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The purpose of this review was to highlight the association between ID and obesity in toddlers and preschool children.

This review aimed to review and evaluate literature of the published research discussing the relationship between ID and overweight and obesity in children under the age of 5 years. Conflicting results of iron status in overweight and obese children under the age of 5 years had been found. However, most articles concluded that ID is associated significantly with overweight and obesity in children because of the systemic inflammatory reaction which is considered the major cause of ID; hepcidin with its resultant effect in decreasing duodenal absorption of iron; in addition to other causes including dietary and genetic factors.

Conflicting results of iron status in overweight and obese children under the age of 5 years had been found, but most articles concluded that ID is associated significantly with overweight and obesity in children, with systemic inflammatory reaction being the major cause through hepcidin with its resultant effect in decreased duodenal absorption of iron, in addition to other causes including dietary and genetic factors.

Many nutrients have been associated with weight gain and ID development. Unbalanced diet either in excess or shortage may affect weight status and serum iron profile. Future research is needed to study more in depth the association between ID and obesity in toddlers and preschool children and to further explore the various factors involved in pathogenesis of ID.

This study aims to assess the students’ stage of change (SOC) for fruits and vegetables (FV) consumption using the 5-a-day and 9-a-day patterns; to validate a tool to measure SOC for consuming 5-a-day and 9-a-day of FV; and to investigate the relationship between SOC for FV consumption and body weight among Jordanian college students.

A cross-sectional study was conducted and included a convenient sample of 788 college students (47.7 per cent men and 52.2 per cent women) who completed validated questionnaires which included socio-demographic data, readiness to consume 5-a-day and 9-a-day servings of FV daily and FV consumption behaviors. Students’ heights and weights were measured. SOC for participants was examined using reparation, contemplation, pre-contemplation, action and maintenance stages.

A majority (69.9 per cent) of college students were in the pre-contemplation stage with regard to 9-a-day behavior. Females tended to be classified in the action stage more than males (P < 0.001). After controlling for age, gender and energy consumption, a significant (P < 0.05) inverse relationship was found between maintenance or action SOC for consuming 9-a-day behavior and body mass index (BMI). A large proportion of college students were in a pre-action stage for either consuming 5-a-day or 9-a-day of FV. Those students who followed the 9-a-day recommendations had significantly (P < 0.05) lower BMI values that those students in the pre-action stages.

The current study is genuine and original, and valuable in designing new strategies in lowering obesity and its comorbidities.

The purpose of this study was to examine the relationship between micronutrient intake and coronary heart disease (CHD) in middle-aged Jordanian participants.

A case-control study was conducted among patients referring for elective coronary angiography. A total of 400 patients were enrolled in this study. Face-to-face interview was used to complete food frequency questionnaire from which the authors derived usual daily intake of micronutrients. The mean age of participates was 52 years and their average BMI was 30.7 kg/m². Multinomial logistic regression model and linear logistic regression model were used to calculate odd ratios (OR) and its 95 per cent confidence interval (CI) and p-value for trend, respectively. The association between the risk of CHD and micronutrients intake was adjusted for the age, gender, BMI, smoking, physical activity, total energy intake, occupation, education level, marital status and family history.

The study results showed no significant differences between cases and controls for dietary intakes of micronutrients, except for the intake of calcium (p < 0.005), magnesium (p < 0.025), phosphorus (p < 0.023) and potassium (p < 0.006) which were lower in cases than controls. Although no significant trend was observed between most of the dietary intake of micronutrients and the risk of developing CHD, a significant protective effect of magnesium [OR 0.52; 95 per cent CI (0.29-0.95)], phosphorus [OR 0.44; 95 per cent CI (0.24-0.80)] and potassium [OR 0.41; 95 per cent CI (0.22-0.74)] against the risk of CHD was detected.

The findings from this study provide strong evidence that the intake of micronutrients such as calcium, magnesium, phosphorus and potassium has no significant associations with the risk of CHD.

Vegetarian diets exclude meat, fish and poultry and/or egg and dairy products, these diets are based on grains, fruits, vegetables, legumes and seeds. The purpose of this study is to compare the nutritional status between lacto-ovo vegetarian and non-vegetarian Jordanian adults.

