Search

Objective:This study aims to investigate the association between iron body status and postpartum depression (PPD) among mothers during the postpartum period.Design:This is a case–control study.Setting:Governmental primary health care centres in the Gaza Strip, Palestine.Participants:This study involved 300 mothers a month after delivery, with one 150 mothers that were recruited in the cases group who were diagnosed with PPD based on Edinburgh Postnatal Depression Scale (EPDS) ≥ 10. The control group included 150 mothers did not have PPD (EPDS < 10). Body iron status is represented by the index of sTfR/log ferritin.Results:Among PPD mothers, 43·3 % had low ferritin level v. 15·3 % for controls (P < 0·001) and cases v. controls difference in mean Hb level was −0·61 (95 % CI −0·86, −0·35). The results of the multiple logistic regression reported that there is a statistically significant association between PPD and the body iron status existed, as mothers who suffered from iron deficiency (ID) were three times more likely to have PPD (ORadj 3·25; P = 0·015). Furthermore, the results of the final regression model showed that the other factors that can lead to PPD are absence of psychological guidance services (ORadj 8·54; P = 0·001), suffering from undesired feeling in the last pregnancy (ORadj 1·77; P = 0·034), in addition to having one of the mental health disorders in the last pregnancy (P = 0·001).Conclusion:Body iron status might be a risk factor for postpartum depression and other possibilities of reverse causality may worsen the condition.

The main objective of this study is to explore the nutritional knowledge, attitude and practice (KAP) of nurses and physicians who are working at major Palestinian hospitals in Gaza Strip. This is a cross-sectional study where 96 nurses and 48 physicians were recruited. The study used a self-administered questionnaire that includes socio-demographic characteristics, knowledge of nutritional science, attitudes towards the use of nutrition care in clinical sittings, and nutrition practicing and counseling. The average age of all the respondents was 32 years, ranging from 22 - 54 years. About 14.6% of all participants attended more than 4 weeks of training in nutrition; however, the majority of this training is intended to deal with healthy subjects. The mean score of physicians’ nutrition knowledge was 10.91, which was significantly higher than the nurses ‘nutrition knowledge score of 7.44. No statistical differences observed between nurses and physicians regarding attitude scale and practice. Overall, the obtained percentages of attitude among nurses were 54.2% positive, 22.9% neutral, and 22.9% negative. The obtained percentages of attitudes among physicians were 47.9% positive, 16.7% neutral, and 35.4% negative. Finally, the percentages of good nutrition practices via assessment and counseling were 53.1% for nurses and 52.1% for physicians. It was concluded that nurses and physicians were unable to provide effective nutrition intervention in health care settings and needed to improve their nutritional knowledge, attitudes and practices.

To determine the risk factors associated with inflammation in hypertensive patients with type-2 diabetes mellitus.A total of 164 hypertensive patients with type 2 diabetes patients aged 38-60 years were selected from 7 primary healthcare centers in Gaza city, Palestine. Interview questionnaire were employed to collect data related to age, gender, smoking habits, and physical activity pattern. Laboratory biochemical tests included fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), interleukin 6 (IL-6), high sensitive C reactive protein (hs-CRP), and adiponectin were estimated in all patients.The study involved 118 (72%) women and 46 (28%) men; the mean of age was 53.7 ± 0.46 years. A tertile of inflammation feature with hs-CRP was developed. The highest tertile of hs-CRP was significantly associated with women, higher obesity indices, metabolic dysregulation involving lipid profile markers, FBG and blood pressure, IL-6, and lower adiponectin. After adjusting for age, gender, smoking habits, and physical activity; the risk factor of high level of hs-CRP were the increased body mass index [OR: 1.17,The inflammation state was affected by obesity and had been related to altered adipokines levels of IL-6 and adiponectin, as well as affected by the glycemic control, as evidenced by higher serum level of FBG.

Chronic respiratory disease (CRD) is an airflow limitation that represents a wide array of serious diseases. The aim of this study is to examine the influence of vitamin C deficiency on metabolic health-related quality in individuals with and without chronic respiratory disease in the Gaza Strip.A matched case-control study including 52 cases of CRD and 52 controls of healthy participants were matched by age, sex, body mass index (BMI) and waist circumferences (WC). The study was conducted at the Ministry of Health secondary health-care centers in Gaza strip, Palestine. The biochemical data included Protein Carbonyl (PC), high sensitivity C reactive protein (CRP), vitamin C, fasting blood glucose (FBG) and markers of the lipid profile.By the qualitative estimation of vitamin C consumption, there was a significantly lower consumption of foods that are rich in vitamin C by CRD patients than the matched controls. By comparing the results between both groups, CRD patients had significantly lower plasma concentrations of vitamins C than the control group (18.43 ± 11.93 μgm/ml vs. 24.06 ± 11.19 μgm/ml, P = 0.025), but significantly higher in PC (3.86 ± 4.21 μgm/ml vs. 2.11 ± 0.97 μgm/ml, P = 0.005), CRP (5.98 ± 8.84 mg/l vs. 1.87 ± 1.96 mg/l, P = 0.001), and FBG (102.46 ± 15.09 mg/dl vs. 95.92 ± 10.88 mg/dl, P = 0.017). The results revealed that CRD patients had significantly lower blood oxygen saturation than the control group (96.36 ± 3.81 vs. 98.51 ± 0.75, P 0.001), whereas no significant differences were observed regarding the lipid profiles markers.CRD patients have lower levels of vitamin C in their plasma and their diet than do healthy matched people; they also have higher oxidative stress and inflammatory markers than healthy people, which are risk factors for predicting metabolic complications.

The purpose of this study is to investigate the effect of inflammatory status on metabolic abnormalities in hypertensive patients. A cross-sectional study involved 106 hypertensive patients. Interview questionnaire was used to collect personal information and lifestyle habits. Participants who suffered from acute or chronic inflammatory diseases or continue using medicines were excluded as it might affect the biomedical results. Patients were categorized into two groups based on the inflammatory status: desirable inflammatory status (DIS) (CRP ˂ 3 mg/L) and undesirable inflammatory status (UIS) (CRP ≥ 3 mg/L). All patients had a stable weight with no fluctuations > 2% of their body weight for at least 2 months prior to the study. UIS condition is associated with women and older patients. The prevalence of UIS decreased significantly as the intensity of physical activity increased, while no effect was detected due to differencing smoking habits. For anthropometric measurements, UIS patients were higher in body mass index (33.4 ± 7.06 vs. 24.8 ± 10.7 kg/m2, P ˂ 0.001) and overall waist circumference (112.0 ± 12 vs. 105.0 ± 19 cm, P = 0.006). The gender-adjusted difference of the waist circumference revealed that UIS patients were higher among men (105.0 ± 19 vs. 114.55 ± 14 cm, P = 0.004), while there no significant difference observed among women patients. The differences of metabolic markers explained that UIS patients were higher in fasting blood glucose, total cholesterol, and triglyceride (106.0 ± 34 vs. 95.5 ± 26 mg/dL, P = 0.025; 191.0 ± 57 vs. 173.0 ± 49 mg/dL, P = 0.017; 151.5 ± 110 vs. 123.0 ± 58 mg/dL, P = 0.002; respectively). In addition, UIS patients were higher on interleukin 6 and lower on adiponectin (2.32 ± 0.80 vs. 1.40 ± 0.75 pg/mL, P ˂ 0.001; 11.15 ± 4.5 vs. 13.5 ± 5.3 mg/L, P = 0.01; respectively), while the differences in systolic and diastolic blood pressure did not reach the level of significance. Hypertensive patients of UIS have significant risks to develop metabolic abnormalities and progress to metabolic syndrome. Managed inflammation and lifestyle habits could reduce the risk of developing metabolic abnormalities in hypertensive patients.

