Consumer Behavior at Supermarkets during Grocery Shopping in Saudi Arabia: A National Observational Study.

BACKGROUND: Use of nutrition facts labels can be associated with healthier eating behaviors; however, consumers currently face difficulty understanding these labels or do not use them often. Thus, improving healthy grocery shopping behaviors among consumers might increase the overall health of the community. AIM: The study aims to explore consumers' behavior during grocery shopping and measure their basic knowledge regarding food product labels. METHOD: A national observational study (cross-sectional) was carried out on a convenience sample of Saudi Arabian residents aged 18 years and above. The data were obtained from all 13 administrative regions in Saudi Arabia at three different major supermarkets in each region. The data were analyzed using descriptive analysis, and binary logistic regression was used to investigate behavior variables. RESULTS: A total of 12,675 participants were observed; of those, 52.2% did not interact with the product before putting it in their shopping cart. The study found that the production date (66.6%) and expiry date (51%) were the most frequently checked aspects of food labels; they were checked more frequently than nutrition facts (29%). Furthermore, there was a low level of dietary knowledge among consumers and a moderate level of believing food packages and media claims. CONCLUSIONS: Our results suggest that the Saudi community's understanding of food product information is limited and greater awareness and community education campaigns are required to improve the use of nutritional labels and increase nutritional knowledge.

Comparing Lifestyle and Behavior of Post-Bariatric Surgery and Participants with Obesity: A Community-Based Cross-Sectional Study.

Background: There is a paucity of research dedicated to exploring behavioral change in patients following bariatric surgery. However, there is a need for comparison analysis of individuals with obesity who have received surgical treatment and those who have not opted for any surgical procedures for weight loss. This study is designed to scrutinize the lifestyle choices, behavioral patterns, psychological elements, and eating habits of individuals who have undergone bariatric surgery, in contrast to those with obesity who have not undergone such a procedure. Methods: This study is a secondary analysis from Sharik Diet and Health National Survey (SDHNS) dataset, which is a cross-sectional investigation covering the period from 2020 to 2022. The study focused on demographic factors like age, gender, educational attainment, and monthly earnings. Furthermore, other variables such as physical activity, leisure and workplace sitting habits, smoking patterns, strategies for managing weight, and eating and consumption behaviors were also examined. Results: Out of the initial 15,980 participants reached, 4,069 satisfied the study's inclusion criteria. Bariatric surgery was reported by 806 participants (19.8%). Upon comparing three obesity status groups - The participants who underwent bariatric surgery with or without obesity, those with obesity who did not opt for any surgical weight loss measure, the analysis found that the three obesity status groups were significantly different in 21 variables from a total of 26. Moreover, a logistic regression analysis revealed that 11 variables influenced persistent obesity in the post-surgery phase, as opposed to those who successfully lost weight. These variables included advanced age, limited education, being female, lower income, waterpipe smoking habits, and the consumption of carbonated drinks. Conclusion: This study showed that inability to lose weight after bariatric surgery are linked to poor lifestyle choices and behavior compared to those who were able to lose weight after the surgery.

Exploring Mental Health Literacy and Its Associated Factors: A National Cross-Sectional Study in Saudi Arabia, 2023.

Objective: The aim of this study is to examine, for the first time, the mental health literacy of the Saudi general population. Additionally, we aim to identify demographic factors associated with elevated mental health literacy scores. Methods: A cross-sectional study using a phone interview survey with quota sampling was conducted for equal distribution of sexes, age and administrative regions. Mental health literacy was assessed by the previously validated mental health literacy scale (MHLS). The MHLS ranges from 35 to 160, and a higher score indicates greater level of mental health literacy. Results: In this study, 4,547 (70.2%) agreed to complete the interview. The sample was equally distributed across Saudi Arabia's 13 administrative regions with 50.1% female and mean age 35.9 (SD: ±12.8). In terms of education, 55.1% have a bachelor's degree or above. The nationally weighted score on the original MHLS was 110.75. the MHLS Saudi validation score was influenced by various variables including: marital status, healthcare-related job, sex, education level, and proximity to individuals with mental health issues. Conclusion: The study offers data for the first time on Saudi Arabian mental health literacy status. The high MHLS score reflects good societal awareness and understanding of mental health related concepts and issues in the Saudi population. The results of this study set the baseline for mental health literacy in Saudi Arabia. Future research may focus on utilizing the validated MHLS and the method used in this study to explore the effect of other social and individual factors on mental health literacy.

