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Article: Beyond transmission: Dire need for integration of nutrition interventions in COVID-19 pandemic-response strategies in Developing Countries like Pakistan.

Hakeem, Rubina / Sheikh, Muhammad Adil

2020 Volume 36, Issue COVID19-S4, Page(s) S85–S89

Abstract: Synergistic associations between infection and nutrition are well known. Impact of nutrition interventions on the outcomes have been scientifically assessed and reported. The role of nutrition in limiting the infection related morbidity and mortality ... ...

Abstract	Synergistic associations between infection and nutrition are well known. Impact of nutrition interventions on the outcomes have been scientifically assessed and reported. The role of nutrition in limiting the infection related morbidity and mortality does not appear to be a debatable question but nutrition interventions do not appear to be an essential part of current COVID-19 management strategies. Given the nature of pandemic and lack of organism-specific evidence, variability in nutrition interventions and lack of nutrition interventions is not unexpected. However, delay in realization of the crucial need of nutrition interventions to limit the immediate and long term outcomes at personal and community level may aggravate health related issues that can have long term impact on quality of life and economy. Due to existing undernutrition and lack of nutrition related awareness and competence, need for timely and appropriate interventions is much more critical for developing countries. This manuscript highlights the need and feasibility of various nutrition interventions to assure optimum quality of life during and after COVID-19 pandemic. Available evidence provides enough guidance for nutrition interventions that are safe and promise to accrue various degrees of benefits with almost no likelihood of harm. Nutrition interventions suggested by author are: 1) population level efforts for promoting better use of existing resources; 2) quicker augmentation of nutrition status of high risk people and non-hospitalized cases by use of supplement and individualized guidance and 3) nutritional support of sever case by timely and adequate enteral and parenteral feeding.
Keywords	covid19
Language	English
Publishing date	2020-06-09
Publishing country	Pakistan
Document type	Journal Article ; Review
ZDB-ID	2032827-8
ISSN	1681-715X ; 1682-024X ; 1017-4699
ISSN (online)	1681-715X
ISSN	1682-024X ; 1017-4699
DOI	10.12669/pjms.36.COVID19-S4.2784
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Article: Beyond transmission: Dire need for integration of nutrition interventions in COVID-19 pandemic-response strategies in developing countries like Pakistan

Hakeem, Rubina / Sheikh, Muhammad Adil

Pak. J. Med. Sci.

Abstract	Synergistic associations between infection and nutrition are well known. Impact of nutrition interventions on the outcomes have been scientifically assessed and reported. The role of nutrition in limiting the infection related morbidity and mortality does not appear to be a debatable question but nutrition interventions do not appear to be an essential part of current COVID-19 management strategies. Given the nature of pandemic and lack of organism-specific evidence, variability in nutrition interventions and lack of nutrition interventions is not unexpected. However, delay in realization of the crucial need of nutrition interventions to limit the immediate and long term outcomes at personal and community level may aggravate health related issues that can have long term impact on quality of life and economy. Due to existing undernutrition and lack of nutrition related awareness and competence, need for timely and appropriate interventions is much more critical for developing countries. This manuscript highlights the need and feasibility of various nutrition interventions to assure optimum quality of life during and after COVID-19 pandemic. Available evidence provides enough guidance for nutrition interventions that are safe and promise to accrue various degrees of benefits with almost no likelihood of harm. Nutrition interventions suggested by author are: 1) population level efforts for promoting better use of existing resources; 2) quicker augmentation of nutrition status of high risk people and non-hospitalized cases by use of supplement and individualized guidance and 3) nutritional support of sever case by timely and adequate enteral and parenteral feeding.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #616747
Database	COVID19

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Article ; Online: Role of HbA1c in predicting risk for congenital malformations.

Hammouda, Sahar Ali Ibrahim / Hakeem, Rubina

Primary care diabetes

2015 Volume 9, Issue 6, Page(s) 458–464

Abstract: Aims: Association between conventionally identified hyperglycemias and rates of congenital abnormalities is known; however there is less information about role of HbA1c in determining gestational hyperglycemias and associated risks. This study tried to ... ...

