Nutritional status of adolescent girls in the eastern province of Saudi Arabia

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.

Prevalence and social determinants of overweight and obesity in adolescents in Saudi Arabia: A systematic review

Obesity in adolescents has a serious impact later in life in the form of disturbances in health and wellbeing. We aimed to evaluate the prevalence of overweight and obesity (Ow/Ob) in Saudi adolescents and to construct an ecological model of social determinants (SDs) of Ow/Ob and evaluate current evidence of their effect on Saudi adolescents. A systematic review of literature reported up until 31 December 2018 on Ow/Ob and factors that can influence them in Saudi adolescents was conducted. Fifty-one studies with n = 97 666 adolescents (55.6% males) were reviewed. The prevalence of Ow/Ob started off high and continued to increase over time. Most of the 49 reviewed SDs reports, from 19 studies, showed positive association between SDs constructed ecological model and Ow/Ob in Saudi adolescents. The prevalence of Ow/Ob among adolescents is a major public health problem in Saudi Arabia, is growing at an alarming rate and SDs play a significant role in this problem, and should be considered in all strategies targeting it. The constructed ecological model for SDs of Ow/Ob in adolescents can serve as a useful exploratory tool that helps investigating the multi-faceted aetiology of adolescent Ow/Ob and facilitates the development of effective intervention and prevention programmes.

The association of eating habits and lifestyle with overweight and obesity among health sciences students in Taif University, KSA

Objectives

This work investigated the impacts of food habits and lifestyle on the prevalence of overweight (OW) and obesity (OB) among health sciences students (HSS) at Taif University, KSA.

Methods

A cross-sectional survey was conducted with 228 HSS in a university setting using a food frequency questionnaire. Body mass index (BMI) was used to assess weight gain, and waist circumference (W_C) was employed for the assessment of abdominal adiposity.

Results

The prevalences of OW and OB were 25.9% and 10.9%, respectively, with an overall prevalence of 36.8%. All demographic variables had an insignificant (P > 0.05) effect on W_C. There were significant links between gender, academic year and discipline and BMI (P < 0.05). Smoking, stress, duration of TV viewing, daylight and night sleep had an effect on BMI and W_C but were statistically insignificant (P > 0.05). Breakfast, light meals, eating with a family, fast food, and regular and diet soft drinks had insignificant impacts on BMI (P > 0.05). A considerable relationship was observed between consumption of liver and BMI (P < 0.05), while meat, egg, milk, fruit and vegetable, and grain intake had no significant effect on BMI (P > 0.05). All varieties of foods had no significant impact on W_C (P > 0.05).

Conclusions

The prevalence of OW and OB was 36.8%. The participants' gender, academic year, discipline, and liver intake had a significant impact on BMI. All other tested variables showed a nonsignificant relationship with W_C.

Nutritional Status and Anthropometric Indices in High School Girls in Ilam, West Iran

Background. Adolescence is one of the most challenging periods for human growth and nutritional status. The aim of this study was to assess the nutritional status and anthropometric indices in high school girls in Ilam. Methods. This cross-sectional study was performed on 360 domestic high school girl students chosen randomly by cluster sampling. Data were gathered through interviews performed by a dietitian to fill 24-hour dietary recall and food frequency and demographic questionnaires. Then we performed the anthropometric measurements and we compared the results with CDC2000 standards. We analyzed our data by N4 food analyzer and SPSS16 software. Results. The prevalence of obesity and overweight was 5% and 10.8%, respectively. Simultaneously, the prevalence of underweight was 20.2%. The prevalence of stunting was 5.8%. We also showed that 50% of high school girls in Ilam suffered from severe food insecurity, 14.7% suffered from mild insecurity, and 4.7% get extra energy from foods. Food analysis showed that micronutrients such as zinc, iron, calcium, folate, fiber, magnesium, and vitamin B12 were less than what is recommended by the RDA. Conclusion. Undernutrition and overnutrition are completely prevalent among girls studied in Ilam. This needs further acts and investigations in the field and more nutritional and health educations.

The health of Saudi youths: current challenges and future opportunities

Background

The health status of the young people is an important indicator for future health and health care needs of the next generation. In order to understand the health risk factors of Saudi youth, we analyzed data from a large national survey in the Kingdom of Saudi Arabia.

