Healthy Shopping & Food labeling: from Choices to decisions: Amal - - PDF document

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Healthy Shopping & Food labeling: from Choices to decisions: Amal Kenanah A healthy and balanced diet can help you to control the condition more effectively. People need to make the right choices when shopping for food. However, this does not need to be a complicated ordeal of label analysis and sugar content measurements. The ideal shopping list for people is trying to eat a healthy, balanced diet. The important of Shopping is:

• Choose healthy food such as low fat, low sodium, sugar free diet will delay any Diabetes

complication diseases such as: Hyper‐lipidemia, Hypertension, Heart disease, and obesity

• Choose food that don’t contain a lot of preservatives such as (artificial colors, and taste)

will avoid infectious diseases and allergies

• Not following media advertising will make the choice for healthy food better
• Wasting time with food choices better than eating unhealthy food
• Spend more time in choosing good product by reading labels, serving size, and low

calorie food will help to spend less time choosing the product from your shelves.

• Smart shopping will be by:
• Eating a variety of foods
• Maintain a healthy weight
• Choose a diet low in fat, saturated fat, and cholesterol
• Choose a diet with plenty of vegetables, fruits, and grain products
• Use sugars only in moderation

Use salt and sodium only in moderation The most important thing to remember for any type of healthy items is this:

• 1gm fat = 9 calories
• 1gm protein = 4 calories
• 1gm carbohydrate = 4 calories

There four type for choosing the healthy items:

• Ingredients
• Food Pyramid
• Exchange list
• Food labels

INGRADIENTS: It is the content of the food but with no amount. First four content are the highest that the products contain and then the rest will be in small amount FOOD PYRAMIDS: It is a guide for healthy eating that suggests eating a variety of food while eating the appropriate amount from each group of food “serving size”. It has six sections for food

• groups. These sections vary in size. The largest group is grains, beans, and starchy

vegetables, rice. That means you should eat more serving of this group than of any of the

• ther foods. The smallest group fats and sweets are at the top of the pyramid. This tells you

to eat very few servings from these food groups. It talked about serving size. EXCHANGE LIST: It is the serving size that needed for the person from all kind of food in each food group FOOD LABELS: Food labels that include nutrition and ingredient information are the most efficient and practical way to communicate much of these data. How to read food labels: According to the Nutrition Labeling and Education Act, all food labels must contain the following information: Title: When you see the title “ Nutrition Facts “, you know this is the current information label approved by the FDA Serving Size: It is the amount of the food you would need to eat to get the amount of listed nutrients

Calories: Is the unit of energy that measures how much energy food provides to your body. Total Calories and Calories for fat, Cholesterol and Saturated Fat: Because fat is very high in calories, it’s maintained with the calories and usually measured in grams. Too much fat can lead to obesity and complication of it such as diabetes, heart disease, and hypertension Sodium: Is a mineral which is found in salt and other foods, it’s a nutrient that can have bad health effects. Total Carbohydrate: Carbohydrates are in foods like bread, potatoes, fruits and vegetables, pasta, rice. It gives the nutrients and energy. Dietary Fiber: Fiber itself has no calories and is necessary part of a healthy diet, and can reduce cholesterol levels. Sugar: Sometimes listed under total carbohydrate, it’s found in most foods, starchy foods (pasta). Sugar is empty calories that increase weight and end up with obesity. Protein: It’s measured by grams, most of the body including muscles, skin and the immune system is made up of protein if the body doesn’t get enough fat and carbohydrates, and it can use protein for energy. Vitamins and Minerals: They are very important to build the body and each person must reach the amount that the body needs to protect the body from diseases. How to live Healthy life style: 1‐ Healthy meals include foods that contain carbohydrate, protein, and fat. For people carbohydrate is the most important nutrient to consider in making food choices. If you know how many grams or CHO you are eating, then you’ll know where your blood glucose level is headed. This is why planning meals and a snack is so important. 2‐ For persons with diabetes, there is no scientific evidence to unnecessarily restrict sucrose and other sugars; foods containing high proportions of added sugars should be used sparingly in the context of a healthful diet, and should be counted for other CHO in the meal plan 3‐ People with Diabetes should eat at least three servings a day because it is important and full of vitamins, minerals and fibers also it is low in calories 4‐ Try to concentrate in fruits on whole one instead of juices because juices increase the blood glucose level very quickly also should be limited to two serving a day 5‐ The recommended daily allowance (RDA) for protein such as meat, poultry, seafood, cheese, egg is 0.8 grams/kg of body weight References: 1‐ World Health Organization (WHO) 2‐ U.S. Food and Drug Administration – Center of Food Safety and Applied Nutrition 3‐ University of Florida – Institute of Food and Agricultural Sciences 4‐ Canadian Diabetes Association 5‐ United State Department of Agriculture (USDA)

Identifying and addressing obesity risk associated with diabetes: Amal Kenanah The significant increase in the prevalence of obesity and diabetes in recent years, and the epidemic is spreading around the world as Western lifestyles are increasingly adopted. Obesity is associated with numerous co‐morbidities, and is also a risk factor for developing type 2 diabetes. Reducing the incidence of obesity may be the most effective health‐care cost‐savings measure available. The prevalence of obesity among persons diagnosed with diabetes was 53% in men and 58% in women. Even higher percentages were classified as

• verweight – 86.3% in men and 84.2% in women. Overweight was deined as a body‐mass

index (BMI) of 25.0 to 29.9, and obesity as a BMI> 30. Waist circumference (WC) is strongly linked to obesity‐associated risks especially for cardiovascular diseases and Diabetes. Modest weight loss, deined as a loss of 5% to 10% of baseline weight, has received increasing attention as a new treatment strategy for overweight and obese patients The Diabetes Prevention Program will be highly successful with multicenter clinic (Physician, Clinical Dietitian, Psychologist, Physical Activity Specialist, treatment options may also include pharmacologic and surgical interventions specially in morbid obese), also the evaluation by following up the person to help them to change their lifestyle prevent or delay the onset of diabetes in individuals at risk. Morbidly obese individuals may require more aggressive intervention. However, many persons who have tried weight loss in the past have regained all or most of the weight they lost. Prevention and control of obesity: 1. Promote the availability of affordable, healthy food and beverages. 2. Support healthy food and beverage choices. 3. Encourage physical activity or limit sedentary activity among people of all ages. 4. Create safe communities that support physical activity. 5. Encourage communities to organize for change. 6. Work with health insurers and third party payors to recognize the link between

• besity and other chronic illnesses, and the need for lifestyle interventions.

