November 2013 Vol. 1 No. 4

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Full Length Research Paper

Prevalence and associated factors for obesity, abnormal waist circumference and diet composition among Arab adults in Israel

¹Bisharat Bishara M.D, MPH, ²Nur Abu-Ahmad Nur M.sc and ³*Bowirrat Abdalla M.D., Ph.D.

¹Senior Physician Specialists in Family Medicine, Director of EMMS Nazareth Hospital, Galilee Medical School – Bar Ilan University
²M.sc in Clinical Dietitian - EMMS Nazareth Hospital, Nazareth
³Prof. Dr. of Clinical Neuroscience and Population Genetics - EMMS Nazareth Hospital, Faculty of Medicine in the Galilee, Bar Ilan University.

*Corresponding Author's E-mail: bowirrat@gmail. Com; Tel: +972 4635-6133; Fax: +972 4602-8882; Mobile: +972 50-720-8143

Accepted November 07, 2013

Abstract

Obesity and overweight are an important adaptable risk factor for many chronic diseases and are the fifth leading risk for global deaths. Remarkably increased prevalence and escalating levels of overweight and obesity over the last 3 to 4 decades give it the character of modern pandemic phenomenon and the major public health crisis challenge worldwide, that is beginning to replace undernutrition, hunger and infectious diseases as the most significant contributor to chronic diseases. In Arab world the effects of overweight and obesity are widely recognized as one of Arab’s leading health concerns, involving all ages and socioeconomic groups. To estimate the prevalence of obesity, covariates associated factors, diet composition and the eating habits among adults Arab population in Israel. A population-based cross-sectional study was performed with a total of 287 hospitalized patients at E.M.M.S hospital (Nazareth) from different departments (Internal, surgical and orthopedics words) aged 18 years and older (123 males and 164 females). Demographic data, anthropometric assessments, dietary assessment, socioeconomic and lifestyle characteristics, BP measurements, and biochemical assessment were collected using standard methods and techniques. Metabolic abnormalities were identified. The mean BMI results were compared between males and females (28.4±0.53) versus (30.31±0.46), respectively (P-value < 0.2). The measurement of WC among males and females was as follow: (104.3±1.67) versus (101.4±1.57) respectively, (P-value = 0.8). High and low risk for hypertension and type 2 diabetes by gender according to waist circumferences (high risk WC > 88 cm for females and WC > 94 males) was shown and illustrate that women with WC > 88 cm had (74.7%) risk for hypertension and diabetes versus (64.9%) risk among males with WC > 94; (P-value =0.03). Comparing the prevalence of type 2 diabetes among high risk group: WC > 88 cm for females and WC > 94 males and low risk group WC < 88 cm for females and WC < 94 for males was 35 (71.5%) vs. 13(26.5%) respectively, P-value = 0.002). Comparing the prevalence of hypertension among high risk group: WC > 88 cm for females and WC > 94 males and low risk group WC < 88 cm for females and WC < 94 for males was 45(70.3%) vs. 19(29.7%) respectively, P-value = 0.003). Median intake of refined grain and the whole grain intake (serving/day) in both genders was examined and showed that the median consumption of refined grain is significantly higher than the whole grain in both genders (P-value < 0.0001). In addition, we compared the median intake of highly fat dairy products in both genders with low fat dairy (serving/day). We observed that the consumption of high fat dairy products is statistically higher than low fat dairy products (P-value <0.0001). Regarding diabetes and food consumptions: we observed that the consumption of refined bread by diabetics patients was significantly lower comparing with non diabetics subjects (P-value <0.001), and the consumption of whole bread by diabetics patients was significantly higher compared with non diabetics patients (P-value <0.024). The median consumption of low fat products (cheese 5%), by diabetics patients was significantly higher compared with the non diabetics subjects (P-value <0.023), in addition, the consumption of soft sweet drinks by diabetic patients was significantly lower than non diabetic subjects (P-value <0.008). The results of this study indicate that rates of abnormal waist circumference in all age groups are high, both in males and females. WC in females over the age 65 continues to increase while in men is decreased. Interestingly, we noticed that the Arab population eating regime is disorganized and usually without awareness and control. Indeed, we observed that unhealthy diet dominate in Arabic kitchens such as high carbohydrates, low fiber and high fat diet consumption. Cultural attitudes may partially underlie the high prevalence of obesity and changes in the economy, modernization, industrialization and socioeconomic status in addition to the influence effect of the surrounding western diet style consumed by the majority population in the country. “Dietary acculturation” or adapting the eating patterns of the majority resulted in rapid changes in diet and physical activity patterns. Adopting less healthy dietary patterns, and relinquishing healthy dietary prototypes, such as higher intake of fibre-rich products in form of legumes and whole grain products are both negative parts of the acculturation process. These results are in conflict with the famous known healthy diet in the Middle East known as “Mediterranean diet”, rich in vegetables, fruits, high fiber and low fat diet.

Keywords: BMI, waist circumference, Obesity, Whole-wheat intake: Diet quality, Adult Arabs