Macro elements are the minerals of which the body needs more amounts and are more important than any other elements. Trace elements constitute a minute part of the living tissues and have various metabolic characteristics and functions. Trace elements participate in tissue and cellular and subcellular functions; these include immune regulation by humoral and cellular mechanisms, nerve conduction, muscle contractions, membrane potential regulations, and mitochondrial activity and enzyme reactions. The status of micronutrients such as iron and vanadium is higher in type 2 diabetes. The calcium, magnesium, sodium, chromium, cobalt, iodine, iron, selenium, manganese, and zinc seem to be low in type 2 diabetes while elements such as potassium and copper have no effect. In this review, we emphasized the status of macro and trace elements in type 2 diabetes and its advantages or disadvantages; this helps to understand the mechanism, progression, and prevention of type 2 diabetes due to the lack and deficiency of different macro and trace elements.

BackgroundThe dietary supply of methyl donors such as folate, vitamin B12, betaine, methionine, and choline is essential for normal growth, development, and physiological functions through the life course. Both human and animal studies have shown that vitamin B12 deficiency is associated with altered lipid profile and play an important role in the prediction of metabolic risk, however, as of yet, no direct mechanism has been investigated to confirm this.ResultsThree independent clinical studies of women (i) non-pregnant at child-bearing age, (ii) in early pregnancy, and (iii) at delivery showed that low vitamin B12 status was associated with higher total cholesterol, LDL cholesterol, and cholesterol-to-HDL ratio. These results guided the investigation into the cellular mechanisms of induced cholesterol biosynthesis due to vitamin B12 deficiency, using human adipocytes as a model system. Adipocytes cultured in low or no vitamin B12 conditions had increased cholesterol and homocysteine levels compared to control. The induction of cholesterol biosynthesis was associated with reduced s-adenosylmethionine (AdoMet)-to-s-adenosylhomocysteine (AdoHcy) ratio, also known as methylation potential (MP). We therefore studied whether reduced MP could lead to hypomethylation of genes involved in the regulation of cholesterol biosynthesis. Genome-wide and targeted DNA methylation analysis identified that the promoter regions of SREBF1 and LDLR, two key regulators of cholesterol biosynthesis, were hypomethylated under vitamin B12-deficient conditions, and as a result, their expressions and cholesterol biosynthesis were also significantly increased. This finding was further confirmed by the addition of the methylation inhibitor, 5-aza-2′-deoxycytidine, which resulted in increased SREBF1 and LDLR expressions and cholesterol accumulation in vitamin B12-sufficient conditions. Finally, we observed that the expression of SREBF1, LDLR, and cholesterol biosynthesis genes were increased in adipose tissue of vitamin B12 deficient mothers compared to control group.ConclusionsClinical data suggests that vitamin B12 deficiency is an important metabolic risk factor. Regulation of AdoMet-to-AdoHcy levels by vitamin B12 could be an important mechanism by which it can influence cholesterol biosynthesis pathway in human adipocytes.Electronic supplementary materialThe online version of this article (doi:10.1186/s13148-015-0046-8) contains supplementary material, which is available to authorized users.

BackgroundThe evaluation of metabolic syndrome in a society predisposed to the diabetes mellitus epidemic opens a new avenue to understanding this rapidly growing global metabolic problem. Although Saudi Arabia reports one of the highest prevalence levels of obesity and diabetes, a very limited number of epidemiological studies have examined the prevalence of metabolic syndrome. Therefore, the main aim of the current study was to estimate the prevalence of metabolic syndrome and its risk factors among the adult Saudi population in comparison to other countries.MethodsA total of 12,126 Saudi subjects were randomly recruited from the 13 administrative regions, and evaluated for metabolic syndrome and its risk factors. This exercise was carried out by trained physicians, through clinical evaluations and overnight fasting blood glucose and lipid profile measurements. Both the International Diabetes Federation (IDF) and modified National Cholesterol Education Program and Adult Treatment Panel III (NCEP ATP III) Criteria were employed, and subjects with metabolic syndrome were identified using country-specific waist circumference cutoff values.ResultsThe prevalence of metabolic syndrome in Saudi Arabia was found to be 39.8% (34.4% in men and 29.2% in women) and 31.6% (45.0% in men and 35.4% in women), according to the NCEP ATP III and IDF criteria, respectively. Metabolic syndrome was also observed to be more prevalent among men and older subjects. The most frequently observed component of metabolic syndrome was found to be low levels of high-density lipoprotein (HDL), followed by abdominal obesity. The most significant risk factors in the studied cohort included age ≥ 45, smoking history, low educational level, and living in urban areas.ConclusionsThis study shows a high prevalence of metabolic syndrome in Saudi Arabia, and thereby warrants urgent implementation of preventive health care strategies to reduce both morbidity and mortality related to this medical problem.

The link between sleep duration and obesity has been well established in adults, but several epidemiological studies revealed inconsistent findings in adolescents and younger children. This study aimed to investigate the relationship between sleep length and obesity in Saudi students. A total of 5,877 Saudi students, boys (55.2%) and girls (44.8%), aged between 10 and 19 years were randomly selected from elementary, intermediate, and secondary schools in different regions of Riyadh. A questionnaire on sleep behaviors was given. Anthropometry included BMI and waist and hip circumferences. Sleeping ≤7 h significantly increased the risk of obesity in both boys and girls (all age categories) (odds ratio = 1.25–1.38, 95% confidence intervals = 1.02–1.89). Overall prevalence of overweight and obese were higher among those sleeping intermittently (18.68%) than those sleeping continuously (14.5%) (P = 0.024). Short sleep duration and poor sleep quality are significantly associated with obesity among Arab youth. Further studies need to employ more objective measures of sleep, such as actigraphy, and examine the mechanism of these associations.

