137 research outputs found
Ramadan-specific nutrition education improves cardio-metabolic health and inflammation—a prospective nutrition intervention study from Pakistan
No full textThere are recent reports that Ramadan fasting (RF) results in weight gain instead of weight loss. In addition, the data on the efficacy of brief nutrition education on healthy eating practices in Ramadan for better health are scarce. Therefore, a study was conducted to investigate the effects of brief nutrition education before the start of RF on healthy eating practices during RF. For this purpose, a prospective observational study focused on “Dietary Education and Awareness for Ramadan (DEAR)” as an intervention was carried out. The participants (n = 74) were recruited and divided into two groups, i.e., intervention and control groups (n = 37 each). As an intervention, nutrition education lessons were given before and during RF month. The control group did not attend these nutrition education lessons. Data on anthropometrics, dietary intake, and other parameters were collected at three time points: before, in the end, and 4 weeks after RF. Weight was measured in kg; height, waist circumference (WC), and hip circumference (HC) were measured in cm; and body mass index (BMI) was calculated. Waist-to-hip ratio (WHR) was calculated by dividing the waist value by the hip value. Body composition analysis was performed by the body composition analyzer (BF-907). Blood pressure (BP) was measured using a validated automated blood pressure. A 3–5 ml of venous blood was collected, and plasma and serum were separated. Serum and plasma samples were processed for general blood chemistry (blood lipid profile, glucose, and CRP) within 2 h. CRP was determined by the immunoturbidimetry method using an auto-analyzer. An enzyme-linked immunosorbent assay (ELISA) was used to determine cytokine/chemokines. Adherence to nutrition education (intervention) was assessed. The results show that nutrition education has positive effects on overall nutrition. Significant improvement in dietary adherence to dietary advice in the intervention group was noted. Significant BW loss (mean loss: 1.21 kg) in the intervention group was observed. The majority (63.3%) had lost BW ≥ 1.0 kg. Other changes observed as a result of the intervention included improvements in blood glucose, cholesterol, CRP levels, and systolic and diastolic BP. There was a notable shift in pro- and anti-inflammatory cytokine concentrations: IL-7, IL-4, and TGF-α decreased, while IL-2, TNF-α and resistin, IL-1 RA, IL-17 A, and sCD40 increased. In conclusion, RF resulted in a loss in mean BW and an improvement in related blood chemistry and cytokine profiles. Furthermore, nutrition education before RF resulted in better nutrition practices during RF and a desirable healthy BW, blood lipid, and cytokine profiles
New Predictive Equations for Resting Energy Expenditure in Normal to Overweight and Obese Population
No full textBackground and Aims. The unique demographic and dietary characteristics of modern Arabic population require development of a new predictive equation for the estimation of resting energy expenditure (REE). This study presented new equations characteristic to Saudi population. Methods. A set of predictive equations for REE was derived for 427 healthy male and female subjects (aged 18–57 ± 14 years). REE was measured (REEm) by indirect calorimetry (IC) and predicted (REEp) using nine equations. REEp was compared with REEm to determine the predictive accuracy of these equations. Using IC and anthropometrics for stepwise linear regression analysis, a new set of equations to predict REE of men and women was developed. Accuracy of the new main equations was further tested in an external sample of 48 subjects (men = 50%). Results. Using a number of parameters (bias, underprediction, overprediction, and % accurate prediction), our results suggested that almost all (9/9 in men and 7/9 in women) equations either underpredicted or overpredicted (2/9) REE. None of the already existing equations showed an acceptable REEp/REEm difference as low as 5% and an accurate prediction (∼55%) at the individual level. Based on these findings, a new prediction equation (hereafter referred to as the Almajwal–Abulmeaty (AA) equation) was developed using this study’s data, after a rigorous stepwise regression analysis using the following formula: REE = 3832.955 + AdjWt (kg) × 48.037 − Ht (cm) × 30.642 + gender × 141.268 − age (years) × 4.525 [AdjWt is Adjusted body weight = (Wt − IBW)/4 + IBW. IBW is Ideal body weight; for men IBW = (Ht(cm) − 152.4) × 1.0714) + 45.36 and for women IBW = (Ht(cm)−152.4) × 0.8928) + 45.36]. The regression model accounted for approximately 70% of the variance in REEm (R2 = 0.702). Conclusion. Previous equations likely over- or underpredicted REE. Therefore, the new predictive AA equations developed in this study are recommended for the estimation of REE in young to middle-aged Saudi men and women with different body mass indexes. Future research is also required for further clinical and cross-validation of these new equations
