Machine learning techniques for the identification of risk factors associated with food insecurity among adults in Arab countries during the COVID-19 pandemic.

BACKGROUND: A direct consequence of global warming, and strongly correlated with poor physical and mental health, food insecurity is a rising global concern associated with low dietary intake. The Coronavirus pandemic has further aggravated food insecurity among vulnerable communities, and thus has sparked the global conversation of equal food access, food distribution, and improvement of food support programs. This research was designed to identify the key features associated with food insecurity during the COVID-19 pandemic using Machine learning techniques. Seven machine learning algorithms were used in the model, which used a dataset of 32 features. The model was designed to predict food insecurity across ten Arab countries in the Gulf and Mediterranean regions. A total of 13,443 participants were extracted from the international Corona Cooking Survey conducted by 38 different countries during the COVID -19 pandemic. RESULTS: The findings indicate that Jordanian, Palestinian, Lebanese, and Saudi Arabian respondents reported the highest rates of food insecurity in the region (15.4%, 13.7%, 13.7% and 11.3% respectively). On the other hand, Oman and Bahrain reported the lowest rates (5.4% and 5.5% respectively). Our model obtained accuracy levels of 70%-82% in all algorithms. Gradient Boosting and Random Forest techniques had the highest performance levels in predicting food insecurity (82% and 80% respectively). Place of residence, age, financial instability, difficulties in accessing food, and depression were found to be the most relevant features associated with food insecurity. CONCLUSIONS: The ML algorithms seem to be an effective method in early detection and prediction of food insecurity and can profoundly aid policymaking. The integration of ML approaches in public health strategies could potentially improve the development of targeted and effective interventions to combat food insecurity in these regions and globally.

Validity and Reproducibility of a Food Frequency Questionnaire for Estimating Macro- and Micronutrient Intakes Among Pregnant Women in Jordan.

Objectives: Assessing the relationship between maternal diet and pregnancy outcomes is a crucial issue that requires valid dietary assessment tools in this critical period. This study aimed to develop and assess the validity and reproducibility of a culture-specific quantitative food frequency questionnaire (QFFQ) to evaluate the dietary intake of macro- and micronutrients from food in a sample of Jordanian pregnant women.Methods: A QFFQ was validated against three repeated 24-hour dietary recalls (24-hr recalls). The QFFQ was administered twice one month apart. A total of 131 Jordanian pregnant women participated in the validation study. Thirty women took part in the reproducibility phase, which was repeated in a time frame of one month.Results: The intra-class correlation coefficients of QFFQ1 and QFFQ2 for energy were 0.79 and for macronutrients ranged from -0.27 for insoluble fiber to 0.81 for dietary fiber, indicating adequate (0.51) reproducibility. The intra-class correlation coefficients between two QFFQs for micronutrients ranged from 0.19 for selenium to 0.85 for vitamin C. The average of correlation coefficient was 0.58 for micronutrients. Energy-adjusted and de-attenuated Pearson correlation coefficients between QFFQ1 and 24-hr dietary recall for macronutrients ranged from 0.13 for soluble fiber and trans fat to 0.90 for cholesterol and for micronutrients from 0.01 for sodium to 0.78 for magnesium.Conclusions: The newly developed QFFQ could facilitate the assessment of the nutrient intake among Jordanian pregnant women. Using this QFFQ will help in evaluating the nutritional status of pregnant women, aiming at improving maternal and newborn health.

Subcutaneous and visceral fat volumes measured by MRI and their relationships with nutrient intakes among adults.

BACKGROUND AND OBJECTIVES: Types and amounts of nutrients may influence the volume of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). This study targeted to investigate the relationship between SAT and VAT volumes and macro- and micronutrients intake among adults. METHODS AND STUDY DESIGN: Data were collected via a private face-to-face interview, in which diet history was obtained using validated quantitative food frequency questionnaire. The different fat volumes were assessed using magnetic resonance imaging (MRI) scanning. RESULTS: Participants with the lowest VAT volume had the highest intake of saturated fats, monounsaturated fatty acids and omega-3 and omega-6 fatty acids (p<0.05). VAT volume was significantly associated with the highest level of total energy and energy from carbohydrate consumption among participants while significantly associated with the lowest energy intake from fat among participants (p=0.013). There was a significant relationship with the highest consumption of total carbohydrate, soluble fiber, and insoluble fiber and VAT volume (p<0.05). Participants in the highest VAT volume had significantly the highest intake of vitamin A, ß- carotene, and copper. CONCLUSIONS: This study underscores the importance of quantifying depot-specific body fat and highlights the unique responsiveness of various fat depots to dietary intake.