7. Advocate for diabetes educators to be reimbursed for self‐management education and training of people with obesity at high risk for developing type2 diabetes. References: 1‐ American Association for Diabetes Educator (AADE) 2‐ American Journal of Clinical Nutrition, Vol. 76, No. 4, 743, October 2002 3‐ American Diabetes Association (ADA) 4‐ World Health Organization

Diabetes in the School Setting: Amal Kenanah Diabetes is one of the most common chronic diseases of childhood, 80 – 90% of children with Diabetes have type1 DM which the child must be insulin injection. In Saudi Arabia type1 DM is a common condition (109.5 / 100,000 child). It is auto‐immune disease NOT caused by overeating, poor life style or self induced, but by a combination of genetic and environmental triggers. General Guidelines for the care of the child in the school and day care setting:

• 1. All materials and equipment necessary for diabetes care tasks must be available in the

school, including blood glucose testing, insulin administration (if needed), glucagon kit, and urine or blood ketone testing. The parent is responsible for the maintenance of the blood glucose testing equipment (i.e., cleaning and performing controlled testing per the manufacturer’s instructions) and must provide materials necessary to ensure proper disposal of materials. A separate logbook should be kept at school with the diabetes supplies for the staff or student to record test results; blood glucose values should be transmitted to the parent/guardian for review as often as requested

• 2. Blood glucose monitoring, including the frequency and circumstances requiring testing.

The teacher must do the self monitoring test every 3 hours to make sure the blood level is under control especially for the DM children that they don't want to be treated differently. The test must be done whenever and wherever the child wants.

• 3. Insulin administration (if necessary), including doses/injection times prescribed for

specific blood glucose values and the storage of insulin.

• 4. Meals and snacks, including food content, amounts, and timing. In younger children the

teacher may need to ensure that all of the meals are eaten on time‐ and that food is not given to ‐ or obtained from ‐ other children. Meals and snack times should be at the same times as other children. Occasionally an additional snack may be necessary just before going into school in the morning. With planning‐ your child can order lunch from the school canteen. Parents need to be informed if there is going to be a change in meal times at school for a special event.

• 5. Symptoms and treatment of hypoglycemia (low blood glucose), including the

administration of glucagon if recommended by the student’s treating physician.

• 6. Symptoms and treatment of hyperglycemia (high blood glucose) by how to give insulin

and what is the treatment dosage, also when he/she have to take it.

• 7. Testing for ketones and appropriate actions to take for abnormal ketone levels, if

requested by the student’s health care provider. References: 1‐ American Diabetes Association (ADA) 2‐ Vermont Department of Health ‐ Diabetes Control Program 3‐ Juvenile Diabetes Foundation 4‐ The Diabetes Children’s Foundation 5‐ American Association for Diabetes Educator (AADE) 6‐ Saudi Med. J. 2009 Feb; 30(2): 310

Post­op Bariatric surgeries protocol diet: Amal Kenanah Bariatric Surgery is known to be the most effective and long lasting treatment for morbid

• besity and many related conditions. Surgeries accepted for adults with BMI of 40 and

above (with or without comorbidities) and a BMI of 35 (with comorbidities). Types of Bariatric surgeries:

• Gastric Banding (LAGB)
• The Gastric sleeve (GS)
• The Gastric Bypass (RYGP)

Post Operative Care and Management (700 – 900 Kcal/day): 1‐ Water intake (for 24 hours after one day of the surgery): 20ml/30 – 60 minutes 2‐ Clear Liquid Diet (for 3 days): 30ml/15 – 30 minutes, such as sugar free juices, Chicken

• r/and meat broth, Herbal tea, Jill‐O, water

3‐ Full Liquid Diet (for 1 week): 30ml/30 minutes, such as all the above, non‐fat Dairy product, low fat and sugar ice‐cream, protein shakes, ready to feed formula, Pudding, wheat creamy style 4‐ Pureed Diet (for 2 weeks): 120ml/3meals/day and in‐between full liquid 60ml 5‐ Mashed Diet (for 2 weeks): 120ml/3meals/day and in‐between full liquid 60ml 6‐ Normal Diet (for 6 months): 180ml/3meals/day and in‐between full liquid 60‐120ml Food must be avoided: 1‐ Caffeine (soft drinks, tea, coffee, energy drinks) 2‐ Citrus food or juice 3‐ Canned or processed food 4‐ Chocolates 5‐ Ready packed soaps 6‐ Fried and fatty food 7‐ Chewing gum Problems may occur after surgery:

• Nausea or vomiting: usually caused by eating too fast, too much, or drinking with meals.
• Hair loss: due to rapid weight loss
• Bad taste in mouth: this is usually common after sugary and should disappear after a

few weeks

• Increased gas: it is a sign of lactose intolerance
• Decreased appetite and taste changes: this is usually common after sugary, meanly the

person must eat a variety of food to prevent complications.

• Excess skin: depend on how much weight they loss, where they lose it, genetics, age, and

gender For Diabetic person bariatric surgery may result in resolution or improvement in type 2 diabetes, but has been found to require lifelong counseling, monitoring, and nutrient supplementation, in order to prevent nutritional deficiencies or a relapse into diabetes References: 1‐ King Saud University – Collage of Medicine, Obesity Chair 2‐ Institute for Advanced Bariatric Surgery (Minimally Invasive Surgery Hospital) 3‐ Johns Hopkins Bayview Medical Center – Bariatric Surgery Program 4‐ The University of Misssissippi Medical Center – Obesity Clinic 5‐ University of Rochester Medical Center 6‐ www.CornellWLS.com

Complications of obesity By : Dr. Khalifa Bin Dainah Obesity is not just a mere disgrace. Disgrace is an issue of modesty. Certain civilisations or parts of the world have even likened obesity to wealth. Rather, the seriousness of obesity is related to the medical complications, disabilities, decrease in life‐expectancy which it creates, and hence the major cost for the society. >> General complications >> Cardio‐vascular complications >> Pulmonary complications >> Endocrine and metabolic complications >> Osteo‐articular complications >> Complications related to anaesthesia >> Other complications related to obesity General complications As we shall see it in details below, obesity provokes many medical complications. These complications can be very specific, such as sleep apnoea, or non‐specific, such as heart angina or hypertension, albeit more pronounced than in normal individuals. We can therefore state that obesity is responsible for an increased risk in mortality and morbidity in each category of age, sometimes up to ten times more. Meanwhile, obesity accounts for numerous disabilities, which interfere with daily life : rejection from others and feeling of loneliness, emotional problems, difficulties in getting a job, a reduced quality of life, decreased physical and sport abilities. Cardio‐vascular complications Obese people are obviously prone to cardiac and vascular complications: ‐Blood pressure increases with weight, and hypertension as an illness is three times more frequent in obese people than in the normal population. ‐The risk for thromboembolism is also increased : atheroma (i.e. cluster of fat tissue inside the artery lumen) of cardiac vessels, which causes angina or even myocardial infarction, or

• f other vessels such as the lower limbs. The occurrence of ischemia, i.e. reduction of blood

supply, is more likely to occur in various organs, with the risk of a complete interruption of blood‐flow and necrosis. ‐Other cardiac diseases can occur : heart failure, rhythm pathologies, and sudden death. ‐There is an increased risk for the venous system : lower limb venous insufficiency (varicose veins, heavy legs), a greater risk for phlebitis, the most serious consequence of which is pulmonary embolism. The risk for the latter is doubled in obese patients above 100 kilos. ‐Higher frequency of diabetes and hypercholesterolemia in obese patients contributes to the above risks, since these two illnesses entail vascular pathologies. Pulmonary complications ‐Obese people are very often breathless under effort, whatever the activity. This hampers practicing sport, or even the simple gestures of daily life such as dressing or climbing the

• stairs. Respiratory tests and exams show almost constant significant impairments of the

respiratory function in morbid obese patients. ‐Sleep apnoea is a specific complication of obesity, and concerns one third of morbid obese people and 10% of the rest of the obese population. It can be matched with the so‐called Pickwick syndrome (described by Burwell in 1956). The patient affected by this syndrome falls asleep at all times during the day, generally while seated and inactive, typically after dinner. It has been described in a startling way by Dickens, whose character, the fat mister Pickwick, actually gave his name to this illness. Sleep apnoea itself may cause other complications (cardiac or neurological for example).

‐Thrombosis is more likely to occur in obese people. For example, the frequency of postoperative (or even spontaneous) phlebitis and pulmonary embolism is much greater in obese people. Osteo‐articular complications They are numerous. >> The most frequent is diabetes mellitus: There is a vast record of medical publications on the subject. More often it is the fat‐related type of diabetes, which is the non insulin‐dependant type, at least in the early stages of

• besity. Thus in the beginning, this type of diabetes can be treated by diet and weight‐loss,

possibly combined with oral medication. Later on, the disease can turn into insulin‐ dependant diabetes, therefore requiring daily injections of insulin. Diabetes is a severe illness that causes many secondary complications: cardiac and vascular complications (atheroma, heart angina and infarction, diseases of the retina that can lead to blindness, etc.).There is a three‐folf risk increase for diabetes in obese patients compared with the normal population. The role of insulin in obese people is complex. Insulin is normally secreted by the pancreas, and acts as a regulator of the sugar level in blood, usually keeping it sufficiently low. Without going into details, an increased level of insulin is observed in the blood flow of

• bese people. But this increase is not correlated with a drop of the sugar level (glycaemia).

The opposite is true, however, for certain rare tumours of the pancreas which secrete an excessive amount of insulin. The mechanism here consists in the occurrence of a multiplication of fat cells, which results in a resistance of the tissues against insulin. This is called the insulin‐resistance phenomenon. >> Blood lipid problems: Circulating fat increases, which enhances the vascular and cardiac risk. This risk is estimated five times more frequent than in the normal population. The most common trouble is a raised level in blood triglycerides. An increase in blood cholesterol is also

• bserved, specifically the " bad cholesterol " that is LDL‐Cholesterol, opposed to the "good

cholesterol" (HDL‐Cholesterol). >> Other metabolic and endocrine consequences: ‐Fertility troubles, leading to sterility. ‐Anomalies of ovulation, the multicyst ovarian syndrome being frequent (resulting in abdominal pain in the middle of the cycle). Osteo‐articular complications Obesity makes articulations generally painful and ill. Some are specifically affected: knees, hips and back bone. Arthritis is more frequent and accelerated, where articulations age faster, until a state of major disability. Slipped disc, lumbago and sciatic are common as well. Whatever the degree of obesity, specialists in rheumatology and orthopaedics often ask their patients to loose a significant amount of weight in order to relieve their articulations and to prevent osteoarthritis and aging of the articulations. Loosing weight is likely to improve the outcome of some operations as well, e.g. the placement of a knee or hip prosthesis, which could otherwise grow fragile much faster. Symptoms of gout are observed more frequently than in the normal population, and are combined with a higher blood level of uric acid (uricemia).

Other complications are tendinitis and osteoporosis (loss of bone substance occurring in

• lder women after the menopause), which increases the risk for bone‐injury.

Complications related to anaesthesia Any anaesthesic procedure puts the obese patient at risk, because of their deteriorated cardiac and pulmonary functions, and because of the greater risk of thromboembolism. Some casual difficulties may also occur in the technical procedure : placement of an intraveinous catheter for perfusions, intubation, ventilation , controlling of respiratory parameters and volume of injected Other complications related to obesity ‐Cutaneous complications: mycosis and maceration of the folds, hypersudation, lower limbs ulcers. ‐Higher frequency of certain cancers: endometrium, breast, colon and rectum, prostate. ‐Digestive complications: cholelithiasis (gallstones), liver steatosis, gastro‐oesophageal reflux. ةﺪﻌﻤﻟا ﺮﻴﻐﺼﺗ ﺔﻴﻠﻤﻋ د . ﺔﻨﻳد ﻦﺑ ﺔﻔﻴﻠﺧ ﻢﻟﺎﻌﻟا ىﻮﺘﺴﻣ ﻰﻠﻋ ﻂﻔﻓ ﺎﻬﻳﺮﺠﻳو ﺎﻴﻤﻟﺎﻋ ةﺪﻳﺪﺠﻟا تﺎﻴﻠﻤﻠﻌﻟا ﻦﻣ ﺔﻨﻤﺴﻟا جﻼﻌﻟ ةﺪﻌﻤﻟا ﺮﻴﻐﺼﺗ ﺔﻴﻠﻤﻋ15 ﺪﻗو ﺮﻴﻇﺎﻨﻣ حاﺮﺟ ﺠﻟا ﺔﻄﺑار ﺲﺌﻳرو ﻰﺒﻄﻟا ﺔﻴﻧﺎﻤﻠﺴﻟا ﻊﻤﺠﻤﺑ ﺮﻴﻇﺎﻨﻤﻟاو ﺔﻣﺎﻌﻟا ﺔﺣاﺮﺠﻟا ىرﺎﺸﺘﺳا ﺔﻨﻳد ﻦﺑ كرﺎﺒﻣ ﺔﻔﻴﻠﺧ رﻮﺘآﺪﻟا ىﺮﺟا ﻦﻴﺣاﺮ ﻦﻣ ﺮﻴﺜآ ﻰﻠﻋ ةﺪﻋ تﺎﻴﻠﻤﻋ بﺮﻌﻟا ﻦﻴﺣاﺮﺠﻟا ﺔﻄﺑار ﻦﻣ ﻖﺜﺒﻨﻤﻟا ﺮﻴﻇﺎﻨﻤﻟا ﻰﺣاﺮﺠﻟ ﺔﻴﺑﺮﻌﻟا ﺔﻋﻮﻤﺠﻤﻟا ﺲﺌﻳرو ﺔﻴﻨﻳﺮﺤﺒﻟا ةﺪﻳﺪﺠﻟا ﺔﻴﻠﻤﻌﻟا ةﺬﻬﺑ ﺎﻨﻔﻳﺮﻌﺘﻟ ﺔﺑ ﺎﻨﻴﻘﺘﻟا ﺪﻗو ﺔﻜﻠﻤﻤﻟﺎﺑ ﻰﺿﺮﻤﻟا لوﻻا لاﻮﺴﻟا :؟ ﺔﻴﻠﻤﻌﻟا ةﺬه ﻰهﺎﻣ ﺼﺘﻟ ﺔﻴﻠﻤﻋ ﻰهو ﻰﺣاﺮﺠﻟا رﺎﻈﻨﻤﻟا ﻖﻳﺮﻃ ﻦﻋ ىﺮﺠﺗ ﺔﻴﻠﻤﻌﻟا ﻢﺠﺣ ﻦﻣ ةﺪﻌﻤﻟا ﺮﻴﻐ ﺔﻴﻠﻤﻋ ﻰﻠﻋ ﻂﻘﻓ ﺪﻤﺘﻌﺗ ﻻو زﻮﻤﻟا ﻢﺠﺤﺑ ةﺪﻌﻤﻟا ﻢﺠﺣ ﺢﺒﺼﻳو ﺮﻴﺒﻜﻟا ﺔﺨﻴﻄﺒﻟا ﺔﻤﻬﻣ ءاﺰﺟا ةﺪﻌﻤﻟا ﻦﻣ ﻞﺻﺎﺘﺼﺗ ﻰﺘﻟا ءاﺰﺟﻻا ﻰﻓ كﺎﻨه ﻦﻜﻟو ﻂﻘﻓ ةﺪﻌﻤﻟا ﺮﻴﻐﺼﺗ ةﺬه ﻦﻣ زﺮﻔﻳ نﻮﻣﺮه كﺎﻨهو ﺔﻨﻤﺴﻟا ﻰﺿﺮﻣ ىﺪﻟ عﻮﺠﻟا ﺔﻴﻠﻤﻋ ﻦﻋ ﺔﻟﻮﺌﺴﻣو ﺼﺘﺳا دﺮﺠﻤﺑو ﻦﻴﻟﺮﻬآ نﻮﻣﺮه ﻰﻋﺪﻳ ﺔﻘﻄﻨﻤﻟا ﻒﻗﻮﺘﺗ ةﺪﻌﻤﻟا ﻦﻣ ءﺰﺠﻟا اﺬه لﺎ ﻞﻗﻻا ﻰﻠﻋ ﻞﺻﺎﺼﺘﺴﺑ حاﺮﺠﻟا مﻮﻘﻳو عﻮﺠﻟا ﺔﻴﻠﻤﻋ75 % ﺢﺒﺼﺗو ةﺪﻌﻤﻟا ﻢﺠﺣ ﻦﻣ ﺔﺑﻮﺒﻧا وا زﻮﻤﻟا ﻞﻜﺷ ﻰﻠﻋ ةﺪﻌﻤﻟا. , ﺔﻘﻠﺣ ﻞﺜﻣ ﺎﻬﻨﻳﺮﺟاو ىﺮﺠﺗ ةﺪﻋ تﺎﻴﻠﻤﻋ كﺎﻨهو ﺎﻬﻨﻣ ﺢﻠﺼﺗﻻ ﻰﺘﻟاو تﺎﻴﺒﻠﺴﻟا ﻦﻣ ﺮﻴﺜآ ﺎﻬﻳﺪﻟ ﺎﻬﻨﻜﻟو ةﺪﻌﻤﻟا ىﺮﻣ ﻞﻳﻮﺤﺗو ةﺪﻌﻤﻟا ﻨﻳﺮﺤﺒﻟا ﻰﺿﺮﻤﻠﻟﺔﻤﺟ ةﺮﻃﺎﺨﻣو تﺎﻔﻋﺎﻌﻀﻣ ﺎﻬﻟ ﺎﻬﻨﻣو ﻦﻴ ؟ﺔﻴﻠﻤﻌﻟا ﺪﻌﺑ ﺾﻳﺮﻤﻠﻟ ثﺪﺤﻳ اذﺎﻣ ﻰﻧﺎﺜﻟا لاﻮﺴﻟا ءاﺪﺒﻳ ﻰﻟﺎﺘﻟﺎﺑو مﺎﻌﻄﻟا ﻦﻣ ةﺮﻴﺒآ تﺎﻴﻤآ ﻞآا ﻰﻠﻋ ﺾﻳﺮﻤﻟا رﺪﻘﻳ ﻻ ﺎﻴﻧﺎﺛو ﺮﻴﺒآ ﻞﻜﺸﺑ ﺾﻳﺮﻤﻟا ىﺪﻟ عﻮﺠﻟا ﺔﺒﺴﻧ ﻞﻘﺗ ﺔﻴﻠﻤﻌﻟا ﺪﻌﺑ ﺎﻴﺠﻳرﺪﺗ لوﺰﻨﻟﺎﺑ نزﻮﻟا ؟ﺔﻴﻠﻤﻌﻟا ةﺬه تاﺰﻴﻤﻣ ﻰهﺎﻣ ﺖﻟﺎﺜﻟا لاﻮﺴﻟا ﻘﻟ ﻞﻴﺒﺳ ﻰﻠﻋ ةﺮﻴﺒآ تﺎﻴﺒﻠﺳ ءﺎﻌﻣﻻا ﻞﻴﺻﻮﺗ ﺔﻴﻠﻤﻋو ةﺪﻌﻤﻟا ﺔﻘﻠﺣ ﺎﻬﻨﻣو ﺔﻨﻤﺴﻟا تﺎﻴﻤﻌﻟ ﺎﻨﺋاﺮﺟا ﺬﻨﻣ ةﺮﻴﺧﻻا ةﺮﺘﻔﻟا ﻰﻓ ﺎﻨﻈﺤﻟ ﺪ ةﺪﻌﻤﻟا ﺔﻘﻠﺣ ﻢﻬﻟ ﻊﻔﻨﺗ ﻻو ةﺪﻳﺪﺸﻟا ﺔﻳراﺮﺤﻟا تاﺮﻌﺴﻟا ﻰﻓ ﻦﻴﻃﺮﻔﻤﻟاو تﺎﻳﻮﻠﺤﻟا ﻦﻴﻠآا ﻰﺿﺮﻤﻠﻟ ﺢﻠﺼﺗﻻ ةﺪﻌﻤﻟا ﺔﻘﻠﺣ ﺔﻴﻠﻤﻋ لﺎﺜﻤﻟا ﻤﻋ ءاﺮﺟا ﻦﻣ ﻊﻳرذ ﻞﺸﻓ كﺎﻨهوﺾﻳﺮﻤﻟا ةﺪﻌﻣ ﻰﻠﻋ ﻰﻧﻮﻜﻴﻠﺳ زﺎﻬﺟ ﺐﻴآﺮﺗ ﻰﻟا ﺔﻓﺎﺿﻻﺎﺑ صﺎﺨﺷﻻا ءﻻﻮﻬﻟ ةﺪﻌﻤﻟا ﺔﻘﻠﺣ ﺔﻴﻠ . ةﺮﻴﺒآ تﺎﻴﻤآ ناﺪﻘﻔآ ﻰﺿﺮﻤﻟا ﻰﻠﻋ ةﺮﻴﺒﻜﻟا تﺎﻔﻌﻀﻤﻟا ﻦﻣ ﺎﻬﻟو ةﺮﻴﺒآ ﺔﻴﻠﻤﻋ ﻰه مﺎﻌﻄﻟا ىﺮﺠﻣ ﻞﻳﻮﺤﺗ ﻰهو ىﺮﺧﻻا ﺔﻴﻠﻤﻌﻟاو ﺑو ءﺎﻨﺛا ﻰﻓ ةﺪﻳﺪﺷ تﺎﻔﻋﺎﻀﻣ ﺎﻬﻟو ﻢﺴﺠﻟﺎﺑ ﺔﻴﺳﺎﺳﻻا داﻮﻤﻟاو تﺎﻨﻴﻣﺎﺘﻔﻟا ﻦﻣﺔﻴﻠﻤﻌﻟا ﺪﻌ. ﻞﻳﻮﺤﺗ ﺔﻴﻠﻤﻋو ﺔﻤﺴﺠﺑ ﺐﻳﺮﻏ ءﺰﺟ ﺐﻴآﺮﺗ ﻰﻟا ﺾﻳﺮﻤﻟا جﺎﺘﺤﻳ ﻻو ﺔﺤﺟﺎﻧو ﺔﻌﻳﺮﺳ ﺔﻴﻠﻤﻋ ﻰﻬﻓ ةﺪﻌﻤﻟا ﺮﻴﻐﺼﺗ ﺔﻴﻠﻤﻋ ﺎﻣا تﺎﻔﻋﺎﻀﻤﻟا ةﺮﻴﺜآ ﺔﻴﻠﻤﻋ مﺎﻌﻄﻟا ىﺮﺠﻣ

