الفهرس 
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Abstract
Obesity represents one of the most serious global health issues. The prevalence of obesity has increased at an alarming rate over the past 2 decades to the extent that it could be considered a pandemic. Over 1.9 billion adults (18 years and older) were overweight. Of these over 600 millions were obese. Overweight and obesity were estimated to cause 3.4 million deaths, 4% of years of life lost, and 4% of disability-adjusted life years (Nazma et al., 2017). Obesity is highly prevalent in Egypt. The estimated prevalence of overweight and obesity (BMI ≥ 25 kg/m²) is 61-70% of the whole population aged 20 and above. This translates to 65% for males and 76% for females aged 15 and above. As for obesity alone, 18-22% of males are obese while 39-48% of females are obese (IASO, 2012; WHO, 2010). Obesity is a disease of multiple and complex causes leading to accumulation of large amounts of body fat due to an imbalance between energy intake and output. Usually, it is measured as excessive weight for a given height, using the body mass index (BMI): Weight in kilograms (kg) over height squared (m2). Obesity is a major risk factor for the development of various pathological conditions including insulin resistance, diabetes, cardiovascular diseases, and non-alcoholic fatty liver disease. Central to these conditions is obesity-associated chronic low-grade inflammation in many tissues including adipose, liver, muscle, kidney, pancreas, and brain (Heping et al., 2020).
Treatment obesity by bariatric surgery gives results in significantly greater weight loss than conventional treatment for obese adults, but surgery is associated with a greater risk of complications including diabetes and hypertension (Kelly et al., 2013). Treating obesity with medications is not recommended for children or adolescents. For adult patients medications typically result in little weight loss, but may help prevent further weight gain. Medication may be considered for adults with BMI > 30 kg/m2 or with BMI > 27 kg/m2 and significant medical complications, if diet and activity modifications do not result in weight loss of 5% at 3 months and 10% after 6 months (Kelly et al., 2013). Thus, treatment with low caloric diet and some of natural seeds has been suggested.
The present work carried out to study the effect of supplementation with Fennel (Foeniculum vulgare) and Black cumin (Nigella sativa) seeds with low caloric diet on adult obese females (20 – 40) years old, for 4 months, .
200 of adult obese females participate age (20-40) years, in the study divided in to 4 groups as following:
- First group had low caloric diet plus light yoghurt without supplementation.
- Second group had low caloric diet supplemented with 5 gm black cumin seeds added to light yoghurt at the dinner meal.
- Third group as 2nd group but supplemented with fennel seeds.
- Forth group supplemented with mix black cumin seeds and fennel seeds.
Socio economic data were collected; Nutritional data included Twenty four hour records - Diet history & Food habits - The nutrients analyzed by using the food composition table (national institute of nutrition).
Anthropometric measurements were taken weekly including (Height - Weight - Body mass index - Waist circumference – Med-upper arm circumference - Triceps skinfold thickness- Arm muscle circumference)
Laboratory investigations used in this study to determine levels of blood lipids Triglyceride, Total cholesterol, low density lipoprotein (LDL), High density lipoprotein (HDL) and Hemoglobin level.
Blood pressure measured weekly for all cases
Results after 4 weeks: Anthropometric measurements showed that: group 1 of cases that received low caloric diet only decreased by 5.7±1.23% than before the study in body weight, increased to 7.9±1.72% in group 2 (black cumin), 6.4±1.59% in group 3 (fennel) and 7.2±1.26 % in group 4 (mix). We can observed that black cumin seeds, fennel seeds, and its mixture increased rate of body weight reduction, the best result was in groups 2 (black cumin).
BMI in group (1) decreased (7.16±0.99 %), followed by (8.65±1.20, 7.65±1.23 & 8.29±1.26 %) for groups (2, 3 & 4) respectively, we can find that the best result was (8.65±1.20 %) in cases of group 2.