Performance of body mass index in predicting diabetes and hypertension in the Eastern Province of Saudi Arabia
No full textBackground and Objectives : Body mass index (BMI) is the most widely used measure to define obesity and predict its complications, such as diabetes and hypertension, but its accuracy and usefulness in Saudi subjects is unknown. This study aimed to assess the validity of standard BMI cut-point values in the Saudi population. Subjects and Methods : 197 681 adults participated in a cross-sectional study to detect diabetes and hypertension in the Saudi Eastern province in 2004/2005, with blood pressure, fasting blood sugar, height and weight measurements taken. Sensitivities, specificities, areas under the curves, predictive values, likelihood ratios, false positive, false negatives and total misclassification ratios were calculated for various BMI values determined from receiver operating characteristic (ROC) curves. The significance of the association between risk factors and BMI was assessed using regression analysis. Results : For the definition of overweight, ROC curve analysis suggested optimal BMI cut-offs of 28.50 to 29.50 in men and 30.50 to 31.50 in women, but the levels of sensitivity and specificity were too low to be of clinical value and the overall misclassification was unacceptably high across all the selected BMI values (>0.80). The relationship between BMI and the presence of diabetes and/or hypertension was not improved when a BMI of 25 was used. Using regression analyses, the odds ratios for hypertension and/or diabetes increased significantly from BMI values as low as 21-23 with no improvement in the diagnostic performance of BMI at these cutoffs. Conclusion : In Saudi population, there is an increased risk of diabetes and hypertension relative to BMI, starting at a BMI as low as 21 but overall there is no cutoff BMI level with high predictive value for the development of these chronic diseases, including the WHO definition of obesity at BMI of 30
Dietetic management of obesity in Saudi Arabia: towards evidence based clinical practice guidelines
No full textObesity is one of the most common disorders encountered in clinical practice and has major public health implications. It is also one of the most difficult and frustrating disorders to manage successfully. The prevalence of overweight and obesity in Saudi Arabia is high and increasing over recent years. Management of obesity should be based on the best available scientific evidence. At present, there are no national clinical practice guidelines of use by dietitians and other health practitioners for the management of obesity. Since dietetics is a relatively new profession in Saudi Arabia there is little published data available in this area. This thesis aimed to describe the current dietetic practices of obesity in Saudi Arabia and to develop a draft set of national clinical practice guidelines for obesity management. The present thesis includes three main projects. Based on the outcomes of these projects, a draft of evidence-based practice guidelines for the nutritional management of obesity in Saudi Arabia was prepared. The first project (Chapter 3) involved dietitians to investigate the context and better understand the range of current practices in obesity management in Saudi Arabia, demand for and level of service, and barriers to obesity management. Analysis of the study showed that Saudi Arabian dietetic practice for the management of obesity does incorporate most practice recommendations, but some specific elements are rarely used. The most common assessment approaches were assessment of BMI, exercise habits and weight history while the most common strategies for obesity management were dietary total fat reduction and increased incidental daily activity. The major barriers for establishment of a weight management clinic were inadequate resources and administration and referral issues. None of the participants used local obesity guidelines but 61% of participants relied on international guidelines. The second project included two studies focused on the validity of the most important practical tools used for the classification of obesity (Chapter 4) and the assessment of energy requirements (Chapter 5) since research has been lacking in this area in the Saudi population. The first study examined the use of different BMI cut-off points for obesity classification. Results indicated that the diagnostic usefulness of BMI alone in defining obesity is limited in the Saudi adult population, for both men and women. It seems likely that limiting management of obesity only to those individuals with a BMI ≥ 30, as defined by the WHO, may mean that many Saudis at risk of serious co-morbidities could be missing necessary interventions. The second study assessed the accuracy of prediction