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Although cancer is still one of the most significant global challenges facing public health, the world still lacks complementary approaches that would significantly enhance the efficacy of standard anticancer therapies. One of the essential strategies during cancer treatment is following a healthy diet program. The ketogenic diet (KD) has recently emerged as a metabolic therapy in cancer treatment, targeting cancer cell metabolism rather than a conventional dietary approach. The ketogenic diet (KD), a high-fat and very-low-carbohydrate with adequate amounts of protein, has shown antitumor effects by reducing energy supplies to cells. This low energy supply inhibits tumor growth, explaining the ketogenic diet’s therapeutic mechanisms in cancer treatment. This review highlights the crucial mechanisms that explain the ketogenic diet’s potential antitumor effects, which probably produces an unfavorable metabolic environment for cancer cells and can be used as a promising adjuvant in cancer therapy. Studies discussed in this review provide a solid background for researchers and physicians to design new combination therapies based on KD and conventional therapies.

Background:The use of plant for medicinal purposes has a long history worldwide. There is a lack of research that identifies the antidiabetic effect of edible Omani wild plants. Oxidative stress mediates the pathogenesis of diabetes and it has been suggested that natural antioxidants might be considered as an effective intervention for combating diabetes. Objective: This study aimed to assess the anti-diabetic and antioxidant potential properties of two edible Omani wild plants (Pteropyrum scoparium and Oxalis corniculata) or their mixture in streptozotocin (STZ)-induced diabetic rats. Methods: Thirty-seven male Sprague Dawley rats, weighting 250–300 grams, were allocated into 5 groups: non-diabetic (9 rats/group), diabetic group (7 rats/group), and three diabetic groups that received oral feeding of either Pteropyrum scoparium, Oxalis corniculata, or their mixture (7 rats/group). Diabetes was induced by a single intraperitoneal injection dose of STZ drug, 50 mg/kg body weight. At the end of the experimental trial, after 8 weeks, all rats were fasted overnight and sacrificed; blood glucose was measured, meanwhile pancreatic tissues were dissected and homogenized for the biochemical assessment of oxidative stress markers (glutathione, GSH, and total antioxidant capacity, TAC). Results: STZ resulted in hyperglycemia and oxidative stress (GSH depletion and TAC impairment) in diabetic group as compared to non-diabetic group. Meanwhile the concomitant treatment of diabetic groups with the two wild the edible Omani plants or their mixture have shown a protective effect against the STZ-induced hyperglycemia, but with no effect on oxidative stress. It was noted that for the final boy weight, the improvement was not significant as well. Histopathological examination of the pancreatic tissues showed that the STZ injection lead to pathological changes associated with diabetes in the pancreatic tissues of all diabetic groups. Conclusion: Pteropyrum scoparium and Oxalis corniculata combated the STZ-induced hyperglycemia with no effect on oxidative stress. Also, there was no synergistic effect of Pteropyrum scoparium and Oxalis corniculata on hyperglycemia or oxidative stress.

Objective: To assess the role of various dietary and lifestyle modifications in the secondary prevention of biomarkers of plaque recurrence in Omani coronary revascularized patients.Methods: Seventy-two patients, from the outpatient cardiology clinic of Sultan Qaboos University Hospital, were included in the study after obtaining an informed consent. In a questionnaire-based study, we collected data about four lifestyle modifications; physical activity, weight reduction, dietary intake and healthy eating patterns and smoking or non-smoking status, in personal interviews. A modified previously validated study questionnaire, which comprised of a semi-quantitative food frequency questionnaire, was used to assess the demographic information, eating patterns, diet quality index score, and daily dietary intake of study participants. The data about patient’s baseline characteristics, revascularization information and biochemical laboratory tests was harvested from the SQUH’s electronic record system. The statistical analysis of data was made using R-studio v.7 and Microsoft excel v.7.Results: The males had higher educational level as compared to females and were more active than females. The data indicated that 16% males and females were diabetic, 10% males and 21% females were hypertensive, and 30% males and 42% females had both diabetes and hypertension. Forty eight percent males and 63% females had body mass index (BMI) >30. However, no significant (P < 0.05) differences were observed in the BMI, diabetes and hypertension status in males and females. Both genders had poor nutritional knowledge. Although the LDL-C and HDL-C values in males and females differed, they were within the normal therapeutic limits. The HbA1c and C-reactive protein values were above the normal ranges with no significant (P < 0.05) difference in both males and females. The average daily energy intake in males (2694 kcalories) was significantly higher compared to females (1603 kcalories). The proportionate contribution of energy from macronutrients was within the acceptable macronutrient distribution ranges. Omani diet score for males (75.5) and females (74.6) didn’t differ significantly (P < 0.05), indicating their adherence to healthy dietary patterns.Conclusions: The results suggest that dietary and lifestyle modifications play significant role in the secondary prevention of biomarkers of plaque recurrence in Omani coronary revascularized patients. Behavioral counseling to promote healthy modifications in dietary and lifestyle factors are therefore recommended in the secondary prevention of risk of plaque recurrence.