Metabolically unhealthy obesity (MUO) was associated with increased cardiometabolic risk. However, it is not fully understood which lifestyle factors are associated with MUO in youth. We aimed to investigate the relationship between MUO and lifestyle patterns in youth. 7-17 years old youth with overweight (N=48; 60.4% girls) and obesity (N=71; 56.3% girls) were recruited in the Pediatric Clinic, Luxembourg (cross-sectional study). Eating and sedentary habits, moderate to vigorous physical activity (MVPA) and vigorous physical activity (VPA) were assessed. 72.3% of the participants had MUO. Multivariable logistic regressions showed that MUO is most likely to be associated with moderate to low weekly levels of MVPA [OR: 2.09 (95% CI: 1.07 – 4.09; p = 0.030)] and moderate to high weekly soda and lemonade drinks consumption [OR: 2.92 (95% CI: 1.32 – 6.48; p = 0.008)]. After adjustment for age, gender and Tanner stages, MUO was most likely to be associated with moderate to high soda and lemonade drinks consumption [OR: 2.72 (95% CI: 1.21– 6.12; p = 0.016)] and with Tanner stages [OR: 2.06 (95% CI: 1.08– 3.94; p = 0.029)]. We support the promotion of MVPA and the moderation in the sugar-sweetened beverages consumption to manage cardiometabolic health in youth with obesity.

Many chronic conditions such as cancer, chronic obstructive pulmonary disease, type-2 diabetes, obesity, peripheral/coronary artery disease and auto-immune diseases are associated with low-grade inflammation. Closely related to inflammation is oxidative stress (OS), which can be either causal or secondary to inflammation. While a low level of OS is physiological, chronically increased OS is deleterious. Therefore, valid biomarkers of these signalling pathways may enable detection and following progression of OS/inflammation as well as to evaluate treatment efficacy. Such biomarkers should be stable and obtainable through non-invasive methods and their determination should be affordable and easy. The most frequently used inflammatory markers include acute-phase proteins, essentially CRP, serum amyloid A, fibrinogen and procalcitonin, and cytokines, predominantly TNFα, interleukins 1β, 6, 8, 10 and 12 and their receptors and IFNγ. Some cytokines appear to be disease-specific. Conversely, OS—being ubiquitous—and its biomarkers appear less disease or tissue-specific. These include lipid peroxidation products, e.g., F2-isoprostanes and malondialdehyde, DNA breakdown products (e.g., 8-OH-dG), protein adducts (e.g., carbonylated proteins), or antioxidant status. More novel markers include also –omics related ones, as well as non-invasive, questionnaire-based measures, such as the dietary inflammatory-index (DII), but their link to biological responses may be variable. Nevertheless, many of these markers have been clearly related to a number of diseases. However, their use in clinical practice is often limited, due to lacking analytical or clinical validation, or technical challenges. In this review, we strive to highlight frequently employed and useful markers of inflammation-related OS, including novel promising markers.

Six honey samples produced by the stingless bee Heterotrigona itama were analyzed for their plant sources, phenolic compositions, and antioxidant activities. The honey samples were acetolyzed and identified microscopically, and the phenolic compounds were identified by using HPLC-DAD. The antioxidant activities were evaluated using three different assays (FRAP, DPPH, and ABTS) by spectrophotometry. The melissopalynological analysis showed that 26 pollen types from 14 plant families were identified in the honey. Cocos nucifera and Rhizophora mucronata presented as predominant pollen. A total of 6 phenolic acids such as catechin, chlorogenic acid, epicatechin, protocatechuic acid, p-coumaric acid, and rutin were identified. Rhizophora mucronata honey possessed the highest antioxidant activity in all assays. The result showed the influence of plant sources on the phenolic compounds and the antioxidant properties of stingless bee honey. These findings could be significant contributions for the sustainability of stingless bee industry as well as to promote Malaysian stingless bee honey worldwide.

We appreciate the commentary by Mrakic-Sposta et al [...]

