This article is available online at http://www.jlr.org infl ammatory eicosanoids ( 1 ). The major dietary LC-PUFA is linoleic acid (LA,, with lower amounts of n-3 fatty acids, chiefl y ␣ -linolenic acid (ALA, 18:3n-3), eicosapentaenoic acid (EPA,, and docosahexaenoic acid (DHA,. The composition of fatty acids in tissues refl ects both dietary fat ( 2 ) and the effi ciency of elongation and desaturation of their dietary precursors, the two essential fatty acids LA and ALA ( Fig. 1 ).Delta-5 and delta-6 desaturases (D5D and D6D) are the key enzymes in endogenous desaturation ( 3, 4 ), expressed at high levels in liver, brain, heart, and lung ( 5, 6 ). D5D and D6D are encoded, respectively, by the FADS1 and FADS2 genes, which lie in a region of strong linkage disequilibrium (LD) on chromosome 11. Several single nucleotide polymorphisms (SNP) in the FADS1-FADS2 cluster have been shown to be associated with plasma or erythrocyte phosphoglyceride LC-PUFA concentrations in genome-wide association (GWA) studies ( 7,8 ). Associations of SNPs and haplotypes in this region have been shown with fatty acids in plasma ( 4, 9-14 ), erythrocyte membranes ( 4,8,(10)(11)(12)15 ), and adipose tissue ( 16 ). Surrogate estimates of desaturase activity based on ratios of product:substrate ( 15, 17 ) suggest lower levels are associated with the minor alleles of SNPs in the FADS1-FADS2 LD block. GWA studies have also identifi ed several loci in the FADS gene cluster, at which minor alleles were associated with lower total cholesterol ( 18 )

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Background Dietitians are healthcare team members responsible for counseling patients with weight concerns. Both traditional/restrictive and intuitive eating/nonrestrictive practices are used with clients seeking weight loss. However, little is known about the weight management practices used with clients by dietitians in Kuwait, which are often related to the dietitians’ knowledge, attitudes, and work experience. Objectives The purpose of this study was to assess the knowledge and attitudes regarding intuitive eating among dietitians dealing with clients for weight management in Kuwait and describe their use of restrictive versus nonrestrictive dietary practices. Method This was a cross-sectional descriptive study. A self-administered survey was distributed among dietitians working with clients for weight management in public and private clinics. Results In total, 163 participants completed the survey. Most dietitians (81.6%) had not heard of intuitive eating as an independent approach to weight loss and scored low on knowledge of intuitive eating; however, many demonstrated positive attitudes towards intuitive eating (68%). Moreover, dietitians in Kuwait used both restrictive/traditional (69.31%) and nonrestrictive/intuitive eating (79.82%) weight management approaches to counsel clients. Total knowledge was positively correlated with use of nonrestrictive/intuitive eating (r=.259, p=.003) and traditional/restrictive practices (r=.227, p=.009). Years of experience was not related to either practice style. Conclusions Dietitians are combining both restrictive and nonrestrictive approaches for weight management with clients, and their practices are related to knowledge. These findings underscore the importance of continuous education for dietitians working in all sectors in Kuwait.

Anemia, defined by low hemoglobin level, is recognized as a major public health problem that has a significant impact on lifelong health. In 2014, the Kuwait Nutrition Surveillance System stated that the prevalence of anemia was 9.7% in adult males and 32.7% in adult females. This study aimed to establish the prevalence and classification of anemia among adult patients attending the Capital Governorate hospital of Kuwait. It is a retrospective record-based study. The study included patients (aged 18-60 years) attending Amiri Hospital OPD and primary care centers affiliated from January 2014 to December 2018. Hemoglobin levels were taken from the Laboratory Information System (LIS) and were classified as mild, moderate, and severe based on WHO classification. This study showed that anemia was more prevalent among the Kuwaiti population than non-Kuwaitis. The maximum percentage of anemic people belonged to the moderate and mild range of anemia; a very low percentage was found in the severe range. The incidence of anemia was significantly higher among females compared to males (16-17% of females and 4-5% of males in the moderate range; 16-18% of females and 10-11% of males in the mild range; 2-3.3% of females and 0.8-1.1% of males in the severe range). Age-wise comparison of data showed that anemia was more common among the older age groups. Prevalence of anemia is quite high in Kuwait; therefore, more studies and interventions are needed for certain vulnerable groups-specifically for women and people from older age groups-to reduce the risk of anemia.

The capacity to convert linoleic acid (18 :2n-6) into longer chain metabolites may be influenced by single nucleotide polymorphism (SNP) for fatty acid desaturase genes FADS1 and FADS2 which encode delta-5 and delta-6 desaturase enzymes (1) . We report the effects of rs174537 and rs174561 SNPs in the FADS1 and FADS2 respectively on the proportions of long-chain n-6 polyunsaturated fatty acids (PUFA) in plasma lipids and erythrocyte membrane phosphoglycerides in 123 men and 195 women aged 45-70 years who were recruited into the MARINA study (2) . DNA was extracted from buffy coats and rs174537 and rs174561 genotypes were determined by KBiosciences UK. Plasma fatty acid composition and erythrocyte phosphoglycerides were determined by capillary gas liquid chromatography. The proportions (wt %) of n-6 PUFA in erythrocytes (RBC) and plasma by genotype adjusted for age, gender, BMI and ethnicity are shown in the Carriers of the minor allele of the FADS1 SNP (rs174537) had higher proportions of dihomogammalinolenic acid (20 :3n-6) in both RBC and plasma. The proportions of arachidonic acid (20: 4n-6) and adrenic acid (22 :4n-6) were corresponding lower in plasma but not in RBC lipids. Carriers of the minor allele of the FADS2 SNP (rs174561) also showed higher proportion of 20 : 3n-6 and a lower proportion of 20 :4n-6 in plasma and RBC lipid. Previous reports of variations in the FADS1 and FADS2 genes have been mainly in children and confined to plasma phospholipids (1) . Our results show that older adults who carry the minor alleles of rs174537 and rs174561 have about 25 % less 20 :4n-6 in their plasma lipids than non-carriers. However, the impact of genotype on the proportion of 20 :4n-6 in membrane lipids is much smaller presumably because acyltransferases can select the fatty acids required. The higher proportion of 20 :3n-6 in carriers of the minor alleles may be advantageous in that eicosanoid metabolites are less inflammatory and prothrombotic compared with those derived from 20 : 4n-6.