Sleep quality and Dietary Inflammatory Index among university students: a cross-sectional study.

PURPOSE: Evidence indicates that most college students face reduced sleep quality due to unhealthy dietary habits and hectic daily schedules. While the relationship between sleep quality and general health has been the subject of intensive research, little is known about the association between sleep and its relation with the inflammatory potential of the diet until recently. This study aimed to investigate the association between Energy-Adjusted Dietary Inflammatory Index (E-DII®) scores and sleep quality in a group of students from the University of Sharjah (UOS). METHODS: A cross-sectional study design was followed, and convenience sampling was used. Participants were assessed for sleep quality using the Pittsburgh Sleep Quality Index (PSQI), E-DII scores were derived from a semi-quantitative food frequency questionnaire (FFQ), and physical activity level was measured using the International Physical Activity Questionnaire (IPAQ). Chi-square tests and two-sample t tests were used to find an association between E-DII scores and sleep quality. RESULTS: A total of 379 college students were included in the study of whom 64 % were female and 81% were between 18 and 21 years of age. Two-thirds of participants experienced poor sleep quality. Although results were trending in the hypothesized direction, no significant association was found between E-DII scores and sleep quality. Among the individual components of sleep quality, a direct significant association was found between E-DII scores and day dysfunction (P = 0.03). CONCLUSIONS: These results suggest that a pro-inflammatory diet maybe related to increased day dysfunction among UOS students. Consuming a more anti-inflammatory diet may reduce daytime dysfunction. Further prospective and controlled studies are required to confirm this association, and to explore other attributes and their sequelae on sleep quality.

Impact of Ramadan diurnal intermittent fasting on the metabolic syndrome components in healthy, non-athletic Muslim people aged over 15 years: a systematic review and meta-analysis.

Studies on the impact of Ramadan diurnal intermittent fasting (RDIF) on the metabolic syndrome (MetS) components among healthy Muslims observing Ramadan month have yielded contradictory results. This comprehensive meta-analysis aimed to obtain a more stable estimate of the effect size of fasting during Ramadan on the MetS components, examine variability among studies, assess the generalisability of reported results and perform subgroup analyses for associated factors. We searched the CINAHL, Cochrane, EBSCOhost, Google Scholar, ProQuest Medical, PubMed/MEDLINE, ScienceDirect, Scopus and Web of Science databases for relevant studies published from 1950 to March 2019. The MetS components analysed were: waist circumference (WC), systolic blood pressure (SBP), fasting plasma/serum glucose (FG), TAG, and HDL-cholesterol. We identified eighty-five studies (4326 participants in total) that were conducted in twenty-three countries between 1982 and 2019. RDIF-induced effect sizes for the MetS components were: small reductions in WC (no. of studies K = 24, N 1557, Hedges' g = -0·312, 95 % CI -0·387, -0·236), SBP (K = 22, N 1172, Hedges' g = -0·239, 95 % CI -0·372, -0·106), FG (K = 51, N 2318, Hedges' g = -0·101, 95 % CI -0·260, 0·004) and TAG (K = 63, N 2862, Hedges' g = -0·088, 95 % CI -0·171, -0·004) and a small increase in HDL-cholesterol (K = 57, N 2771, Hedges' g = 0·150, 95 % CI 0·064, 0·236). We concluded that among healthy people, RDIF shows small improvement in the five MetS components: WC, SBP, TAG, FG and HDL.

A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on body weight in healthy subjects aged 16 years and above.

PURPOSE: Studies on the effect of Ramadan diurnal intermittent fasting (RDIF) on body weight have yielded conflicting results. Therefore, we conducted a systematic review and meta-analysis to estimate the effect size of body weight changes in healthy, non-athletic Muslims practicing Ramadan fasting, and to assess the effect of covariates such as age, sex, fasting time duration, season, and country, using subgroup analysis, and meta-regression. Covariate adjustments were performed to explain the variability of weight change in response to Ramadan fasting. METHODS: CINAHL, Cochrane, EBSCOhost, EMBASE, Google Scholar, ProQuest Medical, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science databases were searched from date of inception in 1950 to the end of August 2019. RESULTS: Eighty-five studies, conducted in 25 countries during 1982-2019, were identified. RDIF yielded a significant, but small reduction in body weight (K = 85, number of subjects, N = 4176 (aged 16-80 years), Hedges' g =- 0.360, 95% confidence interval (CI) - 0.405 to - 0.315, I2 = 45.6%), this effect size translates into difference in means of - 1.022 kg (95% CI - 1.164 kg to - 0.880 kg). Regression analysis for moderator covariates revealed that fasting time (min/day) is a significant (P < 0.05) moderator for weight change at the end of Ramadan, while age and sex are not. Variable effects for the season and country were found. CONCLUSION: RDIF may confer a significant small reduction in body weight in non-athletic healthy people aged 16 years and above, directly associated with fasting time and variably correlated with the season, and country.