Obesity means the accumulation of excessive fat that may interfere with the maintenance of optimal state of health. Obesity causes cardiac and vascular disease through well-known mediators such as hypertension, type-2 diabetes mellitus, and dyslipidemia, but there are evidences for other mediators such as chronic inflammation, oxidative stress, and thrombosis. The decreased levels of antioxidants factors and nitric oxide predispose to further cardiovascular adverse events. To reduce the risks, antioxidants can help by neutralizing the free radicals and protecting from damage by donating electrons. Having the capacity, vitamin C protects from oxidative stress, prevention of non-enzymatic glycosylation of proteins, and enhances arterial dilation through its effect on nitric oxide release. It also decreases lipid peroxidation, and alleviates inflammation. The anti-inflammatory property of vitamin C could be attributed to ability to modulate the NF-kB DNA binding activity and down-regulation in the hepatic mRNA expression for the interleukins and tumor factors.

To identify risk factors of elevated blood pressure due to differences in socio-demographic factors, obesity, and health status. Cross-sectional study. A total of 482 participants were chosen from Primary Healthcare Centers in Gaza City, Palestine, based on objective criteria. Systolic and diastolic blood pressure (SBP and DBP) showed significant differences according to different educational, menopausal, obesity, and health statuses, but no significant differences due to sex, marital status, and family size. Correlations of SBP with age, waist circumference, and weight were significant at P = 0.001 (r s = 0.444, r s = 0.434, and r s = 0.323, respectively). Correlations of DBP with age, waist circumference, and weight were also significant at P = 0.001 (r s = 0.170, r s = 0.374, and r s = 0.362, respectively). A total of 169 subjects out of 482 have SBP ≥130 mmHg and DBP ≥85 mmHg. By the multivariate logistic regression model, the odds ratio (OR) for obesity equaled 2.768 (95% CI: 1.183 to 6.475, P = 0.019), OR for having a mother with one or more chronic diseases equaled 1.886 (95% CI: 1.185 to 3.003, P = 0.007), and OR for a medium-sized family (6–10 members) equaled 0.611 (95% CI: 0.376 to 0.994, P = 0.013). Blood pressure increased by elevated body mass index and waist circumference; participants who have a mother with hypertension and/or diabetes are most likely to have higher blood pressure.

Background To find out the differences on biomedical data between obese and non-obese participants, and to identify risk factors associated with systemic inflammation in healthy Palestinian adults. Methodology A cross-sectional study involved 105 apparently healthy adults. Interview questionnaire was used to collect personal information. Participants were excluded if they suffered from acute or chronic inflammatory diseases, or continued using medicines, which might affect the biomedical results. Results In association with increased Body Mass Index (BMI), the obese group displayed significant higher markers including: interleukin 6 (IL-6), high sensitivity C reactive protein (hs-CRP), total cholesterol (TC), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Obese group in association with increased waist circumference (WC) was higher significantly in inflammatory markers (IL-6, hs-CRP), lipid profile (TC) and triglyceride (TG), and blood pressure (SBP, DBP). A tertile of a feature of systemic inflammation (hs-CRP) was created, by Ordinal Logistic Regression, after adjusting for the age, gender, smoking habits, physical activity pattern, father and mother's health history; risk factors were the increased BMI [OR: 1.24] (95% CI: 1.005–1.548, P=0.050), IL-6 [OR: 3.35] (95% CI: 1.341–8.398, P=0.010), DBP [OR: 1.19] (95% CI: 1.034–1.367, P=0.015), and reduced Adiponectin [OR: 0.59] (95% CI: 0.435–0.820, P=0.001). Finally, BMI correlated with IL-6 and hs-CRP ( r =0.326, P=0.005; r =0.347, P r =0.303, P=0.010), and inversely with Adiponectin ( r =−0.342, P=0.001). Conclusion The increased level of IL-6 and reduced Adiponectin, which strongly associated with obesity, indicated that having high BMI is a useful marker in association with IL-6 and further developed systemic inflammation.