Waist Circumference (WC) revealed that groups (1) decreased with percentage (6.45±1.91 %), group 2 recorded significantly decreased results (8.21±1.30 %) when compared to group (1), while groups (3 & 4) were (7.26±2.66 & 7.64±1.04 %) respectively, decreased insignificantly when compared to group (1)
Arm circumference (AC) in groups (1, 2, 3 & 4) decreased with (7.63±.8, 9.24±1.3, 8.12±.85 & 8.61±.9 %), the most AC decreased value 9.24±1.3% was in group 2 (black cumin)
With regard of TSF figure (38), group 1 decreased (9.6±1.7 %), while groups (2, 3 & 4) were (15.5 ±2.2, 11.9±1.8 & 12.7±0.8 %) respectively increased significantly compared to group 1, this is evidence that the process of burning fat was done correctly by burning fat instead of losing muscle mass
According to AMC, the percentage decreasing value in group 1 was 6.7±.72, while group 2 was 5.8±.54 decreased significantly compared to group 1, groups 3 & 4 were 6.6±.43 & 6.2±.81 respectively decreased insignificantly compared to group 1. As seen for results of TSF & AMC we can see evidence that the process of burning fat was done correctly by burning fat instead of losing muscle mass.
Results for case age (20 –> 30) at the end of study (4 months): Body weight of cases in G2 decreased (18.1±2.2%) more than the others (G: 3, 4 & 1) (17.1±1.8, 17.1±1.8 & 15.6±1.6 %) respectively, it’s observed that using low caloric diet without supplementation recorded the lowest decrement (15.6±1.6 %). As following the same case is happened with BMI. With looking at the measurements of WC, AC & TSF. G2 it is recorded the best significant decrement (19.1±1.8, 23.1±2.1 & 35.7±2.2 %) respectively. About the relation between TSF & AMC it is observed that values of TSF decrement more than AMC as G1 (30.2±1.9 & 15.6±1.87), G2 (35.7±2.2 & 14.7±1.94), G3 (31.2±1.9 & 14.1±1.10) and G4 (33.9±1.9 & 14.3±1.7) for (TSF & AMC) respectively.
Results of cases age (30 – 40) years, at the end of the study (4 months) showed that: Body weight decrease in group 1 of cases received low caloric diet without supplementation recorded (15.1±1.7 %) decreasing in body weight. The percentage of body weight loss increased to (17.5±2.1, 16.9±1.9 & 17.1±1.8%) in groups (2, 3 & 4) respectively, it observed that black cumin seeds increased the percentage of body weight loss in groups (2) more than group (4) which received mix from fennel and black cumin seeds, more than group (3) which received fennel seeds. BMI in group (1) decreased by (14.9±2.0 %), groups (2, 3 & 4) decreased by (17.7±2.3, 16.9±2.1 & 17.2±1.7 %) respectively. Its observed that the best result was (17.7±2.3 %) in cases of group 2, its found that low caloric diet supplemented with fennel seeds in group (3) lead to insignificantly decrease of BMI if it compared with those of group (1). meanwhile group (4) recorded another significantly decrement.
Groups 2 & 4 recorded more significant decrement According to (WC) as group (1) decreased with percentage (16.4±1.5 %), while Groups 2 & 4 recorded more decrement significantly (18.6±1.8 & 18.0±1.4 %), while group 3 was (17.6±2.1 %), increased insignificantly when compared to group (1). Results of Arm Circumference (AC), showed that the most AC significantly decreased 22.8±1.9 % was in group 2 which supplemented by Black Cumin.
About TSF the best decrement (36.6±2.2%) followed by (32.6±1.6%) in groups 2 & 4 respectively. while the reduction of group 3 may be near that of group 1 (non-significantly) (30.4±1.8 & 29.1±1.7 %) respectively
best results in body weight reduction including (weight, BMI, WC, AC, TSF and AMC) were in group (2) which received black cumin seeds, followed by group (4) which received mix from (black cumin seeds and fennel seeds), followed by group (3) which received fennel seeds, followed by group (1) without supplemented seeds. This explains that black cumin seeds and fennel seeds had weight reduction effect, while black cumin seeds had the best effect.