Effect of diurnal fasting on sleep during Ramadan: a systematic review and meta-analysis.

PURPOSE: The current meta-analysis aimed to obtain a more stable estimate of the effect size of Ramadan diurnal intermittent fasting (RDF) on sleep duration and daytime sleepiness. METHODS: Databases (Scopus, ScienceDirect, ProQuest Medical, PubMed/MEDLINE, Web of Science, EBSCOhost, Cochrane, CINAHL, and Google Scholar) were searched from database inception to the end of June 2019. The sleep quality measures analyzed were excessive daytime sleepiness (EDS) measured by the Epworth sleepiness scale (ESS) and total sleep time (TST). Subgroup analyses for age, sex, and levels of physical activity were conducted. RESULTS: We identified 24 studies (involving 646 participants, median age 23.7 years, 73% men) conducted in 12 countries from 2001 to 2019. The results revealed that TST decreased from 7.2 h per night [95% confidence interval (CI) 6.7-7.8] before Ramadan to 6.4 h (95% CI 5.3-7.5) during Ramadan, while the ESS score increased slightly from 6.1 (95% CI 4.5-7.7) before Ramadan to 7.0 (95% CI 5.2-8.8) during Ramadan. Effect sizes on sleep quality measures during RDF demonstrated a moderate reduction in TST (number of studies, K = 22; number of subjects, N = 571, Hedges' g value of -0.43, 95% CI - 0.64 to -0.22, Q = 90, τ2 = 0.15, I2 = 78%, P < 0.001), while ESS score showed negligible effect on EDS (K = 9, N = 362, Hedges' g value of -0.06, 95% CI -0.43 to 0.28, Q = 21, τ2 = 0.13, I2 = 76%, P value = 0.001). CONCLUSION: During the month of Ramadan, there is approximately a 1 hour reduction in TST and nearly a 1 point increase in the ESS score.

The relationship between risk of eating disorders, age, gender and body mass index in medical students: a meta-regression.

PURPOSE: Age, gender and body mass index (BMI) are commonly described risk factors for the development of eating disorders. However, the magnitude of these factors (individually and together) is still not well-defined in some populations. METHODS: A systematic search was performed for studies that reported the prevalence of eating disorder risk among medical students using the Eating Attitudes Test-26 (EAT-26) and age, gender and BMI as risk factors. We included studies published in English peer-reviewed journals between 1982 and 2017. A total of 14 studies were included in the analyses, and the meta-regression analyses were performed using mean age (years), gender (proportion of female subjects), and mean BMI (kg/m2) as moderators with the risk of eating disorders measured using EAT-26 as an outcome variable. Four interaction terms were created (1) age × gender (2) age × BMI (3) gender × BMI and (4) age × gender × BMI to assess if two or more independent variables simultaneously influence the outcome variable. RESULTS: Utilizing the EAT-26, the pooled prevalence of at risk for eating disorders among medical students (k = 14, N = 3520) was 10.5% (95% CI 7.3-13.7%). Meta-regression model of age, gender and BMI alone revealed poor predictive capabilities. Meta-regression model of age × gender × BMI interaction revealed statistically significant results with a covariate coefficient of 0.001 and p value of 0.044. CONCLUSION: Results from this sample of medical students provided evidence for the role of interactions between risk factors (e.g., age × gender × BMI) in predicting individuals at risk for eating disorders, whereas these variables individually failed to predict eating disorders. LEVEL OF EVIDENCE: Level I, systematic review and meta-analysis.

Eating disorders risk among medical students: a global systematic review and meta-analysis.

