Aim: To examine the burden of cardiovascular disease (CVD) risk factors in Middle East and North Africa countries and their associations with dietary behaviors as nutrition transition is unfolding in the region. Data: Data on CVD risk factors were collected from scholarly papers and a systematic review of published articles was performed. Dietary patterns were derived from the WHO Food and Agriculture Organization Statistical Databases. Results: Wide variations exist across countries in the prevalence of CVD risk factors, namely obesity, diabetes, hypertension, hyperlipidemia, smoking and physical inactivity, with some countries showing high values of certain factors which approach those observed in the developed world. In particular, obesity prevalence rates have reached alarming levels, particularly among women in the oil-rich countries (over 40%), making it the most pressing health concern in the region. Trends in the dietary pattern illustrated a consistent rise in total energy supply by approximately 730 kcal per capita per day between 1970 and 2005. Dietary patterns showed an increased consumption of fat and animal protein and a decreased intake of carbohydrates, particularly whole grain cereals, and fresh fruits and vegetables. Conclusion: Regional differences were attributed to differences in lifestyle, occupation and a shift from traditional food habits. Our understanding of the CVD disparities across various geographic regions is key to our effort in planning relevant intervention programs. Public health efforts should focus on obesity, physical inactivity and unhealthy dietary practices. The success of these interventions depends on governmental commitment, multisectoral partnership and a consideration of the sociocultural norms of the target population.

BackgroundPrevalence of metabolic syndrome (MS) in obese adolescents has been reported to range between 18–42%, depending on country of origin, thus suggesting an ethnic-based association between obesity and MS.AimThis study aims to investigate the magnitude of the association between obesity, insulin resistance and components of MS among adolescents in Lebanon.Subjects and methodsThe sample included 263 adolescents at 4th and 5th Tanner stages of puberty (104 obese; 78 overweight; 81 normal weight). Anthropometric, biochemical and blood pressure measurements were performed. Body fat was assessed using dual-energy X-ray absorptiometry.ResultsAccording to International Diabetes Federation criteria, MS was identified in 21.2% of obese, 3.8% of overweight and 1.2% of normal weight subjects. The most common metabolic abnormalities among subjects having MS were elevated waist circumference (96.2%), low HDL (96.2%) and hypertriglyceridemia (73.1%). Insulin resistance was identified in all subjects having MS. Regression analyses showed that percentage body fat, waist circumference and BMI were similar in their ability to predict the MS in this age group.ConclusionsMS was identified in a substantial proportion of Lebanese obese adolescents, thus highlighting the importance of early screening for obesity-associated metabolic abnormalities and of developing successful multi-component interventions addressing adolescent obesity.

Objectives To examine correlates of lifetime mental health services (MHS) use among pregnant women reporting prenatal depressive symptoms by race/ethnicity. Methods This cross-sectional population-based study included 81,910 pregnant women with prenatal depressive symptoms using data from the Florida Healthy Start prenatal screening program (2008-2012). Multivariable logistic regression was conducted to ascertain adjusted odds ratios and corresponding 95 % confidence intervals for racial/ethnic differences in the correlates of lifetime MHS use. Results Findings of this study revealed racial/ethnic differences in MHS use among women with prenatal depressive symptoms, the highest rates being among non-Hispanic Whites and the lowest rates among Mexicans and other Hispanics. Most need for care factors, including illness, tobacco use, and physical or emotional abuse, consistently predicted MHS use across racial/ethnic groups after adjusting for covariates. Adjusted associations between predisposing and enabling/restricting factors and MHS use were different for different racial/ethnic groups. Conclusions Racial/ethnic differences in MHS use were found, with pregnant Hispanic women reporting prenatal depressive symptoms being the least likely to use MHS. Our study findings have significant public health implications for targeted intervention for pregnant women with prenatal depressive symptoms.

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Low-income women who have their first birth in adolescence have higher odds of psychiatric disorders and should be the target of psychiatric screening during their pregnancy. Mothers beginning childbearing before age 19 should be screened during pregnancy for anxiety disorders, including PTSD, and behavior disorders.

Objective This study aimed to examine the effects of interpregnancy weight change on pregnancy outcomes, including recurrent preeclampsia, preterm birth, small-for-gestational age (SGA), large-for-gestational age (LGA), and cesarean delivery, among women with a history of preeclampsia. We also evaluated whether these associations were modified by prepregnancy body mass index (BMI) category in the first pregnancy (BMI < 25 vs. ≥25 kg/m2) and if associations were present among women who maintained a healthy BMI category in both pregnancies. Study Design We conducted a population-based retrospective cohort study including 15,108 women who delivered their first two nonanomalous singleton live births in Missouri (1989–2005) and experienced preeclampsia in the first pregnancy. We performed Poisson regression with robust error variance to estimate relative risks and 95% confidence intervals for outcomes of interest after controlling for potential confounders. Results Interpregnancy weight gain was associated with increased risk of recurrent preeclampsia, LGA, and cesarean delivery. These risks increased in a “dose–response” manner with increasing magnitude of interpregnancy weight gain and were generally more pronounced among women who were underweight or normal weight in the first pregnancy. Interpregnancy weight loss exceeding 1 BMI unit was associated with increased risk of SGA among underweight and normal weight women, while interpregnancy weight loss exceeding 2 BMI units was associated with reduced risk of recurrent preeclampsia among overweight and obese women. Conclusion Even small changes in interpregnancy weight may significantly affect pregnancy outcomes among formerly preeclamptic women. Appropriate weight management between pregnancies has the potential to attenuate such risks. Key Points

Our findings hold important public health implications given the increasing rates of overweight and obesity over the past couple of decades, particularly among rural adults.

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