Methods

The Saudi Health Information Survey sample included 2382 youths aged 15 to 24 years old. The questionnaire included information on socio-demographic characteristics, risk factors, risky behaviors, chronic conditions, functional status, health care utilization, and anthropometric and blood pressure measurements.

Results

Only 45.9 % of men and 48.4 % of women had normal body mass index (BMI). Men were more likely than women to smoke cigarettes or shisha. The prevalence of daily consumption of at least five servings of fruits and vegetables was 6.6 %. The prevalence of no or insufficient physical activity was 41.8 % in men and 75.6 % in women (P < 0.001). Around 40 % of men and 25 % of women had abnormal blood pressure. Mean BMI and prevalence of insufficient physical activity, current smoking, and hypertension was higher in 20-to 24-year-olds than younger ages. Women were more likely to report that they never use seatbelts (82.2 % vs. 65.4 %).

Conclusions

The prevalence of modifiable risk factors and risky driving behaviors is very high among Saudi youth. If these current behaviors are not reversed during this crucial age period, the burden of disease and injuries will rise in the future. Our findings call for developing health prevention programs for youths in Saudi Arabia.

Nurses' views and experiences of caring for malnourished patients in surgical settings in Saudi Arabia - a qualitative study

BACKGROUND

Although the occurrence of malnutrition in hospitals is a growing concern, little is known about how hospital staff understand the care that nurses provide to patients with malnutrition. The purpose of this study was to explore nurses' views and experiences of caring for malnourished patients in Saudi Arabia (KSA).

METHODS

Using a qualitative explorative design, fifteen nurses were interviewed as part of a purposive sample hospital staff. The transcripts were analyzed using latent content analysis.

RESULTS

The nurses spontaneously and consistently linked malnutrition with physical inactivity. The two main categories, which emerged, were: 'Potentials for nurses to provide good nutrition and physical activity', and 'Having the ability but not the power to promote proper nutrition and physical activity'. These arose from the subcategories: Good nursing implies providing appropriate health education; Acknowledging the Mourafiq (sitter) as a potential resource for the nursing, but also as a burden; Inadequate control and lack of influence; Cultural diversity and lack of dialog; and Views of women's weight gain in KSA society.

CONCLUSIONS

The nurses felt they have the capacity and passion to further improve the nutrition and activity of their patients, but obstacles in the health care system are impeding these ambitions. The implications for nursing practice could be acknowledgement of the nurses' views in the clinical practice; culturally adjusted care, improved communication and enhanced language skills.

Selected dietary nutrients and the prevalence of metabolic syndrome in adult males and females in Saudi Arabia: a pilot study

During the last decade, the rapid economic development in Saudi Arabia resulted in an unbalanced dietary intake pattern within the general population. Consequently, metabolic syndrome was also documented to be highly prevalent in the Middle-East region. We aimed to examine the relationship between selected dietary nutrient intakes and the prevalence of metabolic syndrome in the general adult population of Riyadh, Saudi Arabia. In this cross-sectional study, 185 adult Saudis aged 19 to 60 years (87 males and 98 females (mean age 35.6 ± 13.2 and 37.6 ± 11.7 years, respectively)) were included. The criteria for metabolic syndrome were based on the International Diabetes Foundation (IDF) criteria, and the dietary food intake was assessed by two 24-h dietary recall methods. The odd ratios (ORs) of metabolic syndrome risk across quartiles of selected dietary nutrients were significantly lower for carbohydrates and proteins, as well as for vitamins A, C, E and K, calcium, zinc and magnesium (p < 0.05 for all) in the female group with metabolic syndrome than those without. The pattern of daily dietary intake of selected nutrients among the general population of Saudi Arabia raises concern, and this dietary imbalance could increase the risk of metabolic syndrome, particularly in adult Saudi females.