PURPOSE: Medical students appear to be a high-risk group to develop psychological problems including eating disorders (ED). The prevalence estimates of ED risk vary greatly between studies. This systematic review and meta-analysis was done to estimate the prevalence of ED risk among medical students. METHODS: An electronic search of EMBASE, MEDLINE, ProQuest and Google Scholar was conducted. Studies that reported the prevalence of ED risk among medical students and were published in English peer-reviewed journals between 1982 and 2017 were included. Information about study characteristics and the prevalence of ED risk were extracted by four investigators. Each article was reviewed independently by at least two investigators. Estimates were pooled using random-effects meta-analysis using the DerSimonian-Laird method. The main outcome of interest was the prevalence of ED risk in medical students. RESULTS: The prevalence of ED risk among medical students was extracted from nineteen cross-sectional studies across nine countries (total participants n = 5722). The overall pooled prevalence rate of ED risk was 10.4% (497/5722 students, 95% CI 7.8-13.0%), with statistically significant evidence between-study heterogeneity (Q = 295, τ2 = 0.003, I2 = 94.0%, P < 0.001). Prevalence estimates between studies ranged from 2.2 to 29.1%. CONCLUSION: In this systematic review and meta-analysis, the summary prevalence of ED risk among medical students was 10.4%. Further research is needed to identify and prevent ED in this population. Studies are also needed to investigate concurrent pathologies associated with ED risk. LEVEL OF EVIDENCE: Level I, systematic review and meta-analysis.

The risk of eating disorders among children and adolescents with attention deficit hyperactivity disorder: Results of a matched cohort study.

BACKGROUND AND OBJECTIVES: There are some studies on the association between attention deficit and hyperactivity disorder (ADHD) and the risk of eating disorders (ED). Only few have examined the risk of ED among children and adolescents with ADHD. Previous research which included subjects with ADHD with other comorbidities used inadequate controls and did not focus on the type of ADHD or the role of pharmacological treatment. METHODS: This matched cohort study was conducted in the Child/Adolescents Psychiatry Unit (CAPU), Bahrain. Using the CAPU diagnostic frameworks, 70 subjects with ADHD were recruited and matched with their corresponding age- and sex- healthy controls at 1:2 ratio (70 cases:140 controls). The participants were children or adolescents aged between 8 and 19 years old. A brief interview was used to collect socio-demographic information and anthropometrics. The risk of ED was estimated using the eating attitude test -26 (EAT-2). Data were analyzed using cohort analysis. RESULTS: A total of 31.43% of the subjects with ADHD were screened using EAT-26 and found to be 'at risk' for ED, compared to 12.14% of the controls (OR 3.31, 95% CI 1.62-6.78). The prevalence of ED among female cases with ADHD was slightly higher than males (33.33% and 30.77%, respectively). Body weight or body mass index was a statistically significant explanatory factor for the risk of ED. CONCLUSIONS: The present study shows that children and adolescents with ADHD have a three-fold increased risk of ED compared to healthy controls. This research raised the recommendation that children and adolescents with ADHD should be screened for disordered eating patterns.

Diet-Related Inflammation is Associated with Major Depressive Disorder in Bahraini Adults: Results of a Case-Control Study Using the Dietary Inflammatory Index.

PURPOSE: This case-control study aimed to examine the association between the inflammation potential of the diet and depression. PATIENTS AND METHODS: Ninety-six patients with major depression disorder were matched with 96 age- and sex-matched healthy controls. Energy-adjusted DII (E-DIITM) scores were calculated based on the participants' responses to a detailed nutritional assessment using a quantitative food frequency questionnaire. Descriptive results were reported. Logistic regression was used to estimate odds ratios and 95% confidence intervals associated with E-DII scores and depression adjusting for covariates including age, sex, body mass index, comorbidities, level of education, and employment. RESULTS: The mean E-DII score of participants in the study was 1.32±1.08, indicating a generally pro-inflammatory diet. Patients with depression had elevated E-DII scores compared to age- and sex-matched controls with E-DII scores of 1.72± 1.09 vs 0.90±0.90, respectively (P=0.001). Results of logistic regression analysis revealed that patients with depression were nearly three times more likely to be in the extreme ends of pro-inflammatory diet (OR 2.75; 95% CI 1.82-4.15). CONCLUSION: Adult Bahraini patients with depression have higher dietary inflammation potential compared to the general population controls. Further research is needed to confirm these results and provide effective interventions to reduce the burden of this dietary inflammation.

