The rising tide of overweight among Kuwaiti children: study from Al-Adan Hospital, Kuwait

Alterations in glutathione redox homeostasis among adolescents with obesity and anemia

The reduced (GSH)-to-oxidized (GSSG) glutathione ratio represents a dynamic balance between oxidants and antioxidants. However, redox status in adolescents with obesity and anemia has not been investigated. This study investigated the association of erythrocyte GSH redox status (GSH, GSH:GSSG ratio, and glutathione peroxidase [GPx] activity) with anemia and adiposity in adolescents. This case–control study nested in a cross-sectional study enrolled 524 adolescents (268 boys; 256 girls). The prevalence of anemia in overweight and obesity (OWOB) was 5.2% in boys and 11.7% in girls. The GSH:GSSG ratio and GPx activity were significantly higher in girls than in boys (p < 0.001), in anemic than in non-anemic subjects (p < 0.001), and in OWOB than in normal-weight subjects (p < 0.001). Similarly, significantly higher GSH: GSSG level (p < 0.001) and GPx activity (p < 0.001) were found in subjects with 90th percentile waist circumference than in those with < 90th percentile. GPx and GSH:GSSG were positively associated with anemia after adjusting for age, sex, and body mass index (adjusted odds ratio, adjOR [95% confidence interval, CI] 2.18 [1.44–3.29]) or tertiles (adjOR [95% CI], T3 = 2.49 [1.03–6.01]). A similar association was noted for GSH and GPx. A compensatory increased redox defense mechanism exists in anemia and obesity among adolescents without metabolic disturbances.

Childhood Overweight and Obesity is Increasing in Gulf Cooperation Council Countries: A Review of the Literature

Introduction: A review was conducted to examine the prevalence and risk factors of developing overweight and obesity in children residing in Gulf Cooperation Council (GCC) countries. Method: PubMed, Medline, and Google Scholar databases using PRISMA guidelines were searched from January 1, 2007, to January 1, 2017. The inclusion criteria were (a) studies written in English, (b) clinical trials that examined risk factors of childhood overweight or obesity, (c) studies involving children 5 to 10 years of age, and (d) studies conducted in GCC countries. Results: Three main types of childhood obesity risk factors were identified (individual, familial, and lifestyle behavioral factors). The dietary, physical activity, and screen time lifestyle behavior risk factor findings were inconclusive. Discussion: Childhood obesity is increasing in GCC countries. Lifestyle behavior risk factors are still unclear. Researchers need to use instruments that have been psychometric tested and culturally acceptable. A follow-up review should be conducted.

Prevalence of obesity among school-age children and adolescents in the Gulf cooperation council (GCC) states: a systematic review

Background

The Gulf Cooperation Council (GCC) countries have among the highest prevalence of adult obesity and type 2 diabetes in the world. This study aimed to estimate the recent prevalence of obesity among school-age children and adolescents in the GCC States.

Methods

The literature search for obesity prevalence data was carried out in July 2017 in Google Scholar, Physical education index, Medline, SCOPUS, WHO, 2007-2017, and updated in November 2018.In addition, 22 experts from the GCC were contacted to check the search results, and to suggest studies or grey literature which had been missed. Eligible studies were assessed for quality by using the Joanna Briggs Institute (JBI) tool for prevalence studies. Conduct of the systematic review followed the Assessment of Multiple Systematic Reviews Tool (AMSTAR) guidance. A narrative synthesis was conducted.

Results

Out of 392 studies identified, 41 full-text reports were screened for eligibility; 11 of which were eligible and so were included, from 3 of the 6 GCC countries (United Arab Emirates, Kuwait, Saudi Arabia). Surveillance seems good in Kuwait in compared to other countries, with one recent national survey of prevalence. Quality of the eligible studies was generally low-moderate according to the JNBI tool: representative samples were rare; participation rates low; power calculations were mentioned by only 3/11 studies and confidence intervals around prevalence estimates provided by only 3/11 eligible studies; none of the studies acknowledged that prevalence estimates were conservative (being based on BMI-for-age). There was generally a very high prevalence of obesity (at least one quarter-one third of study or survey participants obese according to BMI-for-age), prevalence increased with age, and was consistently higher in boys than girls.

Conclusions

The prevalence of obesity among school-age children and adolescents appears to have reached alarming levels in the GCC, but there are a number of major gaps and limitations in obesity surveillance in the GCC states. More national surveys of child and adolescent obesity prevalence are required for the GCC states.

Trial registration

PROSPERO registration number CRD42017073692.

Discordance between Lifestyle-Related Health Practices and Beliefs of People Living in Kuwait: A Community-Based Study

OBJECTIVE

To examine the concordance between lifestyle practices and beliefs of people living in Kuwait, and between their lifestyle practices and established evidence-informed recommendations for health.

SUBJECTS AND METHODS

A cross-sectional interview questionnaire study was conducted using a convenience sample of 100 adults living in Kuwait (age range 19-75 years). The interview included sections on demographics, and lifestyle-related practices and beliefs related to smoking, diet/nutrition, physical activity/exercise, sleep, and stress. Diet/nutrition and physical activity/exercise benchmarks were based on international standards. Analyses included descriptive statistics and the χ2 test.

RESULTS

Beliefs about the importance of nutrition in lifestyle-related conditions were limited, and this was apparent in participants' dietary habits, e.g., low consumption of fruit/vegetables and multigrains: 16 (16%) and 9 (9%) met the recommended guidelines, respectively. Ninety-nine (99%) believed physical activity/exercise affects health overall, and 44 (44%) exercised regularly. Of the sample of 100, 20 (20%) exercised in accordance with evidence-based recommendations for maximal health. Compared with beliefs about other lifestyle-related behaviors/attributes, respondents believed nutrition contributed more than stress to heart disease, cancer, and stroke, and stress contributed more than nutrition to hypertension and diabetes.

CONCLUSION

In this study, our findings showed a discrepancy between lifestyle-related practices and beliefs, and between each of these and evidence-based recommendations for maximal health, i.e., not smoking, several servings of fruit and vegetables and whole-grain foods daily, healthy weight, restorative sleep, and low-to-moderate stress levels.

Metformin: An Old Drug for the Treatment of Diabetes but a New Drug for the Protection of the Endothelium

The anti-diabetic and oral hypoglycaemic agent metformin, first used clinically in 1958, is today the first choice or 'gold standard' drug for the treatment of type 2 diabetes and polycystic ovary disease. Of particular importance for the treatment of diabetes, metformin affords protection against diabetes-induced vascular disease. In addition, retrospective analyses suggest that treatment with metformin provides therapeutic benefits to patients with several forms of cancer. Despite almost 60 years of clinical use, the precise cellular mode(s) of action of metformin remains controversial. A direct or indirect role of adenosine monophosphate (AMP)-activated protein kinase (AMPK), the fuel gauge of the cell, has been inferred in many studies, with evidence that activation of AMPK may result from a mild inhibitory effect of metformin on mitochondrial complex 1, which in turn would raise AMP and activate AMPK. Discrepancies, however, between the concentrations of metformin used in in vitro studies versus therapeutic levels suggest that caution should be applied before extending inferences derived from cell-based studies to therapeutic benefits seen in patients. Conceivably, the effects, or some of them, may be at least partially independent of AMPK and/or mitochondrial respiration and reflect a direct effect of either metformin or a minor and, as yet, unidentified putative metabolite of metformin on a target protein(s)/signalling cascade. In this review, we critically evaluate the data from studies that have investigated the pharmacokinetic properties and the cellular and clinical basis for the oral hypoglycaemic, insulin-sensitising and vascular protective effects of metformin.