A case-control study was conducted during the period between (April–November 2019). In total, 200 Jordanians in early adulthood aged between 18 and 35 years participated in the present study; 100 subjects were non-vegetarians and 100 subjects were lacto-ovo vegetarians. The ratio was (1:1). Matching between the two groups was done in terms of age, sex and body mass index. A package that consisted of three structured questionnaires: Personal Information Sheet, Food Frequency Questionnaire and Seven-Day Physical Activity Recall were administered to all participants in this study.

The concentration of serum vitamin B12 was significantly higher (P = 0.011) in non-vegetarians than lacto-ovo vegetarians. The means of intake of calories (P = 0.003), calories from fat (P = 0.001), calories from saturated fat (P = 0.001), protein (P = 0.001), fat (P = 0.001), saturated fat (P = 0.001), monounsaturated fat (P = 0.022), polyunsaturated fat (P = 0.001), cholesterol (P = 0.001) and omega-6 (P = 0.039) were significantly higher in non-vegetarians. The intakes Mean of carbohydrates (P = 0.001), fiber (P = 0.001) and soluble fiber (P = 0.001) were significantly higher in lacto-ovo vegetarians compared to non-vegetarians. The mean of beta-carotene intake was significantly higher (P = 0.001) in lacto-ovo vegetarians compared to non-vegetarians, although the intakes of vitamin A(RAE) and retinol were significantly higher (P = 0.029, P = 0.001, respectively) in non-vegetarians as compared to lacto-ovo vegetarians. The means of vitamins B2 (P = 0.018), B3 (P = 0.001), B3NE (P = 0.001), B6 (mg) (P = 0.001), B12 (P = 0.001), E-a-Tocopherol (P = 0.001) and D (P = 0.001) intake were significantly higher in non-vegetarians compared to lacto-ovo vegetarians. The mean intakes of vitamins C (P = 0.033), folate (P = 0.005) and K (P = 0.002) were significantly in lacto-ovo vegetarians compared to non-vegetarians. Means intake of some minerals was significantly higher in non-vegetarians than lacto-ovo vegetarians.

The current study showed that lacto-ovo vegetarians had lower serum vitamin B12 levels. The consumption of fruits, vegetables and legumes was higher in lacto-ovo vegetarians than non-vegetarians. While lacto-ovo vegetarian diet provided less fat, saturated fat, polyunsaturated fat, monounsaturated fat and cholesterol than non-vegetarians, it could be considered a rich source for fiber, folate, beta-carotene, vitamin C and vitamin K.

The purposes of this study were to determine the food intake purchased from the canteens or markets nearby schools; to estimate the percent intakes of energy and nutrients from canteens and markets nearby the schools as a percent of total energy and nutrient intakes; and to evaluate the association between dietary intake of energy and nutrients eaten from school canteens and markets nearby the school and body weight status.

A sample of 398 students, aged 14–18 years, was recruited from schools in Amman/Jordan. Students’ body weights and heights were measured and socio-demographic data and three days food record were collected.

The intakes of boy students from school canteens were significantly higher than those of girls in carbohydrate (g) (125 ± 6 vs 106 ± 6; p = 0.015), energy from saturated fatty acid (Kcal) (97 ± 4 vs 84 ± 5; p = 0.006), sugar (g) (43 ± 3 vs 35 ± 2; p = 0.009) and fiber (g) (6 ± 0 vs 6 ± 0; p = 0.02). Regarding food groups consumed from markets nearby schools, there were significant differences between boys and girls intake (in which the higher intake was detected in girls as compared to boys) of sweets (g) (4 ± 1 vs 3 ± 2; p = 0.017), soft drinks (ml) (28 ± 5 vs 20 ± 5; p = 0.024) and milk (ml)/milk substitutes (g) (5 ± 2 vs 0 ± 0; p = 0.001). Sugar-sweetened beverages and crackers/snacks consumption was significantly higher in boys as compared to girls. There was a significant relationship between BMI and intakes of sugar, fat, vitamin E and calcium from school canteens.

