Cardiovascular disease (CVD) is the leading cause of death globally, responsible for 17.5 million deaths (31%) annually. In Kuwait, CVD accounts for 41% of all deaths. In the 1980s Kuwait had economic growth that influenced food supply and led to a higher intake of caloric dense foods in children, which contributed to increases in childhood OB rates (<1% in 1985 and 31% in 2012). The most recent nutrition study on Kuwaiti children was conducted in 2008-2009 and indicated that 800303% of children did not meet nutrition recommendations, and 500303% exceeded their kcal needs. However, limited studies reported on the prevalence of multiple CVD risks or gender differences. Thus, the primary study objectives were to evaluate a sample of Kuwaiti schoolchildren to determine: 1) the prevalence of CVD risk factors, and if boys will have greater risks than girls; 2) the proportion meeting the US Dietary Guidelines for Americans (DGA) and DRIs, and the WHO joint Food and Agriculture Organization (FAO) nutrition recommendations, and if boys meet fewer recommendations than girls; 3) in a sample of OB, OW, NW and UW children determine if there are differences between weight categories in 1) prevalence of CVD risks 2) meeting US and WHO/FAO nutrition recommendations. Design: A cross-sectional analysis of 367 fifth-graders (age10.4 ± 0.4 years; 53% girls) in Kuwait. Measures: Anthropometric and biometric assessments were conducted to obtain CVD risk factor variables, and an Arabic/English food frequency questionnaire (FFQ) was used to obtain nutrition variables. The CVD risk factor variables were: OW, OB, at risk levels of TC, TG, HDL, TC:HDL, non-HDL, LDL, systolic blood pressure (SBP) and diastolic BP (DBP). Nutrition variables: food groups, macronutrients, and selected micronutrients. Statistical analysis included general linear models and logistic regression controlling for physical activity (PA), screen time (ST), and Kcals with P22640.05. Results: Objective 1: The overall prevalence of OB 39%, at risk BP 23%, and dyslipidemia ranged from 13.2 % to 45.5%. The OB prevalence was not significantly different between gender, though girls had a significantly higher prevalence of OW, and at risk TG, HDL and BP, than boys. Objective 2: The proportion of children meeting the nutrition recommendations was <50% for most variables and 700303% exceeded Kcal needs. There were few significant gender differences. More boys met fruit recommendations while more girls met vegetable and sodium recommendations. Objective 3: OB children had a greater prevalence of at risk for TG, HDL and TC:HDL and BP, while NW children had a greater prevalence of TC and LDL than OB children. The only significant differences for meeting nutrition recommendations by weight status group; more OW met sodium, more OB met protein, and more UW met carbohydrate recommendations. Conclusion: Based on the findings of the three objectives in Kuwaiti children 1) The prevalence of OB has increased, and the prevalence of dyslipidemia and elevated BP are high, particularly among girls, and was contrary to our hypothesis. 2) Few children met nutrition recommendations with few gender differences. 3) As expected, OB children had the highest prevalence of CVD risks; however, NW also had concerning levels of dyslipidemia. These findings indicate a need for CVD risk assessment, and intervention programs for Kuwaiti children regardless of weight status, to improve dietary and other lifestyle behaviors to prevent or reduce CVD risks.
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