Energy Drinks Consumption Is Associated With Reduced Sleep Duration and Increased Energy-Dense Fast Foods Consumption Among School Students: A Cross-Sectional Study.

The study aimed to investigate the prevalence of energy drinks (EDs) consumption and its relationship with sociodemographic characteristics, eating habits, sleep duration, physical activity, and screen time among school students. A cross-sectional study was carried out with a total of 1611 students aged 10 to 18 years from the United Arab Emirates. ED consumption among school students was 27%, with less than half consumed at least one can of EDs 1 to 3 days per week. ED consumers were less likely to meet recommended sleep duration (37% vs 62%, P < .001), more likely to consume high energy-dense fast foods (33% vs 20%, P < .001), and more likely to spend more than 6 hours in front of a screen (40.5% vs 32.3%, P < .001). Students aged 14 to 18 years were twice as likely to consume EDs as students aged 10 to 13 years (P < .001). Overall, the use of EDs was associated with male sex, older age, not meeting sleep recommendations, high energy-dense fast food consumption, and spending a longer time in front of a screen. Educational intervention programs about ED consumption and healthy lifestyle habits are highly recommended.

Assessing dietary and lifestyle risk behaviours and their associations with disease comorbidities among patients with depression: A case-control study from Bahrain.

OBJECTIVES: In Western populations, patients with depression die 10-25 years prematurely compared to controls, mainly due to lifestyle-related diseases. Tobacco smoking, excessive alcohol intake, poor diets and physical inactivity are among the major contributors to disease comorbidities. The objective of this research is to assess the dietary and lifestyle behaviours for Bahraini patients with depression and to determine their associations with different medical comorbidities. METHODS: A case-control study was conducted from March to December 2019. A sample of 96 diagnosed patients with depression was recruited from the Psychiatric Hospital/Bahrain, and 96 age- and sex-matched controls were recruited from primary health centres. Assessment of anthropometrics, dietary and alcohol intakes, tobacco smoking and physical activity levels were undertaken for both cases and controls. National electronic medical records were reviewed retrospectively for medical comorbidities for the recruited cases. Logistic regression analysis was used to identify associations between lifestyle behaviours and medical comorbidities after controlling for confounding factors. RESULTS: Patients with depression reported higher intakes of energy and energy-yielding macronutrients (e.g., carbohydrates, protein, and fat); three-fold higher rates of tobacco smoking; and significantly lower levels of physical activity. Cases appeared to be at a doubled risk for developing obesity, diabetes type 2, hypertension, and musculoskeletal disorders. The risk for cardiovascular problems was similar for cases and controls. CONCLUSIONS: Poor dietary intakes, increased prevalence of smoking, and low levels of physical activity were evident in patients with depression in Bahrain; these factors were associated with some medical comorbidities.

Outcomes of COVID-19 in the Eastern Mediterranean Region in the first 4 months of the pandemic.

OBJECTIVES: To summarize the outcomes of the coronavirus disease 2019 infections in the Eastern Mediterranean Region (EMR) in the first 4 months of the pandemic. METHODS: A meta-analysis approach was used in this context. We used the aggregate data from the World Health Organization Regional Office for the EMRO (until 26 May 2020) to generate this report. RESULTS: An analysis of official data from all 22 countries and territories in the Middle East, North Africa, the Horn of Africa, and Central Asia K=22 (a total of 438,717 cases) was performed. The total number of cases, recovered cases were 438,717,228,986,  and deaths was 11,290 in the EMR. Meta-analytic pooling of the point estimates of recovery rate per country in the EMR was 52.5% (95% CI 52.3% - 52.6%). The lowest recovery rates were in Somalia (4.3%), and the highest rates were in Tunisia (87.4%). Meta-analytic pooling of the point estimates of death rate per country in the EMR yielded 3.85% [95% CI 3.80% - 3.9%]. Meta-analytic pooling of the point estimates of recovery rate per country in the Gulf Cooperation Council countries was 46.1% (95% CI 45.8% - 46.3%). Meta-analytic pooling of the point estimates of death rate per country in the Gulf Cooperation Council countries was 0.6% (95% CI 0.50% - 0.65%). CONCLUSION: Wide variability was found between EMR countries in recovery and mortality, implying the possible impact of resource availability, and genetic and environmental factors on the morality and recovery of the COVID-19.

A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on glucometabolic markers in healthy subjects.

