Status and correlates of food and nutrition literacy among parents-adolescents' dyads: findings from 10 Arab countries.

Background: Food literacy is capturing the attention worldwide and gaining traction in the Arab countries. Strengthening food and nutrition literacy among Arab teenagers are important promising empowering tools which can protect them from malnutrition. This study aims to assess the nutrition literacy status of adolescents with the food literacy of their parents in 10 Arab countries. Methods: This cross-sectional study involving a convenient sample of 5,401 adolescent-parent dyads (adolescents: mean age ± SD: 15.9 ± 3.0, females: 46.8%; parents: mean age ± SD: 45.0 ± 9.1, mothers: 67.8%) was launched between 29 April and 6 June 2022 in 10 Arab nations. The Adolescent Nutrition Literacy Scale (ANLS) and the Short Food Literacy Questionnaire (SFLQ) were used to meet the study aims. Results: More than one-quarter (28%) of adolescents had poor nutrition literacy, with 60% of their parents being food illiterate. The top three countries with nutritionally" less literate" adolescents were Qatar (44%), Lebanon (37.4%), and Saudi Arabia (34.9%). Adolescents' age, gender, education level, primary caregivers, employment status, and the inclusion of nutrition education in the schools' curriculum predicted the nutrition literacy levels of Arab adolescents. Besides, parental weight status, health status, parent's food literacy level, and the number of children per household were significant determinants too. Adolescents studying at a university and having parents with adequate food literacy had the highest odds of being nutritionally literate (OR = 4.5, CI = 1.8-11.5, p = 0.001, OR = 1.8, CI = 1.6-2.1, p < 0.001, respectively). Conclusion: Nutrition literacy inadequacy among Arab adolescents is a prioritized challenge to be tackled.

Hypomagnesemia and the Metabolic Syndrome among Apparently Healthy Kuwaiti Adults: A Cross-Sectional Study.

Magnesium plays a key role in metabolic disorder development, and hypomagnesemia may be implicated in the pathogenesis of metabolic syndrome (MetS) and its components. In this cross-sectional study, we investigated the associations between hypomagnesemia, MetS, and MetS components among 231 adults (193 women and 38 men) living in Kuwait who were apparently healthy without chronic diseases. We used the International Diabetes Federation (IDF) and the United States National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria to define participants with MetS. The Ministry of Health cutoff for hypomagnesemia (<0.74 mmol/L) was employed. IDF- and ATP III-defined MetS prevalence was 22.1% and 15.2%, respectively. Hypomagnesemia occurred in 33.3% of all participants and 53.2% of participants with MetS (p < 0.001). Magnesemia correlated negatively with body mass index, waist circumference, systolic blood pressure [SBP], diastolic blood pressure (DBP), fasting blood glucose (FBG), low-density lipoprotein cholesterol level, and triglyceride level; magnesemia correlated positively with high-density lipoprotein cholesterol (HDL-C) levels (p < 0.001). Multivariate logistic regression, adjusting for BMI, age, and sex, showed that hypomagnesemia was associated with a 12- and 5-fold greater odds of getting IDF-defined (adjusted odds ratio [aOR] 11.70; 95% confidence interval [CI] 4.87−28.14) and ATP-defined (aOR 5.44; 95% CI 2.10−14.10) MetS, respectively, in the study population. Hypomagnesemia was significantly associated with a 3.62, 9.29, 7.01, 2.88, 3.64, and 3.27 higher odds of an increased waist circumference (95% CI 1.48−8.85), elevated serum triglyceride level (95% CI 3.97−21.73), elevated FBG (95% CI 3.25−15.11), elevated SBP (95% CI 1.16−7.11), elevated DBP (95% CI: 1.22−10.89), and lowered HDL-C level (95% CI 1.69−6.32), respectively. Hypomagnesemia could be a consequence of the pathophysiology of MetS and its individual components among adults in Kuwait.

Fruit and Vegetable Intake and Barriers to Their Consumption among University Students in Kuwait: A Cross-Sectional Survey.

