Diabesity in the Arabian Gulf: Challenges and Opportunities

Diabesity [diabetes associated with obesity] is a major global and local public health concern, which has almost reached an epidemic order of magnitude in the countries of the Arabian Gulf and worldwide. We sought to review the lifestyle trends in this region and to highlight the challenges and opportunities that health care professionals face and attempt to address and correct them. In this regard, we aimed to review the regional data and widely held expert opinions in the Arabian Gulf and provide a thematic review of the size of the problem of diabesity and its risk factors, challenges, and opportunities. We also wished to delineate the barriers to health promotion, disease prevention, and identify social customs contributing to these challenges. Lastly, we wished to address specific problems with particular relevance to the region such as minimal exercise and unhealthy nutrition, concerns during pregnancy, the subject of childhood obesity, the impact of Ramadan fasting, and the expanding role of bariatric surgery. Finally, general recommendations for prevention, evidence-based, and culturally competent management strategies are presented to be considered at the levels of the individual, community, and policymakers

Bone mineral density of the spine and femur in United Arab Emirates women: relation to anthropometric, reproductive, and lifestyle factors

Establish normative data for bone mineral density [BMD] at the spine and femur in healthy United Arab Emirates [UAE] women, compare BMD of UAE women to other populations, and examine the relationship of BMD to anthropometric, reproductive, and lifestyle factors. Three hundred and one healthy UAE women volunteers aged 20-79 years were interviewed and studied hr measurements of height, weight, body composition using bioelectric impedance, handgrip strength, aid axial BMD using dual energy x-ray absorptiometry. Mean values for BMD of UAE women were compared to those of other Arabian Gulf women and to US/European Caucasian women. Mean standardized BMD of UAE women showed the expected decline with age after reaching its peak in the 4th decade for the spine and the fifth decade for the total femur Mean spine BMD was significantly lower than US/European Caucasian women across all age decades. Mean total femur BMD was significantly higher than US European Caucasian women, except in the 3rd decade, where it women significantly lower Peak standardized BMD [age range 20-39 years] of spine was significantly lower than the reference range for US European Caucasian women [-0.54 SD, P<0.01], however peck standardized BMD of total femur was not significantly different. There were significant positive correlations between BMD, and weight, body mass index, free fat mass, percent body fat, handgrip strength, and walking duration. There were significant negative correlations between BMD, and age, poor health, sears post menopause, number of pregnancies, and beast-feeding duration [p<0.05/or all comparisons]. Multiple regression analyses showed that age, weight, handgrip strength and number of pregnancies were significant predictors of spine BMD whereas weight, menopausal duration, and walking duration were significant predictors of total femur BMD. We have provided a database of BMD of the lumbar spine and total femur for healthy UAE women Aged 20-79 years and showed that UAE women, like other Arabian women, have louver peak BMD of the spine compared with US/European Caucasian women. We have also demonstrated that multiparity, physical activity and weight are significant predictors of BMD in this population. These factors should be the subject of public health interventions to prevent osteoporosis

Bone mineral density of the spine and femur in United Emirates women: relation to anthropometric, reproductive, and lifestyle factors

Establish normative data for bone mineral density [BMD] at the spine and femur in healthy United Arab Emirates [UAE] women, compare BMD of UAE women to other populations, and examine the relationship of BMD to anthropometric, reproductive, and lifestyle factors. Three hundred and one healthy UAE women volunteers aged 20-79 years were interviewed and studied by measurements of height, weight, body composition using bioelectric impedance, handgrip strength, and axial BMD using dual energy x-ray absorptiometry. Mean values for BMD of UAE women were compared to those of other Arabian Gulf women and to US/European Caucasian women. Mean standardized BMD of UAE women showed the expected decline with age after reaching its peak in the 4th decade for the spine and the fifth decade for the total femur Mean spine BMD was significantly lower than US/European Caucasian women across all age decades. Mean total femur BMD was significantly higher than US/European Caucasian women, except in the 3rd decade, where it was significantly lower peak standardized BMD [age range 20-39 years] of spine was significantly lower, than the reference range for US/European Caucasian women [-0.54 SD, P< 0.01]; however, peak standardized BMD of total femur was not significantly different. There were significant positive correlations between BMD, and weight, body mass index, free fat mass, percent body fat, handgrip strength, and walking duration. There were significant negative correlations between BMD, and age, poor health, years post menopause, number of pregnancies, and breast-feeding duration [P<0.05 for all comparisons]. Multiple regression analyses showed that age, weight, handgrip strength and number of pregnancies were significant predictors of spine BMD whereas weight, menopausal duration, and walking duration were significant predictors of total femur BMD. We have provided a database of BMD of the lumbar spine and total femur for healthy UAE women aged 20-79 years, and showed that UAE women, like other Arabian women, have lower peak BMD of the spine compared with US European Caucasian women. We have also demonstrated that multiparity, physical activity and weight are significant predictors of BMD in this population. These factors should be the subject of public health interventions to prevent osteoporosis

Osteoporosis in renal failure: how accurate is the diagnosis and is there any role for bisphosphonates?

Patients with chronic renal failure [CRF] may be at a particularly increased risk for osteoporosis and its related fractures given the high prevalence of some of the known risk factors for osteoporosis. The challenge is how to accurately make the diagnosis of osteoporosis in subjects with CRF since low bone mineral density and fractures could result from secondary hyperparathyroidism, adynamic bone disease, osteomalacia, as well as osteoporosis. Helpful tests include bone turnover markers and double tetracycline-labeled bone biopsy. In patients with confirmed osteoporosis, preliminary data suggest that bisphosphonates seem to be safe and effective down to glomerular filtration rates of 15 mL/min. Low to moderate doses of vitamin D analogues are also helpful in such patients