Nutritional status and its determinants in the Eastern Mediterranean region. A review.

OBJECTIVES: To review relevant literature on the determinants of the nutritional status of the children below 5 years of age in the Eastern Mediterranean Regional (EMR) countries and investigate the updates related to risk factors associated with malnutrition. METHODS: A search of pertinent literature and databases was conducted using the PubMed and Google Scholar databases by applying some keywords. RESULTS: From the available literature reviewed, the mean prevalence of underweight, wasting, and stunting of the children below 5 years of age in the EMR were 12.8% (6.4%-22.6%), 7.5% (5.9%-9.4%), and 24.2% (15.6%-35.5%) respectively. The EMR countries like Sudan, Yemen, Libya, Afghanistan and Pakistan showed the highest rate of stunting amongst the children (>30%). Furthermore, on average, 5.7% of the children were seen to be overweight. Countries such as Lebanon, Egypt, Syria, Libya, and Tunisia reported the maximal prevalence of overweight children. The study also identified a positive and negative relationship between demographic and socioeconomic and health determinants with nutritional status of these children under 5 years old. CONCLUSION: In this review, the researchers have highlighted the prevalence of malnutrition in EMR countries. Thereafter, the review findings recommend for prioritization of different policies which aimed to improve the nutritional status of the people.

Randomized controlled trial of a good practice approach to treatment of childhood obesity in Malaysia: Malaysian Childhood Obesity Treatment Trial (MASCOT).

CONTEXT: Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world. AIM: To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia. METHODS: Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hours contact over 26 weeks, group based), aiming to change child sedentary behavior, physical activity, and diet using behavior change counselling. Outcomes were measured at baseline and six months after the start of the intervention. Primary outcome was BMI z-score, other outcomes were weight change, health-related quality of life (Peds QL), objectively measured physical activity and sedentary behavior (Actigraph accelerometry over 5 days). RESULTS: The intervention had no significant effect on BMI z score relative to control. Weight gain was reduced significantly in the intervention group compared to the control group (+1.5 kg vs. +3.5 kg, respectively, t-test p < 0.01). Changes in health-related quality of life and objectively measured physical activity and sedentary behavior favored the intervention group. CONCLUSIONS: Treatment was associated with reduced rate of weight gain, and improvements in physical activity and quality of life. More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes.