The Role of Lifestyle Interventions in the Prevention and Treatment of Gestational Diabetes Mellitus.

Gestational diabetes mellitus (GDM) is one of the most common pregnancy-related endocrinopathies, affecting up to 25% of pregnancies globally. GDM increases the risk of perinatal and delivery complications, and the chance of developing type 2 diabetes mellitus and its complications, including cardiovascular diseases. This elevated risk is then passed on to the next generation, creating a cycle of metabolic dysfunction across generations. For many years, GDM preventive measures have had inconsistent results, but recent systematic reviews and meta-analyses have identified promising new preventative routes. This review aims to summarize the evidence investigating the efficacy of lifestyle treatments for the prevention of GDM and to summarize the effects of two lifestyle interventions, including physical activity and dietary interventions. Based on the present research, future studies should be conducted to investigate whether initiating lifestyle interventions during the preconception period is more beneficial in preventing GDM. In addition, research targeting pregnancy should be designed with a personalized approach. Therefore, studies should customize intervention approaches depending on the presence of modifiable and non-modifiable risk factors at the individual level.

Adherence to the Mediterranean diet and its association with environmental footprints among women of childbearing age in the United Arab Emirates.

PURPOSE: To examine the association of adherence to the Mediterranean Diet (MD) with Environmental Footprints (EFPs) among women of childbearing age in the United Arab Emirates (UAE). METHODS: Data belonging to a nationally representative sample of 482 women (19-50 years) were derived from a previous survey in the UAE. In face-to-face interviews, participants completed questionnaires addressing sociodemographic, physical activity, and dietary intake characteristics; the latter assessed using a multiple pass 24-h recall. The composite Mediterranean (c-MED) index was used to examine the adherence to the MD. Metrics for the EFPs (water use, energy use, and GHG emissions) were calculated using Life Cycle Analyses. Descriptive statistics and linear regressions were used in data analysis. RESULTS: In the study sample, the distribution of the c-MED scores was skewed to the right, indicating a low adherence to the MD. The lowest contributions to the total c-MED score were observed for legumes (2.9%) and olive oil (1.8%). The EFPs associated with food consumption per 1000 kcal were: water use: 1256.89 ± 544.95 L/day; energy use: 18.01 ± 7.85 MJ/day, and GHG: 2.46 ± 1.46 kg CO2 eq/day. After adjustment for age, energy intake, and potential confounders, being adherent to the MD was associated with 540.57 [95% CI (- 726.6; - 354.54)] units decrease in water use and 0.94 units decrease in GHG emissions [95% CI (- 1.45; - 0.43)]. CONCLUSIONS: The findings of this study revealed an inverse association between adherence to the MD and EFPs. As such, the MD may represent a promising dietary strategy to improve health outcomes and reduce the environmental impact. Public health programs addressing the low adherence to the MD among women of childbearing age in the UAE are warranted.

Nutritional status and adequacy of feeding Practices in Infants and Toddlers 0-23.9 months living in the United Arab Emirates (UAE): findings from the feeding Infants and Toddlers Study (FITS) 2020.

