Associations of Blood Pressure with Body Composition among Afro-Caribbean Children in Barbados

Despite complex presentation of adult hypertension and a concomitant obesity epidemic, little is known about overweight in relation to blood pressure among Caribbean children. We examined blood pressure in relation to body size in a cross-sectional study of 573 Barbadian children aged 9–10 years (2010-2011).The United States normative blood pressure percentiles were used to identify children with high (≥ 95^th percentile) or high normal blood pressure (90^th – 95^th percentile). The World Health Organization body mass index cut-off points were used to assess weight status.

Major findings

Thirty percent of children were overweight/obese. Percentage fat mass differed between girls (20.4%) and boys (17.72%) (p< 0.05). Mean systolic blood pressure among girls was 106.11 (95% CI 105.05, 107.17) mmHg and 105.23 (104.09, 106.38) for boys. The percentages with high or high-normal mean systolic blood pressurewere14.38% (10.47, 18.29) for girls and 8.08% (4.74, 11.41) for boys. Height and body mass index were independent correlates of systolic and diastolic blood pressure. Mean systolic blood pressure was related to lean mass but not fat mass, while diastolic blood pressure was associated with fat mass index and overweight.

Principal conclusion

One third of 9-10 year old children in Barbados were overweight/obese and 12% had elevated mean systolic blood pressure. BP was related to body size. These findings signal potential adverse trends in weight gain and BP trends for children growing up in the context of a country that has recently undergone rapid economic transition.     

High Sodium and Low Potassium Intake among Italian Children: Relationship with Age,Body Mass and Blood Pressure

Background

Hypertension is the leading cause of death in developed countries and reduction of salt intake is recommended as a key preventive measure.

Objective

To assess the dietary sodium and potassium intakes in a national sample of Italian children and adolescents and to examine their relationships with BMI and blood pressure (BP) in the framework of the MINISAL survey, a program supported by the Italian Ministry of Health.

Population and Methods

The study population included 1424 healthy subjects (766 boys, 658 girls) aged 6-18 years (mean age: 10.1±2.9) who were consecutively recruited in participating National Health Service centers in 10 Italian regions. Electrolyte intake was estimated from 24 hour urine collections tested for completeness by the concomitant measurement of creatinine content. Anthropometric indices and BP were measured with standardized procedures.

Results

The average estimated sodium intake was 129 mmol (7.4 g of salt) per day among boys and 117 mmol (6.7 g of salt) among girls. Ninety-three percent of the boys and 89% of the girls had a consumption higher than the recommended age-specific standard dietary target. The estimated average daily potassium intakes were 39 mmol (1.53 g) and 36 mmol (1.40 g), respectively, over 96% of the boys and 98% of the girls having a potassium intake lower than the recommended adequate intake. The mean sodium/potassium ratio was similar among boys and girls (3.5 and 3.4, respectively) and over 3-fold greater than the desirable level. Sodium intake was directly related to age, body mass and BP in the whole population.

Conclusions

The Italian pediatric population is characterized by excessive sodium and deficient potassium intake. These data suggest that future campaigns should focus on children and adolescents as a major target in the framework of a population strategy of cardiovascular prevention.     

Blood groups and types,hemoglobin variants,and G-6-PD deficiency among Abu Dhabians in the United Arab Emirates

Some erythrocyte genetic factors were studied in the indigenous population of Abu Dhabi, the capital of the United Arab Emirates, on the south-eastern coast of the Arabian peninsula. Determinations carried out included blood groups and types ABO, MNS, Rh_o, KkJs^a, Fy^aFy^b, P₁, Le^a, Vel^a, hemoglobin variants, and screening for G-6-PD deficiency. Prevalence of most blood groups and types harmonized with that among neighboring Arabs and some Arabs elsewhere. The MS and NS gene complexes were noticeably high. African admixture was expressed by the presence of Js^a and Hb S and large numbers of Fy. G-6-PD deficiency was rather high.     