Data on fruit and vegetable (F/V) consumption and barriers to their intake by Kuwait college students are needed for health promotional activities to curtail obesity and related comorbidities prevalent in Kuwait. This study employed a cross-sectional survey aimed at assessing the median F/V intake in a sample of Kuwait University students to determine its relationship with gender, body weight, college affiliation, and family monthly income and to explore perceived barriers to eating F/V. The median total F/V intake was 2.06, and the median intake of F/V without fries was even lower. Significant gender differences were found in intakes of fruit juice and the percentage of juice from fruit intake, with males consuming more servings per day compared to females. Male students were found to consume proportionately more fried potatoes of total vegetable intake when compared to females, whereas female students were found to consume more vegetables without fries than males. Taste, inconvenience, and lack of knowledge on F/V intake recommendations and preparation methods were among the main barriers to consuming more F/V. College students require encouragement to consume more F/V through targeted campaigns to increase awareness of recommendations, health benefits, and ways to incorporate F/V in their daily diet.

Correlates of food intake and mealtime behaviors among Kuwaiti adolescents.

OBJECTIVES: Eating meals with the family improves the food choices of adolescents. Studies conducted on Kuwaiti adolescents have reported suboptimal dietary intake; however, it is unclear what meal-related behaviors and family dynamics influence dietary choices in young Kuwaiti adolescents. This study explored the food intake and meal-related behaviors of young adolescents in relation to their mother's educational level, parental employment, and family size and to identify meal-related behaviors associated with poor dietary choices. CONTENT: A cross-sectional survey was conducted using a modified and validated version of the International Health Behavior in School Children questionnaire recruiting 774 adolescents aged 14-16 years from all six governorates of Kuwait. SUMMARY: A higher level of the mother's education was associated with higher odds of eating fruits and breakfast. A stay-at-home mother was associated with higher odds of consuming milk and home-made desserts. Larger family size was associated with higher odds of eating fruits, and a higher frequency of family meals was associated with higher odds of consuming vegetables and whole grain bread. All unhealthy snacks, including sweets, potato chips, french fries, home-made desserts, and sugar-sweetened beverages, were associated with higher odds of watching TV during mealtime. OUTLOOK: A higher level of mother's education level, large family size, and family meals encouraged consuming fruits, vegetables, whole grain bread, milk, and breakfast, but consuming empty calorie snacks is very common. Family involvement in developing healthy meal-related behaviors is imperative for shaping healthy eating habits of adolescents.

Alterations in glutathione redox homeostasis among adolescents with obesity and anemia.

The reduced (GSH)-to-oxidized (GSSG) glutathione ratio represents a dynamic balance between oxidants and antioxidants. However, redox status in adolescents with obesity and anemia has not been investigated. This study investigated the association of erythrocyte GSH redox status (GSH, GSH:GSSG ratio, and glutathione peroxidase [GPx] activity) with anemia and adiposity in adolescents. This case-control study nested in a cross-sectional study enrolled 524 adolescents (268 boys; 256 girls). The prevalence of anemia in overweight and obesity (OWOB) was 5.2% in boys and 11.7% in girls. The GSH:GSSG ratio and GPx activity were significantly higher in girls than in boys (p < 0.001), in anemic than in non-anemic subjects (p < 0.001), and in OWOB than in normal-weight subjects (p < 0.001). Similarly, significantly higher GSH: GSSG level (p < 0.001) and GPx activity (p < 0.001) were found in subjects with 90th percentile waist circumference than in those with < 90th percentile. GPx and GSH:GSSG were positively associated with anemia after adjusting for age, sex, and body mass index (adjusted odds ratio, adjOR [95% confidence interval, CI] 2.18 [1.44-3.29]) or tertiles (adjOR [95% CI], T3 = 2.49 [1.03-6.01]). A similar association was noted for GSH and GPx. A compensatory increased redox defense mechanism exists in anemia and obesity among adolescents without metabolic disturbances.

Disordered eating attitudes correlate with body dissatisfaction among Kuwaiti male college students.

BACKGROUND: The prevalence of disordered eating attitudes and body dissatisfaction based on muscularity and body fat was investigated among male college students in Kuwait with a range of body mass index values including underweight, normal weight, overweight, and obese participants. METHODS: Data were collected, using the Eating Attitudes Test (EAT-26) and the Bodybuilder Image Grid (BIG), from 400 male undergraduate students (84.8% Kuwaiti nationals) recruited from both public and private universities in Kuwait. An anonymous, self-administered questionnaire was used to determine the prevalence of symptomatology indicative of anorexia nervosa and bulimia nervosa and to examine the associations between body dissatisfaction and muscularity and body fat. RESULTS: Most participants were dissatisfied with their current muscle mass and body fat (67.3 and 69%, respectively). Logistic regression analyses produced odds ratios (ORs) demonstrating that students dissatisfied with their muscularity and body fat and those who indicated a desire to decrease both muscularity and body fat had significantly higher odds of being at risk of disordered eating attitudes (OR = 2.241, 95% CI [1.17, 3.6], p = .032, and OR = 1.898, 95% CI [1.214, 2.967], p = .005, respectively). Obese participants also had higher odds of exhibiting disordered eating attitudes (OR = 2.06, 95% CI [1.17, 3.60], p = .011). CONCLUSION: The high proportion of disordered eating attitudes among Kuwaiti college men was associated with high levels of body image dissatisfaction in relation to both body fat and muscularity. High levels of eating disorder symptoms were also linked to obesity.