The contribution of foods from canteens and markets nearby schools was high, with high content of fats, salt and sugar, implying that there is a vital need to establish a strategy and plan of action to fight malnutrition and reduce the intake of unhealthy foods in the school environment in Jordan.

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. GDM is defined as glucose intolerance of variable severity with onset or first recognition during pregnancy. The purpose of this paper is to produce information on prevalence, screening and diagnosis, pathophysiology and dietary, medical and lifestyle management of GDM.

This literature review aimed to document and record the results of the most updated studies published dealing with dietary, medical and lifestyle factors in managing GDM.

The prevalence of GDM differs worldwide based on population characteristics, race/ethnicity and diagnostic criteria. The pathophysiology of GDM is multifactorial and it is likely that genetic and environmental factors are associated with the occurrence of GDM. Medical nutritional therapy remains the mainstay of GDM management and aerobic and resistance physical activities are helpful adjunctive therapy when euglycemia is not attained by the medical nutritional therapy alone. When diet and exercise fail to achieve glycemic control, pharmacological agents such as insulin therapy and oral hypoglycemic medications are prescribed. Plasma glucose measurement is an essential part of glycemic control during pregnancy, as well as glycemic control can be evaluated using indicators of glycemic control such as hemoglobin A1c (HbA1c), glycated albumin and fructosamine.

This review is a comprehensive review that illustrates the effect of healthy diet, medical therapy and lifestyle change on improving GDM condition.

This paper aims to evaluate macro- and micronutrient intake among Jordanian adults who have metabolic syndrome (MetS) and those MetS-free.

A total of 154 Jordanian adults aged 20-55 years were enrolled from The National Center for Diabetes, Endocrinology and Genetics in this case control study. In total, 77 newly diagnosed cases of MetS and 77 controls were recruited and matched by age and sex. Dietary data were collected by face-to-face interview using a validated food frequency questionnaire.

After adjustment of the energy intake and macronutrients, the cases reported significantly higher intake of the amount of protein (p < 0.001), carbohydrates (p < 0.001), fiber (p < 0.001), sugar (p < 0.001), fat (p < 0.001), saturated fat (p < 0.001), monounsaturated (p < 0.001), polyunsaturated (p < 0.001), trans-fat (p < 0.029), omega-3 (p < 0.001) and omega-6 (p < 0.001) as compared to the controls. The results also showed that the intake of some micronutrients was significantly higher among cases when compared to the controls. In this study, three dietary patterns have been itemized; “fast food dietary pattern”, “Mediterranean dietary pattern” and “high-protein dietary pattern”. Only a direct significant trend between MetS and fast food pattern was detected (p-trend = 0.001). Neither significant associations nor trends were detected in the Mediterranean and high-protein patterns with MetS risk.

The study findings highlighted the presence of associations between fast food dietary pattern, total energy and some macro- and micronutrients intake and the risk of MetS among population living in the Middle East. Even though the findings of this study bridge the gap between theory and practice, a large scale population-based study is warranted to confirm these findings.

The purpose of this study is to evaluate the associations between adolescents’ perceptions of their parents’ and peers’ opinions about body weight and their actual weight status.

A total of 795 Jordanian adolescents, 15-18 years of age, were recruited in this study. Adolescents completed a questionnaire to evaluate their perceptions: about how their parents’ and peers’ viewed their weight, regarding any criticism of their parents and peers about their weight and if their parents compared their weight against their siblings.

The study found that the majority of non-overweight adolescents thought their parents and peers considered them to have a normal weight (94.9 and 94.6 per cent for boys, 76.6 and 85.5 per cent for girls, respectively). For obese girls, 83.4 per cent thought their parents and 91.7 per cent thought their peers perceived them as overweight. The risk of being obese was significantly related to the amount of parental criticism perceived by adolescent girls with OR = 3.9 (95 per cent CI: 1.6-9.4; P = 0.01), while perception of peer criticism showed an increased trend of risk for obesity in boys. Adolescents’ perceptions regarding parental comparisons between their body weights against their siblings’ body weight was found to increase the risk for obesity significantly among girls.