equations and a popular hand-held calorimeter (BodyGem) for assessment of resting energy expenditure (REE). Based on the findings of this study it was concluded that the Harris-Benedict, Schofield and WHO equations tend to predict REE more accurately than the BodyGem device. However, their accuracy was not clinically acceptable on an individual level. Therefore, the value of the use of both BodyGem devices and predictive equations is still uncertain for Saudi population and more research is needed in this area. The third project (Chapter 6) focused on the development of draft clinical practice guidelines, based on a review of existing international guidelines, supplemented with systematic literature reviews, and refined through the use of consultation workshops and Delphi technique consultations with Saudi experts and practitioners. Findings from the systematic mini reviews provided low to medium level evidence for the use of some novel dietary interventions such as the high intake of calcium, PUFA or fiber to assist with weight loss or maintenance. There was also similar evidence for the use of a low glycemic index diet. Higher eating frequency, not exceeding 6 meals per day, may also help in weight reduction. Regular breakfast intake also appears to be associated with lower body weight. Consultations workshops and Delphi consultations indicated that there are cultural differences between Saudi Arabian population and other Western populations. Therefore, specific consensus statements were developed to cover practice areas such as behavioral modifications, dietary counselling strategies, physical activity and obesity management in Ramadan. In summary, this thesis has provided clinical practice guidelines for obesity management in Saudi Arabia. The application of these guidelines will improve nutritional management of obesity and enable dietitians and other health professionals to use approaches based on the best available evidence
New Predictive Equations for Resting Energy Expenditure in Normal to Overweight and Obese Population (P16-048-19)
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Current dietetic practices of obesity management in Saudi Arabia and comparison with Australian practices and best practice criteria
No full textAcacia hydaspica R. Parker ameliorates cisplatin induced oxidative stress, DNA damage and morphological alterations in rat pulmonary tissue
No full textAcacia hydaspica R. Parker ameliorates cisplatin induced oxidative stress, DNA damage and morphological alterations in rat pulmonary tissue
No full textAbstract Background Cisplatin (CP) drug is platinum compounds used for the treatment of various human malignancies. However, adverse outcomes related to CP restrict its usage. Acacia hydaspica is a natural shrub with various pharmacological properties. The current investigation aimed to assess the protective potential of A. hydaspica polyphenol rich ethyl acetate extract (AHE) against cisplatin (CP) induced pulmonary toxicity. Methods Rats were divided into six groups. Group 1 served as control (saline); Group 2 (drug control) recieved single dose of CP (7.5 mg/kg i.p.) on 1st day; Group 3 (extract control) (400 mg/kg bw, p.o.) received AHE for one week; Group 4 (Post-treated) and Group 5 (pretreated) received AHE (400 mg/kg bw/day, p.o) for 7 days after and before CP (7.5 mg/kg b.w., i.p.) respectively; Group 6 (Standard control) received silymarin (100 mg/kg b.w/7 days) before CP. At the end of dosing rats were sacrificed and pulmonary tissue samples were processed for the evaluation of antioxidant enzymes, oxidative stress markers, genotoxicity and histopathological alterations. Results CP caused body weights loss and increase pulmonary tissue weight. The CP significantly increases oxidative stress markers and decreases tissue antioxidant enzyme levels. Furthermore, CP induced deleterious changes in the microanatomy of pulmonary tissue by rupturing the alveolar septa, thickening of alveolar walls, and injuring the cells with subsequent collapse of blood vessels. AHE pretreatment returned MDA, NO, H2O2 production and improved tissue antioxidant enzyme levels to near normalcy. The histological observations evidenced that AHE effectively rescues the lungs from CP-mediated oxidative damage. CP induction in rats also caused DNA fragmentation which was restored by AHE treatment. Our results suggest that pretreatment more significantly improve CP induced deleterious effects compared with post treatment indicating protective effect. Potency of AHE pretreatment is similar to silymarin. Conclusion These findings demonstrated that A. hydaspica AHE extract might serve as potential adjuvant that prevents CP persuaded pulmonary toxicity due to its intrinsic antioxidant potential and polyphenolic constituents
Modulatory influence of Acacia hydaspica R. Parker ethyl acetate extract against cisplatin inveigled hepatic injury and dyslipidemia in rats
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