Abstract	Aims: Association between conventionally identified hyperglycemias and rates of congenital abnormalities is known; however there is less information about role of HbA1c in determining gestational hyperglycemias and associated risks. This study tried to explore the association between HbA1c in women without known diabetes at first antenatal visit and risk of congenital malformations (CM) among Saudi women living at Al-Madinah Al-Monawarah. Methods: Eleven hundred and eighty (1180), healthy, first-trimester pregnant Saudi females without known diabetes, were selected from various antenatal care clinics of Al-Madinah Al-Monawarah city. General clinical and biochemical data was collected for this study by researchers at first visit and the time of delivery. Results: Nearly one fifth (19.6%) of mothers had above normal HbA1c (>5.7) at first visit. Rates of CM had significant positive association with level of HbA1c. Rate of CM among those who had HbA1c in diabetes range, pre-diabetes range or normal range was 27.8%, 9.8% and 3.0%, respectively. The difference was significant between normal and pre-diabetes at the level P=0.000 and between pre-diabetes and diabetes at level P=0.038. Conclusion: In this study HbA1c is found to be a valuable predictor of risk of congenital malformations. This observation calls for further studies and establishment of policies for care of pregnant mothers having higher than normal HbA1c at first visit.
MeSH term(s)	Adolescent ; Adult ; Biomarkers/blood ; Congenital Abnormalities/blood ; Congenital Abnormalities/diagnosis ; Congenital Abnormalities/epidemiology ; Diabetes, Gestational/blood ; Diabetes, Gestational/diagnosis ; Diabetes, Gestational/epidemiology ; Female ; Glycated Hemoglobin A/analysis ; Humans ; Middle Aged ; Prediabetic State/blood ; Prediabetic State/diagnosis ; Prediabetic State/epidemiology ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First/blood ; Risk Assessment ; Risk Factors ; Saudi Arabia/epidemiology ; Up-Regulation ; Young Adult
Chemical Substances	Biomarkers ; Glycated Hemoglobin A ; hemoglobin A1c protein, human
Language	English
Publishing date	2015-12
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2273997-X
ISSN	1878-0210 ; 1751-9918
ISSN (online)	1878-0210
ISSN	1751-9918
DOI	10.1016/j.pcd.2015.01.004
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Article: Assessment of iodine levels in the Pakistani diet.

Hakeem, Rubina

Nutrition (Burbank, Los Angeles County, Calif.)

2004 Volume 20, Issue 10, Page(s) 952–953

MeSH term(s)	Diet ; Food Analysis ; Goiter/epidemiology ; Goiter/prevention & control ; Humans ; Iodine/administration & dosage ; Iodine/deficiency ; Pakistan/epidemiology ; Sodium Chloride, Dietary/administration & dosage
Chemical Substances	Sodium Chloride, Dietary ; iodized salt ; Iodine (9679TC07X4)
Language	English
Publishing date	2004-10
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	639259-3
ISSN	1873-1244 ; 0899-9007
ISSN (online)	1873-1244
ISSN	0899-9007
DOI	10.1016/j.nut.2003.11.006
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Article ; Online: Macronutrient intake and association with the risk factors of diabetic complications among people with type 2 diabetes

Meena Iqbal Farooqi / Palash Chandra Banik / Farzana Saleh / Liaquat Ali / Kulsoom Baqa / Asher Fawwad / Rubina Hakeem / Abdul Basit

Clinical Epidemiology and Global Health, Vol 10, Iss , Pp 100667- (2021)

2021

Abstract: Objective: To assess the intake of macronutrient and proportion of risk factor of diabetic complication among people with type 2 diabetes and to explore their causal relation. Methodology: A retrospective study conducted on retrieved first visit data of ... ...

