviors as nutrition transition is unfolding in the region.
systematic review of published articles was performed. Dietary patterns
were derived from the WHO Food and Agriculture Organization Statistical
RESULTS: Wide variations exist across countries in the prevalence of CVD
risk factors, namely obesity, diabetes, hypertension, hyperlipidemia,
smoking and physical inactivity, with some countries showing high values of
certain factors which approach those observed in the developed world. In
particular, obesity prevalence rates have reached alarming levels,
particularly among women in the oil-rich countries (over 40%), making it
the most pressing health concern in the region. Trends in the dietary
pattern illustrated a consistent rise in total energy supply by approximately
730 kcal per capita per day between 1970 and 2005. Dietary pa erns
showed an increased consumption of fat and animal protein and a
decreased intake of carbohydrates, particularly whole grain cereals, and
fresh fruits and vegetables.
CONCLUSION: Regional differences were attributed to differences in
lifestyle, occupation and a shift from traditional food habits. Our
understanding of the CVD disparities across various geographic regions is
key to our effort in planning relevant intervention programs. Public health
efforts should focus on obesity, physical inactivity and unhealthy dietary
practices. The success of these interventions depends on governmental
commitment, multisectoral partnership and a consideration of the
sociocultural norms of the target population.
J Am Coll Nutr. 2010 Jun;29(3 Suppl):289S-301S.
Obesity, the Metabolic Syndrome, and Type 2 Diabetes in
Developing Countries: Role of Dietary Fats and Oils.
Misra A, Singhal N, Khurana L.
Department of Diabetes and Metabolic Diseases, Fortis Hospital, Vasant
Kunj, New Delhi, India.
Developing countries are undergoing rapid nutrition transition concurrent
with increases in obesity, the metabolic syndrome, and type 2 diabetes
mellitus (T2DM). From a healthy tradi onal high-fiber, low-fat, low-calorie
diet, a shift is occurring toward increasing consumption of calorie-dense
foods containing refined carbohydrates, fats, red meats, and low fiber. Data
show an increase in the supply of animal fats and increased intake of
saturated fatty acid (SFAs) (obtained from coconut oil, palm oil, and ghee
[clarified butter]) in many developing countries, particularly in South Asia
and South-East Asia. In some South Asian populations, particularly among
vegetarians, intake of n-3 polyunsaturated fa y acids (PUFAs) (obtained
from flaxseed, mustard, and canola oils) and long-chain (LC) n-3 PUFAs
(obtained from fish and fish oils) is low. Further, the effect of
supplementation of n-3 PUFAs on metabolic risk factors and insulin
resistance, except for demonstrated benefit in terms of decreased
triglycerides, needs further investigation among South Asians. Data also
show that intake of monounsaturated fatty acids (MUFAs) ranged from
4.7% to 16.4%en in developing countries, and supplementing it from olive,
canola, mustard, groundnut, and rice bran oils may reduce metabolic risk.
In addition, in some developing countries, intake of n-6 PUFAs (obtained
from sunflower, safflower, corn, soybean, and sesame oils) and trans-fatty
acids (TFAs) is increasing. These data show imbalanced consumption of fats
and oils in developing countries, which may have potentially deleterious
metabolic and glycemic consequences, although more research is needed.
In view of the rapid rise of T2DM in developing countries, more aggressive
public health awareness programs coupled with governmental action and
clear country-specific guidelines are required, so as to promote widespread
use of healthy oils, thus curbing intake of SFAs and TFAs, and increasing
intake of n-3 PUFAs and MUFAs. Such ac ons would contribute to
decelerating further escalation of "epidemics" of obesity, the metabolic
syndrome, and T2DM in developing countries.
Am J Clin Nutr November 2010 vol. 92 no. 5 1257-1264
Global Prevalence and Trends of Overweight and Obesity
among Preschool Children
Mercedes de Onis, Monika Blössner, Elaine Borghi
+ Author Affiliations
From the Growth Assessment and Surveillance Unit, Department of
Nutrition for Health and Development, World Health Organization, Geneva,
+ Author Notes
↵2 The authors are staff members of the World Health Organization. The
authors alone are responsible for the views expressed in this publication
and they do not necessarily represent the decisions, policy or views of the
World Health Organization.
