Intradialytic Eating Practices and Health Outcomes Among Hemodialysis Patients, Cross-Sectional Study.

BACKGROUND AND AIMS: Intradialytic eating practices is a subject of debate among hemodialysis patients and is associated with a variety of clinical implications. This study aimed to investigate eating practices during hemodialysis and their influence on health outcome, including various symptoms experienced during dialysis, intradialytic hypotension, dialysis adequacy, and malnutrition. METHODS: A cross-sectional study was conducted on hemodialysis patients. A structured questionnaire was used to collect information related to sociodemographic, medical history, lifestyle, dialysis, and eating practices. The occurrence of intradialytic hypotension was determined according to the patients' blood pressure measured at the beginning and end of the session, and dialysis adequacy was determined based on the ultrafiltration rate of the patients. Malnutrition was evaluated using renal inpatient screening tool (renal iNUT), and biochemical data was recruited from the patient's hospital records. RESULTS: A total of 260 hemodialysis patients participated in this study. The mean age was 51.29±15.92, and half of the participants were females. The findings showed no significant association between intradialytic eating practices and symptoms developed during dialysis session, intradialytic hypotension, or malnutrition (p>0.05). According to Chi-square test, a statistically significant association was found between eating practices and dialysis adequacy (p=0.037), hemoglobin level (p<0.001), and phosphorous level (p=0.003). CONCLUSION: Eating practices were not associated with symptoms that developed during dialysis sessions, intradialytic hypotension, or malnutrition, according to our findings. However, findings reveal that it is possible that eating practices may affect the adequacy of dialysis.

Machine Learning Approach for Predicting the Impact of Food Insecurity on Nutrient Consumption and Malnutrition in Children Aged 6 Months to 5 Years.

BACKGROUND: Food insecurity significantly impacts children's health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of malnutrition. METHODS: Utilizing machine learning algorithms, this study analyzed data from 819 children in the West Bank to investigate sociodemographic and health factors associated with food insecurity and its effects on nutritional status. The average age of the children was 33 months, with 52% boys and 48% girls. RESULTS: The analysis revealed that 18.1% of children faced food insecurity, with household education, family income, locality, district, and age emerging as significant determinants. Children from food-insecure environments exhibited lower average weight, height, and mid-upper arm circumference compared to their food-secure counterparts, indicating a direct correlation between food insecurity and reduced nutritional and growth metrics. Moreover, the machine learning models observed vitamin B1 as a key indicator of all forms of malnutrition, alongside vitamin K1, vitamin A, and zinc. Specific nutrients like choline in the "underweight" category and carbohydrates in the "wasting" category were identified as unique nutritional priorities. CONCLUSION: This study provides insights into the differential risks for growth issues among children, offering valuable information for targeted interventions and policymaking.

Investigating the Association between Nutrient Intake and Food Insecurity among Children and Adolescents in Palestine Using Machine Learning Techniques.

Food insecurity is a public health concern that affects children worldwide, yet it represents a particular burden for low- and middle-income countries. This study aims to utilize machine learning to identify the associations between food insecurity and nutrient intake among children aged 5 to 18 years. The study's sample encompassed 1040 participants selected from a 2022 food insecurity household conducted in the West Bank, Palestine. The results indicated that food insecurity was significantly associated with dietary nutrient intake and sociodemographic factors, such as age, gender, income, and location. Indeed, 18.2% of the children were found to be food-insecure. A significant correlation was evidenced between inadequate consumption of various nutrients below the recommended dietary allowance and food insecurity. Specifically, insufficient protein, vitamin C, fiber, vitamin B12, vitamin B5, vitamin A, vitamin B1, manganese, and copper intake were found to have the highest rates of food insecurity. In addition, children residing in refugee camps experienced significantly higher rates of food insecurity. The findings emphasize the multilayered nature of food insecurity and its impact on children, emphasizing the need for personalized interventions addressing nutrient deficiencies and socioeconomic factors to improve children's health and well-being.