Fast foods perception among adolescents by gender and weight status.

BACKGROUND: Fast food restaurants have become widespread in both developed and developing countries due to nutritional and economic transitions. The frequency of fast food intake is relatively high among adolescents; however, fast food consumption is positively associated with total energy intake and obesity in adolescents. OBJECTIVE: This study aimed to examine the perception of Jordanian adolescents towards fast foods relative to gender and obesity. METHODS: A cross-sectional survey was conducted on 400 boys and 395 girls, aged 15-18 years. The adolescents completed a validated questionnaire to measure the perception of adolescents towards fast foods during the year 2013-2014. Weight and height were measured. Numbers who were non-overweight, overweight, and obese were calculated for each age and sex using the International Obesity Task Force (IOTF) standard. RESULTS: The majority of participants perceived foods which are eaten as sandwiches as fast foods. A significant difference between boy and girl adolescents was reported regarding perception of French fries ( p < 0.012), fried chicken ( p < 0.001), fattayer ( p < 0.001), foul (boiled broad beans) sandwich ( p < 0.001), falafel sandwich ( p < 0.044) and fried eggs sandwich ( p < 0.001) as fast foods. Girls were significantly more enthusiastic than boys to consider cuscusi plate ( p < 0.001), rice dishes ( p < 0.002), Chinese foods ( p < 0.001), Indian foods ( p < 0.010), Mexican foods ( p < 0.011), and Italian foods ( p < 0.004) as non-fast foods. The difference between obese and non-obese regarding the perception of fast foods was only significant among boy participants. Western or non-Arab foods, food prepared fast and eaten fast in self-service outlets, and food rich in calories were significantly perceived as fast food by Jordanian adolescents ( p < 0.05). CONCLUSIONS: The perception of foods as fast foods or non-fast foods was significantly different between both genders as well as in obese and non-obese male Jordanian adolescents.

Association between mass media and body weight concern among Jordanian adolescents' residents of Amman: the role of gender and obesity.

OBJECTIVES: Body image in the mass media promotes an unrealistic picture of body shape that leads to body dissatisfaction among adolescentsQuery. Therefore, the study presented in this paper aimed to assess the association between mass media and adolescents' weight concerns and perceptions of body weight and shape. METHODS: A cross-sectional survey was conducted on school adolescents aged between 15 and 18 years during the academic year 2013-2014. Multistage stratified sampling method was used. The number of participants in the study was 795 students: 400 boys and 395 girls. RESULTS: All participants have a common behavior in rarely reading magazines, but they spend more than 2 h in watching television or less than 3 h using the internet. However, most of obese/non-obese adolescents, boys or girls, have shown high influence (p < 0.05) of reading magazines on the subject of dieting to lose weight. CONCLUSION: While obese students read more magazines on dieting to lose weight, other mass media did not show the same results on weight concerns and body shape among Jordanian adolescents.

Assessment of Nutrients Intake in Pediatrics with Type 1 Diabetes and Dyslipidemia in Jordan.

Background: Dyslipidemias are disorders of lipoprotein metabolism that occur during childhood and adolescence, often persist into adulthood, and increase the risk of developing atherosclerotic lesions. This study aimed to assess the potential association between nutrient intake and dyslipidemia in Jordanian pediatric patients diagnosed with type 1 diabetes mellitus. Methods: This cross-sectional study was conducted in Amman, Jordan, and involved 90 children and adolescents diagnosed with type 1 diabetes mellitus. Caregivers provided the following data: sex, age, type and dose of insulin, age at onset of type 1 diabetes, and level of physical activity. Anthropometric measurements were obtained using calibrated scales, and CDC growth charts were used to assess participants' body weight status. Nutrient intake was estimated using a 120-item food frequency questionnaire (FFQ) previously validated in Jordanian children and adolescents. Serum lipid levels, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. Binary logistic regression was used to assess the relationship between nutrient intake and dyslipidemia. Results: The results indicated that 36.7% of study participants had dyslipidemia. There were no significant differences in nutrient intake between dyslipidemic and normolipidemic individuals, except for a significantly higher median intake of vitamin B12 in the dyslipidemic group compared to the normolipidemic group (3.6 versus 2.7 µg, P-value = 0.046). Conclusion: This study found no significant association between the prevalence of dyslipidemia and nutrient intake in children and adolescents diagnosed with type 1 diabetes mellitus.