BACKGROUNDThe prevalence of metabolic syndrome varies widely by ethnicity and by the criteria used in its definition.OBJECTIVETo identify the optimal cutoff values for waist circumference (WC), waist-to-hip ratio (WHR) and body mass index (BMI) for identifying metabolic syndrome among the Saudi population.DESIGNNationwide household cross-sectional population-based survey.SETTINGThirteen health sectors in Saudi Arabia.SUBJECTS AND METHODSWe used data for subjects in the Saudi Abnormal Glucose Metabolism and Diabetes Impact Study (SAUDI-DM), which was conducted from 2007 to 2009. Using International Diabetes Federation (IDF) criteria, metabolic syndrome and its different components were assessed using anthropometric measurements, blood pressure, fasting plasma glucose, triglycerides and HDL cholesterol. Receiver operating characteristic (ROC) curves were generated to assess sensitivity and specificity for different cutoff values of WC, WHR, and BMI. The Youden index was used to calculate the optimal cutoff value for each anthropometric measurement.MAIN OUTCOME MEASURE(S)Optimal cutoff value for WC, WHR, and BMI for identifying the risk of metabolic syndrome.RESULTSThe prevalence of two or more risk factors for metabolic syndrome was observed in 43.42% of the total cohort of 12 126 study participants ≥18 years of age. The presence of two or more risk factors were significantly higher among men (46.81%) than women (40.53%) (P<.001). The optimal cutoff values for WC, WHR, and BMI were 92 cm, 0.89, and 25 kg/m2 for men and 87 cm, 0.81 and 28 kg/m2 for women for identifying the risk of metabolic syndrome. The prevalence of elevated triglycerides, blood pressure, and fasting plasma glucose significantly increased with age for both genders.CONCLUSIONSThe proposed WC cutoff values were better than WHR and BMI in predicting metabolic syndrome and could be used for screening people at high risk for metabolic syndrome in the Saudi population.LIMITATIONSNo direct measure of body fatness and fat distribution, cross-sectional design.

Our data highlight that acute hyperglycaemia impacts on endothelial function simultaneously at both macrovascular and at microvascular levels, inducing functional change, which could contribute towards explaining the clinical evidence of a strong association between postprandial hyperglycaemia, cardiovascular disease and retinopathy.

IntroductionCarbohydrate counting (CC) is an important nutritional strategy to improve glycaemic outcomes among patients with diabetes. Few studies have investigated CC knowledge among individuals with type 1 diabetes mellitus (T1DM) in Saudi Arabia. Therefore, we aimed to evaluate CC knowledge in Saudi adults with T1DM.Study design and methodsA cross-sectional study was conducted between December 2021 and February 2022, including 224 patients with T1DM from the University Diabetes Center, Riyadh. Adults aged ≥18 years, diagnosed with T1DM for >1 year, and residing in Saudi Arabia were included. CC knowledge was assessed using a previously well-studied tool (AdultCarbQuiz), which was translated into Arabic and tested for validity by a group of dieticians. Descriptive statistics were used for data analysis, and bivariate and regression analyses were conducted.ResultsThe AdultCarbQuiz questionnaire-Arabic version had good validity and reliability (Cronbach’s α: 0.87). The CC method was used by 54% of the participants. The mean CC knowledge score was 23.01±7.31. A significant negative linear relationship between the participants’ CC knowledge scores, and age and glycated haemoglobin (HbA1c) levels, was revealed by simple regression analysis. Furthermore, significant independent variables related to CC knowledge scores were CC use, HbA1c levels, being taught about CC (>5 times), insulin pump usage and DM duration (≤15 years).ConclusionsApproximately half of the patients used the CC method. The mean CC knowledge scores were better in patients who used the CC method, were more frequently taught about CC, were treated using an insulin pump, and had a shorter DM duration than their counterparts. Therefore, designing and implementing a well-structured nutrition education programme tailored to individuals with diabetes is crucial to provide them with up-to-date dietary information, as well as the necessary knowledge and skills, to improve their outcomes and manage their condition.

Introduction: Many changes occur in Muslims’ lives during Ramadan that affect body weight, diet and calorie intake. This study investigated the impacts of fasting during Ramadan on the daily habits, diet, and weight of people with diabetes in Saudi Arabia. Methods: A cohort study analyzed 104 Saudi individuals with diabetes (42 and 62 patients with type I and type II diabetes, respectively) aged ≥ 20 years who fasted a minimum of 15 days during Ramadan. The patients were seen twice per study period (before and during Ramadan). The patients’ demographic data was obtained, their average daily food intake was assessed, and anthropometric parameters were measured. Results: During Ramadan, 52% of patients with type I DM and 66% of patients with type II DM did not perform any physical activity compared to 37% and 42%, respectively, pre-Ramadan. A high percentage of patients slept during the daytime. A paired-sample T test analysis showed that during Ramadan, the calorie intake and carbohydrate intake increased significantly in patients with type II diabetes (p = 0.03). Protein intake remained unchanged, whereas fat consumption increased in patients with both types of diabetes (p = 0.03 and 0.04, respectively). In addition, there was a decrease in anthropometric parameters (statistically significant in patients with type II diabetes, p < 0.05). Conclusion: Ramadan fasting changed the dietary and daily habits of patients with diabetes in Saudi Arabia and had beneficial effects on weight, mainly in patients with type II DM.