Complementary and alternative medicine use for weight management among females in Jordan: a community-based survey

Background: The relationship between obesity and various chronic diseases is well documented. In Jordan, the preva-lence of overweight (30.0%) and obesity (38.8%) among females is on the rise, encouraging many adults to rely on alterna-tive health care methods to manage their weight.Aims: We explored the status of complementary and alternative medicine use for weight management among adult fe-males in Jordan and the possible relationship between complementary and alternative medicine use and body mass index.Methods: An interviewer-administered, structured questionnaire was used to collect data on the use and safety of com-plementary and alternative medicine for weight management from 858 women in 2015. Responses were coded and ana-lysed using SPSS, version 20.Results: Around 40% of the respondents reported using some form of complementary and alternative medicine for weight management. Commercial dietary supplements (31.2%), herbal remedies (26.7%) and folk remedies (18.0%) were commonly used. Green tea and fibre tablets were the most widely used herbal supplements. Logistic regression analysis indicated that overweight participants are more frequent complementary and alternative medicine users compared to obese. Rel-atives and friends were the main sources of information about complementary and alternative medicine. Only 31.9% of women believed that complementary and alternative medicine modalities were safe; around half believed they were not safe during pregnancy (52.5%) and lactation (48.0%). Only 49.7% were aware of side-effects and 41.5% of drug interactions. Conclusion: This study revealed that complementary and alternative medicine is often used for weight management. Awareness of the safe use of complementary and alternative medicine with other medications and during pregnancy and lactation should be addressed.

Contexte : Le lien entre obésité et plusieurs maladies chroniques est clairement attesté. En Jordanie, la prévalence du surpoids (30,0 %) et de l’obésité (38,8 %) chez les femmes est en augmentation, incitant ainsi de nombreux adultes à se tourner vers les méthodes de soins alternatives en vue de gérer leur poids.Objectifs : La présente étude visait à examiner le statut du recours aux médecines complémentaires et alternatives (MCA) dans le cadre de la gestion du poids chez les femmes adultes en Jordanie et le lien possible entre cette pratique et l’indice de masse corporelle (IMC).Méthodes : Un questionnaire structuré, administré par un enquêteur, a été utilisé en 2015 auprès de 858 femmes pour recueillir des données sur l’utilisation et la sécurité des MCA en vue de la gestion du poids. Les données ont été codées et analysées à l’aide du logiciel SPSS, version 20.Résultats : Près de 40 % des femmes interrogées indiquaient avoir recours à certaines formes de MCA en vue de gérer leur poids. Les suppléments alimentaires commercialisés (31,2 %), les remèdes à base de plantes (26,7 %) et les remèdes populaires (18,0 %) étaient couramment utilisés. Le thé vert et les comprimés de fibres étaient les compléments à base de plantes les plus largement utilisés. L’analyse de régression logistique indiquait que les participantes en surpoids recouraient plus fréquemment aux MCA que celles qui étaient obèses. En ce qui concerne les MCA, les proches et les amis constituaient les principales sources d’information. Seuls 31,9 % des femmes estimaient que les modalités du recours aux MCA étaient sûres ; près de la moitié pensaient que ces types de médecines n’étaient pas recommandées pendant la grossesse (52,5 %) et l’allaitement (48,0 %). Seulement 49,7 % avaient connaissance des effets secondaires et 41,5 % des interactions médicamenteuses. Conclusion : Cette étude a révélé que les MCA sont souvent utilisées dans la cadre de la gestion du poids. Il convient d’augmenter la sensibilisation à l’égard de cette pratique en association avec d’autres médicaments et pendant la grossesse et l’allaitement.

WHO European Childhood Obesity Surveillance Initiative: overweight and obesity among 6–9-year-old children: report of the third round of data collection 2012–2013

Surveillance data on the prevalence of overweight and obesity among children and adolescents are essential to inform the development of effective policies and strategies to tackle the challenge of childhood obesity in the WHO European Region. In response to this need, the WHO Regional Office for Europe established the WHO European Childhood Obesity Surveillance Initiative (COSI) in 2007.

The third round of data collection took place during the 2012–2013 school year and included assessment of more than 250 000 primary school-aged children in 19 countries and collection of information about the participating schools. In addition, 17 of the countries collected further data on the school environment, and 11 countries collected data on family diet and physical activity.

