Abstract

The alarmingly rising trend of type 2 diabetes constitutes a major global public health challenge particularly in the Middle Eastern and North African (MENA) region where the prevalence is among the highest in the world with a projection to increase by 96% by 2045. The economic boom in the MENA region over the past decades has brought exceptionally rapid shifts in eating habits characterized by divergence from the traditional Mediterranean diet towards a more westernized unhealthy dietary pattern, thought to be leading to the dramatic rises in obesity and non-communicable diseases. Research efforts have brought a greater understanding of the different pathways through which diet and obesity may affect diabetes clinical outcomes, emphasizing the crucial role of dietary interventions and weight loss in the prevention and management of diabetes. The purpose of this review is to explore the mechanistic pathways linking obesity with diabetes and to summarize the most recent evidence on the association of the intake of different macronutrients and food groups with the risk of type 2 diabetes. We also summarize the most recent evidence on the effectiveness of different macronutrient manipulations in the prevention and management of diabetes while highlighting the possible underlying mechanisms of action and latest evidence-based recommendations. We finally discuss the need to adequately integrate dietetic services in diabetes care specific to the MENA region and conclude with recommendations to improve dietetic care for diabetes in the region.

Highlights

  • The rising burden of diabetes mellitus is one of the major public health challenges of the current century and its prevalence among adults worldwide has more than tripled over the past 2 decades [1]

  • Hydrogenated vegetable oils are major sources of trans fatty acids and their increased consumption contributes to the fattening of the diet which is considered as a central feature of the western dietary pattern, and is closely associated with the development of health and metabolic issues including insulin resistance, cardiovascular diseases (CVD) and T2DM [24]

  • Dietary and lifestyle interventions and adhering to recommendations of specialized healthcare professionals are a cornerstone for the effective prevention and management of diabetes

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Summary

A Review of the Evidence

Citation: Hwalla, N.; Jaafar, Z.; Abstract: The alarmingly rising trend of type 2 diabetes constitutes a major global public health challenge particularly in the Middle Eastern and North African (MENA) region where the prevalence is among the highest in the world with a projection to increase by 96% by 2045. The economic boom in the MENA region over the past decades has brought exceptionally rapid shifts in eating habits characterized by divergence from the traditional Mediterranean diet towards a more westernized unhealthy dietary pattern, thought to be leading to the dramatic rises in obesity and non-communicable diseases. Research efforts have brought a greater understanding of the different pathways through which diet and obesity may affect diabetes clinical outcomes, emphasizing the crucial role of dietary interventions and weight loss in the prevention and management of diabetes. The purpose of this review is to explore the mechanistic pathways linking obesity with diabetes and to summarize the most recent evidence on the association of the intake of different macronutrients and food groups with the risk of type 2 diabetes. We also summarize the most recent evidence on the effectiveness of different macronutrient manipulations in the prevention and management of diabetes while highlighting the possible underlying mechanisms of action and latest evidence-based recommendations. We finally discuss the need to adequately integrate dietetic services in diabetes care specific to the MENA region and conclude with recommendations to improve dietetic care for diabetes in the region. Type 2 Diabetes in the MENA Region: Keywords: type 2 diabetes; dietary management; MENA region; obesity; insulin resistance; insulin glucose homeostasis Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Licensee MDPI, Basel, Switzerland. 4.0/).

Introduction
Risk Factors and Diabetes
Obesity and Diabetes
Significance and Barriers
Result
Carbohydrates
Dietary Fiber
Proteins
Objective
Food Groups
Improving Dietetic Care for Diabetes in the MENA Region
Findings
Conclusions
Full Text
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