Cancer is second leading cause of death worldwide, accounting for an estimated 9.6 million deaths in year 2018, from which 70% death occurred in low- and middle-income countries. World Health Organization estimates that there will be 20 million new cases and 12 million deaths from cancer alone by the year 2020 [1]. Furthermore, the WHO reported that in Western countries, the rate of colorectal cancer (CRC) has increased dramatically as compared to other types of cancers, and this increase was attributed to westernization in food choices and dietary pattern as well as adopting a sedentary lifestyle [1, 2]. CRC is the third most common cancer and a major cause of cancer mortality and over 1.8 million cases were reported during 2018. Although the introduction of colonoscopy techniques has made it easier to diagnose CRC at an early stage, in most of the cases it can occur due to sporadic tumorigenesis via the adenoma-carcinoma sequence [3, 4]. Chronic inflammation is implicated in causing cancer and the process can take years to develop CRC [5]. An early screening will therefore allow in making an advance action plan for CRC diagnosis, which will not only help to reduce health cost for secondary treatments but will also support to improve the efficiency of country’s work force. Although the CRC cases in the USA have dropped by 30% during the last decade, the CRC cases in the Arab world have increased [6, 7]. Hyperhomocysteinemia (HHcy) is an independent risk factor of coronary heart disease, stroke, peripheral vascular diseases, and cancers [8]. HHcy induces cancer by cellular oxidative stress, through oxidant-mediated responses, and epigenetic modifications such as alterations of DNA methylation and their regulatory role in gene expression. High levels of plasma homocysteine levels have been observed in cancer patients, indicating its association with venous and arterial thrombosis [9]. Venous thromboembolism is the second most common cause of death in cancer patients [10].

Homocysteine (Hcy) is a sulfur-containing amino acid, which is produced during the metabolism of methionine. Impairment in one carbon metabolism (OCM) is believed to be responsible for elevated plasma homocysteine (Hcy) levels or hyperhomocysteinemia (HHcy), which is considered as an independent risk factor of coronary artery disease (CAD). There are multifactorial causes of HHcy including the genetic factors, polymorphisms of key OCM enzymes, particularly in case of nutritional deficiencies of certain B-vitamins (folate, riboflavin, vitamin B6 and B12), disease state, smoking and drugs. The association between plasma homocysteine levels and cardiovascular disease risk has spawned attention to develop strategies to lower plasma homocysteine levels that may improve the vascular disease-associated morbidity and mortality. The data derived largely from observational and cross-sectional studies as well as from some clinical trials indicate that elevated levels of circulating homocysteine (>12 μM/L) are cytotoxic and can cause vascular damage, increase the risk for developing atherothrombotic CAD, peripheral vascular disease, myocardial infarction, and stroke. Understanding the cellular mechanisms by which homocysteine promotes the oxidative stress-induced vascular dysfunction, has provided sufficient evidence to conduct clinical trials to lower homocysteine levels with B-vitamins as a novel therapeutic approach to patients with cardiovascular diseases. This chapter reviews the scientific evidence about the potential causes of hyperhomocysteinemia and its link as a risk factor in the pathobiology of CAD and the role of B-vitamin supplementation in the prevention of hyperhomocysteinemia-associated CAD.

When it comes to food, there has been a noticeable increase in the consumption of snacks, fast food, sweets, meat, milk products and savory. This increase is met by a decrease in the consumption of fresh fruits and vegetables. This change is moving forward towards transforming the lifestyle, and several surveys showed that the increase in consumption of fats and carbohydrates as well as other mentioned products lead to high calorie intake which increases the risk of type 2 diabetes (T2DM) [1]. It also noted that this risk is transferred to an earlier age as it is now including preadolescents as well as the late adulthood stage, this will increase the incidence of T2DM unless a health program is developed to combat this risk [2].

The significance of elevated blood homocysteine (Hcy) in clinical practice is a serious subject for researchers and is considered as a marker of certain diseases [1]. Hcy, is a sulfur containing, non-proteinogenic amino acid required for the growth of cells and tissues [2, 3]. It is produced exclusively from methionine (Met), an essential amino acid obtained from diet [4]. Hcy is normally present in human plasma at lower concentrations. The normal range is reported to be 5–15 micromol/L [5]. The level could be affected by health-related behaviours, including diet, excessive coffee intake, alcohol consumption, cigarette smoking, and sedentary lifestyle [6, 7]. Total plasma Hcy could be in the form of free Hcy, protein-bound Hcy, oxidized forms of Hcy, and Hcy-thiolactone [3]. This is used as a predictive risk factor for stroke progression, cardiovascular disorders, test for vitamin B12 deficiency, and screening for inborn errors of Met metabolism. An increase of Hcy is referred to as hyperhomocysteinemia (HHcy) which is a sensitive marker of folate and vitamin B 12 deficiency and is associated with an increased risk of cardiovascular disease (CVD), pregnancy complications, cognitive impairment, stoke, and other diseases [8–10]. Plasma levels between 15 and 30 micromol/L are referred as mild HHcy, whereas levels between 31 and 100 micromol/L are moderate HHcy and levels above 100 micromol/L are described as severe HHcy [11]. There are also other studies which report that HHcy are associated with atherosclerosis, thrombosis, birth defects, osteoporosis, diabetes, and renal disease [2]. It is also reported to be highly prevalent in chronic kidney disease (CKD) patients. There are several risk factors that could lead to HHcy- the main cause being insufficient intake of vitamin B group especially folic acid (B9), pyridoxine (B6), or B12 (cyanocobalamin), and several polymorphisms involved in methionine (Met) metabolism [9]. This could also lead to high excretion of Hcy (oxidized Hcy) in urine (homocystinuria) [12]. The relation between HHcy and morphological changes in the organs are extremely important to improve the diagnostic methods and to develop effective treatment.

