Dietary factors and their association with childhood obesity in the Middle East: A systematic review.
BACKGROUND:
Childhood obesity is a global epidemic that is related to environmental and genetic factors and has adverse consequences throughout life, being obese is a serious health problem in childhood and increases the risk of many co-morbidities.


AIM:
The purpose of this systematic review is to illustrate that dietary factors correlate with obesity among children studied in the Middle East area.


METHODS:
Studies were screened by searching two databases in August 2017 and considered as eligible for inclusion if they: (a) are observational studies, (b) define at least one dietary factor for obese children aged 6-12 years, (c) are undertaken in the Middle East area, and (d) are written in English. The search dependent words and terms used are: diet, nutrition, pediatric obesity, physical activity, Middle East, overweight, children, excess weight, childhood, obesity and dietary factors. Papers were initially evaluated for eligibility based on title and abstract. The full text of articles of studies that met, or appeared to meet, the inclusion criteria, were saved. Quality assessment was conducted using the NIH tool for observational cohort and cross-sectional studies. Out of 730 studies, 4 papers met the inclusion criteria and rated as good quality. These studies were from Iran ( n=2), Saudi Arabia ( n=1) and Lebanon ( n=1) during 2008 and 2016.


RESULTS:
Dietary factors identified were breakfast intake, junk-food consumption, energy intake and micronutrient intake. The present systematic review shows that several dietary behaviors such as missing breakfast, excessive fat and refined carbohydrate intake with low micronutrient intake due to low consumption of fruits, vegetables and milk/diary, are associated with obesity in children in the Middle East.


CONCLUSIONS:
A healthy diet during childhood to control weight and prevent obesity is recommended for a healthy, lifelong adulthood.