Trends in Fast-food Consumption among Kuwaiti Youth.

BACKGROUND: We assessed fast-food consumption including frequency, type, and reasons among college students from the Kuwait University, and whether there were any key sex differences. METHODS: A cross-sectional survey was conducted from January-March 2016 with 421 students (297 women, mean age = 20.99 ± 3.14 years). Students completed self-administered fast-food questionnaires and weight and height measurements were obtained. RESULTS: Most (81.4%) consumed fast food more than twice per week and more men than women were overweight or obese (54.8% vs. 38.7%, respectively; P = 0.002); however, there were no differences in the fast-food frequency per body mass index or sex. Taste was the most reported motivator to consume fast food (46.7%) and women were significantly more likely to value taste as compared to men (49.8% vs. 38.9%, respectively; P = 0.005). CONCLUSIONS: Fast food is a key part of college students' diet in Kuwait; therefore, students should be educated on the negative effects of frequent fast-food consumption. University health promotional activities should include nutrition education on healthier fast-food options and how to prepare easy-to-cook meals at home.

Gender differences in weight status, dietary habits, and health attitudes among college students in Kuwait: A cross-sectional study.

BACKGROUND: A better understanding of the factors involved in health and wellness among college students can aid in the design of interventions that can reduce the rate of weight gain during young adulthood. AIM: The aim of this study was to determine the gender differences in weight status, dietary habits, and health attitudes in a sample of college students at Kuwait University (KU). METHODS: In this cross-sectional study, 615 students were recruited from KU between November 2013 and March 2014. Components of the study included a self-report questionnaire, assessment of body mass index, and calculation of Healthy Eating Score (HES) to assess eating habits and attitudes. Statistical analyses were performed to assess the gender differences among these domains. RESULTS: The findings revealed that a greater proportion of men were overweight and obese compared to women (28.7% and 23.8% vs. 19.9% and 12.1%, respectively). Both genders show equally unhealthy dietary habits, marked by low mean HES scores. Gender-specific dietary patterns were noted, with more men reporting eating >6 oz (168 g) of animal protein per day as compared to women (48.4% vs. 28.9%, p < 0.001). A higher proportion of female students reported regular consumption of potato chips and fatty salty snacks (51.3% and 40.4%, respectively, p = 0.12) and that they ate sweets more than twice a day (52.5% and 39.9%, respectively, p = 0.041). CONCLUSIONS: Our findings highlight the need for evidence-based gender-specific strategies to reduce the number of overweight and obese college students and promote healthy dietary habits and eating attitudes among this population.

Breastfeeding exposure is associated with better knowledge of and attitudes toward BF in Kuwaiti women.

OBJECTIVES: Breastfeeding (BF) has many benefits for both infants and mothers. However, despite evidence in support of BF, its prevalence has remained low in Kuwait. The purpose of this study was to (1) assess and describe BF attitudes and knowledge among women at a college campus; (2) evaluate BF exposures and sociodemographic factors associated with attitudes toward BF; (3) determine the association between BF knowledge and attitudes. MATERIALS AND METHODS: This survey was a cross-sectional descriptive study conducted from February to April 2016. A convenience sample of 330 women (students, faculty and staff) from the College of Life Sciences (CLS) at Kuwait University participated in the survey. RESULTS: Most of the participants respected women who breast fed (81.8%). Some participants believed that BF a baby is painful (43.3%), makes the breasts sag (35.8%), and restricts the mothers' freedom (51.5%). Additionally, 47.6% of the participants reported that they would feel embarrassed if they saw a woman BF her baby. Acceptability of BF in public was low and most participants preferred BF only around friends and family (52.4%). A statistically significant positive association was observed between BF knowledge and attitudes (R2=6.5%, p<0.001); however, the relationship was not independent and was also associated with nationality and having been breast fed as a baby (R2=10.3%, p=0.021). CONCLUSION: BF knowledge is important to encourage positive BF attitudes, and both are enforced with family values and practice across generations.

