1. Reference: TITLE: HIGH CONSUMPTION OF LOW-NUTRIENT, ENERGY-DENSE FOODS AND BEVERAGES IS PUTTING GCC COUNTRIES AT A DOUBLE BURDEN OF NUTRITION AUTHORS: Basma Attia, and Toine Hulshof: Kellogg’s Company, EMEA 3/111 Introduction: There is an alarming increase in the prevalence of obesity in the six Gulf Cooperation Council (GCC) countries and especially among adult females 1. Among the six countries, Kuwait, Bahrain, Saudi Arabia and UAE are at the top ten list of obese countries, worldwide 2. Discussion Poor dietary status and obesity is common in GCC countries: Low fruit and vegetables intake Rely on grain-based foods, mainly rice, as main food Many foods and traditional dishes are considerable high in fat content 11 Table 2: Food groups and suggested daily servings by the Arab Center for Nutrition 12 Since GCC countries diet rely on grain-based food as the main source of energy, the Arab center for Nutrition recommends to eat grains fortified with iron, folic acid, calcium, and vitamin D whenever possible 13. Conclusion A high intake of energy-dense nutrient-low food in combination with low physical exercise have resulted in a double burden of nutrition in GCC countries with high obesity rates and relative high levels of certain nutrient deficiencies GCC countries have set a nine years (2010-2019) regional nutrition strategic approaches to overcome these nutritional challenges 14 : 1.Strengthening political commitment, legislation and multi-sectoral approaches to ensure healthy and sustainable food supply 2.Promoting and protecting the nutritional well-being of women and children and ensuring good nutrition throughout the life-cycle for all age groups. 3.Promoting food with adequate micronutrient content. 4.Providing comprehensive information and education to the public. 5.Promoting implementation of the WHO global strategy on diet, physical activity and health 6.Improving nutrition services and capacity building in the health sector, including emergency situations and support to vulnerable groups 7.Strengthening food safety 8.Ensuring a safe, healthy and sustainable food supply 9.Research, monitoring and evaluation Objectives: To undertake a review of published evidence to: 1.Analyze the current obesity status and physical inactivity in GCC countries 2.Identify the most common micronutrient deficiencies 3.Discuss local/gulf recommendations for food groups that could help overcome current nutritional issues Methods: Systematically review scientific literature on PubMed, ScienceDirect, along with regional published nutrition guidelines to investigate obesity, nutrition deficiencies and physical inactivity status in the six GCC countries Results Obesity: Data are scarce from many countries in the GCC, but even so, there’s compelling evidence that obesity rates are very high and on the rise. Table 1: Prevalence of obesity in adults - GCC countries 3 Physical inactivity: The prevalence of physical inactivity is another major concern as studies in the GCC countries show a serious increase in physical inactivity especially among females 4 Figure 1: Male & Female adolescents additional Metabolic Equivalent (MET) in min/week across obesity Index —Saudi Arabic, 2011 5 Cultural restrictions on females have impact on physical activity/inactivity and consequently body weight: Limited access to sports and exercise activities Easy availability of cheap migrant labor for household work TV and internet being the main leisure activity Multiple pregnancies (gestational weight gain, decreased physical activity, and increased food intake) 6 Micro-nutrient intake and status: Several studies conducted in the Gulf region indicate low intakes of vital nutrients. Vitamin D, Iron and Calcium are lacking in the modern GCC countries diet 84% of Saudi 7 and 78% of UAE 8 population has Vitamin D deficiency More than one third of the population in the GCC countries are anemic 9 In the UAE 90% of children (6-10 years) and 95% of adolescents did not meet current recommendations for calcium intake 10 Kuwait Saudi Arabia UAEBahrainQatarOman Male36%28%25%19% 8% Female48%44%42%32% 17% REFERENCES: (1, 2, 3, 6) ALNohair S. “Obesity in Gulf Countries“. International Journal of Health Sciences. 2014;8(1):79-83. (4, 11, 12, 13) Musaiger, Abdulrahman O. et al. “Food-Based Dietary Guidelines for the Arab Gulf Countries.” Journal of Nutrition and Metabolism 2012 (2012): 905303. (5) Al-Nuaim, Anwar A. et al. “The Prevalence of Physical Activity and Sedentary Behaviours Relative to Obesity among Adolescents from Al-Ahsa, Saudi Arabia: Rural versus Urban Variations.” Journal of Nutrition and Metabolism 2012 (2012): 417589. (7) Nabi G. et al. “High prevalence of vitamin D deficiency and cancer in Saudi Arabian populations: Can we hypothesize a link?“. Medical Hypotheses 2015 Aug;85(2):117-9. (8) Dubai Health Authority. Vitamin D Accessed online June 2016 at: https://www.dha.gov.ae/En/healtheducation/articles/pages/vitamind.aspx. (9, 14) Regional strategy on nutrition 2010–2019. Regional Committee for the Eastern Mediterranean.. World Health Organization, 2010. Available at http://applications.emro.who.int/docs/EM_RC57_4_en.pdf. (10) Ali HI, Ng SW, Zaghloul S, Harrison G, Qazaq H, El Sadig M, Yeatts K. High proportion of 6 to 18 year old children and adolescents in the United Arab Emirates are not meeting dietary recommendations. Nutrition Research. 2013;33:447-456. (11)