Comparative analysis of lifestyle behaviors and dietary intake among obese and non-obese individuals following bariatric surgery: a secondary data analysis from 2020 to 2022.

Objective: The aim of this research is to perform a comparative examination of lifestyle habits and dietary consumption between obese and non-obese subjects who have undergone bariatric surgery. This is done with the intent of investigating the disparities in obesity outcomes attributable to these elements. Method: This study involves a secondary analysis of cross-sectional data obtained from the Sharik Diet and Health National Survey (SDHNS). To ensure a representative distribution of participants, the SDHNS employs a proportional quota sampling strategy, with stratification based on age, sex, and geographic location within Saudi Arabia's 13 administrative regions, utilizing the ZDataCloud® system for this purpose. The data, collected between 2020 and 2022 from over 15,000 participants, were screened to identify the eligible records of individuals who underwent bariatric surgery. Results: Within the entire sample, a mere 5.0% (806 individuals) had undertook bariatric surgery, with females comprising 54% of this specific subgroup. The average age within this group was 38.85 years (SD 13.02) and range (18-87). Post-operative results showed that 33% of these individuals remained classified as obese. Utilizing the backward likelihood ratio regression model, it was determined that factors including age, decreased consumption of fresh juices and chicken, as well as current tobacco use, were significantly associated with persistent obesity. Conclusion: The findings of this study suggest an association between the non-obese group and healthier lifestyle choices, including the consumption of high-protein diets and fresh juices, alongside a decreased prevalence of smoking. These observations underscore the significance of maintaining a healthy lifestyle for positive weight loss outcomes following bariatric surgery.

The Knowledge and Determinants of Sexual Health and Sexual Transmitted Infections Among Women in Saudi Arabia: A Nationwide Survey.

Background: Sexual health is a necessary part of any society because it significantly influences the quality of life. Women's knowledge regarding STIs and safe sex practices in Saudi Arabia has not been thoroughly investigated; therefore, this study aims to investigate and measure the knowledge and the determinants of sexual health and STIs among women in Saudi Arabia. Methods: This study is a nationwide cross-sectional survey conducted through phone interviews in Saudi Arabia in 2021. This study included 1334 female participants aged 18 years or older. Results: The study's results collectively show that women in Saudi Arabia have limited knowledge of sexual health and STIs. The primary causes are the lack of knowledge of different STIs-communicability, symptoms, and an overall lack of technical proficiency in the subject. The study analyzed factors associated with participants' knowledge of sexual health and sexually transmitted infections. Significant associations were found between knowledge and age, region, educational level, and family income. In the multivariable analysis, participants aged 20-29 had higher knowledge compared to those aged >60. Participants in the Eastern region had higher knowledge than those in the Southern region. Participants with less than a bachelor's degree had lower knowledge than those with a bachelor's degree or higher. Participants earning an average of 16,000 SAR to 19,999 SAR had higher knowledge than those with unstable monthly income. Conclusion: The study found that women's understanding of sexual health and STIs in Saudi Arabia is low due to a lack of knowledge and awareness. Knowledge levels were correlated with educational levels; therefore, targeted health promotion initiatives are needed to increase understanding, particularly regarding condom use for HIV and STI prevention.

National screening for anxiety and depression in Saudi Arabia 2022.

