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Damiri B, Safarini OA, Nazzal Z, Abuhassan A, Farhoud A, Ghanim N, Al Ali R, Suhail M, Qino M, Zamareh M, Thabaleh A, Zahran J. Eating Disorders and the Use of Cognitive Enhancers and Psychostimulants Among University Students: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2021; 17:1633-1645. [PMID: 34079261 PMCID: PMC8164711 DOI: 10.2147/ndt.s308598] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/01/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND University students, who are at risk of eating disorders (ED), are more liable to use cognitive enhancers and psychostimulants to improve their cognitive functions and lose weight. ED in Palestinian male students is a neglected health issue. We aimed to investigate the prevalence and the association between ED and cognitive enhancers, and psychostimulants use among An-Najah National University students (ANNU). METHODS In a cross-sectional study conducted in 2020 at ANNU, 1047 students completed anonymous surveys for cognitive enhancers practice, the Eating Attitude Test-26 (EAT-26), Sick, Control, One, Fat and FOOD (SCOFF) screening tests. RESULTS The prevalence of ED among ANNU students was 21.2% based on EAT-26 (17.1% in males, 23.8% in females) and 31.5% based on SCOFF (24.0% in males, 36.3% in females). The binary logistic regression revealed that students at risk to have ED were water-pipe smokers (OR: 1.471, p-value 0.047), especially males, while students who were less likely to have ED were males (OR: 0.341, p-value<0.001), coffee users (OR: 0.581, p-value 0.014) and chocolate users (OR: 0.530, p-value 0.041) than nonusers. Moreover, the risk of ED increased with increasing body mass index (p-value<0.01). Clinical medical students showed the lowest prevalence (11.1%) compared to preclinical (22.5%), health sciences (23.7%), and non-medical students (20.9%) (p-value 0.059). CONCLUSION Our findings highlight water-pipe smoking as a significant health problem in males with ED, which may require unique treatment and prevention strategies. Moreover, coffee and chocolate consumption were associated with decreased risk of ED, only among males. The gender-gap in ED prevalence was very narrow compared to international results. These results prompt the need to focus on both genders in future studies instead of females. They also suggest the urgent need to address ED among Palestinian university students by educating students about mental health, identifying high-risk students, and offering easily accessible psychological help.
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Affiliation(s)
- Basma Damiri
- Medicine & Health Sciences Faculty, Drug, and Toxicology Division, An-Najah National University, Nablus, 00970, Palestine
| | - Omar A Safarini
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, 00970, Palestine
| | - Zaher Nazzal
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, 00970, Palestine
| | - Ahmad Abuhassan
- An-Najah National University Hospital, Department of Neurology, An-Najah National University, Nablus, 00970, Palestine
| | - Ahmad Farhoud
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, 00970, Palestine
| | - Nesma Ghanim
- Medicine & Health Sciences Faculty, Department of Public Health, An-Najah National University, Nablus, 00970, Palestine
| | - Rayyan Al Ali
- Medicine & Health Sciences Faculty, Forensic Medicine Institute, An-Najah National University, Nablus, 00970, Palestine
| | - Mirvat Suhail
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, 00970, Palestine
| | - Mohammad Qino
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, 00970, Palestine
| | - Mohammad Zamareh
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, 00970, Palestine
| | - Ammar Thabaleh
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, 00970, Palestine
| | - Jihad Zahran
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, 00970, Palestine
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Alomari MA, Alzoubi KH, Khabour OF. Differences in oxidative stress profile in adolescents smoking waterpipe versus cigarettes: The Irbid TRY Project. Physiol Rep 2020. [PMCID: PMC7484827 DOI: 10.14814/phy2.14512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mahmoud A. Alomari
- Department of Physical Education Qatar University Doha Qatar
