Abdelmonem S. Hassan

Impact of lifestyle and dietary habits on hypovitaminosis D in type 1 diabetes mellitus and healthy children from Qatar, a sun-rich country.

BACKGROUND There are no population-based studies that have examined the association between vitamin D and type 1 diabetes mellitus (T1DM) and the role of lifestyle habits and dietary factors in young children in the Arabian Gulf and Middle East region. Little data on the intake of these nutrients in Mediterranean countries exist, and predictors of their suboptimal intake are not well defined. OBJECTIVE The objective of this study was to determine the association between vitamin D status and T1DM and assess the impact of lifestyle and dietary habits on hypovitaminosis D in the young population of the State of Qatar. A matched case-control study was carried out among T1DM children and healthy subjects <16 years of age at the pediatric endocrinology outpatient clinics of the Hamad General Hospital and the primary health care clinics center. The survey was conducted over a period from 6 August to 25 December 2007. The sample included 170 cases and 170 controls matched by age, gender and ethnicity. METHODS Face to face interviews were based on a questionnaire that included variables such as sociodemographic information, assessment of non-dietary covariates, assessment of dietary intake including vitamin D, type of feeding, clinical manifestations and laboratory investigations. Their health status was assessed by medical conditions, family history, body mass index, past or present clinical manifestations, serum 25(OH) vitamin D, calcium, alkaline phosphates, phosphorus, hemoglobin A1C, parathyroid hormone, magnesium and creatinine analysis. RESULTS The study revealed that the incidence of severe vitamin D deficiency was considerably higher in T1DM (28.8%) compared with healthy children (17.1%). Although the mean serum level of vitamin D was significantly lower in T1DM children (15.80+/-9.23 ng/ml), compared with nondiabetic children (18.45+/-9.56 ng/ml), both groups belonged to the mild-moderate vitamin D deficiency category. A family history of vitamin D deficiency (35.3%; p=0.012) and diabetes mellitus (56.5%; p<0.001) was significantly higher in diabetic children. More than half of the diabetic (67.1%) and healthy children (51.2%) had no physical activity in their daily life. Both groups (65.9 vs. 62.9%) had very limited exposure to sunlight. Vitamin D supplement intake was very poor in diabetic children compared with healthy children; 60% of diabetic and 40.6% of healthy children never had any vitamin D supplement. The study revealed that vitamin D serum concentration, phosphorus, hemoglobin A1C, magnesium and creatinine show statistically significant differences between T1DM and healthy control subjects. A significant difference was noted between diabetic and healthy children for fractures (p=0.005), weakness (p=0.001) and gastroenteritis (p=0.025). CONCLUSIONS The present study revealed that vitamin D deficiency is a common problem in Qatari children, but the incidence of vitamin D deficiency becomes very severe in T1DM children, compared with healthy children. This suggests that there is an association between vitamin D deficiency and T1DM. The data show that vitamin D status is dependent on sunshine exposure and dietary vitamin D intake. The results suggest the necessity of nutrition education to promote healthy eating habits among adolescents and their parents.

Attitudes of pharmacy and nutrition students towards team-based care after first exposure to interprofessional education in Qatar

Abstract Little is known regarding attitudes of healthcare professional students towards team-based care in the Middle East. As modernization of health systems is rapidly occurring across the Gulf Cooperation Council countries, it is important for students to engage in interprofessional education (IPE) activities. The objective of this study was to assess pre-clinical students’ attitudes towards interprofessional healthcare teams after completion of their first IPE activity. A previously validated questionnaire was distributed to 25 pharmacy and 17 nutrition students at Qatar University after participation in an IPE event. Questions related to quality of team-based care and physician centricity. Results showed high agreement regarding high quality care provided by teams yet students were unsure of the value of team-based care when considering required time for implementation. Results provide baseline data for future studies to assess student attitudes throughout the professional programs and give valuable insight for future IPE program design in the Middle East.

Knowledge and use of folic acid among pregnant Arabian women residing in Qatar and Oman

The objective of this study was to assess the knowledge and use of folic acid among pregnant Arabian women in Qatar and Oman. Three hundred pregnant women were interviewed during their second trimester based on a questionnaire developed for the study. Results of the survey indicated that 94% of the women knew about folic acid, 41.3% knew it should be taken periconceptionally, 58.5% knew that it prevents birth defects and 34.4% were able to identify five or more food sources of folic acid. The majority (88.7%) of women was taking the supplement, 85.0% were taking it regularly and 13.2% took it before getting pregnant. Knowledge and use were significantly influenced by ethnicity, age, education level, employment and family income. Periconceptional use of supplement was lowest among younger women (4.9%) and illiterate and least educated women (5.3%). It was concluded that high level of knowledge of folic acid was not reflected as successful use of the folic acid supplement.

High prevalence of the risk of overweight and overweight among Qatari children ages 9 through 11

Purpose – The purpose of this paper is to estimate the prevalence of the risk of overweight and overweight in Qatari children ages 9 through 11 and to compare the prevalence using CDC and IOTF cut‐offs.Design/methodology/approach – A cross‐sectional study in a randomly selected sample of 1,213 Qatari children was carried out. Weight and height were measured and BMI was calculated for all children. The risk of overweight and overweight were defined using as references both the CDC BMI percentiles for age and gender and IOTF cut‐off values.Findings – Weight, height, and BMI increased with age and differences were significant (p<0.0001). According to the CDC and IOTF references, the overall prevalence of the risk of overweight affected 15.8 and 21.1 per cent respectively, while overweight was prevalent in 21.8 and 17.7 per cent respectively. Using either reference, the prevalence of the risk of overweight was higher among girls compared with boys (22.4 per cent, 19.4 per cent respectively), while overweight ...

Prevalence of undernutrition in a long-term care facility in Qatar.

This study assessed the nutritional status of 130 Qatari patients aged 65 to 90 years who were residing in a long-term care facility for six months. Admission weight was not measured for 49.2% of the subjects. Of those whose weight was measured at admission, assessment at six months indicated that 21.3% had lost more than 10% of their admission weight, 38.9% were under the fifth percentile of body mass index (BMI), 39.8% had a BMI less than 21, 27.1% had albumin level below 34 g/L, and 18.6% had total cholesterol below (140 mg/dl). The study showed a high prevalence of undernutrition among these long-term care residents and indicated that appropriate nutritional assessment and nutrition care were not fully implemented during their stay in the facility.

Breakfast habits and snacks consumed at school among Qatari schoolchildren aged 9‐10 years

Purpose – The objective of this study is to assess breakfast habits and foods mostly consumed as snacks during the school day among fourth grade Qatari schoolchildren.Design/methodology/approach – A cross‐sectional survey on a random sample of fourth grade students was carried out using a questionnaire on food frequency, food habits and types of foods consumed in breakfast and during the school day. The study included 259 students, 124 (47.9 per cent) girls and 135 (52.1 per cent) boys aged 9‐10 years.Findings – Results of the study revealed that 91.1 per cent of the boys and 89.5 per cent of the girls ate breakfast daily. Bread and breakfast cereals consumption at breakfast was significantly higher (p = 0.04) among girls (86.3 per cent) compared with boys (76.3 per cent). Cheese and eggs were consumed by 90.7 per cent of the children at breakfast. Sweets and chocolates consumption was significantly higher (p < 0.001) among girls (56.5 per cent) than boys (28.2 per cent). Consumption of bakery items was s...

CD4-3 Vitamin D deficiency in the young population with Type 1 diabetes: a case-control study

of T1D were examined over time, between areas of differing socioeconomic status, and in urban and rural Canterbury. Second, cluster analysis using the spatial scan statistic was employed to test for spatial-temporal clustering of T1D within the Canterbury region. Finally, Poisson and zero-inflated Poisson regression analyses were utilised to investigate the association between T1D and various measures of population mixing at the area level. Standardised incidence ratios revealed that childhood T1D was higher in the more affluent CAUs in Canterbury, and in areas classed as satellite urban communities. Geographical patterns in incidence were evident and a number of significant spatialtemporal clusters of the disease were noted. Regression analyses revealed significantly higher T1D incidence rate ratios in CAUs which had increased the most in population mixing for three out of four of the analysis periods (1987-1992, 1993-1998 and 19992004). Supporting evidence for this relationship was especially strong in the most recent period (1999-2004) where T1D incidence was positively associated with three different population mixing measures: change in the percentage of total migrants, change in the percentage of child migrants and change in the one year mobility percentage. It is postulated that where population mixing is low in early life, children miss out on important immune system stimulation from common infectious exposure. Subsequent increases in population mixing which introduce new infections to the area could trigger the onset of T1D in genetically susceptible individuals. This study is the first to consider the role of population mixing in the aetiology of type 1 diabetes in New Zealand. Study limitations mean that no causal relationships can be proved, but the associations found highlight the need to investigate the role of population mixing and infections in the pathogenesis of T1D further.