Aflatoxin contamination of rice in the United Arab Emirates

Many people in the United Arab Emirates store rice in large quantities for long periods of time before use. Five hundred samples of rice were collected from households in Al-Ain city during the summers of 1992-1994. Aflatoxin B₁ was detected in 160 samples (64%) of long grain rice and 81 Samples (32%) of short grain rice at levels ranging from 1.2 to 16.5 μg/kg. The moisture content of samples varied between 5.7% and 15.3%. Species ofAspergillus andPenicillium (includingA. flavus andA. parasiticus) were isolated from discoloured, broken and insect damaged grain and it was confirmed that at least two of the isolates ofA. flavus were aflatoxigenic. These findings demonstrate that rice may contribute to dietary exposure to aflatoxins which are known to be carcinogenic and immunosuppressive.     

Breast Cancer Screening Awareness,Knowledge, and Practice among Arab Women in the United Arab Emirates: A Cross-Sectional Survey

Background

Breast cancer screening can reduce morbidity and mortality and improve the survival rate for this malignancy. Low participation in screening programs has been attributable to many factors including lack of knowledge. The aim of this study was to assess breast cancer screening knowledge, attitudes and practices among women of screening age (≥40 years old) in the city of Al Ain, United Arab Emirates (UAE).

Methods

A cross-sectional survey was conducted in 2013 using the Breast Cancer Awareness Measure (CAM). Four out of twelve cultural and religious community centers in Al Ain city were randomly selected. Two hundred and forty seven women were interviewed. Chi Square test and regression analysis were used to analyze the data.

Results

Despite the increase in the uptake of screening modalities in our study group, a lack of knowledge about breast cancer screening is still evident. Almost half (44.8%) of women who never had a Clinical Breast Exam (CBE) and 44.1% of women who never had a mammography expressed a lack of knowledge about the existence of these screening techniques. Nearly one third of the participants interpreted the presence of a breast lump incorrectly and, moreover, expressed fewer worries about the nature of the lump than would normally be expected.

Conclusions

The National screening program needs to be improved and directed towards more efficient and targeted utilization of resources. Healthcare professionals play a major role in alerting women to the importance of periodic screening.     

Patterns of breastfeeding practices among infants and young children in Abu Dhabi,United Arab Emirates

Background

Despite the ongoing efforts to improve infant feeding practices, low rates of breastfeeding and early introduction of complementary feeding have been reported in many countries. Systematic documentation of breastfeeding practices in the United Arab Emirates (UAE) is needed in order to directing successful strategies. The aim of this study was to evaluate breastfeeding practices among mothers in Abu Dhabi, UAE, using the World Health Organization (WHO) infant and young child feeding indicators.

Methods

In this cross-sectional study, mothers of children below the age of two were recruited from the community and health centers located in different areas in Abu Dhabi. Following informed consent, a structured questionnaire including WHO-indicators was used for in-person interviews on sociodemographics and breastfeeding. Exclusive breastfeeding (EBF) was calculated as the percentage of babies 0 – <?6?months of age who had been exclusively breastfed in the last 24?h.

Results

A total of 1822 mothers participated in the study; 95.6% (1741/1822) of mothers initiated breastfeeding and 59.8% (1089/1822) initiated breastfeeding within the first hour. Exclusive breastfeeding among infants 0–6?months was 44.3% (362/818). Although the median duration of “any breastfeeding” was 12?months (95% CI 11.2, 12.7), the median duration of EBF was 3 months (95% CI 2.8, 3.3). Most of the children (894/1004, 89%) aged 6 months and above were receiving complementary feeding, but 21.7% (218/1004) of them had had an early introduction of complementary feeding, i.e. before 6 months of age. Using “the WHO infant and young child feeding indicators” as standard for comparative evaluation, breastfeeding initiation was rated “good”, the proportion of children being exclusively breastfed until 6 months was rated “fair” and the duration of EBF was considered “poor”.

Conclusions

According to the WHO infant feeding indicators the breastfeeding practices were suboptimal in several aspects with a low proportion of children being exclusively breastfed, short breastfeeding duration and early introduction of complementary feeding, despite high socioeconomic status. These findings suggest that there is a need to understand potential barriers towards breastfeeding in order to develop appropriate strategies to promote and support breastfeeding in Abu Dhabi.

