Childhood obesity and its relation with dietary habits among children in Aseer region, Southern Saudi Arabia

Predicting age at onset of childhood obesity using regression, Random Forest, Decision Tree, and K-Nearest Neighbour-A case study in Saudi Arabia

Childhood and adolescent overweight and obesity are one of the most serious public health challenges of the 21st century. A range of genetic, family, and environmental factors, and health behaviors are associated with childhood obesity. Developing models to predict childhood obesity requires careful examination of how these factors contribute to the emergence of childhood obesity. This paper has employed Multiple Linear Regression (MLR), Random Forest (RF), Decision Tree (DT), and K-Nearest Neighbour (KNN) models to predict the age at the onset of childhood obesity in Saudi Arabia (S.A.) and to identify the significant factors associated with it. De-identified data from Arar and Riyadh regions of S.A. were used to develop the prediction models and to compare their performance using multi-prediction accuracy measures. The average age at the onset of obesity is 10.8 years with no significant difference between boys and girls. The most common age group for onset is (5-15) years. RF model with the R2 = 0.98, the root mean square error = 0.44, and mean absolute error = 0.28 outperformed other models followed by MLR, DT, and KNN. The age at the onset of obesity was linked to several demographic, medical, and lifestyle factors including height and weight, parents' education level and income, consanguineous marriage, family history, autism, gestational age, nutrition in the first 6 months, birth weight, sleep hours, and lack of physical activities. The results can assist in reducing the childhood obesity epidemic in Saudi Arabia by identifying and managing high-risk individuals and providing better preventive care. Furthermore, the study findings can assist in predicting and preventing childhood obesity in other populations.

Prevalence of Childhood Obesity Among Children and Adolescents in Saudi Arabia: A Systematic Review

Childhood obesity is a growing public health concern worldwide, with significant implications for long-term health outcomes. Thus, the aim of this study is to highlight the prevalence and trend of obesity among children and adolescents in Saudi Arabia over the last 24 years. This systematic review included participants aged 2 to 19 years without systemic disease, reporting the prevalence of obesity using the Centers for Disease Control and Prevention (CDC) classification and BMI calculation, from studies in English or Arabic published between January 2000 and April 2024. We conducted a comprehensive search across multiple databases including ProQuest, Google Scholar, ISI Web of Science, Embase via Ovid, and MEDLINE via Ovid, and reviewed references of included studies. Data were extracted and quality assessed independently by two authors, with any disagreements resolved through discussion with a third reviewer, using the Newcastle-Ottawa Scale modified for this study. This systematic review included 21 studies from Saudi Arabia, published between 2006 and 2023, with participants aged 2 to 19 years. The studies involved a total of 63,512 subjects. Among children, the prevalence of overweight ranged from 5% to 29%, while obesity ranged from 3.8% to 49.7%, classified using CDC criteria. Quality assessment rated 10 studies as Very Good, 10 as Good, and one as Unsatisfactory. The systematic review of childhood obesity prevalence in Saudi Arabia over the past 24 years highlights alarming trends and significant public health implications. Our analysis emphasizes an increase in obesity rates among children and adolescents, revealing a complex link of socioeconomic, cultural, and lifestyle factors contributing to this epidemic.

Antiobesity effect of healthy food crops and functional foods: A systematic review of their mechanisms

Diet is a modifiable risk factor in the prevention and management of obesity, and various foods have the potential to aid in obesity management by modulating different pathways involved in the disease's pathology. We performed a systematic review of literature, using CINAHL, PubMed, and Google Scholar, focusing on the antiobesity potential of foods crops and functional food products, and their mechanisms of action and clinical evidence. Sixty-four articles were identified, of which 41 investigated food crops, while 23 investigated functional products. Food crops, such as cereals, vegetables, fruits, mushrooms, seaweeds, legumes, herbs, spices, and cocoa seeds, have antiobesity effects through mechanisms such as altering the metabolism of glucolipids by inhibiting enzymes like α-amylase and α-glucosidase, stimulating the bioenergetics of thermogenic fat, modulating gut microbiota, and inhibiting lipogenesis and storage. In addition, developed functional teas, beverages, and yoghurt have antiobesity effects through similar or different mechanisms, such as enhancing energy expenditure and satiety, suppressing adipogenesis and lipolysis, improving glucose and lipid metabolism, and altering hormonal secretion. This review reemphasized the significance of food in the control of obesity, and highlights the distinct methods these explored foods exert their antiobesity effects. In conclusion, foods are safe and effective means of combating obesity without the side effects of conventional drugs, which can help inform dietary choices, assist professionals in providing more accurate advice, and also lead to better understanding of food and its effect on overall health of the public. This approach will eradicate global diseases, especially if more underutilized and indigenous food crops are extensively researched.

Physical activity across days of week, video games, and laptop use are more likely to influence weight gain among Saudi Youth

Purpose

The purpose of this study was to determine the extent and prevalence of daily PA and the sedentary behavior during inactive spare-time among young Saudis and their effect on overweight and obesity.

Methods

A total of 357 students completed all stages of this study. They included 282 boys aged 11.95 ± 0.73 years (213 children aged 11.62 ± 0.506 years and 69 adolescents aged 13.16 ± 0.373 years) and 75 girls (16 children aged 11.94 ± 0.236 years and 59 adolescents aged 13.47 ± 0.626 years). For each participant, height and weight were measured, and BMI was calculated. A questionnaire asking about daily PA and sedentary habits during the previous 7 days was also used. Multiple comparisons were performed to test for differences between groups by sex and age category, and stepwise multiple regression analysis was used to determine which variables significantly affected BMI.

