Influence of maternal characteristics and infant feeding patterns on infant growth from birth till 18 months: The MISC study.

BACKGROUND: The growth and development of infants during the first 1000 days of life are crucial for their health. OBJECTIVES: This study aims to assess the impact of maternal characteristics and infant feeding patterns on infant growth from birth to 18 months. METHODS: Data were derived from the 2-year perspective Mother Infant Study Cohort (MISC) study which included six visits from the third trimester of pregnancy until 18 months postpartum. A convenient sample of 256 pregnant women aged 19-40 years was recruited from Sharjah, Dubai and Ajman in the United Arab Emirates. RESULTS: Amongst mothers' characteristics, Arab nationality, pre-pregnancy overweight/obesity, higher gestational weight gain and lower physical activity were found to increase the likelihood of infants being overweight at 6, 12 and 18 months. Exclusive breastfeeding was positively correlated with reduced odds of the infant being overweight at 18 months (aOR = 0.31, 95% CI: 0.12-0.81). Breastfeeding for up to 6 months and the introduction of solid foods after 6 months was associated with reduced odds of the infant being overweight at 12 months old (aOR = 4, 95% CI: 1.1-14.6; aOR = 2.97, 95% CI: 1.09-8.08, respectively). CONCLUSION: The findings spotlight the influence of maternal characteristics and infant feeding on infant growth. This asserts the need for evidence-based programmes targeting mothers to promote optimal feeding practices and foster healthy child growth.

Diets and dietary supplements used during the COVID-19 pandemic in the United Arab Emirates: A cross-sectional survey.

INTRODUCTION: Since the beginning of the Coronavirus disease 2019 (COVID-19) pandemic, there has been a marked increase in the use of diets and dietary supplements (DDS) for the prevention and treatment of this emerging disease. While DDS are generally regarded as harmless, little evidence exists on the safety and efficacy of their use for COVID-19. OBJECTIVES: To investigate the pattern and determinants of DDS use among the United Arab Emirates (UAE) population for the prevention and treatment of COVID-19. DESIGN: Cross-sectional web-based survey. SETTING: Adults residing in the UAE. PARTICIPANTS: Participants (n = 2,060) residing in the UAE were recruited from databases of the Supreme Council for Family Affairs - Sharjah networks in the various Emirates. PRIMARY AND SECONDARY OUTCOMES: Prevalence and determinants for the use of different DDS for the prevention and treatment of COVID-19 in the UAE, and sources of information for DDS use. RESULTS: The majority of participants reported using a form of the DDS understudy, with special foods being the most common (95.5%), followed by intake of citrus fruits (62.1%), supplements use (56.6%), increased water intake (50%), and herbal teas (38.4%). Only 20% of participants reported the main source of information on DDS to be health care practitioners, with the majority relying on either social media (40.4%) or family and friends (28.7%). After adjustment, female gender, older age (>40 years), and Asian ethnicities were characteristics associated with higher odds of using most of the DDS modalities and were also correlates of reporting health care practitioners as the main source of information for their DDS use. CONCLUSIONS: The findings showed widespread use of DDS for the prevention and treatment of COVID-19. The use of DDS in this study was mainly guided by social media with a marginal role of health care practitioners. These findings call for a more integrative approach towards DDS to ensure its proper and safe use.

Indirect Health Effects of COVID-19: Unhealthy Lifestyle Behaviors during the Lockdown in the United Arab Emirates.

Background: Lockdown measures were implemented in many countries to limit the spread of the COVID-19 pandemic. However, such restrictions could precipitate unintended negative consequences on lifestyle behaviors. The main objective of this study was to investigate the prevalence and determinants of unhealthy behavior changes during the COVID-19 lockdown among residents of the United Arab Emirates (UAE). Methods: A cross-sectional web-based survey of adults residing in the UAE was carried out during lockdown (n = 2060). Using a multi-component questionnaire, the collected data included questions regarding the following lifestyle changes: Increased dietary intake, increased weight, decreased physical activity, decreased sleep, and increased smoking. An unhealthy lifestyle change score was calculated based on the number of unhealthy lifestyle changes each participant reported. In addition, sociodemographic and living conditions information was collected. Descriptive statistics as well as simple and multiple linear regression analyses were used to examine the prevalence and determinants of the unhealthy lifestyle changes considered in this study. Results: Among the unhealthy lifestyle changes examined, increased food intake was the most common (31.8%), followed by decreased physical activity (30%), increased weight (29.4%), decreased sleep (20.8%), and increased smoking (21%). In addition to identifying the correlates of each of the aforementioned lifestyle changes, the results of the multiple regression linear analyses revealed the following correlates for the overall unhealthy lifestyle change score: females (ß = 0.32, CI: 0.22; 0.42), living in an apartment (ß = 0.12, CI: 0.003; 0.23) and being overweight/obese (ß = 0.24, CI: 0.15; 0.32) had higher scores, while older adults (>40 years) had lower scores (ß = -0.23, CI: -0.34; -0.12). Conclusions: The COVID-19 lockdown has resulted in a high prevalence of unhealthy lifestyle behaviors and practices among UAE residents. The findings of this study provided the evidence base for officials to design interventions targeting high-risk groups and aiming to improve healthy lifestyle factors among residents during the pandemic.

