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Hall NY, Hetti Pathirannahalage DM, Mihalopoulos C, Austin SB, Le L. Global Prevalence of Adolescent Use of Nonprescription Weight-Loss Products: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e2350940. [PMID: 38198138 PMCID: PMC10782242 DOI: 10.1001/jamanetworkopen.2023.50940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/10/2023] [Indexed: 01/11/2024] Open
Abstract
Importance Use of nonprescribed weight-loss products in adolescents is a public health concern that is associated with negative physical and psychological consequences. However, the prevalence of nonprescribed weight-loss product use in adolescents is unknown. Objective To determine the global prevalence of nonprescription weight-loss product use in children and adolescents. Data Sources Four databases, including MEDLINE, PsycINFO, CINAHL (Cumulative Index of Nursing and Allied Health), and EMBASE, were searched for quantitative studies that reported prevalence data on use of nonprescription weight-loss products with no restrictions on publication date. The search was performed December 1, 2020, and updated March 6, 2023. Study Selection Studies were included in the meta-analysis if they reported the prevalence of weight-loss product use, were published in English, and included individuals 18 years or younger. Data Extraction and Synthesis Data extraction was completed by 2 independent reviewers. Data analysis determined the overall pooled proportion of weight-loss product use in total and during the past week, past 30 days, past year, or lifetime. Inverse variance heterogeneity effect models were used. Main Outcomes and Measures The main outcome measure was the prevalence of nonprescription weight-loss product use in adolescents for all included studies and over the past week, past month, past year, or lifetime. Subgroup analysis included separation of groups by sex, specific weight-loss product types, geographical location, and study publication time. Results A total of 90 articles (604 552 unique participants) were included in the meta-analysis. Of these, 50 studies (56%) were from North America. The reported prevalence of weight-loss product use in adolescents was 5.5% (96% CI, 5.5%-5.6%) overall. When identifying use of weight-loss products in the general population, prevalence was 2.0% (95% CI, 1.9%-2.1%) in the past week, 4.4% (95% CI, 4.3%-4.5%) in the past month, 6.2% (95% CI, 6.1%-6.3%) in the past year, and 8.9% (95% CI, 8.6%-9.2%) in their lifetime. Use of weight-loss products was higher among girls than boys. Conclusions and Relevance This meta-analysis found that use of weight-loss products occurs at high levels in adolescents, especially girls. These findings suggest that, given the ineffectiveness of these products for weight loss coupled with their harmful long-term health consequences, interventions are required to reduce use of weight-loss products in this group.
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Affiliation(s)
- Natasha Yvonne Hall
- School of Health and Social Development, Deakin University, Melbourne, Australia
| | | | - Cathy Mihalopoulos
- Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - S. Bryn Austin
- School of Public Health, Department of Social and Behavioral Sciences, Harvard University, Boston, Massachusetts
| | - Long Le
- Public Health and Preventative Medicine, Monash University, Melbourne, Australia
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Makki J, Aljebeli S, Alobikan SAA, Altulaihi B. Depressive, Anxiety, and Stress Symptoms Among Schoolgirls With Disordered Eating Behaviors. Cureus 2024; 16:e51562. [PMID: 38313977 PMCID: PMC10835646 DOI: 10.7759/cureus.51562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 02/06/2024] Open
Abstract
Objectives This study aimed to assess the relationship between depression, anxiety, stress, and disordered eating behaviors among schoolgirls in Riyadh, Saudi Arabia. The current study could provide insights into potential intervention strategies for addressing both aspects simultaneously, contributing to a more holistic approach in the field. Method Via simple sampling technique, the current quantitative, descriptive, and cross-sectional study included 347 female adolescents aged between 13 and 18 years in public schools in Riyadh, Saudi Arabia. A self-administered questionnaire comprised demographic information, items on body image satisfaction and perception, the Eating Attitude Test-26 (EAT-26), and the Depression, Anxiety, and Stress Scale-21 (DASS-21). Results Among the participants, 32.6% scored at or above the cutoff point on the EAT-26, indicating a negative eating attitude. Additionally, multiple factors such as age, obesity, body image dissatisfaction, and peer pressure were correlated with disordered eating behaviors, with excessive exercise being the most reported weight control behaviors. The prevalence of depression, anxiety, and stress were 58.5%, 73.2%, and 40.9%, respectively. Notably, anxiety was significantly associated with disordered eating behaviors. Conclusion In conclusion, disordered eating behaviors were reported by 32.6% of the participants, and symptoms of anxiety were significantly associated with these behaviors. Media consumption appeared to influence more than half of the participants in their weight loss attempts.