The systematic collection of these data and their analysis enable intercountry comparisons and a better understanding of the progression of childhood overweight and obesity in Europe, clearly showing that childhood obesity remains a major public health problem in the WHO European Region.

WHO European Childhood Obesity Surveillance Initiative: implementation of round 1 (2007/2008) and round 2 (2009/2010)

Nutritional surveillance in school-aged children, using measured weight and height, is not common in the WHO European Region. At the first consultation with Member States in the process leading to the WHO European Ministerial Conference on Counteracting Obesity in 2006, Member States recognized the need for harmonized surveillance systems among primary-school children on which policy development within the Region could be based. Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) by the WHO Regional Office for Europe was a response to this need. COSI aims to measure trends in overweight and obesity in children aged 6.0–9.9 years in order to monitor the progress of the epidemic and to reverse it, and to make intercountry comparisons within the Region. This is the first official WHO report on the implementation of COSI during two data collection rounds (school years 2007/2008 and 2009/2010) in 16 participating countries. This document uses the strengths, weaknesses, opportunities and threats technique to evaluate the implementation and reports the experiences gained, the challenges encountered and the obstacles overcome by countries participating in COSI.

Evidence for gender responsive actions to prevent and manage overweight and obesity: young people’s health as a whole-of-society response

The WHO Regional Office for Europe supports Member States in improving adolescent health by recommending comprehensive, multisectoral and evidence-informed adolescent health approaches; by delineating the critical contribution of the health sector; by fostering actions towards reducing inequalities; and by addressing gender as a key determinant of adolescent health. This publication aims to support this work in the framework of the European strategy for child and adolescent health and development, and is part of the WHO Regional Office for Europe contribution to the development of a new policy framework for Europe, Health 2020, for which the WHO Regional Office for Europe has been mandated by the 53 Member States. The publication summarizes current knowledge on what works in promoting the well-being of adolescents. It is part of a series that includes social and emotional well-being, chronic conditions and disabilities, adolescent pregnancy, HIV/STIs, overweight and obesity, violence, injuries and substance abuse. The publication assumes the position that young people’s health is the responsibility of the whole society, and that interventions need to be gender responsive in order to be successful. It therefore looks at actions at various levels, such as cross-sector policies, families and communities actions, and interventions by health systems and health services. The publication does not prescribe nor recommend any particular course of action, which needs to be informed by the country specific context. It rather provides a basis to stimulate countries to further refine national policies so that they contribute effectively to the health and well-being of young people.

Anthropometric characteristics and obesity among adolescents in the United Arab Emirates

Anthropometric measurements and the prevalence of overweight and obesity were studied in 661 adolescents aged 12-17 years from Dubai, United Arab Emirates. Mean values for height and weight increased steadily with age in both sexes. Mean values for waist circumference ranged from 70.8-76.6 cm in males and 64.0-68.8 cm in females. Hip circumference varied from 84.8-91.2 cm in males and 84.9-91.2 cm in females. Body mass index was generally higher in males than in females [range 21.9-23.6 kg/m[2] and 19.8-24.1 kg/rn[2] respectively]. The overall prevalence of overweight and obesity was 19.3% and 21.6% in males and 12.3% and 19.5% in females. This study confirms the high incidence of overweight and obesity in Dubai adolescents

Regional fat, weight and osteoporosis in elderly women in Egypt

To test the hypothesis that regional fat and not total body weight has a protective effect on bone mineral density [BMD] in postmenopausal women, a cross-sectional study was conducted during the period from March 2008 to June 2009 on 303 healthy postmenop ausal women presenting to the osteoporosis unit for screening purposes. BMD of the lumbar spine, L2-L4, and the neck of the left femur were measured by dual energy X-ray absorptiometry. Regional fat percentage was measured using the same scanner. While overweight was an independent protective factorfor both spinal and femoral osteoporosis [OR - 0.397, 95% Cl: 0.214-0.739; OR - 0.289, 95% Cl: 0.151-0.553 respectively], regional fat percentage was not

Nutritional status of children hospitalized in Tabriz Paediatric Hospital, Islamic Republic of Iran, 2008

This study aimed to evaluate the nutritional status of children consecutively admitted as inpatients to Tabriz Paediatric Hospital in the north-west of the Islamic Republic of Iran between June and August 2008. A total of 140 children aged 2-12 years were included. Patients' weight, height and triceps skinfold thickness [TSFT] were measured, and nutritional status was evaluated. Evaluation of weight-for-age, height-for-age, weight-for-height and TSFT showed that 48.6%, 30.7%, 32.2% and 14.3% of the patients, respectively, were malnourished. Malnutrition among hospitalized children is worthy of attention, and effective strategies for systematic screening and treatment of malnutrition need to be developed and implemented