Obesity is the accumulation of abnormal or excessive fat that may interfere with the maintenance of an optimal state of health. The excess of macronutrients in the adipose tissues stimulates them to release inflammatory mediators such as tumor necrosis factor α and interleukin 6, and reduces production of adiponectin, predisposing to a pro-inflammatory state and oxidative stress. The increased level of interleukin 6 stimulates the liver to synthesize and secrete C-reactive protein. As a risk factor, inflammation is an imbedded mechanism of developed cardiovascular diseases including coagulation, atherosclerosis, metabolic syndrome, insulin resistance, and diabetes mellitus. It is also associated with development of non-cardiovascular diseases such as psoriasis, depression, cancer, and renal diseases. On the other hand, a reduced level of adiponectin, a significant predictor of cardiovascular mortality, is associated with impaired fasting glucose, leading to type-2 diabetes development, metabolic abnormalities, coronary artery calcification, and stroke. Finally, managing obesity can help reduce the risks of cardiovascular diseases and poor outcome via inhibiting inflammatory mechanisms.

Atherosclerotic cardiovascular disease (CVD) is a collective term comprising of a group of disorders of the heart and blood vessels. These diseases are the largest cause of morbidity and premature death worldwide. Coronary heart disease and cerebrovascular disease (stroke) are the most frequently occurring diseases. The two major initiators involved in the development of atherosclerotic CVD are vascular production of reactive oxygen species (ROS) and lipid oxidation. In atherosclerosis development, ROS is associated with rapid loss of anti-inflammatory and anti-atherogenic activities of the endothelium-derived nitric oxide (NO(·)) resulting in endothelial dysfunction. In part involving activation of the transcription factor NF-κB, ROS have been involved in signaling cascades leading to vascular pro-inflammatory and pro-thrombotic gene expression. ROS is also a potent activator of matrix metalloproteinases (MMPs), which indicate plaque destabilization and rupture. The second initiator involved in atherosclerotic CVD is the oxidation of low-density lipoproteins (LDL). Oxidation of LDL in vessel wall leads to an inflammatory cascade that activates atherogenic pathway leading to foam cell formation. The accumulation of foam cells leads to fatty streak formation, which is the earliest visible atherosclerotic lesion. In contrast, the cardiac sarco/endoplasmic reticulum Ca(2+)-ATPase (SERCA2a) and hepatic apolipoprotein E (apoE) expression can improve cardiovascular function. SERCA2a regulates the cardiac contractile function by lowering cytoplasmic calcium levels during relaxation, and affecting NO(·) action in vascular cells, while apoE is a critical ligand in the plasma clearance of triglyceride- and cholesterol-rich lipoproteins.

Urbanization has provided experimental settings for testing the interactive relationship between genetic background and changes in lifestyle and dietary patterns. The concept of gene-environment interaction was described by epidemic of obesity along with urbanization. Genome-wide association has identified several genes such as melanocortin-4 receptor that associates with environmental influences of obesity. Gene environment (GxE) interaction refers to modification by an environmental factor of the effect of a genetic variant on a phenotypic trait. GxE interactions can serve to modulate the adverse effects of a risk allele, or can exacerbate the genotype-phenotype relationship and increase risk.

Mohammed S Ellulu,1 Asmah Rahmat,1 Ismail Patimah,2 Huzwah Khaza’ai,2 Yehia Abed3 1Department of Nutrition andDietetics, 2Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia; 3Faculty of Public Health, Al-Quds University, Gaza City, Palestine Background: Obesity is well associated as being an interfering factor in metabolic diseases such as hypertension and diabetes by increasing the secretion of proinflammatory markers from adipose tissue. Having healthy effects, vitamin C could work as an anti-inflammatory agent through its antioxidant capacity.Registration: Registration number: FPSK_Mac [13]04.Objective: The aim of the study reported here was to identify the effect of vitamin C on reducing the levels of inflammatory markers in hypertensive and/or diabetic obese adults.Subjects and methods: Sixty-four obese patients, who were hypertensive and/or diabetic and had high levels of inflammatory markers, from primary health care centers in Gaza City, Palestine, were enrolled into one of two groups in an open-label, parallel, randomized controlled trial. A total of 33 patients were randomized into a control group and 31 patients were randomized into an experimental group. The experimental group was treated with 500 mg vitamin C twice a day.Results: In the experimental group, vitamin C significantly reduced the levels of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), fasting blood glucose (FBG), and triglyceride (TG) after 8 weeks of treatment (overall: P