Assessment of selected nutrient intake and adipocytokine profile among Saudi children and adults

We report the dietary intake of selected nutrients in apparently healthy adults and children and its correlation with circulating levels of serum leptin and resistin. In this observational study, 47 Saudi children (mean age 13.1 ± 2.8 year) and 47 adults (mean age 45.7 ± 10.5 year) were recruited. Anthropometric data and lipid profile were obtained. Food intake was assessed by a food questionnaire and a 24-hour diet recall method. The dietary intake of selected nutrients was compared with the estimated average requirement (EAR) or adequate intake (AI) for establishing nutritional status. Results demonstrated that the levels of choline and calcium intake were significantly lower than the EAR in adults (p= 0.01 and 0.04, respectively) and relatively low in children. The level of manganese in adults was significantly higher (p= 0.02) than their AI level. The increasing levels of dietary vitamin B6 and B12 were associated with a significant increase in serum concentrations of leptin in adults and children (p=0.02). Overall, the dietary intakes of selected nutrients in Saudi adults and children were not adequate with most of them below cut-off EAR values except for essential amino acids.

Was there a change in the body mass index of Saudi adolescent girls in Al-Khobar between 1997 and 2007?

BACKGROUND AND OBJECTIVES

Special concern is focused on the nutritional status of adolescent girls in order to avoid future health problems. The aim of this study was to determine the change in body mass index (BMI) among adolescent Saudi girls living in Al-Khobar between 1997 and 2007.

MATERIALS AND METHODS

A cross-sectional sample of adolescent Saudi girls, 15-19-years-old, living in Al-Khobar, Saudi Arabia, was analyzed through two data sets. The first data set (n = 400) was collected in 1997 and the second (n = 321) was collected in 2007. Both data sets used the same sampling method. Anthropometric measurements were made and the BMI was used to determine participants' nutritional status. Statistical analysis was performed.

RESULTS

There was an increase in the median weight of Saudi adolescent girls from 1997 to 2007, but the change was not statistically significant. There was a statistically significant change, however, in adolescent girls' height during the 10-year interval. Using BMI to determine the nutritional status of the sample, no statistically significant difference was found. Overweight and obesity remain prevalent in about 30% of the adolescent girls, and about 3.5% of the girls in both sets were underweight.

CONCLUSIONS

This study concluded that there was no change in BMI among Saudi adolescent girls living in Al-Khobar during the 10-year span. Underweight is of low prevalence, and overweight and obesity are the critical nutritional problems that are faced by this population. Further research using time span comparisons is important to assess changes in maladaptive overweight and obesity.

Poor diet quality and food habits are related to impaired nutritional status in 13- to 18-year-old adolescents in Jeddah

In recent decades, diets have changed rapidly in the Kingdom of Saudi Arabia (KSA) because the Western diet is replacing the traditional Arabic diet. This has resulted in an alarming increase in the number of overweight and obese children and adolescents in KSA. It is well documented that lifestyle is strongly associated with the development of obesity. Nevertheless, this remains to be demonstrated in adolescents from a rapidly developing country in the Middle East such as Saudi Arabia. This study tested the hypothesis that the new current dietary habits are related to the increase in overweight and obese Saudi Arabian adolescents. In 2006, a cross-sectional study was conducted among 239 adolescents (13-18 years old) who were selected by cluster sampling from schools in Jeddah, KSA. The nutritional status was assessed by anthropometric and biochemical parameters at the Saudi German Hospitals Group, Jeddah. Dietary habits were evaluated by a 3-day dietary recall (food diary) and a food frequency questionnaire. The mean age of the participants was 15.5 ± 2.5 years. The mean body mass index was 27.43 ± 4.61 kg/m(2). A total of 44.6% of the adolescents were overweight, and 56.6%, 30.5%, and 13.0% of energy was derived from carbohydrates, fats, and proteins, respectively. Compared with the Dietary Reference Intake, carbohydrate and fat intakes were higher, and calcium, iron, and zinc intakes were lower. Higher cholesterol and lower hemoglobin levels were found in 30.5% and 53.6% of the adolescents, respectively. In summary, increased weight status of 13- to 18-year-old Saudi adolescents was related to their inadequate dietary habits. This indicates the importance of rapidly promoting a healthier lifestyle among Saudi Arabian adolescents.

Anthropometry and body composition of school children in Bahrain

BACKGROUND AND OBJECTIVES

This study was conducted because of the lack of a comprehensive nationwide assessment of data on the anthropometric status and related health problems in Bahraini school children aged 6 to 18 years.