Abstract	Objective: To assess the intake of macronutrient and proportion of risk factor of diabetic complication among people with type 2 diabetes and to explore their causal relation. Methodology: A retrospective study conducted on retrieved first visit data of 9563 subjects visiting the study center between 2006 and 2014. Macronutrient intake was assessed using 24-hr recall. Standard protocols were used for demographic, anthropometric measurements and biochemical variable. Statistical analysis was performed using statistical package for social sciences (SPSS) version 20. Result: Out of 9563 subjects, 53.7% were males; mean age, duration of diabetes and body mass index was 51.02 ± 10.99 (yrs), 11.06 ± 8.2 (yrs) and 28.15 ± 5.34 (kg/m2) respectively. Average daily intake of carbohydrate, proteins and fats was 230.6, 68.1 and 66.1 g; and the mean intake of calories was 51.4%, 15.1% and 33.5% respectively. Obesity was found (≥25 kg/m2) 50.6% and overweight (23–24.9 kg/m2) in 34.9%. Women took more calories from fat (p = 0.001), men from protein and carbohydrates (p = 0.001). People>50 years took more fat than <50 (p = 0.001). Conclusion: Prevalence of risk factors is high among the study subjects. The proportion of carbohydrate and fat in total daily calories is higher than usual recommendations for people with diabetes. This may be the reason behind the high prevalence of the risk factors. Further large-scale studies are needed to validate our findings.
Keywords	Dietary factor ; Nutrient ; Diabetes ; Pakistan ; Public aspects of medicine ; RA1-1270
Subject code	306
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Food choices during Ramadan

Thamina Rashid / Muhammad Yakoob Ahmedani / Rubina Hakeem / Musarrat Riaz

Journal of Fasting and Health, Vol 5, Iss 1, Pp 49-

2017 Volume 49

Abstract: Few studies have assessed the dietary Practices of people with diabetes during Ramadan (1). A sub study of Ramadan prospective diabetes study (2) which was conducted at the outpatient department of Baqai Institute of Diabetology and endocrinology, ... ...

Abstract	Few studies have assessed the dietary Practices of people with diabetes during Ramadan (1). A sub study of Ramadan prospective diabetes study (2) which was conducted at the outpatient department of Baqai Institute of Diabetology and endocrinology, Karachi Pakistan in 2009 analyzed the food choices of patients with diabetes during Ramadan. Several irregularities regarding dietary intake and food choices were noted among the study participants. Although, the patients were counseled regarding diet before Ramadan, many did not follow the dietary advice. All patients had taken food at Iftar but majority of them preferred fried items like samosas, pakoras (fried snack), chicken rolls etc. these deeply fried items can lead to post Iftar hyperglycemia. Patients were also opted for fruit chat, dahibara and chanachaat at Iftar, higher load of these items can also worsen glycemic control. The striking finding was almost absence of meat (protein) intake at Iftar but study from India showed increment of all three macronutrients during Ramadan (3). This may result in higher intake of items from carbohydrate and fat groups resulting in hyperglycemia after iftar. Intake of vegetables at Iftar was also negligible and hence the diet was not well balanced. The food choices at sahoor included roti, paratha (fried bread), slices, khajla, pheni, meat, egg and milk. Though it is advisable to take complex carbohydrates, protein and fat at sahoor as these are slowly digestible and can prevent hypoglycemia during fasting but khajla pheni are extremely rich in fat and carbohydrate content and should be avoided (4). However, paratha in 2 teaspoon of oil can be taken at sahoor.Patients with diabetes who fast during the month of Ramadan should have pre Ramadan dietary guidance and counseling session in order to modify their food preferences and choices during the holy month of Ramadan (4).
Keywords	Ramadan ; Fasting ; Diet ; Medicine (General) ; R5-920
Subject code	590
Language	English
Publishing date	2017-03-01T00:00:00Z
Publisher	Mashhad University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Diabetes education and care in a developing country: observations from Karachi, Pakistan.

Sheikh, Muhammad Adil / Hakeem, Rubina / Asar, Farzana / Shaikh, Abdul Hakeem

Primary care diabetes

2015 Volume 9, Issue 1, Page(s) 48–53

Abstract: Objective: To explore the kind of care being received by a sample of middle income group subjects with diabetes in Karachi.: Design: Cross-sectional.: Place and duration of study: Raana Liaquat Ali Khan College of Home Economics, Karachi from ... ...

