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The beneficial role of breast-feeding for maternal and child health is now well established. Its possible role in helping to prevent diabetes and obesity in children in later life means that more attention must be given to understanding how patterns of infant feeding are changing. The present study describes breast-feeding profiles and associated factors in Kuwait.
Interviews with 1484 recent mothers were undertaken at immunisation clinics across Kuwait. Descriptive analysis and binary logistic regression of results were performed.
Rates of breast-feeding initiation in Kuwait were high (98·1 %) but by the time of discharge from hospital, only 36·5 % of mothers were fully breast-feeding, 37·0 % were partially breast-feeding and 26·5 % were already fully formula-feeding. Multiple social and health reasons were given for weaning the child, with 87·6 % of mothers who had stopped breast-feeding completely doing so within 3 months postpartum. Nationality (P<0·001), employment status 6 months prior to delivery (P<0·001), mode of delivery (P=0·01), sex of the child (P=0·026) and breast-feeding information given by nurses (P=0·026) were all found to be significantly associated with breast-feeding. Few women (5·6 %) got information on infant nutrition and feeding from nursing staff, but those who did were 2·54 times more likely to be still breast-feeding at discharge from hospital. Over 70 % of mothers had enjoyed breast-feeding and 74 % said they would be very likely to breast-feed again.
In Kuwait where the prevalence of both obesity and type 2 diabetes is growing rapidly, the public health role of breast-feeding must be recognised and acted upon more than it has in the past.
The 2H dilution technique is the reference method to estimate total body water for body composition assessment. The aims of the present study were to establish the total body water technique at the Kuwait Institute for Scientific Research and assess body composition of Kuwaiti children.
The isotope ratio mass spectrometer was calibrated with defined international reference water standards. A non-random sampling approach was used to recruit a convenience sample of Kuwaiti children. A dose of 2H2O, 1–3 g, was consumed after an overnight fast and 2H enrichment in baseline and post-dose urine samples was measured. Total body water was calculated and used to estimate fat-free mass. Fat mass was estimated as body weight minus fat-free mass.
The total body water study was implemented in primary schools.
Seventy-five boys and eighty-three girls (7–9 years).
Measurements of the isotope ratio mass spectrometer were confirmed to be accurate and precise. Children were classified as normal weight, overweight or obese according to the WHO based on BMI-for-age Z-scores. Normal-weight and overweight girls had significantly higher percentage body fat (median (range): 32·4 % (24·7–39·3 %) and 38·3 % (29·3–44·2 %), respectively) compared with boys (median (range): 26·5 % (14·2–37·1 %) and 34·6 % (29·9–40·2 %), respectively). No gender difference was found in obese children (median 46·5 % v. 45·6 %).
The establishment of a state-of-the-art stable isotope laboratory for assessment of body composition provides an opportunity to explore a wide range of applications to better understand the relationship between body size, body composition and risk of developing non-communicable diseases in Kuwait.
National nutrition survey covering all geographical areas of the country.
Kuwaitis (n 1704) between 3 and 86 years of age.
Obesity was more prevalent among women than men (50 % and 70 % for females aged 19–50 years and ≥51 years, respectively, v. 29 % and 42 % for their male counterparts). Boys were more obese than girls, with the highest obesity rate among those aged 9–13 years (37 % and 24 % of males and females, respectively). Energy intake was higher than the estimated energy requirements for almost half of Kuwaiti children and one-third of adults. The Estimated Average Requirement was exceeded by 78–100 % of the recommendation for protein and carbohydrates. More than two-thirds of males aged ≥4 years exceeded the Tolerable Upper Intake Level for Na. Conversely, less than 20 % of Kuwaitis, regardless of age, consumed 100 % or more of the Estimated Average Requirement for vitamin D, vitamin E, Ca, n-3 and n-6 fatty acids. Less than 20 % of children met the recommended level for fibre.
Nutrition transition among Kuwaitis was demonstrated by the increased prevalence of obesity and overweight, increased intakes of energy and macronutrients and decreased intakes of fibre and micronutrients. Interventions to increase awareness about healthy foods combined with modifications in subsidy policies are clearly warranted to increase consumption of low-energy, nutrient-dense foods.
Abdominal obesity is a major risk factor for chronic diseases. Yet there are no waist circumference (WC) cut-offs for children in the Arabian Gulf. We developed smoothed WC percentiles for 5–19-year-old Kuwaiti children and adolescents, which could be used in clinical and public health practice. We also examined the percentages of children who had WC ≥ 90th percentile, a value commonly associated with an elevated risk of CVD.
This is a cross-sectional study that was conducted by the Kuwait National Nutrition Surveillance System.
Data were collected from representative primary-, intermediate- and secondary-school children as part of the yearly nutrition and health monitoring. Least mean square regression was used to develop smoothed WC curves.
A total of 9593 healthy 5·0–18·9-year-old children of both sexes were studied from all areas of Kuwait. Age, gender, residency, education level, weight, height and WC were collected for all participants.
We developed the first smoothed WC curves for Kuwaiti children. Male children had higher WC than female children. WC increased with age in both genders, but larger percentages of male children had WC ≥ 90th percentile. Male children aged >10 years have higher WC percentiles than do female children at the 50th, 75th, 90th and 97th percentiles.
Male children (especially those aged >10 years) are at higher risk than female children. Few health-care professionals routinely measure WC. WC measurement should be promoted as an important tool in paediatric primary care practice. The use of these age- and gender-specific percentiles can impact public health recommendations for Kuwaiti and other Arab children from the Gulf.
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