Early Infant Feeding Practices as Possible Risk Factors for Immunoglobulin E-Mediated Food Allergies in Kuwait.

OBJECTIVE: Early feeding and infant exposures have been suggested as potential risk factors for immunoglobulin E- (IgE-) mediated food allergy (FA). We aimed to evaluate the association between IgE-mediated FA in children and early exposures including the child's nutritional status, breastfeeding and its duration, the age at which the solid food was first introduced, antibiotic exposure during the first year of life, and the child's vitamin D status during infancy. DESIGN: A case-control study. SETTING AND SUBJECTS: Children aged 0-13 years were recruited from pediatric allergy and immunology clinics (PAICs) located at major government hospitals in Kuwait (total FA cases: n = 100; boys = 67%), and healthy controls (n = 100, boys 55%) were recruited from various vaccination units at primary healthcare centers. RESULTS: Cow's milk allergy was the most common type of FA. FA status was independently associated with the early exposures of exclusive breastfeeding (aOR = 15.55 (3.26-74.19), p = 0.001), vitamin D deficiency or insufficiency during infancy (aOR = 5.42 (1.92-15.30), p = 0.001), and antibiotic exposure during the first year of life (aOR = 5.00 (1.58-15.84), p = 0.006). CONCLUSIONS: FA is highly prevalent among children in Kuwait, and our data indicate that early nutrition-related and antibiotic exposures are associated with FA risk.

Distorted weight perception correlates with disordered eating attitudes in Kuwaiti college women.

OBJECTIVE: We investigated the presence of disordered eating attitudes and weight perception among young women at body mass index (BMI) values that correspond to underweight, normal weight, overweight, and obese weight status. METHOD: Data were collected from 1,147 female undergraduate students (89% Kuwaiti nationals) recruited from Kuwait University through employment of the eating attitude test (EAT-26) together with an anonymous, self-administered questionnaire to determine the prevalence of symptomatology indicative of anorexia nervosa and bulimia nervosa. RESULTS: The mean EAT-26 scores differed significantly between the weight categories. More students with overweight and obesity scored above the established EAT-26 cut off value indicating at risk of disordered eating compared to students who were at a normal weight or underweight (52.1% vs. 38.8%, respectively, X2 (1) =16.1, p < .001). Logistic regression analyses showed significantly higher odds ratios (ORs) for the groups with overweight and obesity for dieting and bulimic behaviors, while women at normal and underweight had higher ORs for restrictive oral control behaviors associated with anorexia nervosa. Distorted weight perception was found in all weight categories. DISCUSSION: The high proportion of disordered eating attitudes among Kuwaiti college women could not be attributed to obesity alone as the type of disordered eating behavior varied more by weight perception than by weight status. The high levels of eating disorder related symptoms could be due to a combination of the social influences, diet, and lifestyle of college students. Such factors need to be considered by healthcare professionals as early as possible with more focused programs towards promotion of healthy weight for college students.

The nutritional status of adult female patients with disabilities in Kuwait.

OBJECTIVES: Adults with disabilities are at a higher risk of malnutrition than are their non-disabled counterparts owing to feeding problems and associated medical conditions. We evaluated the prevalence of malnutrition in a group of institutionalized women and investigated any feeding difficulties and nutrition-related medical problems. METHODS: This study used two versions of the Mini Nutritional Assessment-Short Form (MNA-SF) to screen malnutrition: the MNA-SF1 which uses the body mass index, and the MNA-SF2 which uses the calf circumference. Data were collected from 53 women with intellectual and physical disabilities in a cross-sectional survey of residents of the Kuwait Rehabilitation Centre. RESULTS: Of all participants, 63.5% were found to be overweight or obese, while 11.5% were underweight. Using the MNA-SF1, 57.7% were found to be at risk of malnourishment while 11.5% were malnourished. More patients were identified to be at risk of malnutrition or to be actually malnourished using the MNA-SF2 (59.6% and 23.1%, respectively). Reported feeding problems included difficulties in maintaining a sitting position, manipulating food on a plate, conveying food to the mouth, and in swallowing. The presence of infections worsened the prognoses of malnourished women regardless of their weight status. CONCLUSIONS: Our findings suggest that MNA-SF2 is a more sensitive tool for identifying malnourishment than MNA-SF1. Obesity can obscure the identification of malnourished patients if clinicians rely solely on the MNA-SF1, which uses the body mass index.