Comparison of premenstrual symptoms, psychological well-being, and nutritional status between Palestinian women with and without polycystic ovarian syndrome: a case-control study.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a widely seen reproductive and endocrinological disorder. PCOS can exert substantial effects on many aspects of an individual's life, including reproductive health and psychological well-being. The objective of this study was to assess the nutritional status, premenstrual syndrome, and mental health of women affected by PCOS in comparison to women without PCOS. METHODOLOGY: A case-control observational study in Palestine included 100 PCOS patients and 200 healthy women. The collected data included socio-demographic information, medical history, premenstrual syndrome, mental health, nutritional status, and lifestyle. Anthropometric measurement and the Mediterranean Diet Adherence Screener (MEDAS) were used to evaluate the nutritional status. The General Health Questionnaire (12-GHQ) was used to evaluate the state of mental health. Premenstrual syndrome (PMS) severity was evaluated using a validated Arabic premenstrual syndrome questionnaire. RESULTS: The study's findings indicated that there was a statistically significant increase in the three dimensions of PMS among participants with PCOS, p < 0.05. Similarly, PCOS patients demonstrated elevated ratings across all aspects of mental health, p < 0.05. In terms of the other variables, it has been observed that PCOS patients have a notably greater prevalence of perceived sleep disturbances and decreased adherence to the Mediterranean diet. Regression analysis revealed that PCOS is associated with mental health problems indicated by a higher GHQ score (OR: 1.09; 95% CI: 1.03; 1.16, p < 0.05), lower adherence to the MD diet (OR: 0.86; 95% CI: 0.76; 0.98, p < 0.05), and pre-menstrual syndrome, especially the physical symptoms (OR: 1.06; 95% CI: 1.003; 1.12, p < 0.05) after adjusting for age, smoking, waist-hip ratio, and body mass index (BMI). CONCLUSION: The study has linked polycystic ovary syndrome to negative mental health outcomes and an increased severity of premenstrual syndrome (PMS). Additional investigation is required in order to establish a causal association between polycystic ovary syndrome (PCOS) and lifestyle behaviors within the Palestinian population. Intervention and instructional studies are necessary to investigate the efficacy of management strategies in alleviating the effects of polycystic ovary syndrome (PCOS) on both physical and mental well-being.

The association between night eating syndrome and GERD symptoms among university students at An-Najah National University in Palestine: a cross-sectional study.

BACKGROUND: Night eating syndrome (NES) is a kind of eating disorder. NES association with gastroesophageal reflux disease (GERD) symptoms among university students is still not fully understood. We aimed to determine the relationship between NES and the presence of GERD symptoms among university students at An-Najah National University in Palestine. METHODS: This study involved undergraduate students from An-Najah National University. The data were collected through online surveys from November to December 2023. The sampling frame involved voluntary sampling, as the data were collected using a structured questionnaire to collect data on sociodemographic variables, medical history, lifestyle habits, nutritional status, GERD risk, and NES. The GERD questionnaire (GerdQ) was used to assess symptoms, while the Arabic version of the validated Night Eating Questionnaire (NEQ) was used to assess night eating. Physical activity was assessed using the short form of the International Physical Activity Questionnaire (SF-IPAQ), and adherence to a Mediterranean diet was assessed using the validated Arabic version of the MEDAS. Both univariate and multivariate analyses were also conducted to assess the study hypotheses. RESULTS: The study involved 554 participants, 59.9% female. A total of 33.4% reported GERD symptoms, with 10.3% having NES. A strong association was observed between GERD and NES and between GERD and physical activity. Night eating syndrome (AOR = 2.84, CI = 1.07-3.19), high physical activity (AOR = 0.473, CI = 1.05-3.19), and non-smoking (AOR = 0.586, CI = 1.27-7.89) were identified as independent predictors of GERD symptoms. CONCLUSION: This study revealed that 33.4% of undergraduate students were at risk of GERD, with night eaters having a greater risk. GERD risk was negatively associated with physical activity level and smoking status. No associations were found between GERD risk and weight status, Mediterranean diet adherence, sociodemographic factors, or sleep disturbances.

Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study.