Background: Mental health disorders, such as major depressive disorder (MDD) and generalized anxiety disorder (GAD), represent a significant public health concern in Saudi Arabia. This study aims to provide a recent mental health screening prevalence, including anxiety and depression screening in the general public and to explore the associated risk factors. Methods: A cross-sectional study was conducted, employing a phone interview survey with 6,015 participants, using a quota sampling strategy to ensure equal representation of both sexes and administrative regions. The study assessed the prevalence of MDD and GAD risk and examined demographic, socioeconomic, and lifestyle factors associated with these mental health disorders. Results: The national prevalence of people at risk of MDD and GAD were found to be 12.7 and 12.4%, respectively. Low diagnosis and treatment rates were observed, with only 1.5 and 0.5% of participants currently diagnosed and treated for depression and anxiety, respectively. Risk factors for MDD and GAD included female sex, lower education and income levels, smoking, and waterpipe use. Protective factors included physical activity, participation in volunteering activities and the practice of daily hobbies in the last 30 days. Conclusion: The relatively high prevalence of MDD and GAD risk and low diagnosis and treatment rates in Saudi Arabia emphasize the need for increased mental health promotion, early detection, and treatment accessibility. The study highlights the importance of addressing modifiable risk factors and fostering protective factors through targeted interventions. Future research should focus on longitudinal associations, potential mediators and moderators, and the development of culturally appropriate and evidence-based interventions to enhance mental health outcomes in the region.

Predicting Multimorbidity Using Saudi Health Indicators (Sharik) Nationwide Data: Statistical and Machine Learning Approach.

The Saudi population is at high risk of multimorbidity. The risk of these morbidities can be reduced by identifying common modifiable behavioural risk factors. This study uses statistical and machine learning methods to predict factors for multimorbidity in the Saudi population. Data from 23,098 Saudi residents were extracted from the "Sharik" Health Indicators Surveillance System 2021. Participants were asked about their demographics and health indicators. Binary logistic models were used to determine predictors of multimorbidity. A backpropagation neural network model was further run using the predictors from the logistic regression model. Accuracy measures were checked using training, validation, and testing data. Females and smokers had the highest likelihood of experiencing multimorbidity. Age and fruit consumption also played a significant role in predicting multimorbidity. Regarding model accuracy, both logistic regression and backpropagation algorithms yielded comparable outcomes. The backpropagation method (accuracy 80.7%) was more accurate than the logistic regression model (77%). Machine learning algorithms can be used to predict multimorbidity among adults, particularly in the Middle East region. Different testing methods later validated the common predicting factors identified in this study. These factors are helpful and can be translated by policymakers to consider improvements in the public health domain.

Exploring the Sociodemographic and Behavioral Status of People Living with Hypercholesterolemia in Saudi Arabia: A Nation-Wide Cross-Sectional Study.

Introduction: Hypercholesterolemia (HC) is a well-known risk factor for cardiovascular diseases, which are the leading cause of death worldwide. Many factors can contribute to HC, including advanced age, chronic diseases (such as diabetes and nephrotic syndrome), and the use of certain medications. Aim: Our goal was to compare the sociodemographic, behavioral, and other comorbid conditions of adult participants living with HC in Saudi Arabia to the general population. Methods: This is a secondary data analysis from the Sharik Health Indicators Surveillance System (SHISS). SHISS consists of cross-sectional phone interviews conducted in all administrative regions of Saudi Arabia on a quarterly basis. Participant recruitment was limited to Arabic-speaking Saudi residents who were ≥18 years old. Results: Out of 20,492 potential participants contacted in 2021, 14,007 completed the interview. Of the total participants, 50.1% were male. The mean age of participants was 36.7 years, with 1673 (11.94%) having HC. A regression model showed that participants with HC had a higher likelihood of being older, living in Tabouk, Riyadh, or Asir regions, being overweight or obese, having diabetes, hypertension, genetic or heart diseases, or having a higher risk of depression. Gender, all types of smoking, physical activity, and education level were eliminated from the model. Discussion: In this study, participants with HC were identified with some co-existing conditions that may affect the progression of the disease and the participants' quality of life. This information could assist care providers in identifying patients who are at higher risk, improve screening efficiency, and improve disease progression and quality of life.

Association between daily use of social media and behavioral lifestyles in the Saudi community: a cross-sectional study.