Abstract	Objective: To explore the kind of care being received by a sample of middle income group subjects with diabetes in Karachi. Design: Cross-sectional. Place and duration of study: Raana Liaquat Ali Khan College of Home Economics, Karachi from January 2009 to September 2009. Patients and methods: Information was collected from 105 type 2 diabetics through a structured, pre-tested, self administered questionnaire distributed in two colleges only to those students who had any adult onset diabetic in their family. SPSS version 16 was used for data entry and analysis (e.g., chi-square tests). Results: The mean duration of diabetes was 8.9 years. Random blood sugar, blood pressure check and urine test for sugar were the most frequently performed tests. Many important diabetes related tests had not been performed even on subjects with duration of diabetes of 10 years or more such as HbA1c had never been performed for 74% of subjects in this class. Test for circulation had never been performed for 93% of subjects with 1 year's diabetes duration and for 62% of subjects with duration of 10 years or more. More than 90% subjects received information about diet and causes of diabetes; >70% had been informed about diabetes complications, foot care, dental care, self monitoring of blood glucose and testing sugar in urine and only 48% had been educated about insulin injections. Physician was the source of this information for more than 70% of subjects. Conclusions: This study has explored insufficient clinical monitoring of diabetes complications and provision of casual diabetes education. These observations highlight the need for provision of appropriate diabetes education, both to health care team and professionals.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Biomarkers/blood ; Blood Glucose/metabolism ; Developing Countries ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/therapy ; Female ; Glycated Hemoglobin A/metabolism ; Guideline Adherence ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility ; Humans ; Male ; Middle Aged ; Pakistan ; Patient Education as Topic ; Practice Guidelines as Topic ; Practice Patterns, Physicians' ; Predictive Value of Tests ; Prognosis ; Risk Assessment ; Risk Factors ; Surveys and Questionnaires
Chemical Substances	Biomarkers ; Blood Glucose ; Glycated Hemoglobin A ; hemoglobin A1c protein, human
Language	English
Publishing date	2015-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2273997-X
ISSN	1878-0210 ; 1751-9918
ISSN (online)	1878-0210
ISSN	1751-9918
DOI	10.1016/j.pcd.2014.04.006
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Maternal and Infant Health Outcomes Associated with Medical Nutrition Therapy by Registered Dietitian Nutritionists in Pregnant Women with Malnutrition: An Evidence Analysis Center Systematic Review

Pari-Keener, Maria / Gallo, Sina / Stahnke, Barbara / McDermid, Joann M / Al-Nimr, Rima Itani / Moreschi, Julie M / Hakeem, Rubina / Handu, Deepa / Cheng, Feon W

Academy of Nutrition and Dietetics Journal of the Academy of Nutrition and Dietetics. 2020,

2020

Abstract: Malnutrition during the critical period of pregnancy has significant health outcomes for both the mother and her offspring. Medical nutrition therapy (MNT) by a registered dietitian nutritionist (RDN) may help mitigate negative health effects, although ... ...

Abstract	Malnutrition during the critical period of pregnancy has significant health outcomes for both the mother and her offspring. Medical nutrition therapy (MNT) by a registered dietitian nutritionist (RDN) may help mitigate negative health effects, although studies that support the role of the RDN have not been comprehensively evaluated. The objective was to explore the health effects of MNT by an RDN on maternal and infant outcomes in pregnant women with malnutrition. A systematic review of studies published between 2000 and 2014 that incorporated MNT by an RDN during pregnancy were retrieved from a PubMed search, using criteria established by the Academy of Nutrition and Dietetics Evidence Analysis Process. Among 94 identified studies, five controlled trials met the inclusion criteria. The initial search was extended to include one study published between 2014 and 2019. Outcomes included maternal gestational weight gain, maternal markers of glycemic control, maternal complications such as hypertension, incidence of caesarean section, infant birth weight both in grams and in clinical categories, infant gestational age, and infant complications. There was good/strong evidence that MNT by an RDN decreased gestational weight gain, although there was no effect on maternal complications, caesarean section deliveries, and gestational age among women with mixed body mass index status or those who were overweight/obese. The evidence was deemed fair in support of an effect on glycemic control, infant birth weight, and infant complications. The heterogeneity in the results are due to the variation among populations studied, types of interventions, and inconsistency among outcomes. In addition, the training and educational requirements of the RDN or the international equivalent may vary widely across the four countries in which studies were conducted. There was good evidence for MNT by an RDN during pregnancy on improving gestational weight gain among overweight/obese women. To better support the role of MNT by an RDN in the health care of pregnant women, research that clearly identifies the role of the RDN in the intervention, includes a control group, and studies more heterogeneous populations is needed.
Keywords	birth weight ; body mass index ; cesarean section ; diet therapy ; dietetics ; dietitians ; gestational age ; glycemic control ; health effects assessments ; health services ; hypertension ; malnutrition ; nutritionists ; obesity ; pregnancy ; pregnant women ; progeny ; systematic review ; weight gain
Language	English
Publishing place	Elsevier Inc.
Document type	Article
Note	Pre-press version
ZDB-ID	2646718-5
ISSN	2212-2672
ISSN	2212-2672
DOI	10.1016/j.jand.2019.10.024
Database	NAL-Catalogue (AGRICOLA)