The aim of this study is to determine the prevalence of taste alterations (TAs) during chemotherapy and their association with nutritional status and malnutrition. In addition to the associated factors with TA, including sociodemographic health-related factors and clinical status, and to investigate coping strategies to manage TA. A multicenter cross-sectional design study was conducted on 120 cancer patients aged at least 18 who had been undergoing at least one round of chemotherapy. TAs were evaluated using the chemotherapy-induced taste alteration scale (CiTAS), the malnutrition universal screening tool (MUST) was used for nutritional screening, the antineoplastic side effects scale (ASES) was used for subjective assessment of chemotherapy side effects, and the Charlson comorbidity index (CCI) was used for comorbidity assessment. SPSS21 software was used to analyze the data, and the independent T-test and one-way ANOVA test were used to determine the association between TAs and a variety of related variables. The prevalence of TAs was 98.3%. Among participants, 48.3% were at low risk of malnutrition, 20% at medium risk, and 31.7% at high risk. Malnutrition risk was associated with taste disorders (p<0.05). Patients' age, gender, educational level, and physical status were associated with TAs (p<0.05). Type of cancer, chemotherapy regimen, and number of chemotherapy cycles were also associated with TAs (p<0.05). A variety of antineoplastic side effects were associated with TAs (p<0.05), including nausea, vomiting, dry mouth, sore mouth and throat, excessive thirst, swallowing difficulty, appetite changes, weight loss, dizziness, lack of energy, disturbed sleep, anxiety, and difficulty concentrating. TAs were associated with an increased number of comorbidities, and individuals with diabetes, pulmonary diseases, and hypertension were associated with TAs (P<0.05). Patients in this study rarely practice self-management strategies to cope with TAs. A high prevalence (98.3%) of TAs in cancer patients receiving chemotherapy was found, and it was linked to a variety of negative outcomes. Chemotherapy-induced TAs are an underestimated side effect that requires more attention from patients and health care providers.

Knowledge and handling practices for raw hen's eggs during purchase, preparation, storage, and consumption: a cross sectional study.

The study aimed to assess the hen's eggs knowledge, handling practices, and consumption among Palestinian consumers using the cross-sectional survey design. Online questionnaire was sent via social media platforms including well-known Facebook and WhatsApp groups in West bank, Gaza and Jerusalem, along with an invitation explaining the research objectives and the voluntary participation. The online questionnaire consisted of three main sections: socio demographic, knowledge and practices for hen's eggs during purchase, preparation, storage, and consumption. The items were developed based on previous literature and international guidelines for hen's eggs purchase and handling, and subjected to content validity process, followed by a pilot study to determine the reliability of the questionnaire using Cronbach's alpha test. The final data were analysed based on the dichotomous Rach model for knowledge and polytomous Rasch model for practices using Winsteps version 5.1.3. The Rasch SPSS output interval data files were used in the inferential analyses tests (one-way ANOVA test and independent samples t-test). The Rasch analysis showed that on average the participants had quite low level of knowledge of hen's eggs consumption safety, (person ability Mean 0.10 logit). The item difficulty measures ranged between + 1.65 (most difficult) and - 2.24 logit (easiest). It was not easy for the participants to endorse the items pertaining their practices in handling the hen's eggs during purchase, preparation, storage and consumption, (person ability Mean - 0.11 logit). The item difficulty measures ranged between + 2.68 logits (most difficult) to - 2.45 logit (easiest). In addition, female participants significantly outperformed males in knowledge scores; and the level of hen's eggs hygiene practices and storage during purchase depended on participants' knowledge level. The research recommended interventional programs to enhance Palestinians' awareness and knowledge about hen's eggs knowledge, handling practices, and consumption. Further quantitative and qualitative research studies were also recommended.

Identification and prediction of association patterns between nutrient intake and anemia using machine learning techniques: results from a cross-sectional study with university female students from Palestine.