؟ﺔﻴﻠﻤﻌﻟا ةﺬه ﺞﺋﺎﺘﻧ ﻰهﺎﻣ ؟ﻊﺑاﺮﻟا لاﻮﺴﻟا ﻳﺮﺟا ﻂﻘﻓ ﺎﺜﻳﺪﺣو ﻦﻄﺒﻟا ﺢﺘﻓ ﻖﻳﺮﻃ ﻦﻋ ىﺮﺠﺗ ﺖﻧﺎآ ﻦﻜﻟو اﺪﺟ ﺔﻤﻳﺪﻗ ﺔﻴﻠﻤﻋ ﺎﻬﻧا ﺪﻘﻔﻳ ﺎﻬﺠﺋﺎﺘﻧو ﻰﺣاﺮﺠﻟا رﺎﻈﻨﻤﻟا ﻖﻳﺮﻃ ﻦﻋ ﺖ ﺺﺨﺸﻟا33 %ﺔﻴﻠﻤﻌﻟا ءاﺮﺟا ﻦﻣ ﺔﻨﺳ لﻼﺧ ﺔﻧزو ﻦﻣ ؟ﺔﻴﻠﻤﻌﻟا ةﺬه ءاﺮﺟا ﻖﺤﺘﺴﻳ ﻦﻣ ﺲﻣﺎﺨﻟا لاﻮﺴﻟا ﺮﻜﺴﻟا ضﺮﻤآ ﺔﻨﻤﺴﻟا تﺎﻔﻋﺎﻀﻣ ﻊﻣ نزﻮﻟا ةدﺎﻳز ﻦﻣ وا ﺔﻨﻤﺴﻟا ﻦﻣ نﻮﻧﺎﻌﻳ ﻦﻳﺬﻠﻟا صﺎﺨﺷﻻا ﺔﻴﻠﻤﻌﻟا ةﺬه ءاﺮﺟا ﻖﺤﺘﺴﻳ او ﻦﻳاﺮﺸﻟا ضﺮﻣو مﺪﻟا ﻂﻐﺿوﺔﻨﻤﺴﻟا ﻰﺿﺮﻣ تﺎﻔﻋﺎﻀﻣ ﻞآو مﻮﻨﻟا ءﺎﻨﺛا ﺲﻔﻨﺘﻟا ﻒﻗﻮﺗ ﻦﻣ نﻮﻧﺎﻌﻳ ﻦﻳﺬﻠﻟا صﺎﺨﺷﻻ ﻰﻔﺸﺘﺴﻤﻟﺎﺑ ﺾﻳﺮﻤﻟا دﻮﺟو قﺮﻐﺘﺴﻳ ﻢآ ؟سدﺎﺴﻟا لاﻮﺴﻟا ةﺪﻌﻤﻠﻟ رﺎﻈﻨﻤآ ﺔﻴﻠﻤﻌﻟا ةﺬه ءاﺮﺟا ﻞﺒﻗ تﺎﺣﻮﺼﻔﻟا ﺾﻌﺑ ﻰﻟا جﺎﺘﺤﻳو ﺔﻴﻠﻤﻌﻟا ءاﺮﺟا ﻦﻣ ﻂﻘﻓ مﺎﻳا ﺔﺛﻼﺛ ﻰﻟا جﺎﺘﺤﻳ ﺾﻳﺮﻤﻟا ﻟا قﻮﻓ ﺔﻌﺷﻻاو مﺪﻠﻟ ﻞﻴﻟﺎﺤﺗوﻦﻄﺒﻠﻟ ﺔﻴﺗﻮﺼ ﺔﻳدﺎﻌﻟا ةﺎﻴﺤﻟا ﺔﺳرﺎﻤﻣو ﻞﻤﻌﻠﻟ دﻮﻌﻟا ﻦﻣ عﻮﺒﺳا لﻼﺧ ﺾﻳﺮﻤﻠﻟ ﻦﻜﻤﻳو ؟ﺔﻴﻠﻤﻌﻟا ﺪﻌﺑ ﻰﺋاﺬﻏ ﺞﻣﺎﻧﺮﺑ كﺎﻨه ﻞه ؟ﻊﺑﺎﺴﻟا لاوﻮﺴﻟا ﺖﻴﺒﻟﺎﺑ ﺔﻴﺋاﺬﻐﻟا لاﻮﺴﻟا مﺎﻈﻧ مﺪﺨﺘﺴﻳ ﺎﻬﻟﻼﺧ نﻮﻜﻳ ﻦﻴﻋﻮﺒﺳا ﻰﻟا ﺾﻳﺮﻤﻟا جﺎﺘﺤﻳ آﺎﻳ نا ﻦﻜﻤﻳ ﺎهﺪﻌﺑو ﻢﻋﺎﻨﻟا ﻞآﻻا ﺎﻬﻟﻼﺧ مﺪﺨﺘﺴﻳ ﻦﻳﺮﺧا ﻦﻴﻋﻮﺒﺳاوءﺎﺷ ﻦﻣ ﻞ ؟ﺔﻴﻠﻤﻌﻟا ةﺬه تﺎﻔﻋﺎﻀﻣ ﻰهﺎﻣ ؟ﻦﻣﺎﺜﻟا لاﻮﺴﻟا ﺔﻈﺣﻼﻤﻟاو ﺔﻴﻠﻤﻌﻟا ﻞﺒﻓ ﺔﻘﻴﻗﺪﻟا تﺎﺻﻮﺤﻔﻟﺎﺑ ﻦﻜﻟو ﺔﻴﺤﺻ ﻞآﺎﺸﻣ ىﺄﺑ ﺔﺑﺎﺻﻼﻟ ضﺮﻌﻣ ﺺﺨﺸﻟا ﺔﻴﻠﻤﻋ ىا ءاﺮﺟا ﻞﺜﻣ ﺎﻴﻤﻟﺎﻋ ﺔﻜﻠﻤﻤﻟﺎﺑ ﻰﺿﺮﻤﻟا ىﺪﻟ تﺎﻔﻋﺎﻀﻤﻟا نﻮﻜﺗ دﺎﻜﺗ ﺔﻴﻠﻤﻌﻟا ءاﺮﺟا ﺪﻌﺑ ةدﺎﺠﻟا0% دﺎﻔﺗ ﺎﻴﻤﻟﺎﻋ ﺔﻄﻴﺴﺑ ﺐﺴﻧ كﺎﻨه ﻦﻜﻟو ﺔﻴﻟﺎﻌﻟا ﺔﻴﻨﻘﺘﻟا ةﺮﺒﺨﻠﻟ ﺔﺠﻴﺘﻧ ﻦﻳﺮﺤﺒﻟﺎﺑ ﺎﻬﻨﻳ ؟ﺔﻴﻠﻤﻌﻟا ةﺬه ﻞﺜﻣ حﺎﺠﻨﻟ ةﺮﻓاﻮﺘﻤﻟا رﻮﻣﻻا ﻰهﺎﻣ ؟ ﻊﺳﺎﺘﻟا لاﻮﺴﻟا ﺔﺜﻳﺪﺤﻟا ﺔﻴﺒﻄﻟا تاﺪﻌﻤﻟا دﻮﺟوو ﻦﻴﺿﺮﻤﻤﻟاو ﻦﻳرﺪﺨﻤﻟا ﻦﻣ ﻢﻗﺎﻃو ﻞﻣﺎﻜﺘﻣ ﻰﺒﻃ ﻖﻳﺮﻓ دﻮﺟو تﺎﻴﻠﻤﻌﻟا ةﺬه حﺎﺠﻧ بﺎﺒﺳا ﻢها ﻦﻣ ﻣ ءاﺮﺟا ﺪﻌﺑو ءﺎﻨﺛاو ﻞﺒﻗ ﺔﻘﻴﻗﺪﻟا ﺔﻈﺣﻼﻤﻟاوﺔﺜﻳﺪﺤﻟا تﺎﻴﻠﻤﻌﻟا ةﺬه ﻞﺜ ﺐﻴﺒﻄﻟا ﻰﻠﻋو ﻢﻬﻟ ﺢﻠﺼﺗ ى تﺎﻴﻠﻤﻌﻟا ﺾﻌﺑو ﺔﻨﻤﺴﻟا ﻰﺿﺮﻤﻟا ﺾﻌﺒﻠﻟ ﺢﻠﺼﺗ تﺎﻴﻠﻤﻌﻟا ﺾﻌﺑ نا ﺔﻘﺑﺎﺴﻟا ماﻮﻋﻻا ﻰﻓ ﺎﻨﻈﺤﻟ ﺪﻘﻟ ﻻ ﻰﺘﺣ ﺾﻳﺮﻤﻠﻟ ﺔﻴﻠﻤﻌﻟا ﻞﺸﻓو حﺎﺠﻧ ىﺪﻣ ﻦﻋ حﻮﺿوو ﻞﻜﺑ ﺾﻳﺮﻤﻟا رﺎﺒﺧاو ﻞﻤﻌﻟا ﻰﻓ ﺔﻧﺎﻣﻻا ﺔﻨﻤﺴﻟا ﻰﺿﺮﻣ جﻼﻌﻟ ﺮﺷﺎﺒﻤﻟا ﺮﺟﺎﺑ ﺾﻳﺮﻤﻟا ﺮﻤﺘﺴﻳﺔﻌﻔﻨﺗﻻ ﺔﻴﻠﻤﻋ ءا ﺔﻟﺎﺧدا مﺪﻋو ﺾﻳﺮﻤﻟا ىﺪﻟ ﺔﻠﻣﺎﻜﻟا ةرﻮﺼﻟا ﺢﻴﺿﻮﺗ ﻰﺿﺮﻤﻠﻟ ﻢﻴﺟﺮﻟا تﺎﻄﻄﺨﻣ ﻞﻤﻋو نزﻮﻟا صﺎﻘﻧﺎﺑ ﺔﻤﺘﻬﻤﻟا تادﺎﻴﻌﻟا ﻰﻠﻋو ﺔﺟﻼﻌﻟ ﺔﺣﺎﺘﻤﻟا قﺮﻄﻟا ﻦﻣ ﺾﻳﺮﻤﻟا ﺪﻴﻔﺘﺴﻳ ﻰﺘﺣ ﺔﻨﻤﺴﻟا ﻰﺣاﺮﺠﻟ ﺔﻠﻳﻮﺤﺗو ﺔﻳﺪﺠﻣﻼﻟا ﻢﻴﺟﺮﻟا ﻢﺋاﻮﻗ ﺔﻣاود ﻰﻓ ﻰﻠﻋ ﻰﻨﺛا نا ﺪﻳراونﻮهﺪﻟا ﻂﻔﺷ قﺮﻃ ﺎﻬﻌﻣ ﻊﻔﻨﺗﻻ ﻰﺘﻟا تﻻﺎﺤﻟا ﻞﻳﻮﺤﺗ ﻰﻓ ﺔﻣﺎﺗ ﺔﻳارد ﻰﻠﻋ ﻢﻬﻧﻻ ﻞﻴﻤﺠﺘﻟا ﻰﺣاﺮﺟ ﺎﻨﺋﻼﻣز ﻚﻠﻤﻟا ﺔﻟﻼﺠﻟ ىﺪﻴﺴﻟ نﺎﻓﺮﻌﻟاو ﻞﻳﺰﺠﻟا ﺮﻜﺸﻟا ﻚﻟﺎﻨهو ﻢﻈﻌﻤﻟا ﻞﻣﺎﺣ ﺪﻬﻌﻟا ﻞﻣﺎﺣ ﻰﻟو ﻮﻤﺳو ﺮﻗﻮﻤﻟا ءارزﻮﻟا ﺲﺌﻳر ﻮﻤﺳو ﺔﻨﻬﻤﻠﻟ ﻰﺘﻟواﺰﻣ ﻦﻴﺤﻟو ﻰﺿﺮﻣ ةﺮﺘﻓ ﻰﻓ ﻰﻟ صﺎﺨﻟا ﺔﻤﻋﺪﻟ ﺔﻳار ةزاﻮﻤﻟاو ﻢﻋﺪﻟا اﺬه نود ﻦﻣو ىﺪﻠﺑ ءﺎﻨﺑا ﺔﻣﺪﺨﻟ ىﺮﺧا ةﺮﻣ ﻰﻓ ﻼﻴﻟﺎﻋ ﺔﻜﻠﻤﻤﻟا ﻢﺳا ﻊﻓﺮﻟ ﺔﻴﻓاﺮﺘﺣاو ﺔﺟو ﻢﺗا ﻰﻠﻋ ىﺮﺧا ةﺮﻣ ﻰﻨﻃﻮﻟا ﻰﺒﺟاو ىدوا حاﺮﺠآ ىﺮﺧا ةﺮﻣ ﻒﻗﻻ ﻦآا ﻢﻟ ةﺪﻳﺪﺸﻟا ﻮﻤﻟا ﺎﻤﺋاد ساﺮﺘﺗ ﻦﻳﺮﺤﺒﻟا ﺖﺤﺒﺻا ﻢﻋﺪﻟا اﺬه ﻞﻀﻔﺑ ﻰﺘﻟاو ﺮﻴﻇﺎﻨﻤﻟا ﺔﺣاﺮﺟ لﺎﺠﻣ ﻰﻓ ﺔﻴﻤﻠﻌﻟا ﻞﻓﺎﺤﻤﻟا ﻞﻴﻤﺤﺗو ﺔﻴﻤﻠﻌﻟا تاﺮﻤﺗ ﺔﻳﺮﻴﻈﻨﺘﻟا ﺔﺣاﺮﺠﻟا ﻰﻓ ةدﺎﻴﻘﻟاو ةدﺎﻳﺮﻟا.