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Article: Maternal and Infant Health Outcomes Associated with Medical Nutrition Therapy by Registered Dietitian Nutritionists in Pregnant Women with Malnutrition: An Evidence Analysis Center Systematic Review.

Pari-Keener, Maria / Gallo, Sina / Stahnke, Barbara / McDermid, Joann M / Al-Nimr, Rima Itani / Moreschi, Julie M / Hakeem, Rubina / Handu, Deepa / Cheng, Feon W

Journal of the Academy of Nutrition and Dietetics

2020 Volume 120, Issue 10, Page(s) 1730–1744

Abstract	Malnutrition during the critical period of pregnancy has significant health outcomes for both the mother and her offspring. Medical nutrition therapy (MNT) by a registered dietitian nutritionist (RDN) may help mitigate negative health effects, although studies that support the role of the RDN have not been comprehensively evaluated. The objective was to explore the health effects of MNT by an RDN on maternal and infant outcomes in pregnant women with malnutrition. A systematic review of studies published between 2000 and 2014 that incorporated MNT by an RDN during pregnancy were retrieved from a PubMed search, using criteria established by the Academy of Nutrition and Dietetics Evidence Analysis Process. Among 94 identified studies, five controlled trials met the inclusion criteria. The initial search was extended to include one study published between 2014 and 2019. Outcomes included maternal gestational weight gain, maternal markers of glycemic control, maternal complications such as hypertension, incidence of caesarean section, infant birth weight both in grams and in clinical categories, infant gestational age, and infant complications. There was good/strong evidence that MNT by an RDN decreased gestational weight gain, although there was no effect on maternal complications, caesarean section deliveries, and gestational age among women with mixed body mass index status or those who were overweight/obese. The evidence was deemed fair in support of an effect on glycemic control, infant birth weight, and infant complications. The heterogeneity in the results are due to the variation among populations studied, types of interventions, and inconsistency among outcomes. In addition, the training and educational requirements of the RDN or the international equivalent may vary widely across the four countries in which studies were conducted. There was good evidence for MNT by an RDN during pregnancy on improving gestational weight gain among overweight/obese women. To better support the role of MNT by an RDN in the health care of pregnant women, research that clearly identifies the role of the RDN in the intervention, includes a control group, and studies more heterogeneous populations is needed.
MeSH term(s)	Birth Weight ; Cesarean Section/statistics & numerical data ; Evidence-Based Medicine ; Female ; Gestational Age ; Glycemic Control/statistics & numerical data ; Humans ; Infant, Newborn ; Malnutrition/complications ; Malnutrition/therapy ; Nutrition Therapy/methods ; Nutritionists ; Pregnancy ; Pregnancy Complications/epidemiology ; Pregnancy Complications/therapy ; Premature Birth/epidemiology ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Weight Gain
Language	English
Publishing date	2020-02-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2646718-5
ISSN	2212-2672
ISSN	2212-2672
DOI	10.1016/j.jand.2019.10.024
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Beliefs of people with diabetes about skin prick during Ramadan fasting.

Masood, Shabeen Naz / Sheikh, Muhammad Adil / Masood, Yasir / Hakeem, Rubina / Shera, A Samad

Diabetes care

2014 Volume 37, Issue 4, Page(s) e68–9

MeSH term(s)	Adult ; Blood Glucose Self-Monitoring ; Diabetes Mellitus/blood ; Diabetes Mellitus/drug therapy ; Fasting ; Humans ; Hypoglycemic Agents/therapeutic use ; Islam ; Middle Aged ; Retrospective Studies ; Skin Tests ; Surveys and Questionnaires
Chemical Substances	Hypoglycemic Agents
Language	English
Publishing date	2014-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/dc13-2277
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