Cardiometabolic deaths attributable to poor diet among Kuwaiti adults.

BACKGROUND: Nutrition transition towards a Western diet is happening in parallel with the rapidly increasing rates of cardiovascular disease and its risk factors in Kuwait. The cardiometabolic deaths attributable to poor diet have not been quantified among Kuwaiti adults. METHODS: Using a Comparative Risk Assessment model that incorporated dietary intake data from Kuwait's first national nutrition survey, number of cardiometabolic deaths from the World Health Organization, and estimated associations of diet with cardiometabolic deaths from the Global Burden of Disease project, we estimated the number and proportion of cardiometabolic deaths attributable to suboptimal intake of 10 dietary factors among Kuwaiti adults ages 25+ years, and by population subgroups. FINDINGS: An estimated 1,308 (95% uncertainty interval [UI] = 1,228-1,485) cardiometabolic deaths were attributed to suboptimal diet, accounting for 64.7% (95% UI = 60.7%-73.4%) of all cardiometabolic deaths in Kuwait in 2009. The low intake of nuts/seeds was associated with the highest estimated number and proportion of cardiometabolic deaths (n = 380, 18.8%), followed by high intake of sodium (n = 256, 12.6%), low intake of fruits (n = 250, 12.4%), low intake of vegetables (n = 236, 11.7%), low intake of whole grains (n = 201, 9.9%), and high intake of sugar-sweetened beverages (n = 201, 9.9%). The estimated proportions of cardiometabolic deaths attributable to suboptimal diet were higher in men (67.7%) than women (57.8%) and in younger adults aged 25-34 years (84.5%) than older adults aged ≥55 years (55.6%). CONCLUSION: Suboptimal dietary intake was associated with a very substantial proportion of cardiometabolic deaths among Kuwaiti adults in 2009, with young adults and men experiencing the largest proportion of diet-associated cardiometabolic deaths in Kuwait.

Effects of COVID-19 Lockdown on Physical Activity and Dietary Behaviors in Kuwait: A Cross-Sectional Study.

The Coronavirus disease (COVID-19) pandemic has brought about drastic measures that have significantly altered the norms of daily living. These measures have affected human behaviors in disparate ways. This study seeks to understand the impact of the pandemic on physical activity and dietary behavior among adults living in Kuwait. A cross-sectional survey was conducted between 18 June and 15 July 2020, using a questionnaire disseminated through social media, including WhatsApp and Facebook. The target population was individuals aged 21 years or older living in the State of Kuwait. The study included 679 respondents; 57.9% were females, and 67.7% were Kuwaiti nationals. Both genders reported an increased consumption of vegetables, fruits, and carbohydrates, and a decreased consumption of fish and sugary drinks. Compared to males, females reported eating more during the outbreak than their pre-pandemic eating behaviors (32.3% vs. 35.9%, p < 0.05). Approximately one-third of respondents (33.1%) reported performing less than 30 min of physical activity or exercise in a week, and 36.4% of respondents rated their quality of sleep as 'poor' or 'very poor'. The rate of smoking cigarettes among males was significantly higher than in females (40.6% vs. 5.3%, p < 0.001). Physical activity was positively correlated with vegetable consumption and quality of sleep. Quality of sleep was negatively correlated with the consumption of sweets and snacks, just as the consumption of vegetables was negatively correlated with the consumption of sugary drinks. The overall negative impact of the COVID-19 pandemic in Kuwait necessitates the development of health promotion interventions to support positive physical activity and dietary behaviors using alternative coping strategies among the residents of Kuwait.

Dietary Patterns Associated with the Prevalence of Cardiovascular Disease Risk Factors in Kuwaiti Adults.

BACKGROUND: Kuwaiti adults have experienced a rapid increase in cardiovascular disease (CVD) and its risk factors. Dietary patterns in the Kuwaiti diet associated with the increasingly higher CVD burden have not been adequately evaluated. OBJECTIVE: The objective of this study was to identify the major dietary patterns in Kuwaiti adults and examine their associations with CVD risk factors. DESIGN: This cross-sectional study examined data from the 2008-2009 National Nutrition Survey of the State of Kuwait. PARTICIPANTS/SETTING: The study included 555 Kuwaiti adults aged ≥20 years who completed a 24-hour dietary recall. MAIN OUTCOME MEASURES: The outcome measures included CVD risk factors such as obesity (body mass index), abdominal obesity (waist circumference), elevated blood pressure, dyslipidemia (blood lipid levels), diabetes (glucose and glycated hemoglobin levels), and metabolic syndrome. STATISTICAL ANALYSIS: Dietary patterns were identified using principal component analysis. The associations between dietary patterns and CVD risk factors were analyzed using survey-weighted multivariable linear and logistic regression models. RESULTS: Three dietary patterns were identified: vegetable-rich, fast food, and refined grains/poultry. Younger adults had higher adherence to the fast-food or refined-grains/poultry dietary patterns, whereas older adults had higher adherence to the vegetable-rich dietary pattern. The fast-food dietary pattern was positively associated with body mass index (ß=.94, 95% CI 0.08 to 1.79), waist circumference (ß=2.05, 95% CI 0.20 to 3.90 cm), and diastolic blood pressure (ß=1.62, 95% CI 0.47 to 2.77 mm Hg). The refined grains/poultry dietary pattern was positively associated with plasma glucose levels (ß=1.02, 95% CI 1.002 to 1.04 mg/dL [0.056 to 0.058 mmol/L]). Individuals in the highest tertile of the fast-food or refined-grains/poultry dietary patterns had higher odds of metabolic syndrome than those in the lowest tertile. CONCLUSIONS: The fast-food and refined grains/poultry dietary patterns were associated with high prevalence of CVD risk factors among Kuwaiti adults. The current findings underscore the need for prospective studies to further explore dietary pattern and CVD risk factor relationships among at-risk Kuwait adults.

Total body water measurement using the 2H dilution technique for the assessment of body composition of Kuwaiti children.

OBJECTIVE: The 2H dilution technique is the reference method to estimate total body water for body composition assessment. The aims of the present study were to establish the total body water technique at the Kuwait Institute for Scientific Research and assess body composition of Kuwaiti children. DESIGN: The isotope ratio mass spectrometer was calibrated with defined international reference water standards. A non-random sampling approach was used to recruit a convenience sample of Kuwaiti children. A dose of 2H2O, 1-3 g, was consumed after an overnight fast and 2H enrichment in baseline and post-dose urine samples was measured. Total body water was calculated and used to estimate fat-free mass. Fat mass was estimated as body weight minus fat-free mass. SETTING: The total body water study was implemented in primary schools. SUBJECTS: Seventy-five boys and eighty-three girls (7-9 years). RESULTS: Measurements of the isotope ratio mass spectrometer were confirmed to be accurate and precise. Children were classified as normal weight, overweight or obese according to the WHO based on BMI-for-age Z-scores. Normal-weight and overweight girls had significantly higher percentage body fat (median (range): 32·4 % (24·7-39·3 %) and 38·3 % (29·3-44·2 %), respectively) compared with boys (median (range): 26·5 % (14·2-37·1 %) and 34·6 % (29·9-40·2 %), respectively). No gender difference was found in obese children (median 46·5 % v. 45·6 %). CONCLUSIONS: The establishment of a state-of-the-art stable isotope laboratory for assessment of body composition provides an opportunity to explore a wide range of applications to better understand the relationship between body size, body composition and risk of developing non-communicable diseases in Kuwait.