Complementary and alternative medicine use among patients with type 2 diabetes living in the United Arab Emirates.

BACKGROUND: The use of Complementary and Alternative Medicine (CAM) among Type 2 Diabetes Mellitus (T2DM) patients is increasing to manage the complexities of their condition, enhance their health, and ease complications. The burden of T2DM in the United Arab Emirates (UAE) coupled with the high prevalence of CAM use and its associated risks among patients with T2DM necessitated the investigation of the use of CAM by this patients' population. The aim of this study is to examine the prevalence, types, and correlates of CAM use among T2DM patients in the UAE. METHODS: Patients with T2DM attending the outpatient clinics in the two governmental hospitals in Dubai and Sharjah, UAE were invited to participate in a cross-sectional survey. Face-to-face interviews were conducted with participants to complete a multi-component questionnaire. The questionnaire comprised of three main sections: demographic data, diabetes-related information, and CAM use details. Data analysis employed descriptive statistics, univariate and multivariate logistic regression to assess the prevalence and correlates of CAM use. RESULTS: Two hundred forty-four T2DM patients completed the questionnaire (response rate: 80%). A total of 39.3% of participants were CAM users since diagnosis. After adjustment; the logistic regression results showed that CAM use was significantly associated with age, sex, education, employment, and having health insurance. The most commonly used type of CAM by participants were folk foods and herbs followed by spiritual and natural healing and vitamins and minerals supplements. The majority of CAM users were referred or encouraged to use CAM by family (42.7%), friends (25%) or social media (17.7%). Only 13.5% of participants used CAM because it was suggested by health care practitioners. Only 1 in four of CAM users disclosed CAM use to their treating physician. CONCLUSION: CAM use among T2DM patients in the UAE is considerably high. Health policy and decision-makers are encouraged to dedicate particular attention to facilitating proper regulation and integration of CAM within conventional medicine to protect the health and wellbeing of patients. A concerted effort by medical schools and public health authorities should be committed to educating health care providers and patients on the safe and effective use of CAM therapies.

Dietary patterns and their associations with gestational weight gain in the United Arab Emirates: results from the MISC cohort.

BACKGROUND: Suboptimum weight gain during pregnancy may carry long term health consequences for the infant or mother. Nutritional imbalances are well recognized as a determinant of gestational weight gain. Few studies examined the effect of dietary patterns on gestational weight gain, especially in countries undergoing nutrition transition, such as the United Arab Emirates. OBJECTIVES: To characterize dietary patterns among pregnant women living in the UAE and examine their associations with gestational weight gain and gestational weight rate. METHODOLOGY: Data were drawn from the Mother-Infant Study Cohort, a two-year prospective cohort study of pregnant women living in the United Arab Emirates, recruited during their third trimester (n = 242). Weight gain during pregnancy was calculated using data from medical records. The Institute of Medicine's recommendations were used to categorize gestational weight gain and gestational weight gain rate into insufficient, adequate, and excessive. During face-to-face interviews, dietary intake was assessed using an 89-item culture-specific semi-quantitative food frequency questionnaire that referred to usual intake during pregnancy. Dietary patterns were derived by principal component analysis. Multiple logistic regression analyses were used to evaluate the associations of derived dietary patterns with gestational weight gain/gestational weight gain rate. RESULTS: Two dietary patterns were derived, a "Diverse" and a "Western" pattern. The "Diverse" pattern was characterized by higher intake of fruits, vegetables, mixed dishes while the "Western" pattern consisted of sweets and fast food. The "Western" pattern was associated with excessive gestational weight gain (OR:4.04,95% CI:1.07-15.24) and gestational weight gain rate (OR: 4.38, 95% CI:1.28-15.03) while the "Diverse" pattern decreased the risk of inadequate gestational weight gain (OR:0.24, 95% CI:0.06-0.97) and gestational weight gain rate (OR:0.28, 95% CI:0.09-0.90). CONCLUSION: The findings of this study showed that adherence to a "Diverse" pattern reduced the risk of insufficient gestational weight gain/gestational weight gain rate, while higher consumption of the "Western" pattern increased the risk of excessive gestational weight gain/gestational weight gain rate. In view of the established consequences of gestational weight gain on the health of the mother and child, there is a critical need for health policies and interventions to promote a healthy lifestyle eating through a life course approach.

Gestational weight gain and gestational diabetes among Emirati and Arab women in the United Arab Emirates: results from the MISC cohort.