     

Parental Weight Perceptions: A Cause for Concern in the Prevention and Management of Childhood Obesity in the United Arab Emirates

Parental participation is a key factor in the prevention and management of childhood obesity, thus parental recognition of weight problems is essential. We estimated parental perceptions and their determinants in the Emirati population. We invited 1541 students (grade 1–12; 50% boys) and their parents, but only 1440 (6–19 years) and their parents consented. Of these, 945 Emirati nationals provided data for analysis. Anthropometric and demographic variables were measured by standard methods. CDC BMI percentile charts for age and sex were used to classify children’s weight. Parental perception of their children’s weight status (underweight, normal, and overweight/obese) was recorded. Logistic regression analyses were used to identify independent predictors of parental perceptions of children’s weight status. Of all parents, 33.8% misclassified their children’s’ weight status; underestimating (27.4%) or overestimating (6.3%). Misclassification was highest among parents of overweight/obese children (63.5%) and underweight (55.1%) children. More importantly, parental perceptions of their children being overweight or obese, among truly overweight/obese children, i.e. correct identification of an overweight/obese child as such, were associated with the true child’s BMI percentile (CDC) with an OR of 1.313 (95% CI: 1.209–1.425; p<0.001) per percentile point, but not age, parental education, household income, and child’s sex. We conclude that the majority of parents of overweight/obese children either overestimated or, more commonly, underestimated children’s weight status. Predictors of accurate parental perception, in this population, include the true children’s BMI, but not age, household income, and sex. Thus, parents having an incorrect perception of their child’s weight status may ignore otherwise appropriate health messages.     

Deaths and Medical Visits Attributable to Environmental Pollution in the United Arab Emirates

Background

This study estimates the potential health gains achievable in the United Arab Emirates (UAE) with improved controls on environmental pollution. The UAE is an emerging economy in which population health risks have shifted rapidly from infectious diseases to chronic conditions observed in developed nations. The UAE government commissioned this work as part of an environmental health strategic planning project intended to address this shift in the nature of the country’s disease burden.

Methods and Findings

We assessed the burden of disease attributable to six environmental exposure routes outdoor air, indoor air, drinking water, coastal water, occupational environments, and climate change. For every exposure route, we integrated UAE environmental monitoring and public health data in a spatially resolved Monte Carlo simulation model to estimate the annual disease burden attributable to selected pollutants. The assessment included the entire UAE population (4.5 million for the year of analysis). The study found that outdoor air pollution was the leading contributor to mortality, with 651 attributable deaths (95% confidence interval [CI] 143–1,440), or 7.3% of all deaths. Indoor air pollution and occupational exposures were the second and third leading contributors to mortality, with 153 (95% CI 85–216) and 46 attributable deaths (95% CI 26–72), respectively. The leading contributor to health-care facility visits was drinking water pollution, to which 46,600 (95% CI 15,300–61,400) health-care facility visits were attributed (about 15% of the visits for all the diseases considered in this study). Major study limitations included (1) a lack of information needed to translate health-care facility visits to quality-adjusted-life-year estimates and (2) insufficient spatial coverage of environmental data.

Conclusions

Based on international comparisons, the UAE’s environmental disease burden is low for all factors except outdoor air pollution. From a public health perspective, reducing pollutant emissions to outdoor air should be a high priority for the UAE’s environmental agencies.     

Age-related plasma chemistry changes in houbara and kori bustards in the United Arab Emirates

Plasma chemistry parameters were measured in adult (> 1.5 yr) and juvenile (4-8 and 9-16 wk) captive houbara bustards (Chlamydotis undulata macqueenii) and from adult (> 1.5 yr) and juvenile (4-8, 9-16, 17-24, 25-32, 33-40 and 41-52 wk) captive kori bustards (Ardeotis kori) to study age-related changes. A comparison of the values obtained was made between adult and juvenile bustards of both species and from the literature with other bustard species. Significant differences between adult and juvenile bustards of both species were found for glucose, total protein, alkaline phosphatase (ALKP), aspartate amino transferase (AST), lactate dehydrogenase, and calcium. Some parameters, such as calcium, showed comparable age-related changes in both species. In contrast, other parameters showed clear differences in the type (ALT, AST) or magnitude (ALKP) of age-related change between the species, demonstrating the importance of determining normal values for individual species. The results obtained from this study provide blood chemistry values for these species and demonstrate age-related differences between adult and juvenile birds.     