Protective effect of dietary micronutrients on gastric cancer risk among Jordanians.

Introduction: Objective: several dietary and non-dietary factors and genetic predisposition may play an important role in gastric carcinogenesis. The findings about associations between micronutrients and gastric cancer (GC) is still inconsistent. This study aimed to investigate the effect of dietary micronutrients on gastric cancer risk. Methods: a case-control study comprised of 173 GC (107 males: 66 females) patients and 313 (190 males: 123 females) population-based controls matched for age, occupation, and marital status. Demographics, medical history, physical activity, and nutrient intake information were collected using reliable interview-based questionnaires. Information on dietary micronutrient intake was collected from the participants using a validated food frequency questionnaire (FFQ). Multinomial logistic regression was used to calculate Odds ratios (ORs) and their corresponding 95 % confidence intervals (CIs) and evaluate associations between dietary micronutrients and GC risk. Results: GC was inversely associated with the consumption of vitamin A, beta-carotene, vitamins D, E, K, B2, B3, B6, B12, and C, folate, chromium, iodine, and selenium. Additionally, a protective effect was observed for consumption of calcium, copper, iron, magnesium, phosphate, sodium, and zinc. In almost all the micronutrients, the second tertile showed a more pronounced reduction in GC risk as compared to the first tertile. Conclusions: our data support favorable effects of dietary consumption of some vitamins and minerals against GC risk.

Introducción: Objetivo: varios factores dietéticos y no dietéticos y predisposiciones genéticas pueden jugar un papel importante en la carcinogénesis gástrica. Los hallazgos sobre las asociaciones entre los micronutrientes y el cáncer gástrico (CG) aún son inconsistentes. Métodos: este estudio tuvo como objetivo investigar el efecto de los micronutrientes sobre el riesgo de cáncer gástrico. Métodos: Un estudio de casos y controles comprendió 173 pacientes con GC (107 hombres: 66 mujeres) y 313 (190 hombres: 123 mujeres) controles basados en la población emparejados por edad, ocupación y estado civil. La información demográfica, el historial médico, la actividad física y la ingesta de nutrientes se recopilaron mediante cuestionarios confiables basados en entrevistas. La información sobre la ingesta de micronutrientes en la dieta se recopiló de los participantes mediante un cuestionario de frecuencia de alimentos (FFQ) validado. Se utilizó la regresión logística multinomial para calcular las razones de probabilidad (OR) y sus correspondientes intervalos de confianza (IC) del 95 % y evaluar las asociaciones entre los micronutrientes de la dieta y el riesgo de GC. Resultados: la GC se asoció inversamente con el consumo de vitamina A, betacaroteno, vitaminas D, E, K, B2, B3, B6, B12 y C, folatos, cromo, yodo y selenio. Adicionalmente, se observó un efecto protector para el consumo de calcio, cobre, hierro, magnesio, fosfato, sodio y zinc. En casi todos los micronutrientes, el tercer tercil mostró una reducción más pronunciada del riesgo de CG en comparación con el primer tercil en hombres. Por el contrario, el segundo tercil exhibió un nivel de protección significativamente marcado en comparación con el primer tercil en mujeres. Conclusiones: nuestros datos respaldan los efectos favorables del consumo dietético de algunas vitaminas y minerales para el riesgo de desarrollar cáncer gástrico.

Prevalence and Risk Factors for Vitamin D Deficiency in Children and Adolescents in the Kingdom of Bahrain.

