Prevalence and associated factors of eating disorders in patrons of sport centers in Saudi Arabia

The Arabic Version of Compulsive Exercise Test among Saudi Population; Translation and Validation

Compulsive exercise is a condition characterized by uncontrollable exercise behaviour that may lead to severe and harmful physical and psychological consequences. Indeed, compulsive exercise is among the early symptoms of eating disorders that may affect different age groups. Globally and among Arab countries, compulsive exercise is common, while the screening methods used to assess compulsive exercise are limited. Thus, the Compulsive Exercise Test (CET) has emerged as a tool to assess cognitive, behavioural, and emotional factors related to compulsive exercise. The CET is a self-report, Likert-type scale comprising five distinct subscales. The increase in the CET scores is more likely associated with worsened pathology. Since the Arab countries lack such an assessment tool, we aimed to translate the CET into Arabic, validate the translated version, confirm the factor structures, and assess the internal consistency of the different subscales. Herein, we used the forward-backward translation method as recommended by the World Health Organization (WHO). The overall validity index of the translated version showed a score higher than 0.78, while the scale-level content validity index based on the average calculating method (S-CVI/Ave) and the agreement method (S-CVI/UA) were 0.91 and 0.58, respectively. Moreover, we recruited 399 Arabs living in Saudi to measure the internal consistency, and the value of the substantive internal consistency with Cronbach's α was 0.81. Subsequently, four of the Arabic-CET subscales had substantive internal consistency with Cronbach's α values higher than or equal to 0.70. Furthermore, the exploratory factor analysis results supported the substantial use of the five-subscale model. Taken together, our study supports using the Arabic-CET version to measure exercise compulsiveness among Arabs.

A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide

BACKGROUND

The purpose of this meta-analysis was to provide a pooled prevalence estimate of self-reported disordered eating (SRDE) in athletes based on the available literature, and to identify risk factors for their occurrence.

METHODS

Across ten academic databases, an electronic search was conducted from inception to 7th January 2024. The proportion of athletes scoring at or above predetermined cutoffs on validated self-reporting screening measures was used to identify disordered eating (DE). Subgroup analysis per country, per culture, and per research measure were also conducted. Age, body mass index (BMI), and sex were considered as associated/correlated factors.

RESULTS

The mean prevalence of SRDE among 70,957 athletes in 177 studies (132 publications) was 19.23% (17.04%; 21.62%), I2 = 97.4%, τ2 = 0.8990, Cochran's Q p value = 0. Australia had the highest percentage of SRDE athletes with a mean of 57.1% (36.0%-75.8%), while Iceland had the lowest, with a mean of 4.9% (1.2%-17.7%). The SRDE prevalence in Eastern countries was higher than in Western countries with 29.1% versus 18.5%. Anaerobic sports had almost double the prevalence of SRDE 37.9% (27.0%-50.2%) compared to aerobic sports 19.6% (15.2%-25%). Gymnastics sports had the highest SRDE prevalence rate, with 41.5% (30.4%-53.6%) while outdoor sports showed the lowest at 15.4% (11.6%-20.2%). Among various tools used to assess SRDE, the three-factor eating questionnaire yielded the highest SRDE rate 73.0% (60.1%-82.8%). Meta-regression analyses showed that female sex, older age, and higher BMI (all p < 0.01) are associated with higher prevalence rates of SRDE.

CONCLUSION

The outcome of this review suggests that factors specific to the sport affect eating behaviors throughout an athlete's life. As a result, one in five athletes run the risk of developing an eating disorder. Culture-specific and sport-specific diagnostic tools need to be developed and increased attention paid to nutritional deficiencies in athletes.

Cardiovascular Disease in Saudi Arabia: Facts and the Way Forward

Cardiovascular diseases (CVDs) remain a major health concern globally. While some risk factors for CVDs are non-modifiable, other determinants like obesity, hypertension, type-2 diabetes and dyslipidemia can be mitigated by a wide plethora of measures to control CVD morbidity and mortality. Those determinants have been on the rise in Saudi Arabia, exacerbated by sedentary lifestyle. The Saudi Vision 2030 aims to reduce CVD clinical and economic burden and to scale up vitality and longevity; in a new era of comprehensive healthcare. From a health economics standpoint, CVDs entail a burden on healthcare systems directly through expenditure and indirectly through years living with the disease, low productivity, premature morbidity and mortality. This manuscript reviews current CV health and unmet needs in Saudi Arabia, discusses G20 countries' initiatives on primary prevention: public health measures, awareness programs; and proposes national registries and digital solutions to facilitate population-specific research, improve CV surveillance and alleviate CVD burden in Saudi Arabia.

