Knowledge of assessment about Tourette’s Syndrome among Medical Students and General Physicians in Jordan: A Cross-Sectional Study.

Non-communicable diseases (NCD) such as CVD, diabetes mellitus, cancer and chronic respiratory conditions are an increasing global health concern, accounting for about 75 % of global deaths in 2021. This growing burden is particularly evident in sub-Saharan Africa, where the prevalence of NCD has risen by 67 % over the past two decades. Obesity is a key driver of this trend, and in South Africa, nearly half of the adult population are overweight or obese. Excessive alcohol consumption is recognised as an important modifiable risk factor for obesity, with evidence showing consistent associations between excessive alcohol intake and increases in body weight. For instance, one study found that harmful alcohol consumption was associated with higher BMI and waist circumference. Similarly, another study highlighted that heavy drinking was more consistently related to weight gain than light-to-moderate alcohol intake, suggesting a dose-dependent relationship. Excessive alcohol consumption contributes to weight gain through two main mechanisms. First, ethanol (the active ingredient in alcoholic beverages) disrupts fat metabolism and increases appetite, leading to overeating. Second, alcoholic beverages are often high in energy content, and consequently, this excess energy is stored by the body as fat. The high energy content of alcoholic beverages primarily comes from ethanol, as each gram of ethanol provides over 29 kilojoules (kJ). Additionally, surplus sugars and other carbohydrates left over from the fermentation process or from added sugars also contribute to the energy content. For example, a 330 ml bottle of cider in Australia has been shown to contain as much as 724 kJ of energy. Similarly, the inclusion of cream in many cocktails increases their energy content due to the cream’s fat composition. Furthermore, since the body cannot store alcohol, the liver prioritises ethanol metabolism, meaning energy from alcohol is used first, while excess energy from food or drinks is stored as fat, leading to fat accumulation. These combined effects of high energy content and metabolic prioritisation of alcohol contribute significantly to weight gain, and ultimately NCD risk. Given the well-established role of alcohol in obesity and NCD risk, investigating the nutritional content of alcoholic beverages is essential. Studies from developed countries have demonstrated significant variations in the nutritional content of these beverages. For example, a 2021 study from Australia found that although most packaged alcoholic beverages lacked nutrition-related information, there were significant variations in nutrient content between similar beverages. Similarly, a study in the Czech Republic evaluated 172 beer samples and found significant energy variations, the highest energy value found was 215 kJ/100 ml, and the lowest was 75 kJ/100 ml. Within this context, disclosing nutritional information and ingredients lists is crucial, as this transparency enables consumers to make more informed dietary choices. Previous research has shown that providing consumers with nutritional labelling can positively influence dietary choices. For instance, one modelling study estimated that mandatory added sugar labelling for food products (alcoholic beverages were excluded) could prevent nearly one million cases of NCD. However, in most countries, nutritional information is not available for alcoholic products. Similarly, international evidence shows strong consumer demand for transparency. A survey conducted in the USA found that majority of alcohol consumers are in favour of mandatory labelling of alcohol content, ingredients, allergens, calories and nutrition facts on alcoholic beverages. These findings underscore the need for improved nutritional labelling, as the lack of clear information may lead to unintentional overconsumption of energy and sugars, thereby exacerbating obesity and related NCD.