The current study highlights that most of the obese adolescents perceived that their parents and peers underestimated their actual weight status. While obese boys were more likely to report being criticized about their body shape by their peers, obese girls indicated that they received more criticism about their weight from their parents.

The study was conducted to investigate the impact of competitive entrance exams on some lifestyle factors that may lead to body weight gain. The paper aims to discuss these issues.

A cross-sectional study was conducted on high school students (n=660), aged 16-20 years, to assess changes in body weight and fat percentage, dietary habits and physical activity practicing before and after the examination.

During the examination period, both males and females experienced weight gain, but the mean change of body weight for males was higher compared to the mean change of body weight observed in females (3.6 vs 0.6 kg). Body fat percentage increased in males and females in approximately 2 and 0.3 percent, respectively. In addition, males were found to skip breakfast (p=0.003) during the examination period as compared to females (p=1.00). Both males and females reported an increased consumption of milk (p=0.007 and 0.001), junk food (p=0.0001 and 0.001), caffeinated beverages (p<0.001) and carbonated drinks (p=0.001). A significant proportion from each gender reported that they quit recreational physical activity during the examination period (p=0.0001).

Several studies were conducted to investigate the impact of academic exams on stress among this vulnerable group; however, the relationship of body weight and obesity is still lacking in this population. Therefore, this study aims to investigate impact of competitive entrance exams on some lifestyle behaviours that may lead to body weight gain.

This paper aims to assess the prevalence of vitamin D deficiency among female university students and employees at the Hashemite University (HU) and, then, to identify risk factors for developing vitamin D deficiency among this population. Vitamin D deficiency remains widespread in many countries, including Jordan, and has been linked to many diseases.

In this cross-sectional study, blood samples were taken from 320 healthy females – 160 students and 160 employees – aged between 18 and 65 years old who presented for routine checkup at the medical center of HU. Level of direct sun exposure and barriers to getting enough sunlight (dress style, skin color and sunscreen use) were questioned. Serum levels of 25-hydroxyvitamin D were measured, and the daily intakes of vitamin D, calcium and phosphorous were estimated through completing an adopted food frequency questionnaire. All required data were collected using a face-to-face interview by trained dietitians. The software package ESHA was used to determine the daily intake from the nutrients.

The prevalence of vitamin D deficiency (25-OHD < 25 nmol/L) was 31.2 per cent in female students compared to 20.5 per cent in female employees. Prolonged exposure to sun was independently related to vitamin D deficiency (odds ratio = 4.55); participants exposed for 30 minutes daily were at a higher risk for vitamin D deficiency. However, estimated vitamin D intake was not affected by age and working status.

The present study has some important limitations. First, this study based on serum 25-OHD results, which alone, without biochemical parameters such as parathyroid hormone (either primary or secondary), might be linked to accelerated degradation of 25-OHD and shorter half-life. Second, the half-life of 25-OHD was not consistently available. Third, the smaller sample size of participants. Finally, the present study did not distinguish between intake of vitamin D2 and D3. This limitation caused the inability to precisely evaluate the prevalence of vitamin D deficiency in the studied population.

This study indicates that it is crucial to create awareness concerning the daily intake of vitamin D in the community to avoid long-term complications related to vitamin D deficiency, by using urgent measures including vitamin D supplementation and fortification of some highly consumed food, milk and other dairy products. Educational endeavors about sensible sun exposure should be implemented to improve vitamin D status among this population. The findings of the present study call for action at the national level to build strategies for health promotion about vitamin D supplementation in groups at risk for low supplementation (e.g. younger female students, with previous chronic diseases and poor sun exposure), and engage these populations in strategizing for successful and demographically relevant outreach and education in their own communities along with effort to prevent obesity and diabetes as well as raising awareness through simple programs to prevent and treat vitamin D deficiency among women living in Jordan.

The high prevalence of vitamin D deficiency among female university students in this study emphasizes the necessity of vitamin D supplementation and calls for action to build strategies for health promotion concerning vitamin D supplementation.