Inflammation is a natural clinical repair response of body’s immune system to protect its tissues from various noxious stimuli that continues to remodel throughout the lifecycle because of interactions between genes, lifestyles, and environments. There is a link between inflammation, elevated plasma homocysteine levels and cardiometabolic diseases. Multiple mechanisms have been proposed through which homocysteine can modulate the inflammatory response, though the exact mechanism is not clearly understood. The serum homocysteine concentration is considered as an independent risk factor for many disease conditions including cardiovascular diseases (CVD). Epidemiological evidence indicates that moderate consumption of anthocyanins is associated with reduced risk of atherosclerosis and cardiovascular diseases. However, a clear relationship between anthocyanin and homocysteine has not yet been developed. Anthocyanins are water soluble blue, red, and purple pigments, present in the vacuolar sap of the epidermal tissues of plant parts. As therapeutic agents, they are well-accepted in folk medicine worldwide and are linked to a myriad of health benefits. Anthocyanins impart an amazing role in lessening inflammation in body tissues. The molecular mechanisms involved in anti-inflammatory activities include inhibition of pro-inflammatory enzymes, such as cyclooxygenase-2, lipoxygenase and inducible nitric oxide (NO) synthase, inhibition of NF-kB and activating protein-1 (AP-1) and activation of phase II antioxidant detoxifying enzymes, mitogen-activated protein kinase (MAPK), protein kinase C and nuclear factor-erythroid 2-related factor 2. This chapter discusses the interrelationship between hyperhomocysteinemia, inflammation and anthocyanins, as well as the mechanisms of action and anti-inflammatory role of anthocyanins in the prevention of cardiometabolic diseases.

Background In the past infectious diseases affected the quality of lifestyle during home confinement. The study conducted examines the influence of home confinement during the COVID-19 pandemic outbreak on lifestyle, mental wellbeing, nutritional status, and sleeping pattern. Method An online multicategorical questionnaire was distributed to collect demographic information combined with the following tools: Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), WHO-5 wellbeing score, and Pittsburgh Sleep Quality Index (PSQI). A snowball non-discriminate sampling procedure was conducted to collect data from people attending or working at higher institutions from March 1, 2020 to April 24, 2020. A total of 1723 completed responses (917 males, 37.4 ±13.4 years old and 806 females 32.2 ± 11.5 years old) were collected. Results The female participants had significantly lower mental health scores than males (53.9% vs. 46.1%). The mental wellbeing scores were higher among participants with medium and high physical activity (PA) levels (p < 0.00). Additionally, the mental wellbeing scores were significantly improved by dietary quality and it’s sleeping score (p < 0.001). However, PA was by far the major determinant of the mental health scores. Conclusion Factors such as PA, diet, and sleeping patterns were associated with mental wellbeing during the COVID-19 confinement among Arab participants.

Folate and vitamin B12 deficiency is associated with depletion of the major intracellular antioxidant glutathione, and oxidative stress is emerging as an etiological mechanism for colon cancer. Azoxymethane (AOM), a potent carcinogen, induces colon cancer in rats by causing pathophysiological changes and oxidative stress. We investigated the synergistic effect of folate and vitamin B12 supplementation against AOM-induced carcinogenesis and oxidative stress in rat colon. Adult male rats were distributed into four groups: 1) Basal diet only; 2) AOM injection (15 mg/kg once per week in weeks 5 and 6); 3) Folate and vitamin B12 supplemented diet; 4) Folate and B12 diet with AOM injection. After 16 weeks, rats were sacrificed, colon tissue dissected, indicators of oxidative stress were measured, and immunohistochemical and ultrastructural changes were evaluated. AOM-injected rats showed oxidative stress, evident by glutathione depletion, oxidation of cellular proteins, and DNA oxidative damage. AOM increased mucosal levels of antiapoptotic and proapoptotic proteins Bcl2 and Bax and caused ultrastructure changes in colonic cell organelles. Folate and vitamin B12 supplementation decreased the level of oxidative stress and ameliorated the cytotoxic effects of AOM. In this in vivo experimental model of colon cancer, folate and vitamin B12 supplementation combats carcinogen-induced oxidative stress.

Background: Colorectal cancer (CRC) represents a heterogeneous group of diseases characterized by uncontrolled growth and spread of abnormal cells in the body. CRC vary on the basis of both the biologic features of the disease and its associated lifestyle characteristics. The risk of CRC increases with several modifiable factors including obesity, physical inactivity, a diet high in red or processed meat, heavy alcohol consumption, and possibly inadequate intake of fruits and vegetables. We aimed to establish a baseline data for dietary and lifestyle characteristics of Omani adults diagnosed with CRC. Methods: A Case control study conducted at Sultan Qaboos University Hospital, a referral hospital for CRC patients in Oman, and included 279 subjects (109 diagnosed CRC cases and 170 matched controls). All study subjects were recruited on volunteer basis and personally interviewed for preset questions related to sociodemographic data, anthropometric assessment, dietary intake and physical activity. Results: There was no significant difference between cases and controls regarding smoking, alcohol intake, physical activity and dietary fiber intake. However the enrolled cases were more overweight (OR =3.27. 95% CI: 1.91, 7.27), and, had a higher caloric (p =0.001) and macronutrient intake (carbohydrate: p = 0.001; protein: p = 0.017; saturated fat: P = 0.034) than the controls. In addition, the dietary pattern of the cases was characterized by a trend towards low vegetables and fruits intake. Conclusion: CRC maybe prevented through dietary management of high risk groups. This primary prevention approach will ultimately reduce the burden of CRC in Oman.

