Assessment of Nutrients Intake in Pediatrics with Type 1 Diabetes and Dyslipidemia in Jordan.

Background: Dyslipidemias are disorders of lipoprotein metabolism that occur during childhood and adolescence, often persist into adulthood, and increase the risk of developing atherosclerotic lesions. This study aimed to assess the potential association between nutrient intake and dyslipidemia in Jordanian pediatric patients diagnosed with type 1 diabetes mellitus. Methods: This cross-sectional study was conducted in Amman, Jordan, and involved 90 children and adolescents diagnosed with type 1 diabetes mellitus. Caregivers provided the following data: sex, age, type and dose of insulin, age at onset of type 1 diabetes, and level of physical activity. Anthropometric measurements were obtained using calibrated scales, and CDC growth charts were used to assess participants' body weight status. Nutrient intake was estimated using a 120-item food frequency questionnaire (FFQ) previously validated in Jordanian children and adolescents. Serum lipid levels, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. Binary logistic regression was used to assess the relationship between nutrient intake and dyslipidemia. Results: The results indicated that 36.7% of study participants had dyslipidemia. There were no significant differences in nutrient intake between dyslipidemic and normolipidemic individuals, except for a significantly higher median intake of vitamin B12 in the dyslipidemic group compared to the normolipidemic group (3.6 versus 2.7 µg, P-value = 0.046). Conclusion: This study found no significant association between the prevalence of dyslipidemia and nutrient intake in children and adolescents diagnosed with type 1 diabetes mellitus.

Dietary Diversity in the Eastern Mediterranean Region Before and During the COVID-19 Pandemic: Disparities, Challenges, and Mitigation Measures.

The COVID-19 pandemic has revealed the Eastern Mediterranean Region's food system's fragility posing severe challenges to maintaining healthy sustainable lifestyle. The aim of this cross-sectional study (N = 13,527 household's family members, mean age: 30.3 ±11.6, 80% women) is to examine the impact of the COVID-19 pandemic on food consumption patterns and household's dietary diversity in 10 Eastern Mediterranean countries. A food frequency questionnaire was used to investigate the consumption patterns along with the calculation of the Food Consumption Score (FCS), a proxy indicator of dietary diversity. Data collected on cooking attitudes, shopping and food stock explore the community mitigation measures. In the overall population, before and during the pandemic, most food groups were consumed less or equal to 4 times per week. As evident from our findings and considering that the pandemic may be better, but it's not over, small to moderate changes in food consumption patterns in relatively short time periods can become permanent and lead to substantial poor dietary diversity over time. While it is a priority to mitigate the immediate impact, one area of great concern is the long-term effects of this pandemic on dietary patterns and dietary diversity in Eastern Mediterranean households. To conclude, the COVID-19 crisis revealed the region's unpreparedness to deal with a pandemic. While the aggressive containment strategy was essential for most countries to help prevent the spread, it came at a high nutritional cost, driving poor dietary diversity.

Identification of Adolescents with Adiposities and Elevated Blood Pressure and Implementation of Preventive Measures Warrants the Use of Multiple Clinical Assessment Tools.

The burden of abdominal adiposity has increased globally, which is recognized as a key condition for the development of obesity-related disorders among youth, including type 2 diabetes, cardiovascular disease, and hypertension. High blood pressure (BP) and cardiovascular diseases increase the rates of premature mortality and morbidity substantially. Aims: to investigate the relation between abdominal adiposity and elevated BP among adolescent males in Jordan. Methods: Nationally representative sample of male adolescents was selected using multi-cluster sampling technique. Study sample included 1035 adolescent males aged 12 to 17 years. Multiple indicators were used to assess adiposity including waist circumference (WC) and total body fat (TF), truncal fat (TrF), and visceral fat (VF). Systolic blood pressure was measured to assess hypertension. Results: After adjusting for age, smoking status, and physical activity, the odds of having stage two hypertension increased 6, 7, and 8 times for adolescents who were on 90th percentile or above for Trf, VF, and WC, respectively. Conclusion: Elevated BP was significantly associated with total and abdominal adiposity among adolescent males in Jordan. Use of multiple clinical assessment tools is essential to assess abdominal obesity among adolescents.

Development and Psychometric Properties of the Arabic Parent Nutritional Assessment Scale (A-PNAS) for Children with Developmental Disabilities.

Aims: To describe the development of the Arabic-Parent Nutritional Assessment Scale (A-PNAS), and to examine construct and known-group discriminant validity, internal consistency, and test-retest reliability of the A-PNAS.Methods: A cross-sectional design was used. Participants were 130-children with CP (mean age = 4.26 ± 3.29 years) who were registered in the national CP registry of Jordan with a matching group of 130-children with typical development (mean age = 4.65 ± 3.54 years). Parents completed the developed A-PNAS through a structured phone interview. Parents of children with CP confirmed their child's level of gross motor function classification system.Results: Exploratory factor analysis identified three subscales in the A-PNAS: Food Intake Problems, Health Problems, and Behavioral Problems which explained 31.6% of the variance in nutritional problems of children with CP. Cronbach's alpha indicated acceptable internal consistency for Food Intake (α = 0.61) and Health Problems (α = 0.67)subscales. Parents of children with CP reported that their children had more food intake, health, and behavioral problems compared to children with typical development (p<.001). Test-retest reliability was excellent for the subscales of the A-PNAS (ICCs = 0.96, 0.98, 0.96).Conclusions: The findings provide support for the face validity, construct validity, internal consistency, Known-Groups discriminant validity, and test-retest reliability of the A-PNAS.

Validity and Reproducibility of a Food Frequency Questionnaire for Estimating Macro- and Micronutrient Intakes Among Pregnant Women in Jordan.