Objective: This study aimed to investigate the association between nine social media platforms use and health-related behavior, including fruit and vegetable intake, physical activity, tobacco use, and risk factors including depression and obesity. Methods: A cross-sectional study was conducted using secondary data from the Sharik Health Indicators Surveillance System (SHISS). Participants 18 years and older were recruited via phone-interviews. The nine social media platform use [Twitter-(X), Facebook, Instagram, WhatsApp, LinkedIn, Snapchat, TikTok, Telegram, and YouTube] were assessed using self-reported use. Health-related variables include behavioral factors including diet, physical activity, and tobacco use including (cigarettes, waterpipes, and e-cigarettes), risk of depression and obesity. Logistic regression analysis was performed to explore the association between social media use and health-related variables. Results: The study indicated that daily Snapchat users had a lower healthy diet (fruit and vegetable intake), whereas daily LinkedIn and WhatsApp users were positively associated with a healthier diet, relative to those with infrequent social media use. Furthermore, daily interaction with Instagram, TikTok, Telegram, and YouTube was significantly associated with increased depression risk. Conversely, Snapchat and WhatsApp usage was significantly linked to a decreased depression risk. Tobacco-smoking behaviors were associated with specific social media platforms: cigarette smoking was associated with Snapchat, TikTok, and YouTube; e-cigarette with Facebook, LinkedIn, Snapchat, and TikTok; and waterpipe smoking with Facebook and TikTok. Interestingly, some platforms, such as Instagram, were associated with reduced cigarette smoking. The relationship between social media activity and health-related outcomes remained significant after adjusting for age and gender. Conclusion: This study highlights the potential negative impact of particular daily social media use on health-related variables, including dietary habits, tobacco use, and depression. Nevertheless, particular daily social media use of some platforms was associated with a potential positive impact on the health-related variables. Social media platforms are tools that can be used to achieve both a positive and negative effect. By knowing which demographic segments have a greater presence on one platform, we are creating opportunities to understand the social phenomena and at the same time use it to reach those segments and communicate with them, because each social media platform has its unique way and framework of user communication.

Fatty acid composition but not quantity is an important indicator of non-alcoholic fatty liver disease: a systematic review.

BACKGROUND: There is still paucity on the effects of dietary and supplemental fatty acid on non-alcoholic fatty liver disease (NAFLD). The aim of this review is to systematically review and summarise the effect of fatty acids intake on liver-related outcomes in adult patients with NAFLD. METHODS: The review was conducted using Cochrane CENTRAL Library, Scopus, Embase, MEDLINE, PubMed, and Web of Science. A total of 2786 records were identified, and of these, 36 studies (31 were randomised control trials (RCTs), and 5 were case-control studies) were included. Quality assessment was conducted using the Revised Cochrane Risk of Bias tool and Joanna Briggs Institute checklists. RESULTS: Of 36 articles, 79% of RCTs and 66% of case-control studies had a low risk of bias. Potential heterogeneity has been observed in assessment of liver-related outcomes. According to the RCTs, there was moderate evidence (3/6 studies) that a diet characterised by a high MUFA, PUFA and low SFA showed reduced liver fat and stiffness. The using of culinary fats that are high in MUFA (4/6 studies) reduces liver steatosis. n-3 PUFA supplementation in combination with a hypocaloric or heart healthy diet with a low SFA improved liver enzyme level (5/14 studies) and steatosis score (3/14 studies). CONCLUSIONS: Effects on NAFLD parameters, including liver fat content (assessed via magnetic resonance imaging/spectroscopy), stiffness and steatosis score (assessed by ultrasonography), were primarily related to fatty acid composition independent of energy intake. Further investigation is needed to determine the mechanism of specific fatty acid on the accumulation of liver fat.

Soft and energy drinks consumption and associated factors in Saudi adults: a national cross-sectional study.