Oxidative stress plays a pivotal role in the development of diabetes and hyperglycaemia. The protective effects of natural extracts against diabetes are mainly dependent on their antioxidant and hypoglycaemic properties. Broccoli (Brassica oleracea) exerts beneficial health effects in several diseases including diabetes; however, the mechanism has not been elucidated yet. The present study was carried out to evaluate the potential hypoglycaemic and antioxidant properties of aqueous broccoli extracts (BEs) in diabetic rats. Streptozotocin (STZ) drug was used as a diabetogenic agent in a single intraperitoneal injection dose of 50 mg/kg body weight. The blood glucose level for each rat was measured twice a week. After 8 weeks, all animals were fasted overnight and sacrificed; pancreatic tissues were homogenized and used for measuring oxidative DNA damage, biochemical assessment of glutathione (GSH), and total antioxidant capacity (TAC) as well as histopathological examination for pancreatic tissues was examined. Diabetic rats showed significantly higher levels of DNA damage, GSH depletion, and impaired TAC levels in comparison to non-diabetics (P

Purpose. Evidence from industrialized/developed countries showed that colorectal cancer (CRC) incidence rates have significantly dropped due to the widespread use of colonoscopy. In Arab countries, however, the CRC had been reported to have increased. Despite the concerted effort in the primary prevention and widespread use of colonoscopy, to our knowledge, there have been no reports of the prevalence rate of CRC among colonoscopy recipients from Oman. This study aims to explore the CRC prevalence estimates over selected sociodemographic characteristics among colonoscopy-recipients at a tertiary hospital in Oman over five years of follow-up. The regional variations in Oman were also examined in this study. Methods. This hospital-based cross-sectional study reviewed reports of colonoscopies performed over 5-years of retrospective follow-up at a tertiary hospital in Oman. CRC prevalence estimates were calculated over age, gender, governorate, and time of follow-up. Results. A total of 442 CRC cases were enumerated among 3701 colonoscopies, with an overall CRC prevalence estimate of 11.9 per 100 colonoscopies (95% CI: 10.9, 13.0). Gender-specific CRC prevalence was higher among males compared with females (13.3 vs. 10.5). Age-specific CRC prevalence increased with advancing age, from 2.8 among those less than 40 years of age to 26.5 among aged 70 years or more. Regional CRC prevalence was highest among residents in Batinah Governorate. Over the 5-years of follow-up, there was a slow rise in CRC prevalence with an annual increment of 0.59%. Conclusion. The study provides supportive evidence for a steady increase in CRC prevalence over age categories and years of follow-up and depicted the variations of gender-specific CRC prevalence estimates over increasing age categories. The study calls for timely formulation and adoption of national CRC screening programs centered on the colonoscopy use as primary prevention and maximizing its utilization and efficiency.

As a major neurodevelopmental disorder, Autism Spectrum Disorder (ASD) encompasses deficits in communication and repetitive and restricted interests or behaviors in childhood and adolescence. Its etiology may come from either a genetic, epigenetic, neurological, hormonal, or an environmental cause, generating pathways that often altogether play a synergistic role in the development of ASD pathogenesis. Furthermore, the metabolic origin of ASD should be important as well. A balanced diet consisting of the essential and special nutrients, alongside the recommended caloric intake, is highly recommended to promote growth and development that withstand the physiologic and behavioral challenges experienced by ASD children. In this review paper, we evaluated many studies that show a relationship between ASD and diet to develop a better understanding of the specific effects of the overall diet and the individual nutrients required for this population. This review will add a comprehensive update of knowledge in the field and shed light on the possible nutritional deficiencies, metabolic impairments (particularly in the gut microbiome), and malnutrition in individuals with ASD, which should be recognized in order to maintain the improved socio-behavioral habit and physical health.

This study aimed to assess the status of B-vitamins (folate, vitamin B6, and B12) and homocysteine (HCY) in the sera of Omani coronary artery disease (CAD) patients. Sixteen Omani patients (10 males and 6 females) gave consent for blood sampling and were enrolled in the study on voluntary basis. All patients were evaluated for their anthropometric and biochemical measurements of B-vitamins, glutathione (reduced and oxidized), HCY, and quantification of N-homocysteinylated albumin protein. It was observed that both male and female patients had a comparable age (57.64 ±9.86, 56.5 ±10.04 years, respectively) with no significant difference, P = 0.69 and both genders were obese based on their body mass index (31.22 ± 8.17 kg/m2 for males and 30.26 ± 4.70 kg/m2for females). Serum levels of folate, vitamins B6, and B12 were lower than the normal reference values in all the study participants. There was depletion in glutathione levels (higher level of oxidized glutathione versus lower level of reduced glutathione) in the sera of all study participants. High serum HCY levels in both males and females (75.81±9.21 and 68.66±8.1 μmol/L, respectively) suggest that both males and females had hyperhomocysteinemia. Correlation coefficient analysis revealed that the serum HCY levels were negatively correlated with serum reduced glutathione, folic acid, vitamins B6, and B12 levels in both male and female study participants. The serum HCY level was positively correlated with age, body mass index, and serum oxidized glutathione. Proteomic measurements of N-homocysteinylation in serum albumin revealed that N-homocysteinylated albumin was present in all the assayed serum samples of study participants. The results suggest that low serum status of B-vitamins might act as a metabolic trigger for the observed hyperhomocysteinemia, oxidative stress, and pathological formation of N-homocysteinylated albumin protein, which collectively aggravates the CAD risk in the studied Omani patients.