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Affiliation(s)
- Joud Makki
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Shahad Aljebeli
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | - Bader Altulaihi
- Department of Family Medicine and Primary Care, King Abdullah International Medical Research Center, Riyadh, SAU
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Alsheweir A, Goyder E, Alnooh G, Caton SJ. Prevalence of Eating Disorders and Disordered Eating Behaviours amongst Adolescents and Young Adults in Saudi Arabia: A Systematic Review. Nutrients 2023; 15:4643. [PMID: 37960296 PMCID: PMC10649920 DOI: 10.3390/nu15214643] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/08/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Eating disorders (EDs) and disordered eating behaviours (DEBs) are significant health problems related to body image and weight dissatisfaction among adolescents and young adults worldwide. During this stage of sensitive development, these behaviours may hinder the optimal growth process and can consequently lead to wasting, stunting, and micronutrient deficiencies. However, there is a limited amount of literature on DEB among Arab populations, particularly in Saudi Arabia. This review aims to assess the prevalence of EDs/DEB and to develop a clear understanding of the epidemiology of such conditions among adolescents and youth in Saudi Arabia. Five databases were systematically searched and 14 papers met the inclusion criteria. The Eating Attitudes Test (EAT-26) was the predominant tool used for evaluating aberrant eating behaviours, indicating a high prevalence of EDs/DEB ranging from 10.2% to 48.1%. The highest prevalence of EDs/DEB was reported in the eastern region ranging from 29.4% to 65.5%. In terms of age and sex, the prevalence was higher among older students compared to younger school students and males reported more Eds/DEB compared to female students. These disorders are found to be prevalent in Saudi Arabia, and the risk of developing such conditions is high across the whole age range.
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Affiliation(s)
- Azzah Alsheweir
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); (S.J.C.)
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 145111, Saudi Arabia
| | - Elizabeth Goyder
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); (S.J.C.)
| | - Ghadah Alnooh
- Centre for Assistive Technology and Connected Healthcare, Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK;
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Samantha J. Caton
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); (S.J.C.)
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Raja N AA, Osman NA, Alqethami AM, Abd El-Fatah NK. The relationship between the high-risk disordered eating and social network navigation among Saudi college females during the COVID pandemic. Front Public Health 2022; 10:949051. [PMID: 36148353 PMCID: PMC9486004 DOI: 10.3389/fpubh.2022.949051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023] Open
Abstract
Background Disordered eating behaviors (DEBs) are complex health issues that may lead to negative physical and mental health outcomes among college students. More studies should be directed toward the screening of DEBs. This study aimed to determine the prevalence of DEBs among Saudi female university students and their association with social networking site (SNSs) usage and composite lifestyle behaviors during the unprecedented period of COVID-19. Methods This cross-sectional study included 445 females recruited using stratified random sampling. The participants self-reported demographic, social, medical, and lifestyle data and completed the validated Arabic version of the Eating Attitudes Test-26, Social Networking Sites (SNSs) Usage Questionnaire, Bergen Social Media Addiction Scale, and Body Shape Questionnaire. Results The prevalence of DEBs was 27.2% among the female students at Taif University. From the pre-pandemic period until the current time, the DEBs-risk group had a significantly higher SNS navigation rate (36.4%) than the normal group (20.4%) (X 2 = 30.015, p = 0.001). The regression analysis revealed that females with a significant body image concern, higher number of SNSs friends, and frequent visits to SNSs, and those seeking social-dependent information in relation to weight loss/dieting were more likely to develop DEBs (Overall Model: Chi-Square X 2 = 158.071, p < 0.000**). Conclusions SNSs usage and DEBs were associated during the COVID-pandemic. However, the composite lifestyle score did not demonstrate a significant association with DEBs among the female students at Taif University. Investigating the magnitude of DEBs and understanding the role of SNS are essential for preventing disordered eating among young females.