Results

The overall prevalence of overweight and obesity was 17.02 and 28.37% in boys and 9.33 and 0% in girls, respectively. The patterns of PA were changing within elements and between sexes. Both groups of boys were more active than girls during breakfast and lunch periods (p < 0.001 for all). A significant difference in favor of boys was also observed between the two groups of boys and the group of adolescent girls regarding after-school physical activity (p < 0.05 for all). Prepubescent boys reported being generally less active during the previous 7 days than their female counterparts and adolescent peers. Sedentary behaviors did not differ between all groups. Playing video games and using laptops were the parameters significantly associated with BMI.

Conclusions

This study noted that the prevalence of overweight and obesity was more pronounced in boys than in girls. However, boys were more active but had the same degree of sedentary behavior as girls. Physical activity across the days of weekly, video games, and laptop use were the parameters that most affected BMI.

Effect of Laparoscopic Sleeve Gastrectomy on HbA1C Level in Children with Type 2 Diabetes Mellitus

Background and Objectives: A third of the American adult population is currently pre-diabetic/morbidly obese and is, therefore, at an elevated risk for developing type 2 diabetes. Unfortunately, such a condition does not spare children from also developing morbid obesity, where incidence rates of childhood obesity—coupled with type 2 diabetes—are markedly elevated. Laparoscopic sleeve gastrectomy (LSG) is gradually becoming the novel benchmark in bariatric surgery for the treatment of morbid obesity and associated co-morbidities, also within pediatric cases. However, no comprehensive study has been conducted in children that emphasizes the effect of LSG on HbA1C levels within such a patient population suffering from type 2 diabetes. Aim: Since HbA1C is a major biomarker for type 2 diabetes progression, this study aimed to identify any dysregulated serum levels for this key molecular player (together with other parameters), for post-surgical monitoring of the beneficial metabolic effects of LSG surgery on type 2 diabetes amelioration/remission within pediatric patients. Materials and Methods: A total of 64 pediatric patients, ranging in age from 5 to 14 years old, were enrolled in this retrospective study. Multiple laboratory-based analyses datasets were also collected from individual study participants, including HbA1C and random blood sugar (RBS). All participating patients were designated for undergoing laparoscopic sleeve gastrectomy, as per standardized surgical protocols and each participant was followed-up for two years post-surgery. Laboratory investigations were re-performed in order to identify any major variations in clinical parameters. Results: HbA1c was significantly reduced among children, from 6.0 ± 0.8 (pre-LSG) to 5.4 ± 0.4 post-surgery, with a reduction rate of 10.9% (p = 0.001). Furthermore, RBS significantly decreased from 102.9 ± 34.0 (pre-LSG) to 87.1 ± 17.3 post- surgery, with a reduction rate of 15.4% (p = 0.036). Conclusions: This study provides further concrete evidence for the beneficial metabolic influence provided by LSG surgery on morbidly obese, childhood-aged patient populations, with effectiveness in reducing co-morbidity progress, in the form of type 2 diabetes, through the reduction in HbA1c levels within such patients post-surgery.

Breakfast Consumption May Improve Fasting Insulin, HOMA-IR, and HbA1c Levels in Predominately Low-Income, Hispanic Children 7-12 Years of Age

Children from low-income households and minority families have high cardiometabolic risk. Although breakfast consumption is known to improve cardiometabolic health in children, limited randomized control trials (RCT) have explored this association in low-income and racial/ethnic U.S. minority families. This study conducted secondary analyses from TX Sprouts, a school-based gardening, cooking, and nutrition education RCT, to examine the intervention effect on breakfast consumption and how changes in breakfast consumption impact cardiometabolic risk in predominately low-income, multi-ethnic children. TX Sprouts consisted of 16 schools (8 intervention; 8 control) in greater Austin, TX. A total of 18 lessons were taught, including topics on breakfast consumption benefits and choosing healthy food options at school. Children completed clinical measures (e.g., anthropometrics, body composition via bioelectrical impedance), and the number of breakfast occasions (BO) per week (at home and school) was captured via validated survey at baseline and post-intervention. Post-study—Baseline changes in breakfast consumption were used to categorize students as: maintainers (BO −1 to 1 day/week), decreasers (BO ≤−2 day/week), and increasers (BO ≥2 day/week). Optional fasting blood draws were performed on a subsample. Generalized weighted linear mixed modeling tested differences between intervention and control, with schools as random clusters. Analysis of covariance and linear regression examined changes in breakfast consumption on cardiometabolic outcomes, controlling for age, sex, race/ethnicity, free and reduced-price school meal participation (FRL), school site, breakfast location, physical activity, baseline cardiometabolic measures, and BMI z-score. This study included 1417 children (mean age 9 years; 53% male; 58% Hispanic, 63% FRL; breakfast consumption patterns: 63% maintainers, 16% decreasers, and 21% increasers). There was no intervention effect on changes in breakfast consumption. Compared to decreasers, increasers had an increase in insulin (−0.3 µIU/mL vs. +4.1 µIU/mL; p = 0.01) and a larger increase in HOMA-IR (+0.4 vs. +1.5; p < 0.01). Every one-day increase in breakfast consumption decreased fasting insulin by 0.44 µIU/mL, HOMA-IR by 0.11, and hemoglobin A1c by 0.01% (p ≤ 0.03). Increased breakfast consumption was linked to improved glucose control, suggesting breakfast can mitigate risk in a high-risk population. To better understand underlying mechanisms linking breakfast consumption to improved metabolic health, RCTs focusing on breakfast quality and timing are warranted.