Objectives: Assessing the relationship between maternal diet and pregnancy outcomes is a crucial issue that requires valid dietary assessment tools in this critical period. This study aimed to develop and assess the validity and reproducibility of a culture-specific quantitative food frequency questionnaire (QFFQ) to evaluate the dietary intake of macro- and micronutrients from food in a sample of Jordanian pregnant women.Methods: A QFFQ was validated against three repeated 24-hour dietary recalls (24-hr recalls). The QFFQ was administered twice one month apart. A total of 131 Jordanian pregnant women participated in the validation study. Thirty women took part in the reproducibility phase, which was repeated in a time frame of one month.Results: The intra-class correlation coefficients of QFFQ1 and QFFQ2 for energy were 0.79 and for macronutrients ranged from -0.27 for insoluble fiber to 0.81 for dietary fiber, indicating adequate (0.51) reproducibility. The intra-class correlation coefficients between two QFFQs for micronutrients ranged from 0.19 for selenium to 0.85 for vitamin C. The average of correlation coefficient was 0.58 for micronutrients. Energy-adjusted and de-attenuated Pearson correlation coefficients between QFFQ1 and 24-hr dietary recall for macronutrients ranged from 0.13 for soluble fiber and trans fat to 0.90 for cholesterol and for micronutrients from 0.01 for sodium to 0.78 for magnesium.Conclusions: The newly developed QFFQ could facilitate the assessment of the nutrient intake among Jordanian pregnant women. Using this QFFQ will help in evaluating the nutritional status of pregnant women, aiming at improving maternal and newborn health.

Assessment of Abdominal Fat Using High-field Magnetic Resonance Imaging and Anthropometric and Biochemical Parameters.

BACKGROUND: To measure the abdominal subcutaneous fat (SF) and visceral fat (VF) volumes using high-field magnetic resonance imaging (MRI) and to investigate their association with selected anthropometric and biochemical parameters among obese and nonobese apparently healthy participants. METHODS: A cross-sectional study was conducted by recruiting 167 healthy participants. Abdominal scans were acquired at 3T MRI, and the SF and VF were segmented and their volumes were calculated. Selected anthropometric and biochemical measurements were also determined. RESULTS: A significant difference (P < 0.05) was observed between normal body weight and overweight and obese participants for SF and VF, total abdominal fat volumes, leptin, resistin, adiponectin and waist circumference. Waist circumferences were measured by tape and MRI. Findings revealed that MRI-measured fat volumes were different between males and females and had a significant (P < 0.01) strong positive correlation with body mass index, leptin, resistin and WC and had a negative correlation with adiponectin level. MRI-measured fat volumes were found to correlate moderately with interleukin-6 and weakly with cholesterol, serum triglyceride and low-density lipoprotein. Except for cholesterol, all measured biochemical variables and abdominal fat volumes in the current study were significantly associated with body mass index. CONCLUSIONS: All anthropometric and biochemical parameters showed weak-to-strong associations with the MRI-measured fat volumes. Abdominal fat distribution was different between males and females and their correlations with some lipid profiles were found to be sex dependent. These findings revealed that MRI can be used as an alternative tool for obesity assessment.

Prevalence of food insecurity among women in northern Jordan.

Food insecurity--not having sufficient quantities of good-quality foods--is inversely related to physical and mental health and directly related to poor dietary intake. The objectives of this research were to (a) measure the prevalence of food insecurity among women in northern Jordan, (b) study the socioeconomic factors associated with an increased risk of food insecurity, and (c) investigate the relationship between household food insecurity and women's reported body-weight. This cross-sectional study was conducted using an interview-based questionnaire. In total, 500 women were interviewed in the waiting rooms of the outpatient clinics of two major public hospitals in northern Jordan. Food insecurity was assessed using the short form of the U.S. food security survey module. The prevalence of food insecurity was 32.4%. Income below the poverty-line, illiteracy, unemployment, rented housing, and woman heading the household were among the socioeconomic factors that increased the probability of food insecurity. No evidence was found to support the relationship between obesity and food insecurity. Except grains, food-insecure women with hunger had lower intake of all food-groups. This study demonstrated that the problem of food insecurity is present in Jordan. Food-insecure women with hunger are at a risk of malnutrition. Interventions that target reduction of the factors associated with food insecurity are necessary.

Assessment of nutritional status among ESRD patients in Jordanian hospitals.

OBJECTIVE: Our objective was to assess nutritional status and compare quality of treatment among hemodialysis patients in public and private hospitals in Jordan. DESIGN: We utilized a cross-sectional survey. SETTING: Our setting involved hospital hemodialysis units. PATIENTS: This study was undertaken in five large Jordanian hospitals between 2004 and 2005. One hundred and eighty participants diagnosed with end-stage renal failure (ESRD) were enrolled. These participants (91 women and 89 men) who underwent hemodialysis treatment were recruited using a convenience sampling technique. Data from participants who received hemodialysis treatment in public hospital settings were compared with equivalent data from participants treated in private hospital settings. MAIN OUTCOME MEASURES: Subjective global assessment (SGA), anthropometry, and biochemical measurements were used as evaluative tools. RESULTS: In the anthropometric measurement of triceps skinfold thickness (TSF), we found a statistically significant difference (P < .05) between participants treated in the two hospital settings. In addition, approximately 62% of all participants, regardless of treatment site, were found to be moderately to severely malnourished. Anthropometric measurements showed some significant increase between prehemodialysis and posthemodialysis weight and body mass index in private hospitals; this was not unexpected. There were no statistically significant differences in the measured mean levels of eight different biochemical parameters, with the exception of plasma phosphorus and sodium levels. CONCLUSIONS: The prevalence of malnutrition and the quality of treatment in our two groups of participants were similar.