AIM: Studies on the effect of Ramadan diurnal intermittent fasting (RDIF) on glucometabolic markers have yielded conflicting results. We conducted ameta-analysis to estimate the effect size for changes in glucometabolic markers in healthy, non-athletic Muslims during Ramadan, and to assess the effect of variable covariates using meta-regression. METHODS: CINAHL, Cochrane, EBSCOhost, EMBASE, Google Scholar, ProQuest Medical, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science databases were searched from date of inceptionto January 2020. The glucometabolic markers analyzed were: fasting glucose (FG), insulin, insulin resistance (HOMA-IR), leptin, and adiponectin. RESULTS: We identified seventy-two studies (3134 participants in total) that were conducted in 22 countries between 1982 and 2020. RDIF-induced effect sizes for the glucometabolic markers were: FG (no. of studies K = 61, number of subjects N = 2743, Hedges'g = -0.102, 95% CI: -0.194, -0.01); serum insulin (K = 16, N = 648, Hedges'g = 0.030 95% CI: -0.165, 0.226); HOMA-IR (K = 10, N = 349, Hedges'g = -0.012, 95% CI: -0.274, 0.250); leptin (K = 13, N = 442, Hedges'g = -0.010, 95% CI: -0.243, 0.223); and adiponectin (K = 11, N = 511, Hedges'g = 0.034, 95% CI: -0.227, 0.296). CONCLUSION: RDIF imposes no adverse metabolic impacts, and might help in improving some glucometabolic markers in healthy subjects.

Increased Dietary Inflammatory Index Is Associated with Schizophrenia: Results of a Case-Control Study from Bahrain.

BACKGROUND: Several studies have indicated that chronic low-grade inflammation is associated with the development of schizophrenia. Given the role of diet in modulating inflammatory markers, excessive caloric intake and increased consumption of pro-inflammatory components such as calorie-dense, nutrient-sparse foods may contribute toward increased rates of schizophrenia. This study aimed to examine the association between dietary inflammation, as measured by the dietary inflammatory index (DII®), and schizophrenia. METHODS: A total of 120 cases attending the out-patient department in the Psychiatric Hospital/Bahrain were recruited, along with 120 healthy controls matched on age and sex. The energy-adjusted DII (E-DII) was computed based on dietary intake assessed using a comprehensive food frequency questionnaire (FFQ). Logistic regression was used to estimate odds ratios and 95% confidence intervals, adjusting for potential confounders including age, sex, body mass index, education, employment, diabetes, hypertension, and cardiovascular disease with E-DII expressed both as a continuous variable and categorized as quartiles. RESULTS: The mean E-DII score for the entire sample was 1.79 ± 1.52, indicating a generally pro-inflammatory diet. The cases with schizophrenia appeared to have a higher E-DII score compared to controls: 1.99 ± 1.39 vs. 1.60 ± 1.38, respectively (p = 0.009). For every one unit increase in the E-DII score, the odds of having schizophrenia increased by 62% (OR 1.62; 95% CI 1.17-2.26). Similarly, increased risk was observed when the E-DII was used as quartiles, with participants in most pro-inflammatory quartile 4 being nearly 6 times more likely to be schizophrenic than participants in the most anti-inflammatory group quartile 1 (OR 5.96; 1.74-20.38; p-trend = 0.01). CONCLUSIONS: The data suggest that a pro-inflammatory diet, as indicated by increasing E-DII score, is associated with schizophrenia. This is the first study to examine the association between the DII and schizophrenia in a Middle Eastern population. Although these results are consistent with findings from research conducted in depression, additional studies are required before generalizing the findings to other populations.

Effect of Ramadan diurnal fasting on visceral adiposity and serum adipokines in overweight and obese individuals.