BACKGROUND: Infant and young child feeding practices (IYCF) impact the early and later health status of the population. Limited data is available regarding IYCF in the United Arab Emirates (UAE). This study aimed to evaluate the nutritional status and adequacy of feeding practices, energy, food, and nutrient intakes of UAE infants and toddlers ages 0-23.9 months. METHODS: This study is a population-based cross-sectional survey of 276 infants and toddlers aged 0-23.9 months of which 180 were nationals and 96 were Arab non-nationals living in the UAE. Data were collected from the three major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometry was collected and assessed using WHO Anthro-Survey Analyzer, and a multicomponent age-specific questionnaire was used to evaluate IYCF and sociodemographic characteristics. Usual intake of energy, micronutrients, and macronutrients, including supplements, were collected using multiple-pass 24-h dietary recall and analyzed using the PC-side software. IYCF practices were assessed using the WHO indicators. RESULTS: Overall, 4% of children were malnourished, 8% wasted, 15% stunted, 18% at risk of overweight, and 7% overweight and obese. 95% of infants were ever breastfed and 37% exclusively breastfed at 6 months. Around 98% of infants had a timely introduction of complementary food. Macronutrient intake exceeded AMDR for fat, carbohydrates, and protein for 27%, 8% and 2% of toddlers respectively. As for the percentage of those exceeding the ESPGHAN cut-off for free sugars set at 5% of energy intake, 28.6% had excessive intakes overall, 10% in 0-5.9, 21.9% in 6-11.9 and 56.7% in 12-23.9 month. Usual iron intake was below the Estimated Average Requirement (EAR) in 47% of infants 6-11.9 months. Above 12 months, the usual intake of iron and vitamin D were below EAR in 11% and 49% of toddlers respectively. Usual intake exceeded the tolerable upper intake levels (UL) for vitamin A (14 to 18%) and zinc (11 to 22%) across all ages. Approximately 93% of toddlers ages 12-23.9 months did not meet food groups' recommendations for vegetables, 87% for fruits, 48% for milk/dairy, 54% for lean meat and beans, and 33% for grains. CONCLUSIONS: This study revealed that a high percentage of infants and toddlers aged 0-23.9 m suffer from a double burden of malnutrition, which is the coexistence of both undernutrition, and overweight and obesity in the same population. In addition to suboptimal feeding practices and inadequate/overconsumption of various nutrients. The findings highlight the need for the development of culturally specific programs aiming to improve the nutritional status of infants and toddlers in the UAE.

Assessment of eating habits and lifestyle during the coronavirus 2019 pandemic in the Middle East and North Africa region: a cross-sectional study.

Coronavirus disease 2019 (COVID-19) has rapidly spread globally, forcing countries to apply lockdowns and strict social distancing measures. The aim of this study was to assess eating habits and lifestyle behaviours among residents of the Middle East and North Africa (MENA) region during the lockdown. A cross-sectional study among adult residents of the MENA region was conducted using an online questionnaire designed on Google Forms during April 2020. A total of 2970 participants from eighteen countries participated in the present study. During the pandemic, over 30 % reported weight gain, 6·2 % consumed five or more meals per d compared with 2·2 % before the pandemic (P < 0·001) and 48·8 % did not consume fruits on a daily basis. Moreover, 39·1 % did not engage in physical activity, and over 35 % spent more than 5 h/d on screens. A significant association between the frequency of training during the pandemic and the reported change in weight was found (P < 0·001). A significantly higher percentage of participants reported physical and emotional exhaustion, irritability and tension either all the time or a large part of the time during the pandemic (P < 0·001). Although a high percentage of participants reported sleeping more hours per night during the pandemic, 63 % had sleep disturbances. The study highlights that the lockdown due to the COVID-19 pandemic caused a variety of lifestyle changes, physical inactivity and psychological problems among adults in the MENA region.

Perceived social support and self-efficacy beliefs for healthy eating and physical activity among Arabic-speaking university students: adaptation and implementation of health beliefs survey questionnaire.

BACKGROUND: Few assessment tools exist for investigating perceived social support and self-efficacy behaviors in Arabic-speaking populations. Moreover, literature on the levels of social support and self-efficacy for adopting healthy eating and engaging in regular physical activity among Arabic-speaking young adults is currently lacking. This study aimed to adapt the Health Beliefs Survey Questionnaire (HBSQ) for Arabic-speaking populations and assess perceived social support and self-efficacy for adopting healthy eating and increased physical activity among university students. METHODS: In the first stage of the study, forward and backward translation and pretesting of the social support and self-efficacy scales of the HBSQ were conducted. The adapted questionnaire was administered to female university students (n = 258), and a subsample of 195 participants retook the questionnaire after 1 month. Construct validity was assessed with confirmatory factor analysis. The internal consistency of each subscale item was assessed by Cronbach's alpha coefficient, and reproducibility was tested with intraclass correlation coefficients (ICCs) and Bland-Altman plots. In the second stage, the adapted questionnaire was used to assess the perceived social support and self-efficacy levels in a different sample of Arabic-speaking female university students (n = 283). RESULTS: Based on the results from confirmatory factor analysis, 6 items were selected for the social support scale and 19 items for the self-efficacy scale. The adapted questionnaire showed moderate to high internal reliability (Cronbach alpha coefficient = 0.681 to 0.900). The ICCs of the various subscales ranged from 0.666 to 0.997, indicating moderate to excellent reproducibility of the culturally adapted questionnaire. This was confirmed by Bland-Altman analysis. Participants in the second stage of the study reported significantly higher (P < 0.001) perceived support from family compared to friends in reducing sugar intake and increasing fiber consumption. CONCLUSIONS: The results of the psychometric testing indicate the shortened Arabic HBSQ is a reliable tool for assessing perceived social support from family and close friends as well as for evaluating self-efficacy for choosing healthy foods and increasing physical activity among female university students.

