Editorial
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Metabolic health problems are considered global public health because population worldwide have overweight, obesity and associated metabolic health problems that include metabolic syndrome, diabetes, hypertensive disorders, cardiovascular disease, stroke, Alzheimer’s disease, cancer and others. Its known risk factors are genetic and unhealthy behaviors.
Many research evidences show the effect of overconsumption of sugar, fructose, trans fat, animal fat, and processed foods on overweight, obesity, metabolic health and its associated diseases. These unhealthy behaviors result in hyperglycemia, dyslipidemia, mitochondrial dysfunction, advanced glycation end products, oxidative stress, free radicals, cytokines disturbances. Then, cellular and systemic pathogenesis occur that include accumulation of extra fatty acid, insulin resistance, endothelial cell dysfunction, pre-inflammatory state, and atherosclerosis. It is a trajectory of pathogenesis across the lifespan; from childhood, adolescent, adult, elderly; affecting all human body systems.
It affects many organs and body systems causing several chronic diseases and complications. For example, cardiovascular system manifestations are coronary heart disease, hypertensive disorders, and chronic kidney disease. Neurological symptoms include stroke, Alzheimer’s disease, dementia, Parkinson's disease, and multiple sclerosis. Endocrine, digestive, and immune system pathological conditions are diabetes, metabolic syndrome, hyperthyroidism, hypothyroidism, systemic lupus erythematosus, fatty liver, carcinoma of prostate gland and colon. Reproductive system manifestations are polycystic ovary syndrome, breast cancer, and endometrial cancer. Musculoskeletal system symptoms are back pain, osteoarthritis and rheumatoid arthritis.
Clearly understanding and wisely modification of dietary patterns and physical activities are strongly recommended to prevent and manage this situation. Metabolic health literacy should be educated for all. Effective program for promotion of healthy dietary pattern and doing regular exercise are the best strategies to implement worldwide in order to minimize the global metabolic health problems.
Research Article
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Objective: To translate and adapt to the Moroccan context the diabetes-39 questionnaire, and to assess the psychometric properties of the adapted version among Moroccan patients with diabetes.
Materials and Methods: The questionnaire was translated from English to spoken Arabic, then back translated to English. A consensus meeting discussed discrepancies and major changes. The adapted version was administered to 92 patients with type 2 diabetes to assess its psychometric properties. Inter-item correlation, item-to-dimension correlation, and Cronbach’s alpha were calculated to assess internal consistency. Additionally, construct validity was assessed using means comparison of domains scores according to the general perception of the quality of life and the perception of disease severity.
Results: Participants’ mean age was 56.4 ± 10.9. The sample was constituted predominantly by women. Cronbach’s alpha ranged from 0.65 for “social burden” and 0.93 for “diabetes control”. Items showed a higher correlation with their own domain as compared to other domains. Higher scores of the five domains of the diabetes-39 were associated with the perception of lower quality of life and higher disease severity.
Conclusion: The results of this study support the reliability and validity of the Moroccan version of the diabetes-39 questionnaire. They justify its use and further assessment among our patients with diabetes.
Mini-Review
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Obesity is a complicated metabolic malfunction linked to disconnected signaling between inter-organs, and inter-molecularly affected by impairment of the neuronal circuit, stemming from environmental stressors in children and adults. Upon environmental intoxication or change in the surrounding environmental stressors; the signaling for hunger could affect regulatory signaling in energy consumption and lead to a wide range of metabolic disruption and sensitivity, cell-to-cell and organ-to-organ. Presently, food addiction is associated with substance-based and behavioral malfunction, which reflects the alteration of molecular and genetic deficiency in animal studies and clinical studies. The prevailing food addiction hypothesis suggest that food types can alter the brain circuitry for a reward compensation which may link to compulsive eating behavior phenotype comparable to drug addiction. Like synthetic drugs, food consumption results in the release of dopamine, which relates to the feelings of being rewarded, and has shown to have similar brain activation patterns. It remains unclear what molecules could engage in the regulatory process, or what are key molecular determinants to control the hormonal secretion. Several interventions such as calorie restriction, exercise, bariatric surgery, and treatments for obesity management have been moderately successful in reducing body fat in the short term, but most fail to maintain long-term weight loss. Herein, we propose the advantage of the molecular-based risk assessment, namely the omics platform, to improve health quality by reviewing the impact of environmental stressors. Bulimia nervosa has received less attention in this regard, despite their regular binge eating symptoms.