Assessing Knowledge of,and Attitudes to,HIV/AIDS among University Students in the United Arab Emirates

Background

The Middle East and North Africa (MENA) region is among the top two regions in the world with the fastest growing HIV epidemic. In this context, risks and vulnerability are high as the epidemic is on the rise with evidence indicating significantly increasing HIV prevalence, new HIV infections and AIDS-related deaths.

Objective

The aim of the survey was to assess HIV/AIDS knowledge and attitudes related to HIV/AIDS among a wide group of university students in the United Arab Emirates (UAE).

Methods

In a cross-sectional survey, a total sample of 2,294 students (406 male; 1,888 female) from four universities in three different Emirates in the UAE were approached to take part in the study. Students self-completed a questionnaire that was designed to measure their knowledge and attitudes to HIV/AIDS.

Results

The overall average knowledge score of HIV.AIDS was 61%. Non-Emirati and postgraduates demonstrated higher levels of knowledge compared to Emirati and undergraduate students respectively. No significant differences between males and females; and marital status were found. Eighty-five percent of students expressed negative attitudes towards people living with HIV, with Emirati and single students significantly holding more negative attitudes compared to non-Emiratis and those that are married respectively.

Conclusions

The findings provide strong evidence that there is a need to advocate for appropriate National HIV/AIDS awareness raising campaigns in universities to reduce the gaps in knowledge and decrease stigmatizing attitudes towards people living with HIV/AIDS.     

Demography and Population Dynamics of Massive Coral Communities in Adjacent High Latitude Regions (United Arab Emirates)

Individual massive coral colonies, primarily faviids and poritids, from three distinct assemblages within the southeastern Arabian Gulf and northwestern Gulf of Oman (United Arab Emirates) were studied from 2006–2009. Annual photographic censuses of approximately 2000 colonies were used to describe the demographics (size class frequencies, abundance, area cover) and population dynamics under “normal” environmental conditions. Size class transitions included growth, which occurred in 10–20% of the colonies, followed in decending order by partial mortality (3–16%), colony fission (<5%) and ramet fusion (<3%). Recruitment and whole colony mortality rates were low (<0.7 colonies/m²) with minimal interannual variation. Transition matrices indicated that the Arabian Gulf assemblages have declining growth rates (λ<1) whereas the massive coral population is stable (λ = 1) in the Gulf of Oman. Projection models indicated that (i) the Arabian Gulf population and area cover declines would be exacerbated under 10-year and 16-year disturbance scenarios as the vital rates do not allow for recovery to pre-disturbance levels during these timeframes, and (ii) the Gulf of Oman assemblage could return to its pre-disturbance area cover but its overall population size would not fully recover under the same scenarios.     

Strengthening desert plant biotechnology research in the United Arab Emirates: a viewpoint

The biotechnology of desert plants is a vast subject. The main applications in this broad field of study comprises of plant tissue culture, genetic engineering, molecular markers and others. Biotechnology applications have the potential to address biodiversity conservation as well as agricultural, medicinal, and environmental issues. There is a need to increase our knowledge of the genetic diversity through the use of molecular genetics and biotechnological approaches in desert plants in the Arabian Gulf region including those in the United Arab Emirates (UAE). This article provides a prospective research for the study of UAE desert plant diversity through DNA fingerprinting as well as understanding the mechanisms of both abiotic stress resistance (including salinity, drought and heat stresses) and biotic stress resistance (including disease and insect resistance). Special attention is given to the desert halophytes and their utilization to alleviate the salinity stress, which is one of the major challenges in agriculture. In addition, symbioses with microorganisms are thought to be hypothesized as important components of desert plant survival under stressful environmental conditions. Thus, factors shaping the diversity and functionality of plant microbiomes in desert ecosystems are also emphasized in this article. It is important to establish a critical mass for biotechnology research and applications while strengthening the channels for collaboration among research/academic institutions in the area of desert plant biotechnology.     