BACKGROUND: Vitamin D deficiency has reached pandemic levels in the Middle East and North Africa (MENA) region, even though sunshine is abundant all year round for the cutaneous synthesis of vitamin D through the skin. This study aimed to determine the prevalence of vitamin D deficiency and risk factors associated with serum 25-hydroxy vitamin D (25(OH)D) in children and adolescents aged from 10 to 19 years, as well as the possible associations of vitamin D with calcium, magnesium and phosphate levels. METHODS: A multi-center, cross-sectional study was conducted between May and August 2019 at the Ministry of Health in the Kingdom of Bahrain. A total of 383 boys and girls were selected from five health centers from five different regions in the Kingdom of Bahrain. Information about sex, age, education level, weight, height, degree of sunlight exposure, and physical activity levels was recorded. A blood sample was taken from each participant to test serum levels of 25(OH)D, calcium, magnesium and phosphate. RESULTS: The results revealed that 92.1% of the participants were deficient in vitamin D. A significantly higher percentage of boys (96.2%) were vitamin D deficient (<20 ng/mL) than girls (88.3%) (p value = 0.004). Vitamin D deficiency were more prevalent among overweight (96.8%) and obese (96.2%) participants than normal body weight and wasted participants (p value < 0.001). Being male, overweight, or obese was significantly positively associated with a risk of vitamin D deficiency. Vitamin D deficiency was significantly associated with low serum levels of magnesium. No significant associations were detected between vitamin D deficiency and calcium and phosphate serum levels. However, vitamin D deficiency was significantly associated with low serum level of magnesium (p value = 0.017). CONCLUSIONS: Our study revealed that vitamin D deficiency was more prevalent among overweight and obese adolescents and mostly boys rather than girls. Magnesium and phosphate were lower in adolescents and children with lower serum 25(OH)D, showing a clear association between these biomarkers and the 25(OH)D.

Effect of caper fruit (Capparis spinosa L.) consumption on liver enzymes, lipid profile, fasting plasma glucose, and weight loss. A systematic review and a preliminary meta-analysis of randomized controlled trials.

This systematic review and meta-analysis aimed to evaluate the overall effect of caper fruit on the modulation of glycemic, lipid profile, liver enzymes, and body mass. Google Scholar, PubMed, and Scopus were explored to collect relevant studies in the last 10 years. RCTs with caper fruit supplementation or consumption in different cohorts of subjects with non-alcoholic fatty liver disease (NAFLD), Type-2-Diabetes (T2D), metabolic syndrome, and hyperlipidemia were included in this systematic review with a mean intervention duration from 2 to 12 weeks. The outcomes measured in this meta-analysis were liver enzymes such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT), the lipid profile represented by triglycerides, total cholesterol (TC) with LDL and HDL and also, weight, and fasting blood glucose. Five randomized controlled trials, which involved a total of 178 adults, were included. According to the results, caper fruit seems to decrease liver enzymes ALT -12.29 U/L [-24.47, -0.11], AST -2.20 U/L [-4.70, 0.31]. Furthermore, the lipid profile seems to improve with a decrease in triglycerides. -11.89 mg/dL [-33.73, 9.95], LDL -4.80 mg/dL [-16.34, 6.74], HDL 0.72 mg/dL [0.10, 1.34], total cholesterol -7.83 mg/dL [-20.04, 4.38], FPG -17.93 [-42.66, 6.79], weight -1.00 kg [-1.44, -0.56]. Significant modulations were found only for ALT, HDL, and weight. In conclusion, this systematic review and meta-analysis showed the paucity of data available on the topic while showing the potential role of caper fruit as a promising food for improving the liver-lipid profile axis in patients with metabolic syndrome and diabetes. Further studies are required to confirm these results.

Meat and dairy products intake is associated with gastric cancer: Case-control study findings.