SUBJECTS AND METHODS

A cross-sectional survey was conducted on the anthropometric status of school children enrolled in the primary, intermediate and secondary government schools in all populated regions of Bahrain. The sample size included 2594 students (1326 girls and 1268 boys) representing 2.5% of the total student population. For sample selection, a multi-stage sampling design was chosen that combined multi-cluster and simple random sampling methods. Anthropometric measurements included height, weight, mid-arm circumference and skin fold thickness at two sites (triceps and subscapular). Anthropometric indices derived were body mass index (BMI) and arm muscle area. The WHO reference standards (2007) and the National Health and Nutrition Examination Survey (NHANES) II data were used for comparison.

RESULTS

Compared to WHO reference standards, the median height of Bahraini children and adolescents in the age range of 6 to 18 years was close to the 25th percentile or lower, while the median BMI during adolescent years was comparable in boys, but higher than WHO standards in girls, reaching the 75th percentile. The cutoff values of BMI for overweight/obesity status (85th and 95th percentile) were higher by 3-6 kg/m(2) compared to WHO standards. While skin fold thicknesses were also higher in Bahraini adolescents compared to their American counterparts (NHANES II), arm muscularity was substantially lower.

CONCLUSIONS

Current study findings for BMI as well as skin fold thicknesses suggest an increased trend toward adiposity among Bahraini adolescents, especially in girls, which puts this age group at a high risk of adult obesity and its consequences. A need for urgent intervention programs is emphasized.

Prevalence and socioeconomic risk factors of obesity among urban female students in Al-Khobar city, Eastern Saudi Arabia, 2003

The aim of this study was to determine the prevalence and the socioeconomic risk factors associated with obesity among female school-aged children and adolescents in primary and intermediate schools in Al-Khobar city, Kingdom of Saudi Arabia. This is a cross-sectional study conducted in Al-Khobar city, which is located in the eastern part of Saudi Arabia, during the period of January to March 2003. It involved 2239 female schoolchildren randomly selected from 30 regular government and private primary and preparatory schools. The students' ages ranged from 6 to 17 years, with a mean of 10.49 +/- 2.64 years. A multistage stratified random sampling technique with proportional allocation was used. Data were collected using questionnaires and anthropometric measurements. Body mass index interpretation was based on using a table of standard definitions for overweight and obesity in children (Cole's). The spss version 10 (SPSS Inc., Chicago, IL, USA) was used for data entry and analysis. A chi-squared test was used in cross-tabulation analysis to test the significance of association between body mass index and socioeconomic variables. The prevalence of overweight and obesity were 20% and 11%, respectively. The prevalence of overweight was higher among schoolchildren with father in private work (P<0.01) and the prevalence of overweight and obesity was higher among schoolchildren with highly educated mothers (P=0.008). The prevalence of overweight and obesity among female school-aged children and adolescents in the Al-Khobar city was very high. Accordingly, it is recommended that health education programmes regarding obesity should be provided to all schoolchildren, their families and teachers.

Overweight and obesity among schoolchildren in Sana'a City, Yemen

AIM

To estimate the prevalence of overweight and obesity among schoolchildren in Sana'a City (Yemen) and to examine the association with lifestyle and some socioeconomic factors.

METHODS

A cross-sectional study was done in public and private schools in Sana'a City during 2002-2003. We selected 1,253 students by the multistage random sampling technique. Weights and heights were measured to calculate body mass index (BMI = weight/height2). Data about age, sex, education level of the parents, food consumption and lifestyle was also collected.

RESULTS

The mean age of the children was 12.6 +/- 2 years. Overweight was 6.2% and obesity was 1.8%. The prevalence of overweight and obesity was higher among private schoolchildren (p<000), females (p = 0.002), children with a sedentary lifestyle (p = 0.001) and children with a family history of obesity (p = 0.013). Also there is a positive association of overweight/obesity with the education level of the parents (p = 0.013 for the father and p = 0.19 for the mother) and consumption of unhealthy foods.

CONCLUSION

Prevalence of overweight and obesity is low and positively associated with the education level of the father, private schooling, sedentary lifestyle, and with students who took unhealthy meals.