Students' perspectives on promoting healthful food choices from campus vending machines: a qualitative interview study.

BACKGROUND: Increasing the healthfulness of campus food environments is an important step in promoting healthful food choices among college students. This study explored university students' suggestions on promoting healthful food choices from campus vending machines. It also examined factors influencing students' food choices from vending machines. METHODS: Peer-led semi-structured individual interviews were conducted with 43 undergraduate students (33 females and 10 males) recruited from students enrolled in an introductory nutrition course in a large national university in the United Arab Emirates. Interviews were audiotaped, transcribed, and coded to generate themes using N-Vivo software. RESULTS: Accessibility, peer influence, and busy schedules were the main factors influencing students' food choices from campus vending machines. Participants expressed the need to improve the nutritional quality of the food items sold in the campus vending machines. Recommendations for students' nutrition educational activities included placing nutrition tips on or beside the vending machines and using active learning methods, such as competitions on nutrition knowledge. CONCLUSIONS: The results of this study have useful applications in improving the campus food environment and nutrition education opportunities at the university to assist students in making healthful food choices.

Could psychobiotics and fermented foods improve mood in middle-aged and older women?

Menopause is a natural physiological phase during which women experience dramatic hormonal fluctuations. These lead to many symptoms, such as depression and anxiety, which, in turn, can negatively affect quality of life. Proper nutrition has an influential role in alleviating depression as well as anxiety. It is well known that gut microbiota dysbiosis contributes to the development of mood disorder. There is mounting evidence that modulating the gut-brain axis may aid in improving mood swings. In this context, this narrative review summarizes recent findings on how aging changes the composition of the gut microbiota and on the association between gut microbiota and mood disorders. In addition, it evaluates the effectiveness of psychobiotics and fermented foods in treating mood swings in middle-aged and older women. A search was done using PubMed, Scopus, and Google Scholar, and thirteen recent articles are included in this review. It is evident that psychobiotic supplementation and fermented foods can improve mood swings via several routes. However, these conclusions are based on only a few studies in middle-aged and older women. Therefore, long-term, well-designed randomized controlled trials are required to fully evaluate whether psychobiotics and fermented foods can be used to treat mood swings in this population.

Validity of Measured vs. Self-Reported Weight and Height and Practical Considerations for Enhancing Reliability in Clinical and Epidemiological Studies: A Systematic Review.

Self-reported measures of height and weight are often used in large epidemiological studies. However, concerns remain regarding the validity and reliability of these self-reported measures. The aim of this systematic review was to summarise and evaluate the comparative validity of measured and self-reported weight and height data and to recommend strategies to improve the reliability of self-reported-data collection across studies. This systematic review adopted the PRISMA guidelines. Four online sources, including PubMed, Medline, Google Scholar, and CINAHL, were utilised. A total of 17,800 articles were screened, and 10 studies were eligible to be included in the SLR based on the defined inclusion and exclusion criteria. The findings from the studies revealed good agreement between measured and self-reported weight and height based on intra-class correlation coefficient and Bland-Altman plots. Overall, measured weight and height had higher validity and reliability (ICC > 0.9; LOA < 1 SD). However, due to biases such as social pressure and self-esteem issues, women underreported their weight, while men overreported their height. In essence, self-reported measures remain valuable indicators to supplement the restricted direct anthropometric data, particularly in large-scale surveys. However, it is essential to address potential sources of bias.

Impact of Skills for Change Program on metabolic control, diet and physical activity levels in adults with type 2 diabetes: A cluster randomized trial.