Countries experiencing a significant shift toward Western lifestyle are facing an increased risk of gastric cancer (GC). While many studies have explored the link between diet and GC, the role of meat and dairy consumption remains uncertain. To delve deeper into this association, we conducted a case-control study in Jordan involving 173 GC cases and 314 controls, matched by age and marital status. Using a validated food frequency questionnaire, we assessed the intake of different dairy and meat products. The adjusted odds ratios and corresponding 95% confidence intervals indicated a strong correlation between high intake of red meat, milk, and buttermilk and GC. Our multinomial logistic regression analysis revealed that daily consumption of red meat (≥1 serving/day; OR, 3.34 [95% CI 1.85-6.03, p value of trend <.001], ≥1 serving/day) and weekly intake of milk (2-3 servings/week; OR, 2.04 [95% CI 1.14-3.64, p value of trend = .041]) and buttermilk (2-3 servings/week; OR, 2.07 [95% CI 1.12-3.83, p value of trend = .018], per 2-3 servings/week) were significantly associated with an increased risk of GC. Furthermore, consuming cooked eggs daily (OR = 2.44, 95% CI 1.24-4.79, p trend <.001) or weekly (OR, 3.34, 95% CI 1.58-7.10, p value of trend <.001) was also associated with an increased risk of GC. These findings highlight the potential health risks associated with excessive meat and some dairy products consumption and suggest that a balanced intake of these products, along with eggs, may help prevent GC.

Does the Mediterranean Diet Have Any Effect on Lipid Profile, Central Obesity and Liver Enzymes in Non-Alcoholic Fatty Liver Disease (NAFLD) Subjects? A Systematic Review and Meta-Analysis of Randomized Control Trials.

The effectiveness of the Mediterranean diet (MD) in non-alcoholic fatty liver disease (NAFLD) subjects has been evaluated in several randomized controlled trials (RCTs). This systematic review and meta-analysis aimed to evaluate the overall effects of MD intervention in a cohort of NAFLD patients targeting specific markers such as central obesity, lipid profile, liver enzymes and fibrosis, and intrahepatic fat (IHF). Google Scholar, PubMed, and Scopus were explored to collect relevant studies from the last 10 years. RCTs with NAFLD subjects were included in this systematic review with a mean intervention duration from 6 weeks to 1 year, and different intervention strategies, mainly including energy restriction MD (normal or low glycaemic index), low-fat MD with increased monounsaturated and polyunsaturated fatty acids, and increased exercise expenditure. The outcomes measured in this meta-analysis were gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), total cholesterol (TC), waist circumference (WC), and liver fibrosis. Ten randomized controlled trials, which involved a total of 737 adults with NAFLD, were included. According to the results, the MD seems to decrease the liver stiffness (kPa) by -0.42 (CI95% -0.92, 0.09) (p = 0.10) and significantly reduce the TC by -0.46 mg/dl (CI95% -0.55, -0.38) (p = 0.001), while no significant findings were documented for liver enzymes and WC among patients with NAFLD. In conclusion, the MD might reduce indirect and direct outcomes linked with NAFLD severity, such as TC, liver fibrosis, and WC, although it is important to consider the variations across trials. Further RCTs are necessary to corroborate the findings obtained and provide further evidence on the role of the MD in the modulation of other disorders related to NAFLD.

Discovering the Physio-Pathological Mechanisms of Interaction between Bone Mineral Density, Muscle Mass, and Visceral Adipose Tissue in Female Older Adults through Structural Equation Modeling.

This study aims to examine the relation between visceral adipose tissue (VAT), as a proxy for metabolically unhealthy obesity, muscle, as a proxy for muscle quality and sarcopenia, and bone, as a proxy for bone mineral density and osteoporosis. Other variables, such metabolic syndrome, nutritional status, number of diseases, kidney and liver function and inflammation were assessed as direct or indirect effects. This study used structural equation modeling (SEM) in a sample of 713 older women (mean age 82.1 ± 6.3). The results indicate a positive statistically significant association between bone and muscle mass (ß = 0.195, <0.001) and nutritional status and muscle mass (ß = 0.139, p < 0.001), but negative association between age with muscle mass (ß = -0.509, p < 0.001) and nutritional status (estimates: -2.264, p < 0.001). A negative association between VAT and muscle mass was also reported (ß = -1.88, p < 0.001). A negative statistically significant association was reported between bone mineral density and functional status (ß = -1.081, p < 0.001), and a positive association between functional status and muscle mass (ß = 9.000, p < 0.001). In addition, functional status was positively statistically associated with cognitive performance (ß = 0.032, p < 0.001). The SEM method demonstrates that the VAT, muscle mass and bone mineral density are associated, but the form of the relation is different in relation to different factors, such as nutritional status, mental and functional status, age, and number of pathologies, having different impacts on metabolic outcomes. SEM is a feasible technique for understanding the complex mechanisms of frailty in the elderly.