Prevalence of overweight among adolescent females in the United Arab Emirates

The purpose of the study was to investigate the prevalence of overweight in adolescent females in the United Arab Emirates (UAE). A total of 898 females, ages 11-18 years, were recruited from five of the seven Emirates with the highest resident Emirati population. Height, weight, triceps skinfold thickness (TSF), and mid-upper-arm circumference were measured in each subject. Reference data from the National Health and Nutrition Examination Surveys (NHANES) were used for comparison. At risk for overweight or overweight were defined as a body mass index (BMI, kg/m(2)) >or=85-95th percentile and >or=95th percentile, respectively. Mean values for BMI and TSF at all ages were higher than the 50th percentile (median) of the NHANES reference data. Using the BMI classification, 14% and 9% of all subjects were classified as at risk for overweight or overweight, respectively. The proportion of subjects at risk for overweight ranged between 7-19% and the prevalence of overweight ranged between 6-15%. The proportion of subjects with a BMI >or=85 percentile ranged from 15% at age 17 years to 33% at age 11 years. Furthermore, 27% and 28% of subjects ages 11 and 12 years, respectively, were above the TSF 90th percentile. These two age groups also showed a high prevalence of overweight using the BMI classification. In conclusion, the findings from our study suggest that a high proportion of adolescent females in the UAE are overweight or at risk for overweight. The consequences of this are a serious concern for public health and need to be addressed.

Comparison between body mass index, triceps skin fold thickness and mid-arm muscle circumference in Saudi adolescents

INTRODUCTION

Adolescence is an important period in an individualâs life. Overweight and obesity are fraught with several health problems even later in life. The objective of this study was to estimate the overweight, obesity, body fat and muscle content of Saudi adolescents as compared to a recognized reference population.

SUBJECTS AND METHODS

Data were collected from a sample of Saudi adolescents in Jeddah from 42 boys' and 42 girls' schools during the month of April 2000. Data collection was done by personal interviews to collect sociodemographic factors and by direct measurement of weight, height, triceps skin fold thickness (TSF) and mid-arm circumference (MAC). The 50th, 85th, and 95th percentiles (P50, P85 and P95) for body mass index (BMI) and triceps skin fold thickness (TSF) were taken, then the 50th, 90th, and 95th percentiles (P50, P90 and P95) for the mid-arm muscle circumference (MAMC) were calculated. These measurements were compared with corresponding values of the National Health and Nutrition Examination Survey I (NHANES I).

RESULTS

The P85 and P95 for BMI and TSF were higher for Saudi adolescents than the NHANES I and the difference was wider for P95. Conversely, there was a lower MAMC at P90 and P95 than the NHANES I reference population curves. The lower MAMC curves were less marked in girls than in boys. On the other hand, Saudi boys and girls showed on average similar body mass index indicated by BMI at P50, which was misleading, since those adolescents showing similar body mass index had more fatness than the average reference population indicated by TSF at P50, and less muscularity on average than reference population indicated by MAMC at P50.

CONCLUSION

Overweight and obesity with increased body fat content and decreased body muscle content appear to be widespread among Saudi adolescents even among those adolescents showing average body mass index. Public health interventions are required to improve quality of food, encourage physical activity and exercise, as well as correct the perception of appropriate body stature.

Profile of body composition of school children (6-18y) in Bahrain

OBJECTIVE

To study the body composition of Bahraini school children.

DESIGN

Cross-sectional national school survey.

SUBJECTS

School children aged 6-18y. The sample comprised 818 boys and 775 girls.

MEASUREMENTS

Weight, height, arm circumference and skinfold thicknesses were measured. Sum of skinfold thickness, body mass index (BMI), mid arm circumference, percentage body fat, fat weight and lean body weight were then calculated to determine body composition.

RESULTS

A significant difference in the sum of skinfold thickness was observed between boys and girls. The girls have almost 50% extra skinfold thickness than boys at all ages. Similar trends were found in BMI, except at ages 9 and 18y. The percentage of body fat was higher in girls than boys. The mean BMI for Bahraini girls aged 13y and above exceeds that of their American counterparts, indicating a trend towards fat accumulation in the Bahraini girls.

CONCLUSION

The data obtained are useful for monitoring obesity in school children in Bahrain as well as being usable as reference data for similar countries in the region. The high proportion of body fat among Bahraini school children, especially girls, urges an intervention program to prevent and control obesity in this age group.