An overview of Nutrition Assessment: Adults & Pediatrics Najla Al.Hraiwi ( summary of presentation topics ) Najla J AlHraiwil , Clinical Dietitian “ Coordinator of the " Qualification program in Clinical Nutrition ‐KSA , Central Region King Saud University , College of Applied Medical sciences .08

• KSA. Riyadh

– Definition of Nutrition Assessment . – Purpose & Goals of Nutrition Assessment. – Types of information & measurements that are most commonly used in Nutritional assessment : 1‐ Historical information : Types & obtaining methods . 2‐ Dietary Assessment & Most common methods used for gathering food intake Data . 3‐ Anthropometric Data : Definition , Uses & values calculating methods for Adults & Pediatrics “ in details “ . 3‐ Body Compositions : an overview . 4‐ Biochemical Analysis : common blood tests related to Nutritional Status & Nutritional Interpretation Of Routine Medical Laboratory Data . Case study . “ Reviewing the different components of a nutrition assessment “ Intervention Approach ­ Obesity in Bahrain

• Dr. Nadia M. Gharib,

The healthy implication of obesity and overweight form a major challenge to the national health strategy. The prevalence of overweight and obesity among the adults reached 60% and 62% among males and females; and 26% and 21% among school age girls and boys, respectively. In general, adults and children had low levels of physical activity, and school age children indulged in a sedentary life style. The major types of non – communicable (cardiovascular, diabetes, neoplasms) as per latest health statistics are responsible for around 40% of total deaths in Bahrain. Levels of intervention programs strategically based on enhancing public awareness, encouraging legislative decisions to improve the quality and services of food and food products and on the practical side by making direct intervention through obesity clinics. Obesity awareness campaigns address issues on related risk of obesity. The medical conditions and its management through healthy eating and active lifestyle were stressed Obesity management clinics which started recently are receiving a very positive response from the public especially that the individual can feel the success of weight loss. The success encouraged us to open more of obesity clinics and to extend it to serve school age children. The established nutrition surveillance system elements include, a) anthropometry: weight, height, BMI, waist circumference; b) laboratory test: hemoglobin, sugar, fat; and blood pressure; c) dietary data: 24‐hrs. recall, food frequency. In conclusion obesity is considered one of the major chronic disease in Bahrain need to be managed through healthy nutrition, lifestyle and when necessary pharmacotherapy and bariatric surgery should be considered.