Adherence to the Qatar dietary guidelines: a cross-sectional study of the gaps, determinants and association with cardiometabolic risk amongst adults.

BACKGROUND: The Qatar Dietary Guidelines (QDGs) were developed as part of the national strategy to prevent chronic diseases. This study aims at characterizing gaps between the QDGs and usual dietary and lifestyle patterns in Qatar, identifying demographic and socioeconomic determinants of adherence to the QDGs and investigating the association between adherence and cardiometabolic risk. METHODS: This study is based on the Qatar National STEPwise cross-sectional survey which was conducted on a nationally representative sample of Qatari adults, aged 18 to 64 years (n = 1109). Data collection included socio-demographic characteristics, lifestyle factors, anthropometric (weight, height and waist circumference (WC)), and blood pressure measurements. The dietary intake of participants was evaluated using a non-quantitative food frequency questionnaire (FFQ). Biochemical assessment was performed to measure the fasting levels of blood sugar, triglycerides (TG) and HDL cholesterol. The metabolic syndrome (MetS) was defined as the presence of three or more cardiometabolic risk factors. To examine adherence to the guidelines, each specifc recommendation was matched to corresponding data drawn from the survey. To investigate the association of sociodemographic, lifestyle and cardiometabolic characteristics with adherence to the QDGs, an adherence score was calculated. RESULTS: More than 83% of adults did not meet the recommendations for vegetables, fruits, whole grains, legumes and high fibre intakes, 70% were overweight or obese, 50-72% reported frequent consumption of sweetened beverages and sweets, and 47% reported frequent consumption of fast foods. Younger adults, the unemployed, the least educated and those not married had lower adherence to the QDGs. Adherence was inversely associated with elevated WC (OR: 0.88, 95% CI:0.82-0.95) and the MetS (OR:0.84,95% CI:0.74-0.96). CONCLUSIONS: Building on the identified gaps and vulnerable population groups, the study findings should provide a road map for the prioritization of interventions and the development of culture- specific programs aiming at promoting adherence to dietary guidelines in Qatar, while serving as a model to other countries in the region.

The impact of COVID-19 on primary health care services in Qatar: 2 years of response and coping 2020-2021.

Background: Health care systems worldwide have rapidly responded to manage the COVID-19 pandemic by providing screening tests, contact tracing, treatment, and vaccination. However, the long duration of the pandemic has had an enormous load on the health care systems, which disrupted continuity of the essential non-covid services, long waiting time for appointments, and increase in the utilization of telemedicine services. Primary health care was established as an essential foundation for the global response to the COVID-19. In Qatar, Primary Heath Care Corporation (PHCC), the main primary care services provided played a major role in the response to the pandemic. However, its services were affected and disrupted, and new services were added. Hence, the aim of this analysis is to understand the long-term impact of the COVID-19 on the services provided by PHCC in Qatar in terms of PHCC pandemic response, change in utilization of the core, and preventative services, and the introduction of new alternative services. Methods: A retrospective data analysis was conducted for all the appointments and visits for all the PHCC health centers in the years of 2020 and 2021. The study conducted a comparison of the services utilizations using the utilization figures of PHCC services between 1st of January and 31st of December 2019 as a reference year. The differences in the utilization per service were presented in frequencies and percentages. Results: The in-person services dropped drastically in 2020 at 36% reduction in compassion to 2019. However, the newly introduced virtual consultation services in 2020 reached their highest utilization figures in 2021 at 908,965 virtual visits. The COVID-19 specific related services ranging from the COVID-19 drive-through testing to vaccine administration constituted a total number of 2,836,127 visits corresponding to 44% of the total PHCC services utilization visits in 2021. In 2021, PHCC dental services dropped by 25.2%. The most noticeable utilization drops in 2021 were among the preventative services with 53.2% and 78.9% in colorectal screening and non-communicable diseases (NCDs) risk factors annual screening services, respectively. However, mental health services have witnessed a surge in utilization at 134.1% increase in 2021 in comparison to 2019. Conclusion: The COVID-19 pandemic caused a disruption in the PHCC utilization of core services, namely dental services. Additionally, PHCC preventive services utilizations were affected drastically including cancer and NCDs risk factors annual screening. Nevertheless, PHCC managed to provide alternative virtual services and played a vital role in responding to the pandemic by leading the COVID-19 vaccination campaign in Qatar. However, future research is needed to establish which vulnerable patient groups were most affected by the pandemic, to continue to inform strategies and policies directed at mitigating the impact of future potential pandemics.

The impact of COVID-19 pandemic on the preventive services in Qatar.

Background: In March 2020, Qatar started reporting increased numbers of COVID-19 cases. At that stage, containment measures were put in place. The health authority in Qatar developed an emergency action plan to respond to the outbreak with the Primary Health Care as the main component of that response and suspended all non-urgent services including preventive health services. The aim of the retrospective analysis to measure the Impact of COVID-19 on the preventive services provided in Qatar. Methods: A retrospective data analysis was conducted for all the preventive services utilization volume across the 27 PHCC health centres from the 1st of January 2017 to the 31st of July 2020. Results: With 17,012 no-show appointments, well-baby and Immunization services utilization demonstrated a reduction of 40% in May and started to come back to volumes higher than expected in June. The breast cancer and colorectal cancer screening programmes expected volumes demand has dropped by 100% in comparison to 2017 demand due to their respective appointments' cancelation. Wellness services only met 20% of its projected utilization in April, however, the services picked up in June. Conclusion: These findings will guide the public health policymakers to understand the effects COVID-19 on preventive services and the risk of having an increased number of outbreaks for childhood communicable disease, cancer cases with delayed diagnosis due to the screening services suspension. In addition, the plan will address the increased number of sedately behaviour due to the service's reduced utilization of wellness services.

Lifestyle Patterns Are Associated with Elevated Blood Pressure among Qatari Women of Reproductive Age: A Cross-Sectional National Study.

Women of childbearing age are particularly vulnerable to the adverse effects of elevated blood pressure (BP), with dietary and lifestyle habits being increasingly recognized as important modifiable environmental risk factors for this condition. Using data from the National STEPwise survey conducted in Qatar in year 2012, we aimed to examine lifestyle patterns and their association with elevated BP among Qatari women of childbearing age (18-45 years). Socio-demographic, lifestyle, dietary, anthropometric and BP data were used (n = 747). Principal component factor analysis was applied to identify the patterns using the frequency of consumption of 13 foods/food groups, physical activity level, and smoking status. Multivariate logistic regression analyses were used to evaluate the association of the identified lifestyle patterns with elevated BP and to examine the socio-demographic correlates of these patterns. Three lifestyle patterns were identified: a "healthy" pattern characterized by intake of fruits, natural juices, and vegetables; a "fast food & smoking" pattern characterized by fast foods, sweetened beverages, and sweets, in addition to smoking; and a "traditional sedentary" pattern which consisted of refined grains, dairy products, and meat in addition to low physical activity. The fast food & smoking and the traditional & sedentary patterns were associated with an approximately 2-fold increase in the risk of elevated BP in the study population. The findings of this study highlight the synergistic effect that diet, smoking and physical inactivity may have on the risk of elevated BP among Qatari women.