Comparisons in childhood obesity and cardiometabolic risk factors among urban Saudi Arab adolescents in 2008 and 2013

Associations between Serum Iron Indices and Self-Assessed Multiple Intelligence Scores among Adolescents in Riyadh, Saudi Arabia

Micronutrient deficiencies, including iron deficiency, are linked to different cognitive impairments and sensory functions. However, whether circulating iron levels affect self-assessed multiple intelligence (MI) scores in adolescents remains uninvestigated. This study aimed to investigate associations between serum iron levels and self-assessed MI scores in adolescents in Riyadh, Saudi Arabia. Recruiting 434 Saudi adolescents (174 boys and 260 girls, aged 12-17), we administered the McKenzie questionnaire to assess MI across nine categories. Anthropometrics and fasting blood samples were collected to measure circulating iron and transferrin levels. Total iron-binding capacity (TIBC) and transferrin saturation (TSAT) levels were calculated. Notably, girls exhibited significantly higher MI scores in the interactive domain than boys (age and BMI-adjusted OR = 1.36, 95% confidence interval = 1.07-1.73, p = 0.01). No significant correlations were observed between serum iron and MI. However, normal TSAT levels (TSAT > 20%) corresponded with higher age and BMI-adjusted odds of MI scores in the musical (OR = 1.59, 95%CI = 1.1-2.2, p = 0.006), linguistic (1.57, 1.1-2.3, p = 0.016), kinesthetic (1.48, 1.1-2.1, p = 0.024), spatial (1.45, 1.1-2.1, p = 0.03), and existential (1.56, 1.1-2.1, p = 0.01) categories compared to ones with lower TSAT levels (TSAT ≤ 20%), only in boys. In conclusion, serum iron levels may not directly influence MI domains in adolescents in Riyadh, Saudi Arabia; however, lower TSAT levels, indicative of iron-deficiency anemia, may influence MI, only in boys, indicating a possible relationship between iron metabolism and cognitive functions.

Change in Growth Status and Obesity Rates among Saudi Children and Adolescents Is Partially Attributed to Discrepancies in Definitions Used: A Review of Anthropometric Measurements

Anthropometric measurements are the first step in determining the health status in children and adolescents. Clinicians require standardized protocols for proper assessment and interpretation. Therefore, this study aims to review the literature of international and Saudi national guidelines and studies previously conducted in Saudi children and adolescents to provide recommendations to establish Saudi guidelines in line with the Saudi 2030 Vision. Systematic search was conducted in several databases: Medline, PubMed, Saudi Digital Library and Google Scholar from January 1990 to January 2021. Further, 167 studies measured anthropometrics in Saudi children/adolescents; 33 of these studies contributed to the establishment/adjustment of Saudi growth charts or specific cutoffs or studied the trend of growth in representative samples or adjusted the international curves to be used in Saudis. This review warrants updating growth charts and establishing the standard cutoffs of Saudi adolescent anthropometrics to avoid over/underreporting. This review provides insights and recommendations regarding the resources that can be used to establish national guidelines in anthropometric measurements for Saudi children/adolescents. This review will help policymakers and the Ministry of Health to establish standardized protocols to be used in Saudi Arabia for anthropometric measurements that may assist in detecting malnutrition.

Relationship between Behavioural Intention for Using Food Mobile Applications and Obesity and Overweight among Adolescent Girls

Changes in the body mass index (BMI) of children and adolescents have been linked to mobile usage, particularly food applications. This study aimed to investigate the relationship between food application usage and obesity and overweight among adolescent girls. This cross-sectional study was conducted among adolescent girls aged 16-18 years. Data were collected using a self-administered questionnaire from female high schools in five different regional offices across Riyadh City. The questionnaire included questions regarding demographic data (age and academic level), BMI and behavioural intention (BI) scale comprising three constructs: attitude towards behaviour, subjective norms and perceived behavioural control. Of the included 385 adolescent girls, 36.1% were 17 years old, and 71.4% had normal BMI. The overall mean BI scale score was 65.4 (SD 9.95). No significant differences were observed between overweight or obesity in relation to the overall BI score and its constructs. A high BI score was more associated with participants studying in the east educational office than those who were enrolled in the central educational office. Behavioural intention to use food applications greatly influenced the adolescent age group. Further investigations are necessary to determine the influence of food application services among individuals with high BMI.