A Review of Ketogenic Dietary Therapies for Epilepsy and Neurological Diseases: A Proposal to Implement an Adapted Model to Include Healthy Mediterranean Products.

Based on the growing evidence of the therapeutic role of high-fat ketogenic dietary therapies (KDTs) for neurological diseases and on the protective effect of the Mediterranean diet (MD), it could be important to delineate a Mediterranean version of KDTs in order to maintain a high ketogenic ratio, and thus avoid side effects, especially in patients requiring long-term treatment. This narrative review aims to explore the existing literature on this topic and to elaborate recommendations for a Mediterranean version of the KDTs. It presents practical suggestions based on MD principles, which consist of key elements for the selection of foods (both from quantitative and qualitative prospective), and indications of the relative proportions and consumption frequency of the main food groups that constitute the Mediterranean version of the KDTs. We suggest the adoption of a Mediterranean version of ketogenic diets in order to benefit from the multiple protective effects of the MD. This translates to: (i) a preferential use of olive oil and vegetable fat sources in general; (ii) the limitation of foods rich in saturated fatty acids; (iii) the encouragement of high biological value protein sources; (iv) inserting fruit and vegetables at every meal possible, varying their choices according to seasonality.

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.

Perspectives and practices of dietitians with regards to social/mass media use during the transitions from face-to-face to telenutrition in the time of COVID-19: A cross-sectional survey in 10 Arab countries.

During the COVID-19 pandemic, most healthcare professionals switched from face-to-face clinical encounters to telehealth. This study sought to investigate the dietitians' perceptions and practices toward the use of social/mass media platforms amid the transition from face-to-face to telenutrition in the time of COVID-19. This cross-sectional study involving a convenient sample of 2,542 dietitians (mean age = 31.7 ± 9.5; females: 88.2%) was launched in 10 Arab countries between November 2020 and January 2021. Data were collected using an online self-administrated questionnaire. Study findings showed that dietitians' reliance on telenutrition increased by 11% during the pandemic, p = 0.001. Furthermore, 63.0% of them reported adopting telenutrition to cover consultation activities. Instagram was the platform that was most frequently used by 51.7% of dietitians. Dietitians shouldered new difficulties in dispelling nutrition myths during the pandemic (58.2% reported doing so vs. 51.4% pre-pandemic, p < 0.001). Compared to the pre-pandemic period, more dietitians perceived the importance of adopting tele nutrition's clinical and non-clinical services (86.9% vs. 68.0%, p = 0.001), with 76.6% being confident in this practice. In addition, 90.0% of the participants received no support from their work facilities for social media usage. Following the COVID-19 outbreak, the majority of dietitians (80.0%) observed a rise in public interest in nutrition-related topics, particularly those pertaining to healthy eating habits (p = 0.001), healthy recipes (p = 0.001), nutrition and immunity (p = 0.001), and medical nutrition therapies (p = 0.012). Time constraint was the most prevalent barrier to offering telenutrition for nutrition care (32.1%), whereas leveraging a quick and easy information exchange was the most rewarding benefit for 69.3% of the dietitians. In conclusion, to ensure a consistent provision of nutrition care delivery during the COVID-19 pandemic, dietitians working in Arab countries adopted alternative telenutrition approaches through social/mass media.

Effectiveness of carbohydrate counting and Dietary Approach to Stop Hypertension dietary intervention on managing Gestational Diabetes Mellitus among pregnant women who used metformin: A randomized controlled clinical trial.

