Does a Gluten-Free Diet Affect BMI and Glycosylated Hemoglobin in Children and Adolescents with Type 1 Diabetes and Asymptomatic Celiac Disease? A Meta-Analysis and Systematic Review.

Background: Children diagnosed with type 1 diabetes mellitus (T1DM) are more prone to having celiac disease (CD) than the normal population. Moreover, patients with this dual diagnosis who are also on a diabetic and gluten-free diet (GFD) risk faltering growth and uncontrolled blood glucose levels. This review aims to assess the efficacy and effectiveness of managing patients with T1DM screened for CD with GFD to prevent complications associated with these chronic pathologies in childhood and adulthood. Materials and Methods: We abided by the PRISMA guidelines in this meta-analysis and used multiple databases and search engines. We included case-control studies. The primary outcomes were changes in the standard deviation score, body mass index (SDS BMI), and glycosylated hemoglobin (HA1C) after being on a GFD for at least twelve months. Results: The pooled data from the six studies included showed that there was neither a statistically significant difference in the mean SDS BMI (-0.28 (95% CI -0.75, 0.42)) (p = 0.24) nor in the mean of HA1C (mean -0.07 (95% CI -0.44, 0.30)) (p = 0.36) for the same group. HDL cholesterol improved significantly in patients on a strict GFD (p < 0.01). Conclusions: In children with T1DM and asymptomatic CD, being on a GFD had no significant effect on BMI or HA1C. However, it can have a protective effect on the other complications found in both chronic pathologies.

Effect of Covid-19 on food security: A cross-sectional survey.

BACKGROUND: Novel coronavirus (COVID-19) and subsequent quarantine could raise the risk of food inadequacy and nutrition deficiency crises. OBJECTIVES: This study aimed to assess the impacts of COVID-19 on household food security in Jordan, determined the percentage of food security and the levels of food insecurity during the quarantine, determined the associated factor with food insecurity, and determined main food groups associated with FINS during the quarantine. DESIGN: A cross-sectional study was conducted using a Web-based validated questionnaire. The Food Insecurity Experience Scale was used to measure the food insecurity during the first four weeks of the quarantine, and a modified food consumption score was used to determine the number of times the household consumes each food group. Univariate and multiple logistic regression models were used to describe, explore, and predict risk factors correlated with food insecurity among Jordanians, during the first four weeks of the quarantine. RESULTS: A total of 3129 Jordanians had responded to the assessment and fully answered the questionnaire. 23.1% of the total participants were severe food insecure, while 36.1% were moderate food insecure, 40.7% were food secure. The regression model demonstrated the monthly income per capita below the poverty line and a number of the family member (1-4 and 5-7) associated significantly with moderate food insecurity (OR: 5.33; 95% CI: 4.44-6.40, OR: 0.64; 95% CI: 0.47-0.86, OR: 0.76; 95% CI: 0.58-0.98, respectively). As well as with the severe food insecurity (OR: 6.87; 95% CI: 5.542-8.512, OR: 0.52; 95% CI: 0.37-0.74, 0.64; 95% CI: 0.48-0.87, respectively). Age 18-30 years old (OR: 1.80; 95% CI: 1.23-2.65) and living in a rented house (OR: 1.30; 95% CI: 1.01-1.69) were associated significantly with severe food insecurity. Carbohydrates and the meat group were significantly related to food insecurity (p-value was <0.001 for both groups). CONCLUSION: Covid-19 and its subsequent quarantine have a tangible impact on food security levels for the populations. Awareness and strategies to support individuals at higher risks should be guided not only by the income but also by other risk factors identified in the present study as the number of persons in the family, younger adults (18-30 years old), and those who do not own their houses).

Attitudes, Anxiety, and Behavioral Practices Regarding COVID-19 among University Students in Jordan: A Cross-Sectional Study.

The COVID-19 pandemic represents a major public health, economic, political, and scientific concern in most countries around the globe where COVID-19 cases and deaths have been confirmed. This study assessed the attitudes, anxiety, and behavioral practices of university students in Jordan regarding COVID-19 during the early period of the infection (March 19-21, 2020) using a validated, self-administered survey questionnaire. Positive attitudes or low-risk practices were given 1 point, whereas negative attitudes or high-risk practices were scored 0. Percentages of the total score were used for categorizing data into negative attitudes or high-risk practices (≤ 60%), moderate attitudes or moderate-risk practices (60.01-80%), and positive attitudes or low-risk practices (> 80%). Generally, the university students displayed positive attitudes and low-risk practices toward preventing COVID-19, with an average score of 81.1% and 84.3%, respectively. Approximately two-thirds (69.1%) of the students showed a positive attitude toward COVID-19 seriousness, concern of contracting the virus, and the appropriate prevention measures, and low-risk practices (67.6%) toward preventing COVID-19 including implementation of social distancing and good hygiene. Female, older, medical, or postgraduate students practiced significantly more (P ≤ 0.05) appropriate hygiene and social distancing behaviors toward COVID-19 than their counterparts of each group. More than two-thirds (69.2%) of the students were anxious that they might become infected with COVID-19. These results are important for health authorities to develop appropriate educational programs and protective health measures including good respiratory etiquette and handwashing practices, to enhance safer lifestyles and prevent COVID-19 transmission.