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

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

Descriptive Analysis of Physical Activity Initiatives for Health Promotion in Saudi Arabia

Background: Although the benefits of physical activity are well acknowledged, a high percentage of Saudi population, especially females, remain essentially physically inactive. Getting inactive people to start participating in physical activity and to keep exercising remains a great challenge. Physical activity initiatives in the country have not been previously documented. Therefore, the aim of this article was to provide a narrative review of the physical activity initiatives and discusses influencing factors.Methods: Publically-available physical activity initiatives conducted before June 2018 were searched through the web or they were obtained straight from the organization themselves. The search focus was on any initiative aimed to promote physical activity and mass sports participation and encourage people to adopt active living habit.Results: Numerous initiatives aimed at promoting physical activity existed in Saudi Arabia. However, a common attribute of these initiatives is that they were fragmented, short term attempts, and lacked a coordinating body. The majority of the physical activity initiatives also lacked objective evaluations of their outcomes. It was clear that more physical activity opportunity must be provided for Saudi girls, women, and elderly. There is a need for establishing a national policy encouraging active living and discouraging sedentary lifestyle with contributions from all involved parties.Conclusions: Based on the available evidences, more intensified efforts toward promoting physical activity and reducing sedentary behaviors among Saudi population are needed in order to reduce the risks of NCD's

The Prevalence of Physical Activity and Sedentary Behaviours Relative to Obesity among Adolescents from Al-Ahsa, Saudi Arabia: Rural versus Urban Variations

Purpose. The aims of this study were to explore the lifestyle of young people living in Al-Ahsa Governorate; to investigate differences due to gender, age, school type, and geographical location. Methods. 1270 volunteered youth (15–19 years) completed a self-report questionnaire that contained 47 items relating to patterns of physical activity (PA), sedentary activity, and eating habits. The questionnaire allows the calculation of total energy expenditure in metabolic equivalent (MET-min) values per week. Results. Significant differences in the PA levels of youth were evident with regard to gender, geographical areas, and type of school. Also, normal weight males reported the highest levels of PA compared to overweight and obese. Conclusions. Youth living in rural desert were less physically active than those living in urban or rural farm environments. Youth of “normal” weight were more active than obese. Males were more active than females and PA levels appeared to decline with age

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

Arabic translation, cultural adaptation, and pre-testing of neighborhood environment walkability scale for adults-abbreviated (NEWS-A): Arabic NEWS-A

BackgroundImproving neighborhood walkability is critical for sustainable and livable urban development and is associated with increased physical activity. The Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) is a tool for assessing neighborhood walkability among adults. Currently, no Arabic version is available for this important walkability scale.ObjectiveTo translate the NEWS-A to Arabic, culturally adapt, and pre-test it for adults.MethodsThe NEWS-A was translated and culturally adapted using Cross-cultural Survey Guidelines and then pre-tested using 65 households selected randomly from the neighborhoods of three districts in Riyadh. After answering the survey, 55 participants took part in a semi-structured cognitive interview, which sought their understanding of the words in the Arabic questionnaire, the clarity of each item, and their suggestions for improvement.ResultsTranslation and adaptation of NEWS-A to Arabic resulted in adding two items (mosque and healthcare center) to section B of the scale (stores, facilities, and other things in your neighborhood) and one related item to section C (access to services). The total individual items became 57 instead of the original 54 items in the English version. Also, we added “ATM machine” to item 14 (Bank/credit union) in section B. In addition, the overall results of the cognitive interview showed that most of the participants understood the intended meaning of the questionnaire (99.5%). Further, 99.8% of the respondents stated that the items were not difficult to comprehend, while 100% of the sample indicated that the sentences were comfortable and not sensitive to them.ConclusionTranslating, adapting, and pre-testing the NEWS-A resulted in retaining all the original items and adding three additional items. The Arabic NEWS-A provides an important tool for future research on neighborhood environment walkability among adults

Feasibility and acceptability of a cohort study baseline data collection of device-measured physical behaviors and cardiometabolic health in Saudi Arabia: expanding the Prospective Physical Activity, Sitting and Sleep consortium (ProPASS) in the Middle East

Background: Physical behaviors such physical activity, sedentary behavior, and sleep are associated with mortality, but there is a lack of epidemiological data and knowledge using device-measured physical behaviors. Purpose: To assess the feasibility of baseline data collection using the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS) protocols in the specific context of Saudi Arabia. ProPASS is a recently developed global platform for collaborative research that aims to harmonize retrospective and prospective data on device-measured behaviors and health. Using ProPASS methods for collecting data to perform such studies in Saudi Arabia will provide standardized data from underrepresented countries. Method: This study explored the feasibility of baseline data collection in Saudi Arabia between November and December 2022 with a target recruitment of 50 participants aged ≥ 30 years. Established ProPASS methods were used to measure anthropometrics, measure blood pressure, collect blood samples, carry out physical function test, and measure health status and context of physical behaviors using questionnaires. The ActivPal™ device was used to assess physical behaviors and the participants were asked to attend two sessions at (LHRC). The feasibility of the current study was assessed by evaluating recruitment capability, acceptability, suitability of study procedures, and resources and abilities to manage and implement the study. Exit interviews were conducted with all participants. Result: A total of 75 participants expressed an interest in the study, out of whom 54 initially agreed to participate. Ultimately, 48 participants were recruited in the study (recruitment rate: 64%). The study completion rate was 87.5% of the recruited participants; 95% participants were satisfied with their participation in the study and 90% reported no negative feelings related to participating in the study. One participant reported experiencing moderate skin irritation related to placement of the accelerometer. Additionally, 96% of participants expressed their willingness to participate in the study again. Conclusion: Based on successful methodology, data collection results, and participants’ acceptability, the ProPASS protocols are feasible to administer in Saudi Arabia. These findings are promising for establishing a prospective cohort in Saudi Arabia