Increased F3-Isoprostanes in the Canadian Inuit Population Could Be Cardioprotective by Limiting F2-Isoprostane Production.

CONTEXT: F3-isoprostanes (F3-IsoPs), derived from peroxidation of eicosapentaenoic acid (C20:5n-3), could be cardioprotective by limiting production of F2-isoprostanes (F2-IsoPs), a cardiovascular disease risk factor. OBJECTIVE: The objective of the study was to determine whether the n-3-polyunsaturated (PUFA)-rich Inuit diet is associated with a lower plasma ratio of F2-IsoPs to F3-IsoPs. DESIGN: This was a cross-sectional observational study. SETTING: The study was conducted in 36 Canadian Arctic Inuit communities. PARTICIPANTS: Participants included a random subset (n = 233) of Inuit adults taken from a population-based survey. MAIN OUTCOME MEASURES: Plasma F2-IsoPs and F3-IsoPs, cardiometabolic risk factors (blood lipids, C-reactive protein, blood pressure, fasting glucose) and markers of dietary exposure (erythrocyte n-3 and n-6 PUFA, blood levels of Se, mercury, polychlorinated biphenyls) were measured. RESULTS: Inuit aged 40 years old and older vs younger Inuit showed higher concentrations of plasma F3-IsoPs and erythrocyte n-3 PUFA and lower plasma F2-IsoPs concentrations despite having higher blood lipids, fasting glucose, systolic blood pressure, and percentage body fat. Plasma F3-IsoPs were not associated with any cardiometabolic measures. When subjects were categorized into tertiles according to total n-3 PUFA erythrocyte concentrations, F3-IsoPs increased with increasing tertiles, whereas the F2-IsoP to F3-IsoP ratio was lowest at the highest n-3 tertile. The F2-IsoP to F3-IsoP ratio was significantly predicted by C20:5n-3 (ß= -.365, P = .002); C20:4n-6:C20:5n-3 (ß = .056, P = .006), blood mercury (ß = -.812, P =.015), blood Se (ß = -1.95, P = .015), and smoking (ß = .745, P = .025). CONCLUSIONS: Plasma F3-IsoPs were not associated with cardiometabolic risk factors previously seen with F2-IsoPs. Higher n-3 fatty acid status was associated with lower plasma F2-IsoPs and higher plasma F3-IsoPs, which provides partial explanation to the cardioprotective effects of the n-3 PUFA-rich Inuit diet.

New insights regarding tissue Se and Hg interactions on oxidative stress from plasma IsoP and IsoF measures in the Canadian Inuit population.

Despite animal and in vitro studies demonstrating pro-oxidative effects of Hg, previous human work showed no relationship between tissue Hg and plasma levels of F2-isoprostanes (IsoPs), a whole-body oxidative stress marker. We hypothesized that another IsoP species, isofurans (IsoFs), was a more sensitive indicator of Hg-mediated oxidative stress, which can be modified by tissue Se status. A cross-sectional study was carried out involving individuals from a random subset (n = 233) of Inuit adults from a population-based survey (n = 2,595) of 36 Canadian Arctic Inuit communities to assess the relationships of plasma IsoPs to Se and Hg status indicators. F2-IsoPs were inversely correlated with blood Se (r = -0.186, P = 0.005) and toenail Se (r = -0.146, P = 0.044), but not correlated with Hg. IsoFs were inversely correlated with blood Se (r = -0.164, P = 0.014) and positively correlated with Hg (r = 0.228, P < 0.001) and Hg:Se (r = 0.340, P < 0.001). The strength of the correlations remained unchanged after multivariate adjustments. Multivariate analysis showed that F2-IsoPs were not positively associated with Hg but with Hg:Se (ß = 0.148, P = 0.021). We conclude that Se and Hg status and their interactions are important factors modulating F2-IsoP and IsoF levels such that the Inuit may be protected from Hg-induced oxidative stress because of their high Se status.

Isoprostanes and isofurans as non-traditional risk factors for cardiovascular disease among Canadian Inuit.