Objectives: This study aimed to examine the relationship between body mass index (BMI) z-scores and lifestyle-related factors including nutrition, physical activity, screen time and time spent sleeping in 6–10-year-old Omani children. Methods: This cross-sectional study included mother-child dyads that were recruited from five provinces in Oman. Children’s BMI measurements and questionnaires on nutrition intake, physical activity, screen time and time spent sleeping and a single-day dietary recall were collected. Results: A total of 197 dyads were included in this study. The children's mean age was 7.7 ± 1.6 years and 53% were female. In this study, 17.4% of the children were classified as overweight or obese. No significant relationship was found between the children's BMI z-scores and nutrition intake, moderate-to-vigorous physical activity time or screen time ( P ≥0.05). Increased time spent sleeping at night was positively associated with childhood obesity ( P

Vitamin or mineral supplementation is considered to be the most commonly used medical treatment for autism spectrum disorder (ASD), in addition to other interventions such as neurological and psychological interventions. There is not much evidence of therapeutic efficacy between vitamin and mineral supplementation and improvements in ASD. However, several researchers have noted that patients with ASD have various metabolic and nutritional abnormalities including issues with sulfation, methylation, glutathione redox imbalances, oxidative stress, and mitochondrial dysfunction. There is some evidence that vitamin and mineral supplementation may support these basic physiologic processes. Recently, the nutritional status of ASD patients has been gaining focus in this particular area. Pointing out the nutritional status as a potential etiological factor for attention/communication disorders, more importance has been given to this particular point. Moreover, autistic specific considerations like the feature and behavior of ASD might be increased or at least fall in the higher risk due to the sub-optimal nutritional status.

Maha AH Sulaiman,1 Yahya M Al-Farsi,1 Maha M Al-Khaduri,2 Jumana Saleh,3 Mostafa I Waly4,5 1Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Al-Khoudh, Sultanate of Oman; 2Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, Sultan Qaboos University, Al-Khoudh, Sultanate of Oman; 3Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, Al-Khoudh, Sultanate of Oman; 4Department of Food Science and Nutrition, College of Agricultural and Marine Sciences, Sultan Qaboos University, Al-Khoudh, Sultanate of Oman; 5Nutrition Department, High Institute of Public Health, Alexandria, Egypt Purpose: Literature emerging from Western countries has reported increased levels of serum oxidative stress markers among polycystic ovarian syndrome (PCOS) women. In the Arab region, there is limited research about the association between oxidative stress and PCOS. This study aimed to compare sociodemographic and clinical characteristics, sex hormones, and oxidative stress indices between PCOS women and non-PCOS women and to investigate the correlation between oxidative stress biomarkers and sex hormones.Methods: This hospital-based case-control study was conducted among reproductive-aged women. The study included 51 women diagnosed with PCOS (as per Rotterdam 2003 criteria) and 45 control women who were not diagnosed with PCOS. Serum samples were collected to measure the mean levels of the following sex hormones: total testosterone, dehydroepiandrosterone sulfate, estradiol and progesterone, as well as to measure biomarkers of oxidative stress including glutathione peroxidase (GPx), glutathione reductase (GR), glutathione (GSH), and total antioxidant capacity (TAC).Results: PCOS women exhibited clinical characteristics including irregular menses, hirsutism, and acne compared to the control group (P≤0.05). Significant differences were observed in the waist-hip ratio of PCOS women compared to controls (P=0.004). GPx and GR activity levels appeared to be higher among PCOS women compared to controls; however, no statistically significant differences were observed between the two groups (P>0.05). PCOS women had lower GSH and TAC levels compared to controls with a statistically significant difference observed for GSH levels (P=0.006). Correlation analysis showed a significant negative correlation between estradiol and TAC in the total sample (r=-0.284, P=0.005).Conclusion: This study provides supportive evidence that oxidative stress might play a role in the pathogenesis of PCOS and, hence, oxidative stress parameters could be suggested as diagnostic markers for early diagnosis of high-risk groups. Also, the study provides supportive evidence that obesity and sex hormones, particularly estradiol, in PCOS may contribute to enhanced oxidative stress. Keywords: PCOS, oxidative stress, Oman, case-control, anthropometric, glutathione

Despite the importance of physical activity and training, the optimum nutrient intake and good nutritional knowledge have been recognized as important factors in improving the athletic performance and health status of athletes. The present study was conducted to assess the nutritional knowledge, dietary habits, nutrient intake and nutritional status of Sultan Qaboos University student athletes. A cross-sectional study design was used to achieve the objectives. Seventy one (49 male and 22 female) student athletes with a mean age of 21.0±1.81 and 19.32±0.72 years and body mass index (BMI) of 22.51±1.98 and 20.34±2.97 kg/m for male and female respectively, participated in study. All subjects were interviewed in person. The 2 study questionnaire consisted of questions related to demographic information, nutritional knowledge and a 7-days food diary to identify nutrient intake, food frequency and variety of food consumption. Significant differences (p

Colorectal cancer (CRC) is the world’s third most common cancer. Before the twentieth century, CRC was relatively uncommon; however, the incidence has risen dramatically especially in the last 50 years. Several risk factors have been proposed, including the adoption of westernized diet, obesity, and physical inactivity. The majority of colorectal cancer continues to occur in industrialized countries. According to the recent studies, CRC is associated with several modifiable and non-modifiable risk factors. These risk factors involve CRC history in first-degree relative, inflammatory bowel disease, consumption of red meat, fruit, and vegetables, cigarette smoking, body mass index to overall population, race, gender, personal habit of alcohol consumption and smoking, ethnicity diabetes, and physical activity. Here we review the key evidence for the role of different risk factors and their effect on CRC prevention and progression.

Clinical studies have claimed in general to show a correlation between high consumption of phenolic antioxidants and reduced risks of certain types of cancer. The main antioxidant activity that has been associated with polyphenols is the ability to scavenge free radicals. Prevention of cancer may be accomplished through primary prevention, secondary prevention, or a combination of these approaches. The objective of primary prevention is to prohibit effective contact of a carcinogenic agent with a susceptible target in the human body, so that the sequence of events that culminates in the occurrence of clinical cancer does not begin or is aborted at the start. Primary prevention of cancer might be implemented by fortifying the human diet with an effective dietary chemoprevention, among this approach is the date pit extract.

The preventive measures of diseases are based on the risk and their severity. However, in reality, multiple risks are involved and cumulative risk factor is defined as the combination of threats from exposure to multiple agents or stressors. Cancer is a multifactorial disease caused by combined effects of both genetic and environmental factors. The environmental risk factors include non-genetic factors, such as diet, alcohol consumption, smoking, lifestyle, and infectious agents. The environmental factors include wide exposure of chemicals from environment, atmosphere, and foods. The genetic factors and their interrelationships with the environmental factors also play an important role. Consequently, it is important to understand both genetic and environmental risk factors properly to take actions towards the reduction of the overall risk. It is also important to be aware of the risk factors and initiate communications between different parties to combat cancer.

Today, millions of people are living with cancer or have had cancer. The risk of developing most types of cancer can be reduced by changes in a person’s lifestyle or by adopting primary intervention strategies. Often, the sooner a cancer is found and treatment begins, the better are the chances for living for many years. Cancer is a disorder of cell proliferation and it is the leading global cause of death. Cancer research has traditionally focused on allocating bioactive components for the cancer prevention by eliminating cancerous cells and cellular carcinogenesis metabolites. Carcinogenesis is a multistage process that is distinguished with two steps; the first step is called initiation that occurs when cells are exposed to cancer-producing agents, which damage the cell’s deoxynucleic acid. The second step is called promotion which occurs when the cancerous cells divided subsequently, and this post ignition step is characterized by neoplasia and DNA adducts formation. Cancer morbidity and mortality afflicts both genders, and at a global level, there are about 945,000 new cancer cases and 620,000.

The common etiological factors for cancer are obesity, nutritional deficiencies, smoking, radiation, environmental toxins, sedentary lifestyle, and aging. These factors cause cancer by damaging genes in combination with existing genetic mutation within cells. Epidemiological studies have shown that diet containing fruits and vegetables reduce the risk of several types of cancer. High intake of fruits and vegetables has an active role in the prevention of chronic disease associated with oxidative stress-mediated carcinogenesis. World Health Organization projects 10,000,000 cases of cancer per year worldwide and 6,000,000 mortality from cancer per year worldwide. It also projected 15 million cases/year in 2020. Cancers vary on the basis of age, gender, race, and genetic predisposition.

The present cross sectional study was conducted on 811 Saudi women to evaluate their food safety knowledge and practices and explore factors affecting them. They reported better food safety practices than knowledge in overall food safety and all parameters except cooking. Personal hygiene was the parameter where they reported higher mean knowledge and practice (63.4% and 73.8%; respectively) with the lowest mean knowledge score in utensils and equipment (49.8%) whereas the lowest mean practice (60.2%) was in cooking. Saudi women with higher studies and those with 60 years and more showed higher mean knowledge and practice score in overall food safety and most parameters than those in other educational levels or age groups with significant variations (P