Sociodemographic Variables and Body Mass Index Associated with the Risk of Eating Disorders in Spanish University Students

Background: The passage through university is a complex experience that can heighten personal susceptibility to eating disorders. The objective of this research is to determine how gender, age, course, educational faculty, and body mass index (BMI) can influence the risk of eating disorders among university students. Method: A transversal and descriptive study is conducted with a sample of 516 Spanish students (57.2% female, 42.8% male; Mage = 21.7, SDage = 4.1) following 26 university degrees. The Inventory Eating Disorder-Reference criterion (EDI-3-RF) was administered to the students. Contingency tables were used between categorical variables with the chi-squared statistic, at a significance level of p < 0.05. The Student t-test was used for two independent samples and a one-way ANOVA test with the post hoc Bonferroni test for more than two groups. Pearson’s correlation and a simple linear regression analysis were used to analyze the relationship between the variables in its quantitative version. Results: It was found that the female students enrolled in the second year presented a greater obsession with thinness and body dissatisfaction (p = 0.029; d = 0.338); the male students practiced more physical exercise to control their weight (p = 0.003); and that students under the age of twenty (p < 0.010; d = 0.584) and students from both the Health (p = 0.0.13) and Law (p = 0.021) educational faculties showed greater bulimic behavior (d = 0.070). More females are underweight (z = 2.8), and more men are overweight (z = 2.4). Normal-weight students scored significantly higher in thinness obsession (p = 0.033). Overweight students scored significantly higher on thinness obsession (p < 0.001) and body dissatisfaction (p < 0.001). Obese students scored significantly higher on body dissatisfaction (p = 0.04). Conclusions: The data obtained in this study, reinforce the hypothesis that the female gender, at an age within the limits of early adolescence, in the first year of the degree courses, with specific university qualifications, and a high BMI constituted factors that could provoke an eating disorder. Consequently, it is necessary to implement preventive measures adapted to the circumstances of each university student.

Prevalence and Factors Associated with Eating Disorders in Military First Line of Defense against COVID-19: A Cross-Sectional Study during the Second Epidemic Wave in Peru

Few studies have evaluated eating disorders in military personnel engaged in defense activities during the COVID-19 pandemic. We aimed to determine the prevalence and factors associated with eating disorders in military personnel from Lambayeque, Peru. A secondary data analysis was performed among 510 military personnel during the second epidemic wave of COVID-19 in Peru. We used the Eating Attitudes Test (EAT-26) to assess eating disorders. We explored associations with insomnia, food insecurity, physical activity, resilience, fear to COVID-19, burnout syndrome, anxiety, depression, post-traumatic stress and selected sociodemographic variables. Eating disorders were experienced by 10.2% of participants. A higher prevalence of eating disorders was associated with having 7 to 12 months (PR: 2.97; 95% CI: 1.24-7.11) and 19 months or more (PR: 2.62; 95% CI: 1.11-6.17) working in the first line of defense against COVID-19, fear of COVID-19 (PR: 2.20; 95% CI: 1.26-3.85), burnout syndrome (PR: 3.73; 95% CI: 1.90-7.33) and post-traumatic stress (PR: 2.97; 95% CI: 1.13-7.83). A low prevalence of eating disorders was found in the military personnel. However, prevention of this problem should be focused on at-risk groups that experience mental health burdens.

The Prevalence of "at Risk" Eating Disorders among Athletes in Jordan

Eating disorders (EDs) are addressed as one of the expanding mental health problems worldwide. While an ED is a clinical psychiatric diagnosis that can only be established after a psychiatric assessment, it is important to note that "at-risk" refers to people who will exhibit aberrant eating patterns but do not fully meet the requirements for an ED diagnosis. This study was designed to address the ED symptoms (i.e., "at-risk") in Jordanian athletes and their association with age, sex, body mass index (BMI), and type of sport. A convenient, cross-sectional study was conducted among 249 athlete participants by answering the Eating Attitude Test (EAT-26). The EAT-26 results indicated an ED prevalence of 34% among Jordanian athletes. Within "at-risk" ED athletes, sex, age, and BMI had no significant differences in the rates of EDs. Outdoor sports had the least effect on EDs, while the highest was amongst gymnastics. EDs prevalence is alarming among Jordanian athletes. Gymnastics is a risk factor for increasing EDs. Our results should be taken into consideration by physicians, mental health professionals, sports nutritionists, coaches, and sport medicine specialists. We recommend establishing strategies pertaining to mental health, especially EDs in sports centers, along with screening programs for those who demand additional assessment and supervision.

The relationship between the high-risk disordered eating and social network navigation among Saudi college females during the COVID pandemic

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.

Prevalence of Binge-Eating Disorder and Its Association with Nicotine Dependence Among Under-Graduate Students at a Saudi Public University

Purpose

There is minimal information regarding the prevalence of binge-eating disorders in Saudi Arabia. This study aims to measure the prevalence of BED and its association with nicotine dependency (ND) among undergraduate university students at Imam Mohammad Ibn Saud Islamic University (IMSIU).

Methods

A cross-sectional study recruited 878 participants, with an inclusion criteria that encompassed all IMSIU undergraduate students of either sex. The online-based self-report questionnaire was distributed through e-mail, which used the Binge-Eating Disorder Screener-7 (BEDS-7) to evaluate BED symptoms and the Fagerstrom Test of Nicotine Dependence (FTND) to measure the levels of ND. The e-FTND version was also adapted into the questionnaire to account for modern methods of nicotine usage.

Results

A total of 165 participants were BED positive, with a prevalence of 18.8%, 99 of whom were women, and 66 were men. Women were significantly more predicted for BED than men (p = 0.035). Men appeared to be mainly more expected to be nicotine dependent (p < 0.001). BED positive participants showed a higher probability of being nicotine dependent than BED negative participants in the multivariate logistic regression analysis (95% CI 1.3–3.2; p = 0.002).

Conclusion

BED prevalence was notably high compared to worldwide estimates, with a significant association to nicotine dependence by the multivariate analysis. In the future, more investigations regarding the prevalence of specific types of eating disorders, including BED, in Saudi Arabia need to be considered.