↵3 The project had no specific funding.
↵4 Address reprint requests and correspondence to M de Onis, Department
of Nutri on, World Health Organiza on, 20 Avenue Appia, 1211 Geneva 27,
Switzerland. E-mail: firstname.lastname@example.org.
problems and the risk of premature illness and death later in life.
Monitoring related trends is important.
trends of overweight and obesity among preschool children on the basis of
the new World Health Organization standards.
from 144 countries were analyzed. Overweight and obesity were deﬁned as
the propor on of preschool children with values >2 SDs and >3 SDs,
respectively, from the World Health Organization growth standard median.
Being “at risk of overweight” was deﬁned as the propor on with values >1
SD and ≤2 SDs, respec vely. Linear mixed-effects modeling was used to
estimate the rates and numbers of affected children.
were es mated to be overweight and obese; 92 million were at risk of
overweight. The worldwide prevalence of childhood overweight and obesity
increased from 4.2% (95% CI: 3.2%, 5.2%) in 1990 to 6.7% (95% CI: 5.6%,
7.7%) in 2010. This trend is expected to reach 9.1% (95% CI: 7.3%, 10.9%),
or ≈60 million, in 2020. The es mated prevalence of childhood overweight
and obesity in Africa in 2010 was 8.5% (95% CI: 7.4%, 9.5%) and is expected
to reach 12.7% (95% CI: 10.6%, 14.8%) in 2020. The prevalence is lower in
Asia than in Africa (4.9% in 2010), but the number of aﬀected children (18
million) is higher in Asia.
CONCLUSIONS: Childhood overweight and obesity have increased
drama cally since 1990. These ﬁndings conﬁrm the need for eﬀec ve
interventions starting as early as infancy to reverse anticipated trends.
EMHJ (Eastern Mediterranean Health Journal), 2010;16(2).
Practices in Child Growth Monitoring in the Countries of
the Eastern Mediterranean Region
Abul-Fadl,1 K. Bagchi 2 and L. Cheikh Ismail
Growth reference charts are among the most sensitive and valuable tools
for assessing the health
and development of children. A ques onnaire survey was answered by 16
of the 21 ministries of health in the Eastern Mediterranean Region
countries (EMR) about their use of growth charts for children under 5 years.
Most of the countries (13/16) used the NCHS/WHO charts and weight-for-
age was the most commonly used. Charts for height-for-age and head
circumference-for-age were less commonly used. Problems in the use of
charts were identified. The introduction of the new WHO Child Growth
Standards, based on exclusively breastfed babies, is a unique opportunity to
support growth monitoring and optimal feeding practices in EMR.
East Mediterr Health J. 2009 May-Jun; 15(3):549-62.
Stunting is a Major Risk Factor for Overweight: Results
from Na onal Surveys in 5 Arab Countries.
El Taguri A, Besmar F, Abdel Monem A, Betilmal I, Ricour C, Rolland-Cachera
Hôpital Necker Enfants Malades, Paris, France. email@example.com
We analysed data on overweight and stunting from large national surveys
performed between 2001 and 2004 in 5 Arab countries (Djibouti, Libyan
Arab Jamahiriya, Morocco, Syrian Arab Republic and Yemen). Overweight
and stunting were defined according to new WHO growth standards.
Overweight ranged from 8.9% in Yemen to 20.2% in Syrian Arab Republic.
The risk ratio (RR) for overweight in stunted children ranged from 2.14 in
Djibou to 3.85 in Libyan Arab Jamahiriya. RR ranged from 0.76 in mildly
stunted children of Yemen to 7.15 in severely stunted children in Libyan
Arab Jamahiriya. E ological frac on in the popula on ranged from 7.49% to
Diab Vasc Dis Res. 2008 Nov;5(4):304-9.
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