- Division of Physical Therapy Department of Rehabilitation Sciences Jordan University of Science and Technology Irbid Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy Jordan University of Science and Technology Irbid Jordan
| | - Omar F. Khabour
- Department of Medical Laboratory Sciences Jordan University of Science and Technology Irbid Jordan
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Alomari MA, Khabour OF, Alzoubi KH, Eissenberg T. Puffing topography and physiological responses in men and women with low versus high waterpipe dependence during smoking: The WiHi Irbid project. Drug Alcohol Depend 2020; 212:108037. [PMID: 32417361 PMCID: PMC9271691 DOI: 10.1016/j.drugalcdep.2020.108037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Waterpipe smoking is spreading worldwide, and it is associated with many adverse effects. The aim of this study was to investigate the interaction of waterpipe smoking puffing topography, and related physiological measures, with both gender and level of dependence on waterpipe. METHOD Exclusive waterpipe smokers were asked to smoke a single waterpipe session in a specialized laboratory while their smoking topography, and in-breath CO level were recorded pre- and post- smoking. Waterpipe dependence was measured using the LWDS-11 scale. RESULTS In the high dependence group, the total number of puffs, was greater in men than women. In addition, the average flow rate was greater in men with high compared to low dependence. For inter-puffing intervals, greater values were recorded in men and women with low versus high dependence. No other differences were found between the subgroups in total session time, average puff duration, average puff volume, and maximum flow rate. Pre-smoking CO content and CO boost were greater in men versus women in both dependence groups. Post-smoking CO content was greater in women with high versus low dependence, whereas it was lower in women versus men with low dependence. CONCLUSIONS The current results indicate several effects for waterpipe smoking dependence on smoking topography. Many of these differences were gender dependent with men having higher exposure than women in most aspects.
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Affiliation(s)
- Mahmoud A. Alomari
- Department of Physical Education, Qatar University, Doha 2713, Qatar.,Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Omar F. Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Alomari MA, Khabour OF, Alzoubi KH. Metabolic differences between men and women who are long-term users of the water pipe: The Irbid WiHi project. JOURNAL OF VASCULAR NURSING 2020; 38:18-24. [PMID: 32178786 DOI: 10.1016/j.jvn.2019.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/05/2019] [Accepted: 12/08/2019] [Indexed: 02/08/2023]
Abstract
Smoking tobacco and metabolic disorders are global epidemics associated with cardiovascular, immune, respiratory, and metabolic diseases. Cigarette smoking seems to affect metabolic disorders. However, the effect of water pipe (Wp), also called hookah, smoking duration on obesity and lipid profile is still a sparse. The present study examined the relationship of smoking Wp with body weight (Bw), body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), total cholesterol/HDLc, LDLc/HDLc, and triglycerides. Obesity, lipid profile, and smoking status were obtained from a total of 291 participants of which 147 smoked Wp. Smokers were divided into 3 groups: smoked <10 years (Wp1) (n = 72), smoked 10-20 years (Wp2) (n = 43), and smoked >20 years (Wp3) (n = 30). The ANCOVA revealed greater BMI and Bw and lipid profile measures in individuals smoking Wp vs never (P < .01). Additional analysis revealed that Bw and BMI were greater in the women (n = 11) with longer Wp smoking history (P < .05) but not the men (n = 19). In addition, Tc, LDLc, Tc/HDLc, and LDLc/HDLc levels were greater among the men smoking Wp for longer time (P < .05), but not the women. In conclusion, the study found greater obesity and lipid profile in the adults smoked Wp vs never, especially the ones smoked for longer time.
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Affiliation(s)
- Mahmoud A Alomari
- Department of Physical Education, Qatar University, Doha, Qatar; Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan.