Sex-Specific Cut-Offs of Single Point Insulin Sensitivity Estimator (SPISE) in Predicting Metabolic Syndrome in the Arab Adolescents

The Single Point Insulin Sensitivity Estimator (SPISE) is a novel surrogate marker for insulin sensitivity and was found comparable to the gold standard clamp test as well as for predicting the Metabolic Syndrome (MetS) in several populations. The present study aimed to assess for the first time, the validity of SPISE in predicting MetS among Arab adolescents. In this cross-sectional study, 951 Saudi adolescents aged 10−17 years were randomly recruited from different schools across Riyadh, Saudi Arabia. Anthropometrics were measured and fasting blood samples were collected for the assessment of glucose, lipid profile, adipokines, C-reactive protein and 25 hydroxyvitamin (OH) D. MetS was defined using the National Cholesterol Education Program’s (NCEP) criteria with age-specific thresholds for adolescents. The SPISE as well as insulin resistance (HOMA-IR) indices were calculated. The over-all prevalence of MetS was 8.6% (82 out of 951). SPISE index was significantly lower in MetS than non-MetS participants in both sexes (5.5 ± 2.5 vs. 9.4 ± 3.2, p < 0.001 in boys and 4.4 ± 1.4 vs. 8.6 ± 3.2, p < 0.001 in girls). The SPISE index showed a significant inverse correlation with resistin, leptin, and C-reactive protein, and a significant positive correlation with adiponectin and 25(OH) D. Areas under the curve (AUC) revealed fair and good accuracy for predicting MetS 84.1% and 90.3% in boys and girls, respectively. The sex-specific cut-off proposed was SPISE index ≤6.1 (sensitivity 72.2% and specificity 83.9%) for boys and ≤6.46 (sensitivity 96.3% and specificity 73.4%), for girls. This study suggests that the SPISE index is a simple and promising diagnostic marker of insulin sensitivity and MetS in Arab adolescents.

Impact of the Intake of Snacks and Lifestyle Behaviors on Obesity among University Students Living in Jeddah, Saudi Arabia

Unhealthy eating habits increase the risk of obesity. This study investigated the association between obesity and the intake of snacks and lifestyle behaviors among university students in Saudi Arabia. The study included 662 students aged 18–29 years, studying at King Abdulaziz University. An online survey collected data on sociodemographic characteristics, height, and weight, to calculate body mass index (BMI), lifestyle behaviors, dietary habits, and snack intake. The prevalence of overweight and obese students was 18.6% and 12.7%, respectively. Sociodemographic characteristics and lifestyle behaviors had insignificant effects on obesity. Obese students consumed two meals daily and more cereals during breakfast. Non-obese students consumed more beverages at breakfast and had their daily meals with their families. The frequency of intake of snacks had an insignificant effect on obesity. However, obese students had a significantly higher intake of potato chips, popcorn, and biscuits, while non-obese students had a significantly higher intake of salads compared with obese students. Students consumed significantly less fruit and vegetables, chocolate, biscuits, nuts, and dairy products as snacks when inside the university compared to outside. To reduce obesity among students, universities should ensure access to healthy snacks, and provide health education programs to encourage healthy eating habits and lifestyles.

Cardiometabolic Effects of a 12-Month, COVID-19 Lockdown-Interrupted Lifestyle Education Program for Arab Adolescents

BACKGROUND

Childhood obesity and pediatric metabolic syndrome (MetS) have steadily increased during the last decade in Saudi Arabia. Intervention programs to prevent cardiometabolic disorders in Arab youth are needed.

OBJECTIVE

In this multi-school intervention study which was disrupted by COVID-19-imposed lockdowns (September 2019-April 2021), a 12-month lifestyle education program focused on improving the cardiometabolic status of Arab adolescents was investigated.

METHODS

A total of 2,677 Saudi students aged 12-18 years were recruited from 60 different secondary and preparatory year schools in Riyadh city, Saudi Arabia. The intervention was initially in-person counseling sessions and the subsequent sessions conducted virtually post-pandemic. Baseline anthropometrics and fasting blood samples for glucose, HbA1c, and lipid assessments were collected at baseline and after 12 months (704 participants).

RESULTS

Only 704 out of 2,677 (73.7% dropout) completed the intervention. At baseline, 19.6% of the participants were overweight and 18.1% were obese. A modest but significant decrease in the prevalence of central obesity [11.2 vs. 6.7% (-4.5% change, p = 0.002)], hypertension [22.3 vs. 11.4% (-10.9% change, p < 0.001)], and low-HDL cholesterol [61.6 vs. 23.3% (-38.3% change, p < 0.001)] was noted. Consequently, the prevalence of hypertriglyceridemia increased from 22.7 to 56.3% (+ 33.6%, p < 0.001) overtime. Also, the proportion of subjects who were able to change their status from MetS to non-MetS was significantly more in overweight/obese at baseline than normal weight (16.9 vs. 3.6%, adjusted OR = 3.42, p < 0.001).