Maha AH Sulaiman,1 Yahya M Al-Farsi,1 Maha M Al-Khaduri,2 Mostafa I Waly,3 Jumana Saleh,4 Samir Al-Adawi5 1Department of Family Medicine and Public Health, 2Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, 3Department of Nutrition and Food Sciences, College of Agricultural and Marine Sciences, 4Department of Biochemistry, 5Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Al-Khoudh, Muscat, Sultanate of Oman Purpose: Previous studies in Euro-American populations have shown that women with polycystic ovarian syndrome (PCOS) have increased levels of “psychological burden”. While PCOS has been reported in Arab countries such as Oman, there is a dearth of studies of the occurrence of psychological burden among PCOS women in the Arab region. This study aimed to compare sociodemographic and clinical characteristics of PCOS women diagnosed with non-PCOS women and prevalence of severity of depression, anxiety and stress and to explore the association between PCOS and indices of psychological disturbances after adjusting for potential confounding factors.Patients and methods: This hospital-based case–control study was conducted among women aged 16–49years. The study included 52 women diagnosed with PCOS (as per Rotterdam 2003 criteria) and 60 control who were PCOS-free. The presence of psychological burden – depression, anxiety and stress – was quantified using Depression, Anxiety and Stress Scale-21 (DASS-21).Results: The crude odds ratios (ORs) generated by logistic regression models indicated an increased risk of depression, anxiety and stress among women with PCOS compared to controls. The adjusted OR also indicated an increased risk of depression (OR =1.10; 95% confidence interval [CI] 0.50, 2.43), anxiety (OR =1.09; 95% CI 0.47, 2.52) and stress (OR =1.45; 95% CI 0.68, 3.12), However, no statistical differences were observed along the three psychological distresses (p>0.05) between the two study groups.Conclusion: The study indicates that the presence of PCOS is associated with an increased risk of psychological burden. If this study will withstand further scrutiny, meeting psychological needs of such population would need to be contemplated. Keywords: PCOS, depression, anxiety, stress, Oman, case–control

To investigate the effect of gamma-aminobutyric acid (GABA) on acute renal injury (ARI), we used here a rat model of acute tubular necrosis induced by the anticancer drug cisplatin (CP). GABA was given orally (100 or 500 mg/kg/day for ten consecutive days), and on the 6th day, some of the treated rats were also injected intraperitoneally with either saline or CP (6 mg/kg). Four days after CP treatment, urine was collected from all rats, which were then anaesthetized for blood pressure and renal blood flow monitoring. This was followed by intravenous injection of norepinephrine for the assessment of renal vasoconstrictor responses. Thereafter, blood and kidneys were collected for measurement of several functional, biochemical and structural parameters. GABA treatment (at 500 but not 100 mg/kg) significantly mitigated all the measured physiological and biochemical indices. Sections from saline- and GABA-treated rats showed apparently normal proximal tubules. However, kidneys of CP-treated rats had a moderate degree of necrosis. This was markedly lessened when CP was given simultaneously with GABA (500 mg/kg). The concentration of platinum in the cortical tissues was not significantly altered by GABA treatment. The results suggested that GABA can ameliorate CP nephrotoxicity in rats. Pending further pharmacological and toxicological studies, GABA may be considered a potentially useful nephroprotective agent in CP-induced ARI.

Background : Preschool years are characterized by striking changes in the physical development, language, cognitive and social behavior. Nutritional anthropometry is widely used for the assessment of the nutritional status of preschool children. Subjects : One hundred and twenty eight children (in the age group of 2-6 years) were recruited for this cross sectional study. We evaluated the underweight, wasting and stunting prevalence among this cohort using Z-Scores as compared to reference population. The middle upper arm circumference and body mass index (BMI) percentile were also evaluated. Results: Indicators of under nutrition were as follow; underweight (3.9%), wasting (3.1%), and stunting (2.3%) among the sampled preschool children. Conclusion: Stunting was the lowest among the examined preschool children. Overweight and obesity were not detected among the studied population. Conclusion : A nutrition intervention program should be developed and directed to this vulnerable group, preschool children, to combat these nutritional problems that might predispose children to under nutrition during adulthood.

This study aimed at comparing the effects of feeding mice and rats with adenine to induce a state of chronic renal failure (CRF), and to assess the effect of treatment with gum acacia (GA) thereon.We compared the outcome, in mice, of feeding adenine at three different doses (0.75%, 0.3%, and 0.2%, w/w). Biochemical and histopathological studies were conducted in plasma, urine and renal homogenates from both species.When mice and rats were fed adenine (0.75%, w/w), all treated rats survived the treatment, but all treated mice died within 1-2 days. The dosage in mice was reduced to 0.3%, w/w, for 4 weeks, but again all treated mice died within 3-4 days. A further reduction in the dosage in mice to 0.2%, w/w, for 4 weeks resulted in no mortality, and produced alterations similar to those observed in rats fed adenine at a dose of 0.75%,w/w, for 4 weeks. Plasma creatinine, urea and urinary protein were significantly increased (P0.001) in adenine-treated mice and rats, and this action was incompletely, but significantly (P0.05), reversed by GA. Adenine significantly (P0.001) reduced superoxide dismutase (SOD) activity and reduced glutathione (GSH) concentration in renal homogenates from both species, and these reductions were significantly (P0.05) ameliorated by GA.Our data suggest that mice are more sensitive to adenine than rats, and that a dose of adenine of 0.2%, w/w, for 4 weeks in mice is suggested as a model for CRF. In both models, GA (15%, w/v, in the drinking water for 4 weeks) given concomitantly with adenine ameliorated the severity of CRF to a similar extent.