AIM: Excessive visceral adiposity is a major risk factor for developing insulin resistance and systemic low-grade inflammation. Ramadan diurnal fasting (RDF) is a religious ritual practiced by more than one billion Muslim throughout the world. It has been considered as one of the most common types of complementary and integrative health practices. The aim of this study is to examine the impact of RDF on visceral adiposity, circulating adipokines and glucoregulatory markers in patients with overweight or obesity. METHODS: Overweight and obese subjects (n = 61; 23 men and 38 women) were included in the study. Body weight, visceral fat tissue area (measured by 3D-MRI), glucoregulatory factors, serum adipokines concentrations, dietary intake, and physical activity were assessed one week before and at the end of the lunar month of Ramadan. RESULTS: From baseline, body weight and visceral fat tissue area serum total cholesterol, triglycerides, HDL-cholesterol, and systolic blood pressure significantly decreased (P < 0.05 for each) at the end of Ramadan. The serum levels of adiponectin, IL-6, TNF-α, and IGF-1 significantly decreased (P < 0.05 for each), but serum visfatin, leptin, apelin, IL-10, and IL-10/IL-6 ratio significantly increased (P < 0.05 for each) at the end of Ramadan. Changes in visceral adiposity significantly correlated with changes in plasma glucose (r = 0.4, P < 0.5) and resistin (r = 0.44, P < 0.001) at the end of Ramadan. CONCLUSION: RDF lowers visceral adiposity, body weight and variably affects adipokines without adversely affecting markers of glucose homeostasis in individuals with overweight or obesity.

Ramadan diurnal intermittent fasting modulates SOD2, TFAM, Nrf2, and sirtuins (SIRT1, SIRT3) gene expressions in subjects with overweight and obesity.

AIM: A growing body of evidence supports the impact of intermittent fasting on normalizing body metabolism and lowering oxidative stress and inflammation. Mounting evidence confirms that oxidative stress and chronic inflammation trigger the way for the development of metabolic diseases, such as diabetes. This research was conducted to evaluate the impact of Ramadan intermittent fasting (RIF) on the expression of cellular metabolism (SIRT1 and SIRT3) and antioxidant genes (TFAM, SOD2, and Nrf2). METHODS: Fifty-six (34 males and 22 females) overweight and obese subjects and six healthy body weight controls were recruited and monitored before and after Ramadan. RESULTS: Results showed that the relative gene expressions in obese subjects in comparison to counterpart expressions of controls for the antioxidant genes (TFAM, SOD2, and Nrf2) were significantly increased at the end of Ramadan, with percent increments of 90.5%, 54.1% and 411.5% for the three genes, respectively. However, the metabolism-controlling gene (SIRT3) showed a highly significant (P < 0.001) downregulation accompanied with a trend for reduction in SIRT1 gene at the end of Ramadan month, with percent decrements of 61.8% and 10.4%, respectively. Binary regression analysis revealed significant positive correlation (P < 0.05) between high energy intake (>2000 Kcal/day vs. <2000 Kcal/day) and expressions of SOD2 and TFAM (r = 0.84 and r = 0.9, respectively). CONCLUSION: Results suggest that RIF ameliorates the genetic expression of antioxidant and anti-inflammatory, and metabolic regulatory genes. Thus, RIF presumably may entail a protective impact against oxidative stress and its adverse metabolic-related derangements in non-diabetic obese patients.

Premenstrual Syndrome Is Associated with Dietary and Lifestyle Behaviors among University Students: A Cross-Sectional Study from Sharjah, UAE.

Premenstrual syndrome (PMS) is a cyclical late luteal phase disorder of the menstrual cycle whereby the daily functioning of women is affected by emotional and physical symptoms substantially interfering with their quality of life. Little is known about PMS in the United Arab Emirates (UAE). This study aimed to determine the prevalence and severity of PMS among university students in Sharjah, UAE, and clarify its associations with dietary habits, lifestyle behaviors, and anthropometric factors. A cross-sectional study was conducted on female college students at the University of Sharjah, UAE. Data were collected using self-administered questionnaires and anthropometric assessments. Descriptive statistics and multiple logistic regression analyses were performed. Participants were 300 adult university students aged 18-24 years (mean age 20.07 ± 1.53 years). In total, 95% of participants reported at least one PMS symptom during their menstrual period. The prevalence of PMS was 35.3%, with mild symptoms being the most commonly reported. Multiple regression analysis showed that smoking was associated with increased risk of reporting psychological (OR 2.5, 95% CI 1.1-5.8; p < 0.05) and behavioral symptoms (OR 2.2, 95% CI 1.0-4.9; p < 0.05), while high calorie/fat/sugar/salt foods intake was associated with increased risk of reporting physical symptoms (OR 3.2, 95% CI 1.4-7.3; p < 0.05). However, fruit consumption (OR 0.34, 95% CI 0.125-0.92; p < 0.05) was associated with a decreased risk of reporting behavioral symptoms. A high prevalence of PMS was reported among university students, with smoking and high calorie/fat/sugar/salt food consumption identified as strong risk factors for PMS.