Aflatoxin in human and camel milk in Abu Dhabi,United Arab Emirates

During an initial survey, using thin layer chromatography, 10 of 64 samples of mothers’ breast milk, collected from donors at the Corniche Maternity Hospital and the Al-Nehyan Clinic for Maternity and Childhood, were found to contain Aflatoxin M₁ at concentrations ranging from 0.3 to 1.3 ng mL^?1. A second survey using HPLC showed Aflatoxin M₁ at concentrations ranging from 7 to 23 pg mL^?1 in all of the 15 samples collected. 6 of 20 samples of camel milk collected from several sources in Abu Dhabi were also found to contain Aflatoxin M₁ at levels ranging from 0.25 to 0.8 ng mL^?1.     

Sedimentary facies analysis of the subsurface triassic and hydrocarbon potential in the United Arab Emirates

Summary The Triassic sediments in the subsurface of the United Arab Emirates has been divided into three formations (from bottom to top): Sudair, Jilh (Gulailah) and Minjur. The Sudair Formation consists of four lithofacies units composed mainly of limestones and minor dolomites interbedded with terrigenous shaley mudstones and anhydritic dolomitic limestones. These were deposited in shallow marine supratidal to subtidal settings. The Jilh (Gulailah) Formation has five lithofacies units dominated by anhydritic dolomitic limestone, fine terrigenoclastic sediments and bioclastic and intraclastic limestones. The formation was laid down under lagoonal to supratidal sabkha conditions with little normal marine influence. The Minjur Formation is composed of three lithofacies units characterized by argillaceous quartzitic sandstones, shales, mudstones, dolomitic and ferruginous limestones with thin coal seams. These facies represent deposition in prograding delta lobes, reflecting humid continental to marginal-marine conditions. Diagenesis plays a major role in the reservoir development in the Triassic sediments, the pores are occluded by dolomite and anhydrite. The grains are compacted, leached or cemented by marine cements. Porosity generally ranges from fair to poor with values from 6% to 9% in the carbonates and from 6% to 15% in the clastics. Interparticle and vuggy porosities are the main pore types. The porosity was controlled by diagenesis, depth of burial and lithology. No oil has been discovered so far in the Triassic sediments of the United Arab Emirates but pronounced gas shows have been reported from offshore fields. Western offshore United Arab Emirates is a promising area for potential hydrocarbon accumulations. The Triassic sediments have low to moderate source rock potential; the organic matter is mainly sapropelic kerogen, and the degree of thermal alteration ranges between mature to highly mature stages.     

Longitudinal Assessment of High Blood Pressure in Children with Nonalcoholic Fatty Liver Disease

Objective

Nonalcoholic fatty liver disease (NAFLD) affects 9.6% of children and may put these children at elevated risk of high blood pressure and subsequent cardiovascular morbidity and mortality. Therefore, we sought to determine the prevalence of and risk factors for high blood pressure in children with NAFLD.

Methods

Cohort study performed by the NIDDK NASH Clinical Research Network. There were 484 children with NAFLD ages 2 to 17 at enrollment; 382 children were assessed both at enrollment and 48 weeks afterwards. The main outcomes were high blood pressure at baseline and persistent high blood pressure at both baseline and 48 weeks.

Results

Prevalence of high blood pressure at baseline was 35.8% and prevalence of persistent high blood pressure was 21.4%. Children with high blood pressure were significantly more likely to have worse steatosis than children without high blood pressure (mild 19.8% vs. 34.2%, moderate 35.0% vs. 30.7%, severe 45.2% vs. 35.1%; P = 0.003). Higher body mass index, low-density lipoprotein, and uric acid were independent risk factors for high blood pressure (Odds Ratios: 1.10 per kg/m², 1.09 per 10 mg/dL, 1.25 per mg/dL, respectively). Compared to boys, girls with NAFLD were significantly more likely to have persistent high blood pressure (28.4% vs.18.9%; P = 0.05).

Conclusions

In conclusion, NAFLD is a common clinical problem that places children at substantial risk for high blood pressure, which may often go undiagnosed. Thus blood pressure evaluation, control, and monitoring should be an integral component of the clinical management of children with NAFLD.