Anthropometric measurements of term neonates from a state hospital in Turkey

To determine regional percentile values and compare them with currently used national and international curves, we determined the birth weight, height and head and chest circumference of 3688 term neonates born in a state hospital in the Anatolian part of Istanbul, Turkey. Mean birth weight, height and head and chest circumference were 3334 [SD 494] g, 48.3 [SD 2.2] cm, 34.4 [SD 1.3] cm and 32.8 [1.9] cm respectively. For both boys and girls, the current Turkish national percentile curves overestimate the birth weight, height and head circumference at the 10th percentile. For boys, the national curves and those from the USA underestimate birth weight of neonates above the 90th percentile

New growth charts for Libyan preschool children

To draw up new growth charts for Libyan children under 5 years of age, a cross-sectional survey was carried out in urban and rural areas in 2 regions of the Libyan Arab Jamahiriya from June 1999 to February 2000. Using WHO cluster sampling methodology, 1473 infants and children of both sexes aged between 0 and 59 months were selected from residential areas, maternal and child health centres, kindergartens and the delivery section of hospitals. Growth charts for weight-for-age, height for-age and weight-for-height were plotted and smoothed, to provide reference curves for clinical, epidemiological and research purposes. In addition, mean Z-scores were analysed by sociodemographic variables collected from interviews with parents. Factors with a strong influence on childhood growth patterns were child's age, mother's education level and sex

Body mass index of Kuwaiti adolescents aged 10-14 years: reference percentiles and curves

The aim of this population-based study was to develop body mass index [BMI] reference standards for Kuwaiti adolescents for use in Kuwait and other Gulf countries. All available intermediate school students aged 10-14 years [32 624 males and 30 209 females] were measured for weight and height. Polynomial regression smoothing techniques were used to obtain the best-fitting curves for BMI percentiles. The BMI of boys at lower centiles and ages was almost always higher than girls. At higher centiles, the BMI of girls was almost always higher than boys. The data were compared with the United States National Center for Health Statistics standards and data from Saudi Arabian and Iranian adolescents

Growth of infants in relation to type of feeding in Jahrom, Islamic Republic of Iran

We evaluated the growth of 597 infants < 24 months attending health centres in Jahrom according to type of infant feeding. We also compared our growth curves with those of the National Center for Health Statistics [NCHS]. The infants were divided to 3 groups: exclusively breastfed, exclusively bottle-fed and both breast- and bottle-fed and were assessed monthly for the first year and every 2 months in the second year. There were no significant differences between the groups in height and weight in the first few months of birth; later, breastfed infants were significantly heavier and taller. The mean heights and weights of our infants were lower that those for NCHS

Protein-energy malnutrition among preschool children in Oman: results of a national survey

We assessed the prevalence of underweight, wasting and stunting among preschool children in Oman from March to December 1999. Within each region, samples of males and females in the age groups 0-5, 6-11, 12-23, 24-35, 36-47 and 48-60 months were drawn from the registers of health institutions and the weight and height/length of the children were measured. The total sample comprised 19 440 children; 9911 males and 9529 females. Data were analysed according to the World Health Organization protocols. The prevalence rates of wasting, stunting and underweight were 7.0%, 10.6% and 17.9% respectively at the national level. There were no sex differences

[Anthropometrical parameters in infants in Monastir region, Tunisia]

We evaluated the distribution of anthropometrical parameters in infants in Monastir and compared them with the National Center of Health Statistics reference. Our prospective study included 3033 infants attending primary health care centres for vaccinations who were followed for 18 months. In each visit, we measured weight-for-age, height-for-age and weight-for-height. We found a difference between our distribution curve and the NCHS reference. The prevalence of growth retardation increased with age. The prevalence of under-weight and of wasting were less than 10%. Obesity was seen 6.2% of infants aged 3 months and 11.6% aged 9 months

Blood pressure distribution among healthy schoolchildren aged 6-13 years in Tehran

