title: Nutrition transition and cardiovascular disease risk factors in Middle East and North Africa countries: reviewing the evidence.
abstract: OBJECTIVE
  To examine the burden of cardiovascular disease (CVD) risk factors in Middle East and North Africa countries and their associations with dietary behaviors as nutrition transition is unfolding in the region.
  
  
  METHODS
  Data on CVD risk factors were collected from scholarly papers and a systematic review of published articles was performed. Dietary patterns were derived from the WHO Food and Agriculture Organization Statistical Databases.
  
  
  RESULTS
  Wide variations exist across countries in the prevalence of CVD risk factors, namely obesity, diabetes, hypertension, hyperlipidemia, smoking and physical inactivity, with some countries showing high values of certain factors which approach those observed in the developed world. In particular, obesity prevalence rates have reached alarming levels, particularly among women in the oil-rich countries (over 40%), making it the most pressing health concern in the region. Trends in the dietary pattern illustrated a consistent rise in total energy supply by approximately 730 kcal per capita per day between 1970 and 2005. Dietary patterns showed an increased consumption of fat and animal protein and a decreased intake of carbohydrates, particularly whole grain cereals, and fresh fruits and vegetables.
  
  
  CONCLUSIONS
  Regional differences were attributed to differences in lifestyle, occupation and a shift from traditional food habits. Our understanding of the CVD disparities across various geographic regions is key to our effort in planning relevant intervention programs. Public health efforts should focus on obesity, physical inactivity and unhealthy dietary practices. The success of these interventions depends on governmental commitment, multisectoral partnership and a consideration of the sociocultural norms of the target population.
authors.affiliation: Department of Epidemiology and Population Health, American University of Beirut, Lebanon.
authors.forename: Abla
authors.initials: A
authors.lastname: Mehio Sibai
authors.forename: Lara
authors.initials: L
authors.lastname: Nasreddine
authors.forename: Ali H
authors.initials: AH
authors.lastname: Mokdad
authors.forename: Nada
authors.initials: N
authors.lastname: Adra
authors.forename: Maya
authors.initials: M
authors.lastname: Tabet
authors.forename: Nahla
authors.initials: N
authors.lastname: Hwalla
mesh_terms: D000293:Adolescent; D000328:Adult; D000352:Africa, Northern / Q000453:epidemiology; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D009748:Nutrition Disorders / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult