Overweight and Obesity in Eastern Mediterranean Region: Prevalence and Possible Causes

The objective of this paper was to explore the prevalence of overweight and obesity among various age groups as well as discuss the possible factors that associated with obesity in the Eastern Mediterranean Region (EMR). A systematic review of published papers between 1990 and 2011 was carried out. Obesity reached an alarming level in all age groups of the EMR countries. The prevalence of overweight among preschool children(<5 years) ranged from 1.9% to 21.9%, while the prevalence of overweight and obesity among school children ranged from 7% to 45%. Among adults the prevalence of overweight and obesity ranged from 25% to 81.9%. Possible factors determining obesity in this region include: nutrition transition, inactivity, urbanization, marital status, a shorter duration of breastfeeding, frequent snacking, skipping breakfast, a high intake of sugary beverages, an increase in the incidence of eating outside the home, long periods of time spent viewing television, massive marketing promotion of high fat foods, stunting, perceived body image, cultural elements and food subsidize policy. A national plan of action to overcome obesity is urgently needed to reduce the economic and health burden of obesity in this region

Prevalence and risk factors associated with nutrition-related noncommunicable diseases in the Eastern Mediterranean region

This paper reviews the current situation concerning nutrition-related noncommunicable diseases (N-NCDs) and the risk factors associated with these diseases in the Eastern Mediterranean region (EMR). A systematic literature review of studies and reports published between January 1, 1990 and September 15, 2011 was conducted using the PubMed and Google Scholar databases. Cardiovascular disease, type 2 diabetes, metabolic syndrome, obesity, cancer, and osteoporosis have become the main causes of morbidity and mortality, especially with progressive aging of the population. The estimated mortality rate due to cardiovascular disease and diabetes ranged from 179.8 to 765.2 per 100,000 population, with the highest rates in poor countries. The prevalence of metabolic syndrome was very high, ranging from 19% to 45%. The prevalence of overweight and obesity (body mass index ≥25 kg/m2) has reached an alarming level in most countries of the region, ranging from 25% to 82%, with a higher prevalence among women. The estimated mortality rate for cancer ranged from 61.9 to 151 per 100,000 population. Osteoporosis has become a critical problem, particularly among women. Several risk factors may be contributing to the high prevalence of N-NCDs in EMR, including nutrition transition, low intake of fruit and vegetables, demographic transition, urbanization, physical inactivity, hypertension, tobacco smoking, stunting of growth of preschool children, and lack of nutrition and health awareness. Intervention programs to prevent and control N-NCDs are urgently needed, with special focus on promotion of healthy eating and physical activity

Convergent Validity of the Arab Teens Lifestyle Study (ATLS) Physical Activity Questionnaire

The Arab Teens Lifestyle Study (ATLS) is a multicenter project for assessing the lifestyle habits of Arab adolescents. This study reports on the convergent validity of the physical activity questionnaire used in ATLS against an electronic pedometer. Participants were 39 males and 36 females randomly selected from secondary schools, with a mean age of 16.1 ± 1.1 years. ATLS self-reported questionnaire was validated against the electronic pedometer for three consecutive weekdays. Mean steps counts were 6,866 ± 3,854 steps/day with no significant gender difference observed. Questionnaire results showed no significant gender differences in time spent on total or moderate-intensity activities. However, males spent significantly more time than females on vigorous-intensity activity. The correlation of steps counts with total time spent on all activities by the questionnaire was 0.369. Relationship of steps counts was higher with vigorous-intensity (r = 0.338) than with moderate-intensity activity (r = 0.265). Pedometer steps counts showed higher correlations with time spent on walking (r = 0.350) and jogging (r = 0.383) than with the time spent on other activities. Active participants, based on pedometer assessment, were also most active by the questionnaire. It appears that ATLS questionnaire is a valid instrument for assessing habitual physical activity among Arab adolescents

Food-Based Dietary Guidelines for the Arab Gulf Countries

The concept of food-based dietary guidelines (FBDG) has been promoted by several international organizations. However, there are no FBDG for the countries in the Arab region. As the Arab Gulf countries share similar a socioeconomic and nutrition situation, an attempt was made to develop FBDG for these countries. This paper summarizes the steps taken to develope such guidelines by the Arab Center for Nutrition. The FBDG were developed through 6 steps: (1) determination of the purpose and goals for establishing FBDG, (2) characteristics of FBDG, (3) determination of the food consumption patterns, (4) review the current nutrition situation, (5) determination of the lifestyle patterns that are associated with diet-related diseases and (6) formulating the FBDG. The FBDG consist of 14 simple and practical pieces of advice taking into consideration the sociocultural status and nutritional problems in the Arab Gulf countries. The FBDG can be a useful tool in educating the public in healthy eating and prevention of diet-related chronic diseases

Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region

<p>Abstract</p> <p>Background</p> <p>Few lifestyle factors have been simultaneously studied and reported for Saudi adolescents. Therefore, the purpose of the present study was to report on the prevalence of physical activity, sedentary behaviors and dietary habits among Saudi adolescents and to examine the interrelationships among these factors using representative samples drawn from three major cities in Saudi Arabia.</p> <p>Methods</p> <p>This school-based cross-sectional study was conducted during the years 2009-2010 in three cities: Al-Khobar, Jeddah and Riyadh. The participants were 2908 secondary-school males (1401) and females (1507) aged 14-19 years, randomly selected using a multistage stratified sampling technique. Measurements included weight, height, sedentary behaviors (TV viewing, playing video games and computer use), physical activity using a validated questionnaire and dietary habits.</p> <p>Results</p> <p>A very high proportion (84% for males and 91.2% for females) of Saudi adolescents spent more than 2 hours on screen time daily and almost half of the males and three-quarters of the females did not meet daily physical activity guidelines. The majority of adolescents did not have a daily intake of breakfast, fruit, vegetables and milk. Females were significantly (<it>p </it>< 0.05) more sedentary, much less physically active, especially with vigorous physical activity, and there were fewer days per week when they consumed breakfast, fruit, milk and diary products, sugar-sweetened drinks, fast foods and energy drinks than did males. However, the females' intake of French fries and potato chips, cakes and donuts, and candy and chocolate was significantly (<it>p </it>< 0.05) higher than the males'. Screen time was significantly (<it>p </it>< 0.05) correlated inversely with the intake of breakfast, vegetables and fruit. Physical activity had a significant (<it>p </it>< 0.05) positive relationship with fruit and vegetable intake but not with sedentary behaviors.</p> <p>Conclusions</p> <p>The high prevalence of sedentary behaviors, physical inactivity and unhealthy dietary habits among Saudi adolescents is a major public health concern. There is an urgent need for national policy promoting active living and healthy eating and reducing sedentary behaviors among children and adolescents in Saudi Arabia.</p

Prevalence of Overweight, Obesity, and Abdominal Obesity among Urban Saudi Adolescents: Gender and Regional Variations

The nutrition transition with associated lifestyle-related non-communicable diseases has rapidly reached many developing countries, including Saudi Arabia. Therefore, the objective of this study was to examine the prevalence of overweight, obesity, and abdominal obesity among Saudi adolescents. This school-based multicentre cross-sectional study was conducted during 2009-2010 in three major cities in Saudi Arabia: Al-Khobar, Jeddah, and Riyadh. Participants included 2,908 students of secondary schools (1,401 males and 1,507 females) aged 14 to 19 years, randomly selected using a multistage stratified cluster-sampling technique. Weight, height, and waist-circumference were measured; prevalence of overweight and obesity was determined using age- and sex-specific BMI cutoff reference standards of the International Obesity Task Force (IOTF). Abdominal obesity was determined using waist-to-height ratio (WHtR) cutoffs (above 0.5). The prevalence of overweight was 19.5% in males and 20.8% in females while that of obesity was 24.1% in males and 14% in females. The prevalence of abdominal obesity in males and females was 35.9% and 30.3% respectively. Higher prevalence of obesity was observed among adolescents in private schools. Across all ages, overweight and obesity ranged from 39.9% to 45.6% in males and from 30.4% to 38.7% in females. ANCOVA, controlling for age, showed significant interaction effects (city by gender). It is concluded that the proportions of overweight, obesity, and abdominal obesity, observed among Saudi adolescents were remarkably high. Such high prevalence of overweight and obesity is a major public-health concern

Joint Associations of Activity Energy Expenditure and Sedentary Behaviors with Adolescent's Obesity and Dietary Habits

PURPOSE: Physical inactivity and sedentary behaviors are thought to be independent entities and differently associate with adverse health outcomes. Thus, the aim of this study was to investigate the joint associations of physical activity and sedentary behaviors with obesity indices and dietary habits among adolescents from the Gulf Cooperation Council (GCC) countries. METHODS: Data were from the Arab Teens Lifestyle Study (ATLS), a school based, cross-sectional lifestyle study. The present analysis included 6279 adolescents (49.4% males) aged 14-20 years, randomly selected from eight major cities in the GCC countries, using a multistage stratified cluster sampling technique. Anthropometric and self-reported lifestyle data were obtained from participants. Adolescents were classified into four categories: high active & low sedentary (HA-LS), high active & high sedentary (HA- HS), low active & low sedentary (LA-LS) and low active & high sedentary (LA-HS), based on cut off scores of total activity energy expenditure and daily screen time above and below 1680 METs-min/week and above or below 3 hours/day, respectively. RESULTS: Results of MANCOVA tests controlling for age revealed that compared with those with LA-HS, adolescents with HA-LS had signifi cantly (<0.001) lower mean (SD) values for BMI (22.6 (5.5) vs 23.7 (6.2)), waist to height ratio (0.45 (.07) vs 0.48 (.08)), and less frequent intakes of sugar-sweetened drinks (3.7 (2.5) vs 4.5 (2.3)), fast foods (2.2 (1.9) vs 2.9 (1.9)), French fries/potato chips (2.1 (2.0) vs 2.9 (2.1)), cakes/donuts (2.4 (2.1) vs 2.7 (2.1)) and sweets (2.5 (2.1)) vs 3.8 (2.3) but more frequent intakes of breakfast (3.9 (2.7) vs 3.3 (2.6)), vegetables (4.4 (2.3) vs 3.5 (2.4)), fruits (4.2 (2.3) vs 2.8 (2.2)) and milk (4.3 (2.5) vs 3.6 (2.5)). CONCLUSIONS: Adolescents with combined high activity energy expenditure and low sedentary behaviors tend to have lower risk of obesity and have more favorable (healthy) dietary habits. These findings carry important implications for adolescent’s health promotion and obesity prevention.American College of Sports Medicin