BACKGROUND: Type 2 diabetes mellitus is highly prevalent in the Arab Gulf countries. Despite this, limited culturally-adapted lifestyle intervention studies have been conducted in this region. METHODS: In this culturally adapted 12-month cluster randomized trial, 382 patients with type 2 diabetes, aged 20-70 years were recruited from 6 public healthcare centers (3 interventions and 3 controls) in Al Ain, United Arab Emirates. The primary outcome of this study was a change in hemoglobin A1c (HbA1c). The secondary outcomes were Body Mass Index (BMI), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, dietary intake, and physical activity levels. A diet and physical activity intervention, guided by the social cognitive theory, was delivered individually and in group format to the intervention group. The control group continued receiving only their usual diabetes management care. The data were collected at baseline and 1 year after participation. RESULTS: The mean baseline HbA1c levels of the control and the intervention groups were 7.45 ± 0.11% and 7.81 ± 0.11%, respectively. At the end of the 12-month intervention, there was no significant difference in the changes of mean HbA1c between the intervention and the control groups. On the other hand, BMI and daily caloric intake were significantly decreased in the intervention compared to the control group by 1.18 kg/m2 (95% CI: -1.78 - -0.60) and 246 kcal (95% CI: -419.52 - -77.21), respectively, after controlling for age, gender, education, marital status, duration since diabetes diagnosis, diabetes treatment, treatment clinic, and baseline values. Sitting time during the week-end was significantly lower, difference 52.53 minutes (95% CI: 93.93 - -11.14). CONCLUSIONS: This community-based lifestyle intervention for patients with baseline HbA1c <8% did not result in a significant decrease of HbA1c but reduced caloric intake, body weight, and weekend inactivity after controlling for the covariates. TRIAL REGISTRATION: This trial was registered on February 11, 2020 with Clinicaltrials.gov (NCT04264793).

Micronutrient Status in Pregnant Women after Metabolic Bariatric Surgery in the United Arab Emirates: A Prospective Study.

Metabolic bariatric surgery (MBS) helps reduce comorbidities, such as hypertension and gestational diabetes, and is more effective than diet management for women with obesity-related health issues. Vitamin B12, vitamin D, and iron play important roles in ensuring the health of a neonate. However, pregnancies occurring after MBS may face complications related to micronutrient deficiencies, particularly of vitamins B12 and D and iron. This study aimed to investigate the vitamin B12, vitamin D, ferritin, and iron status of pregnant women who underwent MBS compared with women without MBS history. The study included 217 pregnant women (105 with a history of MBS and 112 without a history of MBS) who visited a major maternity hospital in Abu Dhabi, United Arab Emirates (UAE) between July 2021 and November 2022. The maternal vitamin B12, vitamin D, iron, and ferritin levels were measured twice, initially during the first or second trimester and subsequently during the third trimester. The iron was measured once during the pregnancy. Vitamin B12 deficiency was higher among pregnant women with MBS history compared to non-bariatric pregnant women (24.4% vs. 3.9%, p < 0.001). Women with a history of MBS had a higher prevalence of vitamin D deficiency (62.3% vs. 37.7%, p < 0.002). Linear regression analysis indicated that vitamin B12 levels decreased by 55 pg/mL in women with a history of MBS and by 4.6 pg/mL with a unit increase in body mass index (kg/m2). Furthermore, vitamin D levels in women with a history of MBS decreased by 4.9 ng/mL during pregnancy. Metabolic bariatric surgery is associated with vitamin B12, vitamin D, and iron deficiencies during pregnancy.

Validity and Reliability of the Arabic Version of the Three-Factor Eating Questionnaire-R18.