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common complication of pregnancy that has significant impacts on both mother and her offspring health. The present study aimed to examine the effect of carbohydrate counting, carbohydrate counting combined with DASH, and control dietary interventions on glycemic control, and maternal and neonatal outcomes. METHODS: A total of 75 pregnant women with GDM at 24th - 30th week of gestation were enrolled and randomized to follow one of the three diets: control or carbohydrate counting, or carbohydrate counting combined with Dietary Approach to Stop Hypertension (DASH). Only 70 of them completed the study until delivery. Fasting blood samples were taken at baseline and the end of the study to measure fasting blood glucose (FBG), fasting insulin, glycated hemoglobin (HbA1c), and fructosamine. Homeostatic model assessment-insulin resistance (HOMA-IR) score was calculated using HOMA2 calculator program. The participants recorded at least four blood glucose readings per day. Maternal and neonatal outcomes were collected from medical records. Dietary intake was assessed by three-day food records at the baseline and the end of the study. RESULTS: Adherence to the three dietary interventions, resulted in decreased FBG levels significantly among all the participants (P < 0.05). Consumption of the carbohydrate counting combined with the DASH diet showed significant reduction in serum insulin levels and HOMA-IR score compared to carbohydrate counting group and control group. Means of fructosamine and HbA1c did not differ significantly among the three intervention diet groups. Overall mean of 1-h postprandial glucose (1 h PG) level was significantly lower in the carbohydrate counting combined with DASH group compared with that in the carbohydrate counting group and the control group (P < 0.001). The number of women who were required to commence insulin therapy after dietary intervention was significantly lower in carbohydrate counting group and carbohydrate counting combined with DASH group (P = 0.026). There were no significant differences in other maternal and neonatal outcomes among the three dietary intervention groups. CONCLUSIONS: The carbohydrate counting and the carbohydrate counting combined with DASH dietary interventions resulted in beneficial effects on FBG and 1 h PG compared with the control diet. The three dietary interventions produced similar maternal and neonatal outcomes in women with GDM. TRIAL REGISTRATION: This trial was registered on ClinicalTrials.gov under the identification code: NCT03244579. https://clinicaltrials.gov/ct2/show/NCT03244579.

Macronutrients Intake and Risk of Stomach Cancer: Findings from Case-Control Study.

Studies on the association between gastric cancer (GC) and the intake of nutrients in Jordan are very limited, while findings from other reports on the intake of energy and macronutrients are controversial. This study aimed to examine the associations between intake of energy and macronutrients and the risk of GC in a Jordanian population. A case-control study was carried out between March 2015 and August 2018 in four major hospitals, including an oncology center in Jordan. Study participants were 173 cases with incident and histologically confirmed GC and 314 frequency-matched controls. Interview-based questionnaires were used to obtain the study's information. Data on nutrient intake were collected using a validated Arabic food-frequency questionnaire (FFQ). Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated through multinomial logistic regression and adjusted for potential confounders, including age, marital status, education, body mass index (BMI), smoking, period of smoking, family history of gastric cancer, history of gastric ulcer, and physical activity. Intakes of total fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, trans-fat, and omega-6 fatty acids were significantly associated with increased risk of GC. The ORs for the highest versus the lowest tertiles were 6.47 (95% Cl: 3.29-12.77), 2.97 (95% CI: 1.58-5.58), 6.84 (95% CI: 3.46-13.52), 6.19 (95% CI: 3.15-12.17), 3.05 (95% CI: 1.58-5.88), 8.11 (95% CI: 4.20-15.69), and 2.74 (95% CI: 1.47-5.09), respectively. No significant association was found for energy, protein, carbohydrate, sugar, fibers, and omega-3 fatty acids. The findings of this study suggest that high intake of selected types of fats was associated with an increased risk of GC.

Mediterranean Dietary Pattern is Associated with Lower Odds of Gastric Cancer: A Case-Control Study.