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Affiliation(s)
- Alotaibi Abdulaziz Raja N
- Department of Public Health, Directorate of Health Affairs in Taif, Ministry of Health, Riyadh, Saudi Arabia
| | - Nermin A. Osman
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Abdullah Muidh Alqethami
- Department of Public Health, Directorate of Health Affairs in Taif, Ministry of Health, Riyadh, Saudi Arabia
| | - Nesrin Kamal Abd El-Fatah
- Department of Nutrition, High Institute of Public Health, Alexandria University, Alexandria, Egypt,*Correspondence: Nesrin Kamal Abd El-Fatah
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Kanellakis S, Karalexi MA, Apostolidou E, Skoufas E, Kontoe M, Bacopoulou F, Tsitsas G, Migdanis A, Boudouvi E, Canellopoulos L, Manios Y. Earlier Age at Menarche Is Associated with Body Fat and Negative Body Image in Adult Life. Behav Med 2022; 49:105-114. [PMID: 35387571 DOI: 10.1080/08964289.2022.2033158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Earlier age at menarche is one of the well-documented antecedents of a range of adverse health effects in adulthood including obesity and psychopathological effects. Yet, few researchers have examined the potential association of menarcheal age with body fat distribution, self-perception, and body image. We retrospectively tested a sample (N = 392) of adult women (18-80 years) to examine the associations of age at menarche with body composition and body image indices. Analyses of covariance and multivariable logistic and linear regression were fitted adjusting for age, physical activity level, smoking, and alcohol consumption. Further adjustment was made for body mass index (BMI) and percentage of fat mass. Earlier age at menarche was associated with slightly increased odds of higher BMI and abdominal fat percentage; of note is the positive correlation with lower body composition indices including hip and calf circumferences/skinfolds. Additionally, earlier age at menarche was associated with higher scores in the negative body image scales, namely overweight preoccupation and self-classified weight, whereas lower risks were found for higher scores in the positive body image scales, namely appearance evaluation and body area satisfaction scales. These findings remained significant after correcting for body fat percentage. The present results showed positive associations for earlier age at menarche with gross indices of obesity with the associations mainly confined to distribution of body fat in the lower part of the body, whereas an increased risk of negative body image was also found. Future research could refine our understanding of the biological and psychological mechanisms underlying these associations.
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Affiliation(s)
- Spyridon Kanellakis
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Maria A Karalexi
- Third Department of Pediatrics, General University Hospital "Attikon," National and Kapodistrian University of Athens, Athens, Greece
| | - Eftychia Apostolidou
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Estathios Skoufas
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Maria Kontoe
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Georgios Tsitsas
- Counseling Psychology, Harokopio University of Athens, Athens, Greece
| | - Athanasios Migdanis
- Nutrition, Dietetics and Food Technology Department, ATEI of Thessaly, Larissa, Greece
| | - Evangelia Boudouvi
- Third Department of Pediatrics, General University Hospital "Attikon," National and Kapodistrian University of Athens, Athens, Greece
| | - Lissy Canellopoulos
- Department of Psychology, School of Philosophy, National and Kapodistrian University of Athens, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
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Chan MF, Al Balushi R, Al Falahi M, Mahadevan S, Al Saadoon M, Al-Adawi S. Child and adolescent mental health disorders in the GCC: A systematic review and meta-analysis. Int J Pediatr Adolesc Med 2021; 8:134-145. [PMID: 34350324 PMCID: PMC8319685 DOI: 10.1016/j.ijpam.2021.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/25/2021] [Indexed: 12/01/2022]
Abstract
Background The Gulf Cooperation Council (GCC), with a predominant ‘youth bulge’ among its 54 million people, has witnessed an exponential increase in research pertinent to child and adolescent mental health (CAMH). Aside from a few narrative reviews, to date, no critical appraisal examining the magnitude of CAMH has emerged from this region. Aims This study aimed to report the prevalence rates of CAMH disorders in the GCC through a systematic review of the existing literature followed by a meta-analysis. Methods A systematic review of the literature from the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) was conducted. The databases used included Scopus, ProQuest, Pubmed, and a final check was performed on Google Scholar to account for any remaining studies that may have still been under review. Meta analytic techniques were then used to estimate prevalence rates of each specific mental disorder, i.e. ADHD, depression, anxiety, stress, eating disorders, and tobacco use disorder. Results A total of 33 studies from the six countries were included. The pooled prevalence of ADHD as per the Vanderbilt ADHD Diagnostic Rating Scale (VADHDDRS), clinical judgments, Attention Deficit Disorders Evaluation Scale (ADDES), and the Strengths and Difficulties Questionnaire (SDQ) was found to be 13.125%, 13.38%, 26.135%, and 12.83%, respectively. The pooled prevalence of depressive symptoms solicited by the Patient Health Questionnaire (PHQ-9), Depression, Anxiety, and Stress Scale (DASS), and Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) was 44.684%, 45.09%, and 26.12%, respectively. The pooled prevalence of anxiety according to the DASS and the MINI Kid was 57.04% and 17.27%, respectively, while the pooled prevalence of stress as per the DASS was found to be 43.15%. The pooled prevalence of disordered eating solicited by the Eating Attitudes Test (EAT-26) was 31.55%. Lastly, the pooled prevalence of tobacco use disorder per the Global Youth Tobacco Survey was 19.39%. Discussion To date, this is the first systematic review and meta-analysis of its kind from the GCC. The prevalence rate of CAMH disorders appears to be in the upper range of international trends. The higher rates could be attributed to the existing studies using suboptimal methodological approaches and instruments to solicit the presence of CAMH.