The present study translated and validated an Arabic version of the Three-Factor Eating Questionnaire-R18 (TFEQ-R18), which assesses eating behaviour traits among Arabic speakers in the three domains: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Three bilingual experts first translated the English questionnaire into Arabic, and the questionnaire's comprehension was tested among 298 Arabic speakers. Confirmatory factor analysis (CFA) tested the model fit and flagged four items in the questionnaire with low consistency. These items were modified, and the revised Arabic version of TFEQ-R18 was validated in a population of 513 individuals. Validity was evaluated using CFA and Pearson's correlation coefficients, internal consistency using Cronbach's α, and the reproducibility of the questionnaire was confirmed with Bland-Altman analysis and T-test. The construct validity of the Arabic TFEQ-R18 was evaluated by comparing the response score in the population based on gender, BMI and age group. CFA confirmed that the model fit is good and strongly agrees with the collected data. Except for item 15 in the CR domain, all questions showed moderate to high correlation within their respective domains. The Cronbach's α for UE, EE, and CR domains recorded was 0.778, 0.784 and 0.588, respectively. Item 15 had the lowest consistency in the Arabic-TFEQ-R18, and Cronbach's α increased to 0.608 with its removal. There was no significant difference between the first and second attempts of the Arabic TFEQ-R18, indicating good test-retest reliability. Moreover, UE and EE were positively correlated to the BMI of the participants (r = 0.159, p = 0·000; r = 0.158, p = 0·000, respectively). The study concludes that the Arabic TFEQ is a valid and reliable tool for studying the three psychometric domains of UE, EE and CR among Arabic speakers.

The benefits of physical activity in middle-aged individuals for cardiovascular disease outcomes.

Regular physical activity (PA) has a positive role in preventing cardiovascular disease (CVD). Due to a trend toward a more sedentary lifestyle, the middle-aged population (35-65 years) is at greater risk of developing CVD. It is well established that PA improves cardiorespiratory fitness and reduces the risk of cardiovascular mortality and cardiovascular events, including stroke, coronary heart disease, heart failure, hypercholesterolemia, atherosclerosis, diabetes, and blood pressure. PA can potentially decrease oxidative stress and systemic inflammation, which are the two main underlying mechanisms leading to CVD. By reducing CRP, TNF-α, INF-γ, NF-κB and increasing IL-10, IL-4, and IL-8, PA can prevent the initiation and progression of CVD in middle-aged adults, highlighting the importance of being physically active for this age group. The general recommendation for PA to prevent CVD is at least 150 min/week at a moderate level of intensity; the type of PA should be adapted to the fitness level and medical condition of the individual. However, standardized guidelines for middle-aged individuals with cardiovascular events still need to be established.

Soluble and Insoluble Dietary Fibre in Date Fruit Varieties: An Evaluation of Methods and Their Implications for Human Health.

Dietary fibre analysis is expensive due to its reliance on enzymes such as α-amylase, protease, and amyloglucosidase. This study investigated whether enzymes are essential in analysing insoluble, soluble, and total dietary fibre (IDF, SDF and TDF) contents in dry fruits with very low starch and protein contents. The IDF, SDF, and TDF were measured in date fruits using the enzymatic gravimetric method AOAC 991.43 in the ANKOM dietary fibre analyser, with and without enzymatic digestion. The study analysed six date fruit varieties with a range of texture profiles. Our results highlighted agreement between both methods in the measured IDF, SDF, and TDF values. TDF values in date fruit varieties varied considerably, from 5.67% g/100 g to 10.33% g/100 g. Results from both methods also indicate that IDF constituted the bulk of dietary fibre content in all date fruit varieties (77.8% to 91.6%), while the proportion of SDF was between 8.4% and 22.2%. This study confirms that dates are a rich source of dietary fibre, and can be a valuable functional ingredient in foods that reduce the risk of chronic diseases. The study confirmed that the inexpensive non-enzymatic technique is a viable substitute for the enzymatic method for analysing dietary fibre in dry fruits.

Cancer Patients during COVID-19 Pandemic: A Mini-Review.

Since its emergence, coronavirus disease 2019 (COVID-19) has affected the entire world and all commerce and industries, including healthcare systems. COVID-19 adversely affects cancer patients because they are immunocompromised. Increased COVID-19 infection and shortage of medical supplies, beds and healthcare workers in hospitals affect cancer care. This paper includes a description of the existing research that shows the impact of COVID-19 on the management of cancer patients. Aged people with various chronic conditions such as cancer and comorbidities face more challenges as they have a greater risk of disease severity. COVID-19 has affected care delivery, including patient management, and has been responsible for increased mortality among cancer patients. Cancer patients with severe symptoms require regular therapies and treatment; therefore, they have a higher risk of exposure. Due to the risk of transmission, various steps were taken to combat this disease; however, they have affected the existing operational efficiency. Herein, we present the changing priorities during COVID-19, which also affected cancer care, including delayed diagnosis, treatment, and surgeries.