OBJECTIVES: The aim of the present study was to investigate the potential importance of oxidative stress, measured by isoprostanes-related compounds, as non-traditional risk factor for cardiovascular disease. We planned to examine the relationship between concentrations of plasma F2-isoprostanes (F2-IsoPs), isofurans (IsoFs), measures of obesity and various cardiometabolic risk factors. MATERIALS AND METHODS: Cross-sectional study using a sub-sample from the population of a survey conducted in the summer and fall 2007 and 2008 by Canadian Coastguard Ship Amundsen in 36 Canadian Arctic Inuit communities. Subjects included a subset (n = 233) of a total study population (n = 2595) with a mean age 42.56 ± 15.39 years and body mass index 27.78 ± 5.65 kg/m². Plasma levels of F2-IsoPs and IsoFs was determined by gas chromatography/negative ion chemical ionization/mass spectrometry (GC/NICI/MS) method; and their relationships to waist circumference (WC), blood pressure C reactive proteins (CRP), blood lipids and fasting glucose were assessed by multivariate analyses. RESULTS: Plasma F2-IsoPs correlated positively with CRP (r =.132, P =.048) and systolic blood pressure (SBP) (r =.157, P =.024) after adjustment for age, sex and body mass index. IsoFs correlated with WC (r =.190, P =.005) and SBP (r =.137, P =.048). F2-IsoPs were not found elevated in smokers (P =.034), whereas IsoFs were decreased in smokers (P =.001). WC, SBP and sex were found to be major correlates of oxidative stress in Canadian Inuit. CONCLUSIONS: Plasma measures of F2-IsoPs and IsoFs increase with increased obesity and associated cardiometabolic risk factors, including CRP and blood pressure. Simultaneous measurement of IsoFs provides an advantageous mechanistic insight into oxidative stress not captured by F2-IsoPs alone.

Increased HDAC in association with decreased plasma cortisol in older adults with chronic fatigue syndrome.

Hypocortisolism is a frequent finding in individuals with chronic fatigue syndrome (CFS) with other research findings implying potential dysregulation of glucocorticoid signaling. Glucocorticoid signaling is under the influence of several pathways, several of which are of interest in the study of CFS. Oxidative stress and decreased antioxidant capacity are known to disrupt the hypothalamic-pituitary-adrenal (HPA) axis (Epel et al., 2004) and the presence of histone deacetylases (HDAC) could also impact glucocorticoid signaling. The intent of this pilot study was to investigate the relationship among oxidative stress elements, select HDAC's (2/3) and glucocorticoid receptor signaling in an elderly sample with CFS. Findings suggest increased histone deacetylase activity, lower total antioxidant power, in the context of decreased plasma cortisol and increased plasma dehydroepiandrosterone concomitant with decreased expression of the encoding gene for the glucocorticoid receptor. These findings support the presence of HPA axis dysregulation in elderly individuals with CFS.

Oxysterol as a marker of atherogenic dyslipidemia in adolescence.

CONTEXT: Oxysterols represent potentially important oxidative stress biomarkers in adolescence. OBJECTIVE: The objective of the study was to examine the relationship between the concentrations of serum enzymatically and nonenzymatically generated oxysterols, measures of obesity, and metabolic components including insulin resistance and levels of blood pressure and serum lipids. DESIGN: This was a cross-sectional study. SETTING: All subjects were examined between 2003 and 2005 at a hospital, a part of a follow-up evaluation mother-daughter pairs representing pregnancies affected or unaffected by gestational diabetes that resulted in the deliveries in 1989-1991. SUBJECTS: Subjects included a subset (n=89) of the total study population of 189 adolescent girls with a mean age of 15.32+/-0.65 yr and body mass index of 22.54+/-3.98 kg/m2. MAIN OUTCOME MEASURES: Measures included serum levels of the oxysterols 7alpha-hydroxy-cholesterol, 7beta-hydroxycholesterol, and 7-ketocholesterol; and body mass index, homeostasis model assessment insulin resistance index, fasting insulin, fasting glucose, blood pressure, total cholesterol, non-high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoprotein B (ApoB). RESULTS: Serum oxysterol concentrations in the adolescent cohort correlated positively with insulin (P<0.05), total cholesterol (P<0.05), non-high-density lipoprotein cholesterol (P<0.05), low-density lipoprotein cholesterol (P<0.05), and ApoB (P<0.01). ApoB and fasting insulin were found to be the major determinants of serum oxysterols after adjustment for body mass index. Being a daughter of gestational diabetes pregnancy alone did not seem to be a predisposing factor to increased oxidative stress in our cohort. CONCLUSION: Serum oxysterol concentrations increase with obesity, insulin, and ApoB, which are established derangements associated with the metabolic syndrome.