Assessing dietary and lifestyle risk factors and their associations with disease comorbidities among patients with schizophrenia: A case-control study from Bahrain.

OBJECTIVE: Acquired dietary habits and lifestyle behaviors of patients with schizophrenia may affect their life expectancy, disease complications and prognosis. The objectives of the current study were to assess the dietary habits and other lifestyle behaviors for Bahraini patients with schizophrenia, and to determine their associations with different medical comorbidities. METHOD: A case-control study was conducted during the period of March to December 2016. A sample of 120 cases were recruited from the Psychiatric Hospital, Bahrain and age-sex-matched with 120 controls. Controls were recruited from primary health centres, and were free from serious mental illness. Dietary habits and lifestyle behaviors including smoking, alcohol intake and physical activity were assessed using a questionnaire. All medical records were reviewed retrospectively. Logistic regression analysis was used to identify dietary and lifestyle risk factors that are associated with one or more disease comorbidities. RESULTS: Cases had higher prevalence of smoking and alcohol intake, excessive dietary intake, and decreased physical activity (all P<0.05) compared with controls. Cases appeared to be at higher risk for developing chronic medical conditions such as obesity, type 2 diabetes, hypertension, cardiovascular disease, and musculoskeletal disorders. Cases were three times more likely to have up to three or more medical comorbidities compared with controls. Excessive dietary intake and decreased physical activity were identified as the main risk factors. CONCLUSION: Excessive caloric intake and decreased physical activity represent the main dietary and lifestyle risk factors associated with comorbidities among patients with schizophrenia in Bahrain.

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.

Chemopreventive Effect of Cardamom (Elettaria cardamomum L.) Against Benzo(α)Pyrene-Induced Forestomach Papillomagenesis in Swiss Albino Mice.

Prevention of cancer through dietary intervention has recently gained significant recognition. Cardamom (Elettaria cardamomum), a dietary phytoproduct, is a popular spice that is regularly used as a flavoring agent in various cuisines, and is much valued for its medicinal properties. In the present study, the cancer chemopreventive potential of cardamom was investigated against benzo(α)pyrene [B(α)P]-induced forestomach papillomagenesis in mice. Results showed that treatment with cardamom [(B(α)P + cardamom] reduced tumor incidence and multiplicity significantly (P<0.001) by 41.67% and 74.55%, respectively, compared to that of the B(α)P control group. Biochemical assays revealed a significant enhancement in the hepatic activities of glutathione-S-transferases (P<0.01), superoxide dismutase (P<0.01), glutathione peroxidase (P<0.001), and catalase (P<0.001) in mice treated with cardamom compared with the control. Furthermore, the nonenzymatic antioxidant glutathione was significantly (P<0.001) increased in the cardamom-treated group, whereas the lipid peroxidation level along with lactate dehydrogenase activity exhibited a significant (P<0.01) reduction with cardamom treatment compared to the control. These results suggest that cardamom has the potential to become a pivotal chemopreventive agent against forestomach cancer.

Impact of ramadan intermittent fasting on oxidative stress measured by urinary 15-f(2t)-isoprostane.

Fasting and caloric restriction have been associated with reduced incidence of chronic diseases and cancers. These effects have been attributed to reduced oxidative stress. Since Ramadan intermittent fasting (RIF) has been associated with reduced caloric intake, it was hypothesized that RIF would alleviate oxidative stress in healthy volunteers. The study was designed to elucidate the impact of RIF on oxidative stress measured by 15-F(2t)-Isoprostane (15FIP). Fifty healthy subjects (23 men and 27 women) who intended to fast Ramadan were recruited. Urine and serum sampling and anthropometric and dietary assessments were conducted one week before Ramadan (T0), at the end of the third week of Ramadan (T1), and one month after Ramadan (T2). Biochemical measurements included urinary 15FIP, creatinine, and hematological indices. Results revealed that the urinary level of 15FIP measured at T0 was normal, while they showed a significantly (P < 0.05) higher level when measured at T1 concomitant with a significant (P < 0.05) increase in the body weight and total body fat percent. In conclusion, results suggest that increased body weight is associated with increased lipid peroxidation and oxidative stress, and the impact of RIF on oxidative stress is mediated by the changes in body weight at the end of the month.