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Baalbaki R, Itani L, El Kebbi L, Dehni R, Abbas N, Farsakouri R, Awad D, Tannir H, Kreidieh D, El Masri D, El Ghoch M. Association Between Smoking Hookahs (Shishas) and Higher Risk of Obesity: A Systematic Review of Population-Based Studies. J Cardiovasc Dev Dis 2019; 6:E23. [PMID: 31208138 PMCID: PMC6617155 DOI: 10.3390/jcdd6020023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/10/2019] [Accepted: 06/14/2019] [Indexed: 12/17/2022] Open
Abstract
The American Heart Association has published a scientific statement on the effect of hookah smoking on health outcomes; nevertheless, hookah smoking continues to be popular worldwide, especially among the young. Recent reports mention a potential link between hookah smoking and obesity; however, uncertainties still surround this issue. The aim of the current study was to conduct a systematic review to clarify whether hookah smoking is associated with a higher risk of obesity among the general population. This study was conducted in compliance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, and data were collated by means of a meta-analysis and a narrative synthesis. Of the 818 articles retrieved, five large-population and low-bias studies comprising a total of 16,779 participants met the inclusion criteria and were reviewed. All included studies reported that, regardless of gender, hookah smoking increases the risk of obesity among all ages and observed an association between the two after a correction for several confounders or reported a higher prevalence of obesity among hookah smokers. This was confirmed by the meta-analysis. Therefore, hookah smoking seems to be associated with a higher risk of obesity. Public health policymakers should be aware of this for the better management of obesity and weight-related comorbidities.
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Affiliation(s)
- Reem Baalbaki
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Lara El Kebbi
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Rawan Dehni
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Nermine Abbas
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Razan Farsakouri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Dana Awad
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Dana El Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon.
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Shattnawi KK, Alomari MA, Al-Sheyab N, Bani Salameh A. The relationship between plasma ferritin levels and body mass index among adolescents. Sci Rep 2018; 8:15307. [PMID: 30333502 PMCID: PMC6193036 DOI: 10.1038/s41598-018-33534-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/01/2018] [Indexed: 01/28/2023] Open
Abstract
Circulatory Ferritin concentration varies with age, sex, and body composition. Studies that determine the relationship of different body weight measurements with plasma ferritin concentration in adolescents are lacking. A descriptive cross-sectional design was utilized. Data collection involved self-reporting demographics, blood samples, and body composition measures for a sample of 814 healthy Jordanian adolescents. Ferritin deficiency was observed in 55.8% of the study population. Simple linear regression showed that BMI, gender, location, and smoking status 2.5%, 3.9%, 0.4%, and 0.4%, respectively, associated positively with plasma ferritin level (p < 0.05). After controlling for gender, location, and smoking status, additional hierarchal multiple linear regression showed that BMI explained 2.2% of plasma ferritin (p < 0.000). However, the obesity-stratified hierarchal multiple linear regression, showed that BMI explained 2.1% of plasma ferritin in the overweight and obese (HI) adolescents (p = 0.02), but not in the under and normal weight (LO) adolescents (p = 0.91). After controlling for gender, location, and smoking status, the ANCOVA showed that plasma ferritin level was greater (p < 0.000) in the HI (19.00 ± 13.6) versus the LO (15.20 ± 10.4) obesity group. Our results indicated that normal ferritin level among obese people does not necessarily indicate normal iron storage.
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Affiliation(s)
- Khulood K Shattnawi
- Jordan University of Science and Technology, Maternal & Child Health Nursing Department, Irbid, 22110, Jordan.