To obtain blood pressure distribution for Iranian children, we assessed 10,288 students aged 6-13 years [4871 boys and 5417 girls] in Tehran. Mean systolic and diastolic blood pressure showed incremental increases with age, weight and height in both sexes. Mean increases in systolic blood pressure for boys and girls were 1.7 and 0.8 mmHg per year respectively and for diastolic blood pressure were 0.7 and 0.9 mmHg respectively. According to Second Task Force [STF] criteria, 4.9% of boys and 3.5% of girls had significant systolic hypertension and 10.1% of boys and 3.3% of girls had significant diastolic hypertension. Mean systolic and diastolic blood pressures were higher than STF reports, especially among boys

Rapid reinfection by Giardia lamblia after treatment in a hyperendemic area: the case against treatment

We selected 405 children aged 1-10 years with Giardia lamblia infection but without abdominal or gastrointestinal complaints for the previous month. For 5 days, 204 received metronidazole 15 mg/kg/day and 201 received B-complex syrup. Stool samples were examined 2-3 weeks and 3 months after treatment and results were tested with chi-squared. Weight and height 6 months after treatment were compared with primary weight and height by Z-score and Student t-test. Metronidazole efficacy at 2-3 weeks was 85.3%. Three months after treatment, 60 were reinfected [34.5%] and 71 had spontaneously cleared [35.3%]. Because of high reinfection, spontaneous clearing and treatment failure rates, and the lack of effect on nutritional status or growth, we do not recommend treatment for children with asymptomatic giardia infection

Two decades of nutrition assessment in the Eastern Mediterranean Region: scope, methodologies and dissemination

Different nutritional disorders prevail at different stages in the life cycle, e.g. growth retardation in the fetus, protein energy deficiency in children, noncommunicable conditions in adults. The scope of nutrition assessment has changed over the past 2 decades. The focus shifted from pregnant and lactating mothers and children, through functional consequences of malnutrition to deficiency disorders. Now the focus is on obesity. Clinical methods of assessment [usually indicators of late-stage malnutrition] have become less important recently although clinical indicators of iodine deficiency and vitamin A deficiency are still useful. The key method now is anthropomorphic measurement, such as weight-for-age or body mass index. All the countries of the Region have nutrition education programmes for dissemination of information and most have drawn up national dietary guidelines applying the strategies that were developed after the 1992 International Conference on Nutrition

Normal uterine size in women of reproductive age in northern Islamic Republic of Iran

To determine the efficacy of ultrasonographic assessment of uterus size in women of reproductive age, we conducted a cross-sectional analytic study of 231 women aged 15-45 years in Babol, northern Islamic Republic of Iran. Mean uterus size was 86.6 mm x 49.6 mm x 40.6 mm overall, 72.8 mm x 42.8 mm x 32.4 mm for nulliparous women and 90.8 mm x 51.7 mm x 43.0 mm for multiparous women. Mean age was 31.7 +/- 9.6 years and mean body mass index [BMI] was 24.7 +/- 4.0 kg/m2. Uterus size was significantly associated with parity and age; but not with BMI. Our findings show a greater mean uterus size than reported by others. Ultrasonographic measurement of uterus size is valuable for predicting pathologies associated with abnormal uterine size

Socioeconomic predictors of unconstrained child growth in Muscat, Oman

We conducted a study to identify socioeconomic factors associated with unconstrained growth among preschoolers in Muscat, Oman. A sample of children born in 1995 and aged 28-43 months was drawn from the Child Health Registers of 2 health care centres. Sociodemographic data were collected by oral interview and maternal and child anthropometry measured. Regression analysis was used to identify socioeconomic indicators and cut-offs associated with unconstrained growth. Children from households with a monthly income > or = 800 Omani rials and mother's education > or = 4 years attained height-for-age levels comparable to the current international growth reference. By screening using this criterion, we could obtain a suitable sample for the World Health Organization Multicentre Growth Reference Study in Muscat

Effect of exclusive breastfeeding and complementary feeding on infant growth and morbidity

A cohort study was conducted in the Islamic Republic of Iran between January 1997 and February 1998 to compare the growth and morbidity of 100 infants who were exclusively breastfed for 6 months and 100 who received breast milk and complementary foods between 4-6 months. Infants' feeding pattern, weight and height were assessed and recorded. There were no significant differences in infants' weight and height gain between 4 and 6 months. The rate of diarrhoea between ages 4 and 6 months was significantly lower in exclusively breastfed infants than in complementary food-fed infants [11% versus 27%] and respiratory infections were also lower [23% versus 35%]. We conclude that exclusive breastfeeding is superior at least until an infant is 6 months of age