A systematic review of randomized controlled trials of dietary interventions for weight loss in adults in the Middle East and north Africa region

Abstract

Summary The prevalence and incidence of obesity, and associated complications, such as type 2 diabetes, in the Middle East and north Africa (MENA) region rank among the highest in the world. Little is known about the effectiveness of dietary weight loss interventions conducted in the MENA region. We conducted a systematic review of randomized clinical trials aiming to assess the effectiveness of dietary interventions for weight loss in the adult population originating from and residing in the MENA region. In accordance with PRISMA guidelines, PubMed, CINAHL, Cochrane, and EMBASE were systematically searched for randomized controlled trials (RCT) using dietary interventions for weight loss conducted in the MENA region. RCTs examining weight loss as an outcome in adults (≥ 18 years old) were included. The Cochrane Collaboration tool for assessing risk of bias was used to ascertain the quality of the eligible RCTs and the Template for Intervention Description and Replication for population health and policy interventions (TIDieR‐PHP) checklist was used to evaluate the reporting of the interventions. Twenty‐nine RCTs including 2792 adults from five countries in the MENA region met the search criteria. Study participants were predominantly middle‐aged females. Duration of follow up was mostly 3 months or less. Weight loss ranged from −0.7 to 16 kg across all intervention groups and the average weight loss was 4.8 kg. There was paucity of description of the weight loss interventions and variations amongst studies did not allow a meta‐analysis of findings. It was not possible to draw firm conclusions on the effectiveness of dietary weight loss interventions in the region. High quality studies using more structured interventions of longer duration with standardized outcome measures are needed in the MENA region to support clinical practice with evidence‐based interventions for obesity.

A Real-World Study in Patients with Type 2 Diabetes Treated with Gliclazide Modified Release during Fasting in Gulf Cooperation Council Countries: An Analysis from the International DIA-RAMADAN Study

“…Of note, previous studies have shown increasing rates of obesity and sedentary lifestyle in the GCC countries in recent years. As a result, more efforts are warranted to reduce obesity in this region, through improvements in diet and physical activity that would translate into increased glycemic control [24, 25].…”

Dietary Management of Type 2 Diabetes in the MENA Region: A Review of the Evidence

“…Obesity is a primary etiological contributor in the development of diabetes and is by far the leading risk factor behind the rising prevalence of diabetes worldwide [6]. Over the past few decades, the MENA region has witnessed major economic, social, lifestyle, and political changes that have potentially contributed to the rise in obesity prevalence [28]. The significant association between diabetes and obesity has been documented in several countries of the MENA region [29][30][31].…”

“…In the MENA region, various dietary interventions for weight loss and glycemic control have shown superior results for carbohydrate-restricted, Mediterranean and American Diabetes Association (ADA) diets. However, higher quality, longer-duration and culture-sensitive studies are still needed to clearly describe an effective dietary strategy specific to the region [28]. The current dietary guidelines endorse the use of these healthy dietary patterns and recommend individualizing nutrition therapy and tailoring it to patients' eating patterns, preferences, and metabolic goals [98].…”

Qatar Diabetes Mobile Application Trial (QDMAT): An Open-Label Randomised Controlled Trial To Examine The Impact of Using A Mobile Application To Improve Diabetes Care In Type 2 Diabetes Mellitus – A Study Protocol

“…Diabetes Mellitus (DM) is a chronic disease associated with serious micro-and macro-vascular complications that reduce quality of life and longevity with adverse social and economic consequences (1). DM prevalence is increasing globally but at a more rapid pace in the Middle East and North Africa (MENA) region, and particularly in Arab countries in the Gulf Cooperation Council (2,3). DM management is focused around glycaemic, blood pressure, and lipid control.…”