Objectives : This study aimed to investigate the lifestyle habits—physical activity (PA), eating habits (EH), and sleep duration (SD)—of Omani adolescents, and to examine gender differences in such variables. Methods : 802 Omani adolescents (442 females and 360 males), aged 15‒18 years were randomly recruited. Anthropometric indices, PA level, and EH and SD were evaluated by the Arab Teenage Lifestyle questionnaire. A semi-quantitative food frequency questionnaire for dietary assessment was also administered. Results : The results showed that although the study subjects had a sedentary lifestyle (lack of PA, average of 6.7 hours sleep, and consumption of high calorie foods), they maintained a normal body mass (less than 25 Kg/m2). Males were more than twice as active as females. With respect to EH, there were few gender differences, except in dairy and meat consumption where 62.5% and 55.5% of males consumed more than 3 servings, respectively, compared to 18.78 % and 3.76% of females, respectively. In addition, waist/height ratio, height, reasons for being active, energy drinks, potato consumption, eating sweets, vigorous PA and breakfast EHs were statistically significant independent predictors for BMI, P

Children with special needs such as those with autism spectrum disorder have been recorded as ostracized and stigmatized in many parts of the world. Little is known about whether such negative views are present among mainstream teachers in Oman. A cross-sectional study was conducted to evaluate school teachers’ awareness about autism spectrum disorder in an urban region in Oman. A total of 164 teachers were randomly enrolled from five schools. Misconceptions about autism spectrum disorder were found to be common among mainstream teachers in the country. We posit that such lack of awareness was likely to be rooted with sociocultural patterning as well as conflicting views often “spun” by the scientific community and mass media. Enlightened views toward children with autism spectrum disorder should be presented to Omani teachers to overcome misconceptions and negative attitudes toward children with autism spectrum disorder.

Objectives: Autism is a lifelong neurodevelopmental disorder of early childhood. Dietary supplementation of the u-3 fatty acid (docosahexaenoic acid [DHA]) during prenatal and postnatal life is considered a protective dietary intervention strategy to minimize the risk for autism spectrum disorder (ASD). To our knowledge, no relevant studies have been conducted in the Middle East investigating the status of DHA among children with autism during early childhood. The aim of this study was to investigate the serum levels and dietary intake status of DHA among Omani children recently diagnosed with ASD. Methods: The present case–control study involved 80 Omani children (

Objective Arab populations lack data related to nutritional assessment in children with autism spectrum disorders (ASDs), especially micronutrient deficiencies such as folate and vitamin B12. Methods To assess the dietary and serum folate and vitamin B12 statuses, a hospital-based case–control study was conducted in 80 Omani children (40 children with ASDs versus 40 controls). Results The ASD cases showed significantly lower levels of folate, vitamin B12, and related parameters in dietary intake and serum levels. Conclusion These data showed that Omani children with ASDs exhibit significant deficiencies in folate and vitamin B12 and call for increasing efforts to ensure sufficient intakes of essential nutrients by children with ASDs to minimize or reverse any ongoing impact of nutrient deficiencies.

Background: The incidence of various types of cancers including the non-Hodgkin’s lymphoma (NHL) has increased during the recent years. Diet and lifestyle factors have been reported to play an important role in the etiology of NHL. However, no such data are available from the Middle Eastern countries, including Oman. Materials and Methods: Forty-three histologically confirmed cases of non-Hodgkin’s lymphoma (NHL) diagnosed at the Sultan Qaboos University Hospital (SQUH) and the Royal Hospital (RH), Muscat, Oman and forty-three age and gender matched controls were the subjects of this study. Frequency matching was used to select the control population. Information on social and demographic data as well as the dietary intake was collected by personal interviews, using a 117-items semi-quantitative food frequency questionnaire. Results: A non-significant increased risk of NHL was observed with higher body mass index (BMI) (OR=1.20, 95%CI: 0.45, 2.93), whereas a significantly decreased risk of NHL was associated with a higher educational level (OR=0.12, 95%CI: 0.03, 0.53). A significantly increased risk was observed for higher intake of energy (OR=2.67, 95%CI: 0.94, 7.57), protein (OR=1.49, 95%CI: 0.54, 4.10) and carbohydrates (OR=5.32, 95%CI: 1.78, 15.86). Higher consumption of daily servings from cereals (OR=3.25, 95%CI: 0.87, 12.09) and meat groups (OR=1.55, 95%CI: 0.58, 4.15) were also found to be associated with risk of NHL, whereas a significantly reduced risk was associated with higher consumption of vegetables (OR=0.24, 95%CI: 0.07, 0.82). The consumption of fruits, milk and dairy products however showed no significant association with the risk of developing NHL. Conclusion: The results suggest that obesity, high caloric intake, higher consumption of carbohydrate and protein are associated with increased risk of NHL, whereas a significantly reduced risk was observed with higher intake of vegetables.

Objective: To evaluate the association between suboptimal breast-feeding practices and autism spectrum disorders (ASDs). Methods: A case–control study was conducted in 102 ASD cases and 102 matched healthy controls. Results: Based on adjusted odds ratios from logistic regression models, ASD was found to be associated with the late initiation of breast-feeding (odds ratio 1.48, 95% confidence interval 1.01– 3.1), a non-intake of colostrum (odds ratio 1.7, 95% confidence interval 1.03–4.3), prelacteal feeding, and bottle-feeding. The risk of ASD was found to decrease in a dose–response fashion over increasing periods of exclusive breast-feeding (P for trend ¼ 0.04) and continued breast-feeding (P for trend ¼ 0.001). Conclusion: The study indicates that increased ASD risk is generally associated with suboptimal breast-feeding practices.