The Emirates Heart Health Project: A Family-based Diet and Exercise Intervention in Obese and Overweight Patients
The latest available data from the Department of Health of Abu Dhabi show that cardiovascular disease is the leading cause of death among both the non-national and national populations of the emirate of Abu Dhabi. This trend has not improved over time despite concerted efforts. Particularly striking is that cardiovascular disease was listed as the cause of death in over 39% of those over the age of 45. In those aged over 60 years of age, this causes more deaths than the combined effect of the second, third and fourth leading causes of death, cancer, respiratory diseases, and infectious disease, respectively. A survey of the Middle East and North Africa showed that eating an unhealthy diet was the leading risk factor for cardiovascular deaths and estimated that this pattern of eating accounted for 72% of cardiovascular deaths in the United Arab Emirates (UAE). In particular, the low consumption of whole grains was responsible for 22% of these deaths in the UAE. Other risk factors included high levels of processed meat, red meat, and sugar sweetened beverages. Studies done in the UAE show that despite knowledge of healthy diet and exercise practices, barriers exist to lifestyle change. For example, a study of patients in the UAE with type 2 diabetes showed only 3% of the surveyed population of 390 patients in the UAE met numerous guidelines' recommendations for 150 minutes of moderate intensity aerobic activity or 90 minutes of vigorous aerobic activity per week. The reasons given by the participants in that study for not exercising included cultural reasons (29.2%), "exercise is boring" (20.3%), and lack of family support (4.1%). Despite availability and access to individual appointments with dieticians based in primary health centers, rates of obesity, overweight, and cardiovascular disease risk factors have not improved. Need for a trial: To the investigators' knowledge, no study has investigated the effect of family based lifestyle interventions led by a health coach and supported by technology such as fitness trackers and smartphone applications to track dietary intake. In the setting of the traditional culture of the nationals of the UAE (called Emiratis), family based interventions that specifically address cultural and religious beliefs and practices and accommodate family obligations may have a greater benefit than individual dietician visits. There may also be greater adherence to physical activity and health eating habits if the family commits to this lifestyle together.
Start: October 2021