Evaluation of circulating levels of Interleukin-10 and Interleukin-16 and dietary inflammatory index in Lebanese knee osteoarthritis patients.

OBJECTIVES: To investigate plasma concentrations of Interleukin-16 (IL-16) and Interleukin-10 (IL-10) in Lebanese knee osteoarthritis (KOA) patients and to examine the association between the diet-associated inflammation and increased risk for KOA. METHODS: A total of 208 study participants were assigned to one of the 3 groups: Diagnosed Knee Osteoarthritis group (DKOA) (N = 78); Undiagnosed Knee Osteoarthritis group (UKOA) (N = 60) and controls matched on age, sex and sociodemographic characteristics (N = 70). UKOA represents KOA features before they are altered by therapeutic intervention and lifestyle modifications that follow the diagnosis. Energy-adjusted dietary inflammatory index (E-DII™) scores were calculated using 2-day 24-hour recalls. IL-10 and IL-16 were measured using commercially available sandwich enzyme-linked immunosorbent assay kits. RESULTS: The UKOA group and controls did not show any significant difference in plasma IL-16 levels (p = 0.28), whereas significantly higher levels of IL-10 were observed in the UKOA group compared to controls (21 ± 41 vs 7.5 ± 12 pg/mL; p = 0.01). The UKOA group had significantly higher IL-16 levels compared to the DKOA group (177 ± 215 vs 80 ± 57 pg/ml; p = 0.001) and significantly higher IL-10 levels compared to the DKOA group (21 ± 41 vs 8 ± 14 pg/mL; p = 0.02). Significantly higher levels of IL-16 were observed in the control group compared to the DKOA group (140 ± 161 vs 80 ± 57 pg/ml; p = 0.009) whereas the DKOA group and controls did not show any significant difference in plasma IL-10 levels (p = 0.82). Additionally, we found significantly higher E-DII scores in the UKOA group compared to controls (0.53 ± 1.028 vs 0.04 ± 1.580; p = 0.04) and in the UKOA group compared to the DKOA group (0.53 ± 1.028 vs -0.37 ± 1.899; p = 0.001). However, there was significant difference in E-DII scores between the DKOA group and controls (p = 0.16). CONCLUSIONS: Our findings indicate an association between circulating levels of IL-10 and KOA in Lebanese population, and a potential role of pro-inflammatory diet in KOA pathology. We did not find an association between circulating levels of IL-16 and KOA.

Validation of an Arabic Version of the Obesity-Related Wellbeing (ORWELL 97) Questionnaire in Adults with Obesity.

BACKGROUND: No specific questionnaire that evaluates Health-Related Quality Of Life (HRQOL) in individuals with obesity is available in the Arabic language. The aim of this study was therefore to propose and examine the validity and reliability of an Arabic language version of the ORWELL 97, a validated obesity-related HRQOL questionnaire. METHODS: The ORWELL 97 questionnaire was translated from English to Arabic language and administered to 318 Arabic-speaking participants (106 from clinical and 212 from community samples), and underwent internal consistency, test-retest reliability, construct and discriminative validity analysis. RESULTS: Internal consistency and the test-retest reliability were excellent for ORWELL 97 global scores in the clinical sample. Participants with obesity displayed significantly higher ORWELL 97 scores than participants from the community sample, confirming the good discriminant validity of the questionnaire. Confirmatory factor analysis in the clinical sample revealed a good fit for a modified two-factor structure. CONCLUSION: Overall, the Arabic version of the ORWELL 97 can be considered validated in Arabic adult patients with obesity, paving the way to further assessment of its responsiveness in measuring changes in health-related quality of life associated with obesity treatment.

The Association between Body Mass Index and Health-Related Quality of Life in Treatment-Seeking Arab Adults with Obesity.

Few studies have thus far been carried out on Health-Related Quality of Life (HRQoL) and obesity in Arab-speaking countries, an issue that we therefore set out to investigate in this study. HRQoL was assessed by the validated Arabic version of the ORWELL 97 questionnaire in 129 treatment-seeking individuals with obesity referred to the Nutritional and Weight Management Outpatient Clinic at the Department of Nutrition and Dietetics of Beirut Arab University (BAU) in Lebanon, and 129 normal-weight participants of similar age and gender. Participants with obesity, regardless of gender, displayed higher total ORWELL 97 scores when compared with normal-weight controls, indicating that obesity is associated with lower HRQoL. Linear regression analysis showed that a higher body mass index (BMI) is associated with an increase in ORWELL 97 scores, but only among female, not male, participants with obesity (ß = 2.89, 95% confidence interval (CI) = 1.43-4.53, p < 0.001). Moreover, logistic regression analysis showed that a one unit increase in BMI increases the odds of an ORWELL 97 score ≥ 71.75-considered indicative of a clinically significant impairment of HRQoL-by nearly 23% (odds ratio (OR), 95% CI = 1.23, 1.09-1.40, p < 0.05). If confirmed, our findings should prompt clinicians operating in Arab countries to encourage patients with obesity to initiate and persevere in weight-loss programs at the earliest opportunity.

Long-term Lifestyle-modification Programs for Overweight and Obesity Management in the Arab States: Systematic Review and Meta-analysis.

BACKGROUND: Obesity is a growing health problem worldwide. It is associated with serious medical and psychosocial comorbidities that increase the risk of mortality. However, strong evidence confirms lifestyle-modification programs as the cornerstone treatment for excess weight and obesity. The aim of this systematic review was to assess the effectiveness of the lifestyle-modification programs for weight management delivered in Arabic-speaking countries. METHODS: The PubMed database was searched, and studies conducted in humans were identified and screened as per the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Data were collated using meta-analysis and a narrative approach. RESULTS: Of the 1057 articles retrieved, six studies, conducted in four Arab countries, comprising a total of 444 adolescent and adult participants of both genders with overweight and obesity, met the inclusion criteria and were reviewed. Most studies that assessed weight loss at 6-month follow-up showed no significant reduction in body weight. Meta-analysis confirmed that the lifestyle-modification programs delivered were no more effective than other treatments. Only one article reported significant weight-loss maintenance after 12 months of follow-up. However this was a prospective non-controlled study in which the weight loss maintained (=4%) did not conform to the standard for clinical significance (>10%). CONCLUSION: Lifestyle-modification programs for weight management delivered in Arabic-speaking countries seem lacking in effectiveness due to methodological weaknesses in program adaptation, a lack of expert clinical supervision before and during implementation, and the presence of barriers to lifestyle modification, especially for women. Future studies should bear these features in mind.

Exploration of the Risk Factors of Generalized and Central Obesity among Adolescents in North Lebanon.

Adolescents' obesity is an emerging public health problem globally and in the Arab countries. Alarming rates of overweight/obesity have been rising progressively in Lebanon. However, the risk factors for the development of adolescents' obesity have not yet been thoroughly explored in North Lebanon. To determine the dietary and lifestyle risk factors associated with generalized and central obesity among adolescents living in Tripoli, a cross-sectional survey was conducted including a representative sample of 311 students aged 11-16 years from both sexes chosen from public and private schools in Tripoli. Data were collected using a standardized questionnaire to determine sociodemographic characteristics, dietary patterns, and physical activity and sedentary behaviors. Body mass index (BMI) was evaluated using the Center for Disease Control BMI for age percentiles. Central obesity was assessed using both waist-to-height ratio and gender-specific waist circumference for age indices. Multiple logistic regression analysis revealed that skipping breakfast and physical inactivity were the most significant independent risk factors associated with both generalized and central obesity. In addition, higher screen time and male gender were associated with increased risk for generalized and central obesity, respectively. Intervention strategies to prevent the development of obesity should be implemented among adolescent students to encourage regular breakfast intake and adopting healthy dietary and lifestyle behaviors.

The Dual Burden of Malnutrition and Associated Dietary and Lifestyle Habits among Lebanese School Age Children Living in Orphanages in North Lebanon.

Childhood is a crucial period affecting physical and intellectual development. Although children living in orphanages are among the most vulnerable groups at risk of malnutrition, there is scarcity of data concerning their nutritional status in Lebanon. To investigate these data, a cross-sectional survey was conducted including a sample of 153 institutionalized children aged 5-14 years from all orphanages in Tripoli. Nutritional status was assessed using anthropometric, clinical, and dietary tools. Interpretation of anthropometric data showed that 13.8% were stunted while the prevalence of overweight/obesity was 9.2% according to the World Health Organization (WHO) reference criteria. Physical signs suggesting nutritional deficiencies were detected in about 25% of the sample. Dietary intake evaluation showed that about half of the participants had inadequate dietary intakes of proteins, fruits, and vegetables and 92% had inadequate milk and dairy intakes recommended for their age specific needs. Multivariate regression analysis revealed statistically significant positive association of age, skipping breakfast, and increased screen time with stunting while it showed statistically significant negative association of inadequate protein intake with overweight/obesity. The coexistence of under- and overnutrition among institutionalized children calls for implementation of comprehensive intervention strategies committed to reducing undernutrition while simultaneously preventing overnutrition through improving diet quality and physical activity of these children.

Exploration of the Dietary and Lifestyle Behaviors and Weight Status and Their Self-Perceptions among Health Sciences University Students in North Lebanon.

University students may experience significant environmental changes that exert a negative influence on the quality of their diet and lifestyle. There is scarcity of data concerning the dietary and lifestyle behaviors and weight status of students in the health field in North Lebanon. To investigate these data, a cross-sectional survey was conducted including 369 health sciences students aged 18-25 chosen from four public and private universities in North Lebanon. Data were collected using a standardized interview questionnaire to determine sociodemographic, dietary, and lifestyle behaviors, appetite changes, stress related dietary behaviors, and food cravings, as well as self-perceptions of dietary adequacy, physical activity levels, and weight status. Body mass index was assessed. Results had revealed significant differences in some of the dietary consumption patterns and weight status among seniors compared to juniors. However, the overall prevalence of overweight and obesity recorded 32.2% and the dietary consumption patterns fall below recommended levels. Multivariate regression analysis showed that parental obesity, comfort eating, increased appetite, food cravings, and stressful eating were associated with increased risk of obesity while a healthy diet score was associated with decreased risk. The study's findings call for tailoring culture specific intervention programs which enable students to improve their dietary and lifestyle behaviors and control stress.