Triglyceride was decreased in group 1 by (12.11±0.9 %) this percentage increased significantly in group 2 to (17.05±1.4 %), followed by (15.12±1.3 & 16.10±2.1 %) in groups (3 & 4) respectively. cholesterol levels was 16.09±2.7 % we can see in group 2. More significantly than group 1 (11.93±1.5), group 3 recorded (13.98±3.3) and group 4 was (14.92±2.4). LDL decreased with (12.12±1.2 %), group 2 was (16.05±1.9 %) followed by (14.04±2.1 & 14.92±1.8 %) in groups 3 and 4. In case of HDL it can be observed that results of groups (2, 3 & 4) increased (15.79±4.5, 13.89±3.0 & 14.71±2.9 %) respectively, recorded significant increasing results compared to group 1 was (10.25±2.1 %).
Changes in lipid profile levels at the end of the study (4 months), age (20 – > 30) years showed that, triglycerides was decreased (17.31±2.2 %) in group 1, (20.15±2.5 %) in group 2, followed by (18.42±2.1 & 19.51±1.9 %) in groups (3 & 4) respectively. This mean that group 2 registered the best result in triglyceride decreasing followed by group 4 who received mix fennel and black cumin followed by group 3 which received supplementation with fennel seeds. cholesterol levels decreased (20.19±2.4 % in G2) & (17.98±2.5% in G4). While it showed that non-significant decrease (15.73±2.5 & 16.1±2.9 %) in groups (1 & 3) respectively. Also results of LDL decreased (26.12±2.3 %) in group 1, group 2 decreased (30.65±2.9 %) followed by (29.24±2.8 & 29.52±1.6 %) in groups 3 and 4 respectively. All are decreased significantly if any is compared with that of G1. HDL levels in groups (2 & 4) increased significantly by (36.89±5.5 & 35.71±3.2%) respectively if any is compared with that of G1.
Results of the changes in lipid profile levels of obesity female patients at the end of the study, age (30 – 40) years, showed that: Triglycerides (TG) was decreased (13.18±1.1 %) in group 1, this percentage increased significantly in group 2 up to (18.15±1.3 %), followed by (16.19±1.3 & 17.21±2.3 %) in groups (3 & 4) respectively. This mean that group 2 who received supplementation with black cumin seeds registered the best result in triglyceride decreasing followed by group 4 who received mix fennel and black cumin followed by group 3 which received supplementation with fennel seeds. The results showed significant decreasing percentage in cholesterol levels (18.73±2.7 % in G2) & (16.92±2.4% in G4). While it showed that non-significant decrease (14.23±2.5 & 15.21±2.9 %) in groups (1 & 3) respectively. Also results of LDL decreased (24.12±2.2 %) in group 1, group 2 decreased (29.05±1.9 %) followed by (27.04±2.1 & 28.82±1.8 %) in groups 3 and 4 respectively. All are decreased significantly if any is compared with that of G1. The results refers that the HDL level in groups (2 & 4) increased significantly by (35.79±2.5 & 34.65±2.7 %) respectively if any is compared with that of G1.
Results of this study approved that low caloric diet play important role in decreasing the excessive of blood lipids (cholesterol, triglyceride and LDL) while increased the percentage of HDL (good cholesterol). The supplementation with fennel seeds, black cumin seeds and its mixture with low caloric diet decreased cholesterol, triglyceride and LDL levels compared to supplemented group (1), while increased HDL level compared to group (1). The best result was in Groups 2 (black cumin seeds).
Hemoglobin levels of obesity female patients at the end of study. Hemoglobin level in group 1 increased (9.85±2.55 %). groups (2, 3 & 4) were (11.11±3.24, 9.92±2.70 & 10.16±4.64 %) respectively increased insignificantly compared to group 1. The increasing in hemoglobin levels in all groups may related to increasing iron intake post dietary intervention
Systolic blood pressure (SBP) it is observed that group 1 decreased 3.3±.21, while groups (2, 3 & 4) decreased (7.2±.35, 4.1±.29 & 5.7±.37 %) respectively. According to Diastolic blood pressure (DBP), group 1 decreased 3.8±.19 %, while groups (2, 3 & 4) decreased (8.4±.41, 6.1±.34 & 6.3±.42) respectively, it is observed that most decreasing was in group 2 followed by group 4 then group 3. According to this result it concluded that black cumin had hypotensive effect meanwhile fennel had moderate hypotensive effect.