| | - Mahmoud A Alomari
- Jordan University of Science and Technology, Division of Physical Therapy, Department of Rehabilitation Sciences, Irbid, 22110, Jordan
- Qatar University, Division of Physical Education, Department of Educational Sciences, Doha, Qatar
| | - Nihaya Al-Sheyab
- Jordan University of Science and Technology, Maternal & Child Health Nursing Department, Irbid, 22110, Jordan
| | - Ayman Bani Salameh
- Al-Zaytoonah University of Jordan, Faculty of Nursing, Amman, 11733, Jordan
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Alomari MA, Al-Sheyab NA, Khabour OF, Alzoubi KH. Serum VEGF Level Is Different in Adolescents Smoking Waterpipe versus Cigarettes: The Irbid TRY. Biomolecules 2018; 8:E102. [PMID: 30274185 PMCID: PMC6316401 DOI: 10.3390/biom8040102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 01/02/2023] Open
Abstract
Waterpipe (Wp) use is associated with most devastating diseases and particularly popular among adolescents. Vascular endothelium growth factor (VEGF) is essential for generating new vessels. The effect of smoking tobacco on VEGF is controversial and unknown among adolescents. Therefore, the current study compared serum VEGF in adolescents smoking cigarettes (Cg) only (9.3%), Wp only (19.6%), and dual (Wp and Cg) (36.4%) versus nonsmokers (34.6%) in adolescents. A self-reported questionnaire and enzyme-linked immunosorbent assay (ELISA) were used to obtain smoking status and serum VEGF, respectively, in 475 (age: 14.6 ± 1.0 years) boys (n = 263) and girls (n = 212) from Irbid, Jordan. The analysis showed that smoking status (R² = 0.021; p = 0.001) and gender (R² = 0.035; p = 0.000) can predict VEGF. Furthermore, 2-way-ANCOVA revealed that VEGF was lower in the dual cohort versus the Cg (33.4%; p = 0.04) and nonsmoker (29.6%; p = 0.003) cohorts; VEGF in smokers, was lower (33.6%; p = 0.04) in the Wp versus nonsmokers in the boys but not the girls. These results are unique and suggest that smoking lowers VEGF, which might adversely affect vascular growth and function. This is alarming given that adolescents are still in the development stage and smoking, particularly Wp, is popular among them. Therefore, interventions targeting smoking among schoolchildren are urgently needed to avoid the negative effects of smoking, especially on vascular health.
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Affiliation(s)
- Mahmoud A Alomari
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan.
- Division of Physical Education, Department of Educational Sciences, Qatar University, Doha 2713, Qatar.
| | - Nihaya A Al-Sheyab
- Faculty of Applied Medical Sciences, Allied Medical Sciences Department, Jordan University of Science and Technology, Irbid 22110, Jordan.
- Faculty of Nursing, Maternal and Child Health Department, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan.
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Al-sheyab NA, Alomari MA. Unhealthy eating habits among adolescent waterpipe smokers in Jordan: The Irbid-TRY study. Tob Induc Dis 2018; 16:19. [PMID: 31516419 PMCID: PMC6659496 DOI: 10.18332/tid/89976] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The relationship between waterpipe smoking and eating habits among adolescents has not been investigated, thus the aim of the current study was to compare eating habits among adolescent cigarette-only, waterpipe-only, dual smokers versus non-smokers. We hypothesize that adolescent smokers practice unhealthy eating habits with worse habits among waterpipe smokers and dual smokers. METHODS Using a descriptive, cross-sectional design, self-reporting patterns of waterpipe, cigarette smoking and eating habits were collected from a random representative sample of 1720 boys and girls in grades 7-10 in Northern Jordan. RESULTS A total of 6.9%, 23.2% and 26.2% reported cigarette-only, waterpipe-only, and dual smoking, respectively. After controlling for gender, family income and education level of the mother and father, subsequent post hoc ANCOVA analyses revealed the following: mean (±SD) weekly breakfast consumption was greater in non-smokers (3.9±2.4) than waterpipe-only smokers (3.5±2.5, p=0.040) and dual smokers (3.2±2.5, p<0.000). Mean soda consumption frequency was lower in non-smokers (3.6±2.3) versus waterpipe-only (4.2±2.3, p=0.004) and dual smokers (2.7±2.2, p<0.000). Mean vegetable consumption was less in waterpipe-only (4.5±2.0, p=0.026) and dual smoking (4.4±2.0, p=0.013) smokers versus non-smokers (4.8±1.8). Mean consumption of energy drinks was the highest among dual smokers (1.2±1.9) versus non-smokers (0.5±1.4, p<0.000), cigarette-only (0.6±1.4, p≤0.01), and waterpipe-only (0.6±1.4, p<0.000) smokers. CONCLUSIONS Overall, both waterpipe and dual smoking are associated with several unhealthy eating habits in adolescents. Given the growing epidemic of tobacco smoking in the Eastern Mediterranean Region, especially adolescent waterpipe smoking, and its association with unhealthy eating habits, public health actions and enforcing policies to decrease uptake of waterpipe smoking as well as improving food choices in schools among youth are urgently needed.
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Affiliation(s)
- Nihaya A. Al-sheyab
- Maternal and Child Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mahmoud A. Alomari
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
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