Pregnant Women's Perception and Knowledge of the Impact of Obesity on Prenatal Outcomes-A Cross-Sectional Study.

The prevalence of obesity and overweight has been rapidly increasing and is significantly higher among adult females in the Arab States. The aim of the present study was to explore pregnant Emirati women's perception of their weight, their knowledge of the healthy gestational weight gain, and the possible weight-related pregnancy complications. A total of 526 self-administered questionnaires were obtained with a response rate of 72%. The majority (81.8%, n = 429) entered pregnancy as overweight or obese. The percentage of pregnant women who underestimated their weight category was 12.1% in normal weight participants, 48.9% in overweight participants, and 73.5% in obese participants (p < 0.001). The overweight and obese participants were 13 times more likely to underestimate their weight status and 3.6 times more likely to correctly select their healthy gestational weight gain. Women's awareness of pregnancy-related complications due to weight varied from 80.3% for diabetes to 44.5% for fetal complications; their awareness of breastfeeding difficulty was the lowest at 2.5%. Moreover, there was a misconception about personal BMI and the appropriate range for gestational weight gain (GWG). Healthy lifestyle counselling urgently needs to be addressed in preventative health programs such as pre-marital and preconception counselling.

Total Usual Nutrient Intakes and Nutritional Status of United Arab Emirates Children (4 Years-12.9 Years): Findings from the Kids Nutrition and Health Survey (KNHS) 2021.

This study aims at investigating the anthropometric status and food consumption patterns of children in the United Arab Emirates (UAE) and assessing their adherence to nutrient and dietary recommendations. It is a population-based cross-sectional survey of 690 children (4-12.9 years), from 3 major Emirates. Socio-demographic and anthropometric characteristics were collected. Dietary intakes were assessed using the 24-hour recall approach. Of the total sample, 4% were stunted, 8% were wasted and 28% were overweight/obese. A third of participating children consumed above the Estimated Energy Requirement, while the majority's intakes carbohydrate, total fat, and protein were within the recommendations; whereas over 70% and 90% of participants consumed above the WHO daily limits of free sugars and saturated fats, respectively. Inadequate intakes of linoleic acid (36% of children), alpha-linolenic acid (91%) and dietary fiber (100%) were observed. All children failed to meet the recommendation for vitamin D and considerable proportions had inadequate intakes of vitamin A, calcium, zinc, folate, and magnesium. Compared with the American Heart Association/American Academy of Pediatrics recommendations, low dietary adherence was noted for fruits (9%), vegetables (4%), and milk/dairy (14%). These findings may be used in the development of nutritional policies aimed at improving the diets of children in the UAE.

Comparison of students' perceptions of online and hybrid learning modalities during the covid-19 pandemic: The case of the University of Sharjah.

Hybrid learning enables educators to incorporate elements of conventional face-to-face learning methods with structured online schemes. This study aimed to assess university students' perceptions of online and hybrid learning during the ongoing COVID-19 pandemic. A web-based cross-sectional study was conducted at the University of Sharjah, in the United Arab Emirates (n = 2056). Students' sociodemographic characteristics, perceptions of online and hybrid learning, concerns, and university life changes, were investigated. Perception statements were dichotomized into "positive" and "negative" based on a 50% cut-off point. Scores of > 7 and >5 indicated positive perceptions of online and hybrid learning respectively while scores of ≤ 7 and ≤ 5 indicated negative perceptions. Binary logistic regression analysis was performed to predict students' perceptions of online and hybrid learning according to demographic variables. Spearman's rank-order correlation was performed to determine the relationship between students' perceptions and behaviors. Most students preferred online learning (38.2%) and on-campus learning (36.7%) to hybrid learning (25.1%). Around two-thirds of the students had a positive perception of online and hybrid learning in terms of university support, however, half of them preferred the assessment during online or on-campus learning. Main difficulties reported in hybrid learning were lack of motivation (60.6%), discomfort when on-campus (67.2%), and distraction due to mixed methods (52.3%). Older students (p = 0.046), men (p<0.001), and married students (p = 0.001) were more likely to have a positive perception of online learning, while sophomore students were more likely to have a positive perception of hybrid learning (p = 0.001). In this study, most students preferred online or on-campus over hybrid learning and expressed certain difficulties while on hybrid learning. Future research should focus on investigating the knowledge and capability of graduates from a hybrid/online model compared to a traditional model. Obstacles and concerns should be considered for future planning to ensure the resilience of the educational system.