CONCLUSION

Interrupted lifestyle education programs secondary to COVID-19-imposed lockdowns still provided modest effects in improving cardiometabolic indices of Arab adolescents. Given the high digital literacy of Arab youth, improving the delivery of virtual lifestyle education programs may prove beneficial.

Depression, Anxiety, Stress, and Obesity among Male Adolescents at Abha City, Southwestern Saudi Arabia

The objective was to study depression, anxiety, stress, and obesity among male adolescents in Abha City, southwestern Saudi Arabia. A cross-sectional study was conducted on a sample of 398 male students. Standard methods for measuring body weight and height were applied. Body Mass Index (BMI) was calculated. The Arabic version of the Depression Anxiety Stress Scale (DASS-21) was used to detect common mental disorders. Results of the study showed that only 69 (17.3%) adolescents had normal body weight, 176 (44.2%) had overweight, and 153 (38.4%) were obese. The present study showed that obese male adolescents had more stress, anxiety, and depression (44.4%, 73.2%, and 65.7%, respectively) than normal weights. The study showed that obesity was a significant risk factor for anxiety (aOR = 1.97; 95% CI: 1.01-3.27) and depression (aOR = 1.90; 95% CI: 1.06-3.40). In conclusion, there is an urgent need for depression and anxiety screening and treatment programs among adolescents to prevent adolescent obesity. It should be hand in hand with nutritional and exercise-based interventions as an essential tool in preventing teenage obesity.

Lifestyle Habits in Relation to Overweight and Obesity among Saudi Women Attending Health Science Colleges

The study examined the associations between lifestyle habits and overweight/obesity among Saudi females attending health science colleges. A total of 454 female students were randomly recruited from five health science colleges at King Saud University, using a multistage stratified cluster sampling technique. Body weight and height were measured, and body mass index was calculated. All participants answered a validated questionnaire to assess physical activity (PA), sedentary behaviors (SB), sleep duration, and dietary habits. Results showed that the prevalence of overweight (21.4%) plus obesity (8.1%) among female participants was 29.5%. There was no significant difference between overweight/obese and nonoverweight/nonobese females in PA, screen time, sleep duration, or dietary habits. Overall, 50.4% of the participants were physically inactive (activity energy expenditure was <600 metabolic equivalent minutes per week). Active females showed significantly (p < 0.01) higher intakes of vegetables and fruits, lower chocolate/candy consumption (p = 0.05), and higher proportion of sufficient sleeping duration (>8 hours per night) (p < 0.001). It was concluded that half of the Saudi females in this study were physically inactive. Although PA positively impacted some of the lifestyle habits of college females, overweight/obesity was not associated with PA, SB, sleeping time, or dietary habits among the participants. Future research should attempt to elucidate the key factors involved in such relationship.

Associations of Serum Nitric Oxide with Vitamin D and Other Metabolic Factors in Apparently Healthy Adolescents

Introduction

Nitric oxide (NOx) is an important biomolecule which interacts with other molecules including 25(OH)D to mediate various metabolic pathways. Interactions and associations of NOx with 25(OH)D have been well studied both in vitro and in vivo, yet associations in apparently healthy adolescents have never been studied.

Methods

A total of 740 (245 boys and 495 girls) apparently healthy Saudi adolescents aged 10-17 years were included in this cross-sectional study, to determine the associations of NOx with 25(OH)D and other biomarkers in Saudi adolescents. Serum NOx, 25(OH)D, and other biochemical and anthropometric parameters were measured following standard protocols and manufacturers' guidelines.

Results

NOx level was significantly higher in boys than girls (p<0.001). In all subjects, NOx showed a significant inverse correlation with 25(OH)D. After stratification according to sex however this significant association was observed only in boys and not in girls. NOx was also significantly associated with BMI, serum triglycerides, and systolic blood pressure in all subjects.

Conclusion

The significantly inverse association of NOx and 25(OH)D among apparently healthy adolescents is influenced by sex and further strengthens the extraskeletal role of 25(OH)D in maintaining endothelial homeostasis in this age group, particularly in boys. Whether vitamin D correction can influence NOx production over time among adolescents remains to be proven.