BACKGROUND: Nutritional status of women during pregnancy has been considered an important prognostic indicator of pregnancy outcomes. OBJECTIVES: To investigate the pattern of gestational weight gain (GWG) and gestational diabetes mellitus (GDM) and their risk factors among a cohort of Emirati and Arab women residing in the United Arab Emirates (UAE). A secondary objective was to investigate pre-pregnancy body mass index (BMI) and its socio-demographic correlates among study participants. METHODS: Data of 256 pregnant women participating in the cohort study, the Mother-Infant Study Cohort (MISC) were used in this study. Healthy pregnant mothers with no history of chronic diseases were interviewed during their third trimester in different hospitals in UAE. Data were collected using interviewer-administered multi-component questionnaires addressing maternal sociodemographic and lifestyle characteristics. Maternal weight, weight gain, and GDM were recorded from the hospital medical records. RESULTS: Among the study participants, 71.1% had inadequate GWG: 31.6% insufficient and 39.5% excessive GWG. 19.1% reported having GDM and more than half of the participants (59.4%) had a pre-pregnancy BMI ≥ 25 kg/m2. The findings of the multiple multinomial logistic regression showed that multiparous women had decreased odds of excessive gain as compared to primiparous [odds ratio (OR): 0.17; 95% CI: 0.05-0.54]. Furthermore, women with a pre-pregnancy BMI ≥ 25 kg/m2 had increased odds of excessive gain (OR: 2.23; 95%CI: 1.00-5.10) as compared to those with pre-pregnancy BMI < 25 kg/m2. Similarly, women who had a pre-pregnancy BMI ≥ 25 kg/m2 were at higher risk of having GDM (OR: 2.37; 95%CI: 1.10-5.12). As for the associations of women's characteristics with pre-pregnancy BMI, age and regular breakfast consumption level were significant predictors of higher pre-pregnancy BMI. CONCLUSIONS: This study revealed alarming prevalence rates of inadequate, mainly excessive, GWG and GDM among the MISC participants. Pre-pregnancy BMI was found a risk factor for both of these conditions (GWG and GDM). In addition, age and regular breakfast consumption were significant determinants of pre-pregnancy BMI. Healthcare providers are encouraged to counsel pregnant women to maintain normal body weight before and throughout pregnancy by advocating healthy eating and increased physical activity in order to reduce the risk of excessive weight gain and its associated complications.

The Mother-Infant Study Cohort (MISC): Methodology, challenges, and baseline characteristics.

BACKGROUND: The United Arab Emirates (UAE) exhibits alarming high prevalence of Non-Communicable Diseases (NCDs) and their risk factors. Emerging evidence highlighted the role of maternal and early child nutrition in preventing later-onset NCDs. The objectives of this article are to describe the design and methodology of the first Mother and Infant Study Cohort (MISC) in UAE; present the baseline demographic characteristics of the study participants; and discuss the challenges of the cohort and their respective responding strategies. METHODS: The MISC is an ongoing two-year prospective cohort study which recruited Arab pregnant women in their third trimester from prenatal clinics in Dubai, Sharjah and Ajman. Participants will be interviewed six times (once during pregnancy, at delivery, and at 2, 6, 12 and 24months postpartum). Perinatal information is obtained from hospital records. Collected data include socio-demographic characteristics, lifestyle, dietary intake and anthropometry; infant feeding practices, cognitive development; along with maternal and infant blood profile and breast milk profile. RESULTS: The preliminary results reported that 256 completed baseline assessment (mean age: 30.5±6.0 years; 76.6% multiparous; about 60% were either overweight or obese before pregnancy). The prevalence of gestational diabetes was 19.2%. Upon delivery, 208 women-infant pairs were retained (mean gestational age: 38.5±1.5 weeks; 33.3% caesarean section delivery; 5.3% low birthweight; 5.7% macrosomic deliveries). Besides participant retention, the main encountered challenges pertained to cultural complexity, underestimation the necessary start-up time, staff, and costs, and biochemical data collection. CONCLUSIONS: Despite numerous methodological, logistical and sociocultural challenges, satisfactory follow-up rates are recorded. Strategies addressing challenges are documented, providing information for planning and implementing future birth cohort studies locally and internationally.

Energy drink consumption is associated with reduced sleep quality among college students: a cross-sectional study.

AIM: Intake of caffeinated energy drinks has significantly increased, specifically among young adults and adolescents. College students are prone to developing unhealthy eating habits and dependence on stimulants, which puts them at a greater risk of sleep problems. This study aims to investigate the prevalence of caffeinated energy drink consumption and its association with sleep quality in college students. METHODS: A sample of 919 randomly selected adults (237 males and 682 females) from various colleges at the University of Sharjah/United Arab Emirates participated in this cross-sectional study. Data were collected using an online validated questionnaire. RESULTS: The current study revealed that 376 students (41%) were consuming energy drinks on a regular basis. Approximately half of the students had normal sleep patterns; the other half had sleep problems (anxiety and intermittent sleep). Results of the present study revealed a significant (r = -0.10, P < 0.05) relationship between the consumption of energy drinks and sleep quality and patterns. CONCLUSIONS: Moderate consumption of energy drinks was reported among college students. Consumption of energy drinks was significantly associated with changes in sleep quality and patterns of students.