Background: Diet pattern is an important modifiable lifestyle factor. However, epidemiological studies show that the association between dietary patterns and gastric cancer (GC) is conflicting. This study aims to assess the impact of several dietary choices on the risk of GC among newly diagnosed Jordanian patients. Methods: A case-control study was conducted at major oncology centers and hospitals in Jordan. Study participants included 172 patients with incident gastric cancer and 314 controls. Data was collected using interview-based questionnaires. Dietary intake was estimated using a validated Arabic and reproducible food-frequency questionnaire (FFQ). Dietary patterns were derived using Principal Component Analysis (PCA). Multinomial logistic regression was used to estimate the association between dietary patterns and GC. Results: Four dietary patterns were itemized; "Mediterranean", "Prudent", "Unhealthy" and "High-fruit" dietary patterns. The "Mediterranean" dietary pattern, which includes a diet rich in fresh fruits, vegetables, milk, yogurt, lentils, and olive oil was associated with a significant decrease in the odds ratio (OR) of GC for the third and fourth quartiles (OR, 0.394 (confidence interval (CI): 0.211-0.736); 0.212 (CI: 0.107-0.419), respectively) after adjusting for age, gender, body mass index, smoking, marital status, total energy intake, education level, and physical activity. While the "Unhealthy" and "Prudent" dietary patterns enhance the risk of developing GC, this risk was insignificant at any quartile. Additionally, the "High-Fruit" dietary pattern shows an insignificant protective effect against the risk of GC. Conclusion: The "Mediterranean" dietary pattern was associated with a reduced risk of GC among Jordanians. However, the other three identified dietary patterns were not significantly associated with the risk of GC.

Dietary patterns associated with the risk of pancreatic cancer: Case-control study findings.

Diet is an important modifiable lifestyle factor, but epidemiological studies evaluating the association between dietary patterns and pancreatic cancer (PC) have reported inconsistent findings. This study aimed to evaluate the impact of several dietary choices on the risk of PC among newly diagnosed Jordanian patients. A case-control study was conducted at major teaching and general hospitals, including a Jordanian oncology center. The study included 101 patients with incident pancreatic cancer and 314 controls. Data was collected using interview-based questionnaires. Dietary intake was estimated using a validated Arabic and reproducible food-frequency questionnaire. Dietary patterns were derived using Principal Component Analysis. Multinomial logistic regression was used to estimate the association between dietary patterns and PC. Four dietary patterns were identified. The "Traditional" dietary pattern, which presented a diet rich in fresh fruits, vegetables, milk, yogurt, and lentils, was associated with a significant decrease in the odds of PC (OR = 0.42, 95% CI = 0.21-0.84) for the third quartile compared to first one. The "High-fruit" dietary pattern, which was loaded with strawberry, melon, watermelon, and other fruits, significantly reduced the odds of PC (OR = 0.38, 95% CI = 0.19-0.75) for the second quartile compared to the first one. The "Soup" dietary pattern was mainly composed of vermicelli soup, vegetable soup, lentil soup, and mushroom soup, which decreased the odds of PC (OR = 0.18, 95% CI = 0.07-0.38). There was no relation between PC and the "Western" dietary pattern, loaded with beer, wine, roasted lamb, meat, chicken sandwich, beefsteak, and fried fish. The "Traditional," "High-fruit," and "Soup" dietary patterns were associated with reduced risk of PC among Jordanians.

Macronutrients Not Micronutrients Are Associated With the Risk of Pancreatic Cancer: A Jordanian Case-Control Study.

OBJECTIVES: Pancreatic cancer (PC) has been related directly to many risk factors; however, diet is considered one of the most modifiable risk factors. This study is designed to observe the associations between the intake of macromicronutrients and the risk of pancreatic cancer in a Jordanian population. METHODS: A case-control study included 100 patients with the incident and histologically confirmed PC and 309 control subjects frequency-matched on age, educational level, occupation, and marital status. Face-to-face interview was used to collect the study's sociodemographic, physical activity, and dietary information. Intakes of macronutrients and micronutrients were assessed by a validated food-frequency questionnaire. Multinomial logistic regression was used to calculate odds ratios and confidence intervals. RESULTS: The patients reported higher consumption of almost all the macromicronutrients and micronutrients as compared with control subjects. The highest tertile of dietary intake of carbohydrates, sugars, fats, saturated fats, monounsaturated fats, trans fats, cholesterol, and vitamin B3 was positively associated with PC risk (Ptrend < 0.05). However, dietary intakes of polyunsaturated fats, omega-3, and some vitamins and minerals were not associated (Ptrend > 0.05) with the risk of PC. CONCLUSIONS: Our findings support the positive role of proteins, carbohydrates, sugars, fats, saturated fats, monounsaturated fats, trans fats, and cholesterol on pancreatic carcinogenesis.