Public's calorie literacy and perceived effectiveness of restaurant menu calorie labeling in the United Arab Emirates.

Restaurant menu calorie labeling is regarded as a promising, cost-effective, and innovative method that will have an impact on the food environment, raise awareness among consumers, and aid in global efforts to prevent obesity. This study aimed to assess the public's calorie literacy, dining practices, and perceived effectiveness of restaurant menu labeling implementation in the United Arab Emirates (UAE). A descriptive, web-based cross-sectional study was conducted among 1279 adults in the UAE. Socio-demographic characteristics, calorie literacy, and perceived effectiveness of restaurant menu labeling among participants were investigated. Chi-square analysis was used to compare indicators across demographic characteristics. More females than males completed the online survey, (56.1% and 43.9%). Most of the participants aged < 30 years old (54.8%), The majority of participants reported eating away from home at least once per week (89.6%). 66.0% of participants were knowledgeable about calorie definition, but only 37.1% knew about average daily energy requirements. Younger participants, with a normal BMI, and higher education levels reported a significantly higher likelihood of eating at a chain restaurant with caloric information on the menu (p <0.05). The majority of participants (76.0%) preferred to see calorie information and other nutrition information on menus. To conclude, menu labeling is a welcomed policy to be implemented in food outlets. Further investigation is necessary to ascertain the most efficacious method of presenting nutrition information to consumers to facilitate informed purchasing decisions considering the potential benefits of mandating calorie declaration in obesity prevention efforts.

Barriers and Facilitators of Weight Management among School Children with Obesity: A Qualitative Investigation of Parents' Perceptions.

Parents play a critical role in influencing the eating habits of their children. This study examined parents' perceptions of factors that contributed to childhood obesity and sought their suggestions on various modalities for overcoming the barriers to healthy eating. Semi-structured in-depth interviews were undertaken with 26 parents of 9-13 years old school children with obesity from the United Arab Emirates. Three main topics covered in the interviews were: (1) Parents' perceptions of their children's weight and eating habits; (2) Attitudes towards healthy eating and weight management; and (3) Suggestions on how their children can adopt a healthy lifestyle. Interview transcripts were thematically analyzed using the NVIVO software to identify the emerging main themes and sub-themes. Parents identified individual/intrapersonal (child), interpersonal (peers, family, nannies), and institutional/school environment barriers and facilitators to a healthier lifestyle. The three major themes that emerged were: (1) Negative effects of obesity on children's lives; (2) Barriers to weight management and healthy lifestyle; and (3) Facilitators to healthy eating. Nutritional education and a supportive home and school environment were suggested for the adoption of a healthy lifestyle by children.

Food Systems' Transformation to Address Malnutrition in Selected Countries-Panel-Data Analysis on Undernourishment and Obesity.

Global awareness of the 2030 Sustainable Development Goals (SDGs) has heightened the importance and role of food systems' transformation in accelerating countries' progress to achieve such goals in a timely manner. The agricultural and food systems' transformation goal is to build resilience to vulnerabilities, shocks, and diseases such as undernourishment and obesity. The objective of this study is to specify the agricultural and food systems' factors that contribute to reducing the impacts of undernourishment and obesity in selected populous and high-income countries. This study used panel data from 2000 to 2020, applying fixed and random-effect econometrics models to conduct the analyses. Results indicated that the per capita Gross Domestic Product (GDP), level of urbanization, and flood losses at food retail from a food systems perspective were the most influential factors in the prevalence of undernourishment. Meanwhile, the supply of fatty food was the significant nutrition variable affecting undernourishment. The cereal import dependency, per capita GDP, percentage of food imports from the value of food export, and value of domestic food production factors were the influential food system variables affecting the prevalence of obesity. Cereal import dependency and dietary energy supply are the significant factors affecting the prevalence of obesity. This study recommended a set of policy actions to address malnutrition, including sustainable and balanced food and nutrition systems' transformation, food trade openness, and efforts to reduce adversary impacts of urbanization.