The roles of Omega-3 FAs are inflammation antagonists, while Omega-6 FAs are precursors for inflammation. The plant form of Omega-3 FAs is the short-chain α-linolenic acid, and the marine forms are the long-chain fatty acids: docosahexaenoic acid and eicosapentaenoic acid. Omega-3 FAs have unlimited usages, and they are considered as omnipotent since they may benefit heart health, improve brain function, reduce cancer risks and improve people's moods. Omega-3 FAs also have several important biological effects on a range of cellular functions that may decrease the onset of heart diseases and reduce mortality among patients with coronary heart disease, possibly by stabilizing the heart's rhythm and by reducing blood clotting. Some review studies have described the beneficial roles of Omega-3 FAs in cardiovascular diseases (CVDs), cancer, diabetes, and other conditions, including inflammation. Studies of the effect of Omega-3 FAs gathered from studies in diseased and healthy population. CVDs including atherosclerosis, coronary heart diseases, hypertension, and metabolic syndrome were the major fields of investigation. In studies of obesity, as the central obesity increased, the level of adipocyte synthesis of pro-inflammatory cytokines like tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) were increased and the level of anti-inflammatory adiponectin was decreased indicating a state of inflammation. The level of C reactive protein (CRP) synthesized from hepatocyte is increased by the influence of IL-6. CRP can be considered as a marker of systemic inflammation associated with increased risks of CVDs. In molecular studies, Omega-3 FAs have direct effects on reducing the inflammatory state by reducing IL-6, TNF-α, CRP and many other factors. While the appropriate dosage along with the administrative duration is not known, the scientific evidence-based recommendations for daily intake are not modified.

To assess the differences on inflammatory and metabolic indicators between pre-menopause and post-menopause women among hypertensive and/or diabetic type-2 women. A total of 236 obese women included in the study have chosen from Primary Health Care Centers in Gaza City, Palestine, through a cross-sectional study. Selection depended on health status hypertensive and/or diabetic type-2 (HT, T2DM, HT+T2DM). In HT group, post-menopause women had significant higher values than pre-menopause women on TC (200±47 vs. 172.5±55 mg dL–1, p

Urbanization has provided experimental settings for testing the interactive relationship between genetic background and changes in lifestyle and dietary patterns. The concept of gene-environment interaction was described by epidemic of obesity along with urbanization. Genome-wide association has identified several genes such as melanocortin-4 receptor that associates with environmental influences of obesity. Gene environment (GxE) interaction refers to modification by an environmental factor of the effect of a genetic variant on a phenotypic trait. GxE interactions can serve to modulate the adverse effects of a risk allele, or can exacerbate the genotype-phenotype relationship and increase risk.

Background : Obesity is a degree of excess weight that predisposes people to metabolic syndromes via an inflammatory mechanism. Hypertensive and diabetic people have higher risks of developing systemic inflammation. Long chain omega-3 polyunsaturated fatty acids (LC ω-3 PUFAs) can reduce the cardiovascular events and help against inflammation. Objective : To identify the effects of LC ω-3 PUFAs on reducing the levels of inflammatory markers on hypertensive and/or diabetic obese adults. Materials and methods : Sixty-four patients, who were hypertensive and/or diabetic obese with high levels of inflammatory markers, from primary healthcare centers of Gaza City, Palestine, enrolled in two groups of an open-label, parallel, randomized, controlled trial for 8 weeks. Thirty-three patients were in the control group, and 31 patients were in the experimental group. The experimental group was treated with a daily dose of 300 mg eicosapentaenoic acid and 200 mg of docosahexaenoic acid. Results : Treatment with LC ω-3 PUFAs significantly reduced the level of high sensitivity C reactive protein (hs-CRP) [14.78±10.7 to 8.49±6.69 mg/L, p

Almost all countries are facing obesity endemic, although great variation exists between and within countries. Sedentary lifestyle and high fat (high caloric) diet have increased globally as a result of industrial, urban and