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Affiliation(s)
- Moon Fai Chan
- Department of Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Rola Al Balushi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Maryam Al Falahi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Sangeetha Mahadevan
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Muna Al Saadoon
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Daeie-Farshbaf L, Ebrahimi-Mameghani M, Sarbakhsh P, Roshanravan N, Tarighat-Esfanjani A. Age at menarche, eating disorders, and their relationships with some parameters in female adolescents in Iran. BMC Res Notes 2021; 14:72. [PMID: 33632311 PMCID: PMC7905913 DOI: 10.1186/s13104-021-05482-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/10/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Adolescence as one of the most challenging periods of humans’ growth is accompanied with major physical, behavioural, social-emotional, and neuroendocrine changes. Early maturation and eating disorders (EDs) have been reported to be associated with adverse health conditions. Therefore, the present study was conducted to assess age of onset of menarche (AM), EDs, and their possible relationships with weight, body mass index (BMI), waist circumference (WC), and socioeconomic status (SES) in the Iranian female adolescents. Results In the study population, mean ± standard deviation (SD) of AM was 12.95 ± 1.14 years. Inverse significant relationships were found between weight and AM, also BMI and AM (p < 0.05). There was a negative association between weight and anorexia nervosa (AN), BMI and AN, also WC and AN (p < 0.001). A significant positive correlation was found between SES and AM, also EDs and AM (p < 0.05) then between weight and bulimia nervosa (BN) & binge-eating disorder (BED), BMI and BN & BED, also WC and BD & BED (p < 0.001). Our results also revealed that AM in mothers had a significant positive relationship with AM in their daughters (p < 0.001, r = 0.34).
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Affiliation(s)
- Lida Daeie-Farshbaf
- Student Research Committee, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrangiz Ebrahimi-Mameghani
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St., POBOX: 14711, Tabriz, 5166614711, Iran
| | - Parvin Sarbakhsh
- Statistic and Epidemiology Research Center, Tabriz University Medical Sciences, Tabriz, Iran
| | - Neda Roshanravan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Tarighat-Esfanjani
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St., POBOX: 14711, Tabriz, 5166614711, Iran.
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Karim A, Qaisar R, Hussain MA. Growth and socio-economic status, influence on the age at menarche in school going girls. J Adolesc 2020; 86:40-53. [PMID: 33310201 DOI: 10.1016/j.adolescence.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/28/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Onset age at menarche has been considered an important indicator of reproductive maturity in females and reflects the health status of the population. The purpose of this study was to determine the mean menarcheal age and to examine whether anthropometric and socio-economic status (SES) influences age at menarche in the girls from Punjab province of Pakistan. METHODS In this population-based cross-sectional study, 10,050 school-going girls aged 8-16 years from 35 schools across 12 districts of Punjab were recruited. Menarcheal data was obtained by using a questionnaire, while the anthropometric data were obtained by the measurements of standing height, body weight, waist, and hip circumference. The anthropometric indices of pre- and post-menarcheal girls were compared. Student's t-test, ANOVA, and post-hoc Tukey's test was applied for comparison between two and multiple groups respectively, P < 0.05 was considered statistically significant. RESULTS There was a normal distribution of age at menarche and mean was 12.4 years in the study population. The girls who reached menarche were found to be taller and heavier with higher BMIs, having a greater waist and hip circumference as compared to their pre-menarcheal peers. Waist-hip-ratio was less, and the waist-to-height ratio was higher in post-menarcheal as compared to pre-menarcheal girls. The girls belonging to low SES had delayed onset of menarche as compared to those belonging to middle/high SES. CONCLUSION The age at menarche was associated with SES and changes in various anthropometric measurements reflecting the growth status of girls.
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Affiliation(s)
- Asima Karim
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; Department of Physiology & Cell Biology, University of Health Sciences, Lahore, Pakistan.
| | - Rizwan Qaisar
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - M Azhar Hussain
- Department of Finance and Economics, College of Business Administration, University of Sharjah, Sharjah, United Arab Emirates; Department of Social Sciences and Business, Roskilde University, Roskilde, Denmark
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