PURPOSE: This study utilized data mining and machine learning (ML) techniques to identify new patterns and classifications of the associations between nutrient intake and anemia among university students. METHODS: We employed K-means clustering analysis algorithm and Decision Tree (DT) technique to identify the association between anemia and vitamin and mineral intakes. We normalized and balanced the data based on anemia weighted clusters for improving ML models' accuracy. In addition, t-tests and Analysis of Variance (ANOVA) were performed to identify significant differences between the clusters. We evaluated the models on a balanced dataset of 755 female participants from the Hebron district in Palestine. RESULTS: Our study found that 34.8% of the participants were anemic. The intake of various micronutrients (i.e., folate, Vit A, B5, B6, B12, C, E, Ca, Fe, and Mg) was below RDA/AI values, which indicated an overall unbalanced malnutrition in the present cohort. Anemia was significantly associated with intakes of energy, protein, fat, Vit B1, B5, B6, C, Mg, Cu and Zn. On the other hand, intakes of protein, Vit B2, B5, B6, C, E, choline, folate, phosphorus, Mn and Zn were significantly lower in anemic than in non-anemic subjects. DT classification models for vitamins and minerals (accuracy rate: 82.1%) identified an inverse association between intakes of Vit B2, B3, B5, B6, B12, E, folate, Zn, Mg, Fe and Mn and prevalence of anemia. CONCLUSIONS: Besides the nutrients commonly known to be linked to anemia-like folate, Vit B6, C, B12, or Fe-the cluster analyses in the present cohort of young female university students have also found choline, Vit E, B2, Zn, Mg, Mn, and phosphorus as additional nutrients that might relate to the development of anemia. Further research is needed to elucidate if the intake of these nutrients might influence the risk of anemia.

Factors associated with positive body image among Palestinian university female students, cross-sectional study.

Background: Studies suggested that body image is influenced by biological, psychological, historical, individual, cultural, and social factors. This study aimed to investigate the relationship between body image, lifestyle, social pressure, and social media in Palestinian female university students. Method: A sample of 905 female undergraduate students (mean age: 20 ± 1.55 years old) from Palestinian universities were included in this cross-sectional study. In this study, the Body Appreciation Scale (BAS-2) was used for measuring body appreciation. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 28. One-way ANOVA, independent t-test, Cohen's d and Partial Eta Square, Pearson's correlation, and simple linear regression tests were performed. In addition, a mixed regression model was used to identify the predictors of Body Appreciation. Results: It was found that higher BMI, following models and celebrities on social media, following models/celebrities' nutritional advice, self-perceived family and friends pressure, previous dieting, and longer daily phone time were associated with lower body appreciation among female university students. While physical activity was associated with higher body appreciation. Conclusion: Body appreciation was significantly associated to lifestyle, social pressure, and social media use in the study sample. A higher BMI, following models and celebrities on social media, family and friend pressure, dieting, and daily phone use time decreased body appreciation. While being more physically active was linked to a higher body appreciation.

Assessment of the vitamin D status and its determinants in young healthy students from Palestine.

The global prevalence of vitamin D deficiency is high. Poor vitamin D status, especially in women, has been reported in several countries in the Middle East despite adequate year-round sunlight for vitamin D synthesis. However, data on vitamin D status in Palestine are scarce. The aim of this cross-sectional study was to evaluate vitamin D status based on serum concentrations of 25-hydroxycholecalciferol [25-(OH)D] among young healthy Palestinian students (18-27 years) and to assess associations between 25-(OH)D concentrations and several predictors. The mean 25-(OH)D concentration of women (n 151) was 27⋅2 ± 14⋅5 nmol/l, with the majority having insufficient (31⋅1 %) or deficient (<60 %) 25-(OH)D status. Only 7 % of women achieved sufficient or optimal 25-(OH)D status. In contrast, men (n 52) had a mean 25-(OH)D concentration of 58⋅3 ± 14⋅5 nmol/l, with none classified as deficient, and most obtaining sufficient (55⋅8 %) or even optimal 25-(OH)D status (11⋅5 %). Among women, 98 % wore a hijab and 74 % regularly used sunscreen. Daily dietary vitamin D intake (3-d 24-h recalls) was 45⋅1 ± 36⋅1 IU in the total group (no sex differences). After adjustment, multiple linear regression models showed significant associations between 25-(OH)D concentrations and the use of supplements (B = 0⋅069; P = 0⋅020) and dietary vitamin D (B = 0⋅001; P = 0⋅028). In gender-stratified analysis, the association between supplement use and 25-(OH)D concentrations was significant in women (B = 0⋅076; P = 0⋅040). The vitamin D status of women in the present cohort is critical and appears to be mainly due to wearing a hijab, regular use of sunscreen and low dietary vitamin D intake. The vitamin D status of the women should be improved by taking vitamin D containing supplements or fortified foods.