Introduction: The consumption of soft and energy drinks poses a significant risk for non-communicable diseases, such as diabetes and heart disease. Studies in Saudi Arabia have reported elevated consumption of soft/energy drinks, but nation-wide data is not available. Therefore, this study aims to explore the prevalence of soft and energy drinks consumption and its associated factors among a representative sample of Saudi adults. Methods: The present research is a secondary data analysis of the 2021 Sharik Diet and Health National Survey (SDHNS). Current analysis used data on socio-demographics, anthropometrics, physical activity, and soft and energy drink consumption. The frequency of soft and energy drinks consumption is assessed on a weekly basis. Results: Of the 5,194 Saudi adults, 3,928 were analyzed. Overall, 67% consumed soft drinks weekly, while 30% consumed energy drinks weekly. In multiple logistic regression, consumption of either soft drinks or energy drinks was associated with males, a younger age, lower income, and lower physical activity. Individuals with overweight or obesity were less likely to consume energy drinks [OR (95%CI): 0.83 (0.71, 0.99) and 0.73 (0.60, 0.90), respectively] than those with healthy weight. However, education level was not associated with either soft or energy drink consumption. These findings highlight the need for targeted interventions designed to reduce soft and energy drinks consumption in Saudi adults.

How Could Different Obesity Scenarios Alter the Burden of Type 2 Diabetes and Liver Disease in Saudi Arabia?

INTRODUCTION: Obesity is a major risk factor for type 2 diabetes (T2DM) and liver disease, and obesity-attributable liver disease is a common indication for liver transplant. Obesity prevalence in Saudi Arabia (SA) has increased in recent decades. SA has committed to the WHO "halt obesity" target to shift prevalence to 2010 levels by 2025. We estimated the future benefits of reducing obesity in SA on incidence and costs of T2DM and liver disease under two policy scenarios: (1) SA meets the "halt obesity" target; (2) population body mass index (BMI) is reduced by 1% annually from 2020 to 2040. METHODS: We developed a dynamic microsimulation of working-age people (20-59 years) in SA between 2010 and 2040. Model inputs included population demographic, disease and healthcare cost data, and relative risks of diseases associated with obesity. In our two policy scenarios, we manipulated population BMI and compared predicted disease incidence and associated healthcare costs to a baseline "no change" scenario. RESULTS: Adults <35 years are expected to meet the "halt obesity" target, but those ≥35 years are not. Obesity is set to decline for females, but to increase amongst males 35-59 years. If SA's working-age population achieved either scenario, >1.15 million combined cases of T2DM, liver disease, and liver cancer could be avoided by 2040. Healthcare cost savings for the "halt obesity" and 1% reduction scenarios are 46.7 and 32.8 billion USD, respectively. CONCLUSION: SA's younger working-age population is set to meet the "halt obesity" target, but those aged 35-59 are off track. Even a modest annual 1% BMI reduction could result in substantial future health and economic benefits. Our findings strongly support universal initiatives to reduce population-level obesity, with targeted initiatives for working-age people ≥35 years of age.

Validation and psychometric testing of the Arabic version of the mental health literacy scale among the Saudi Arabian general population.

OBJECTIVE: This study aimed to validate the Arabic Version of the Mental Health Literacy Scale (Arabic-MHLS) among the Saudi Arabian general population, assessing its internal consistency, test-retest reliability, and structural validity. METHODS: A total of 700 Arabic-speaking Saudi adults were randomly selected to complete the electronic questionnaire in May 2023, which generated 544 participants. Data were coded and stored in the ZdataCloud research data collection system database. Test-retest reliability was assessed using a subsample of 48 participants who completed the questionnaire twice, with a one-week interval. Structural validity was examined using confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA). RESULTS: The Arabic-MHLS demonstrated good internal consistency (Cronbach's alpha = 0.87) and test-retest reliability (intraclass correlation coefficient = 0.89). EFA revealed a four-factor model closely resembling the model identified in the Slovenian validation of MHLS, with factor loadings ranging from 0.40 to 0.85. The four factors included knowledge of mental health disorders, knowledge of help-seeking, knowledge of self-help strategies, and knowledge of professional help also showed good internal consistency. CONCLUSION: The Arabic-MHLS is a valid and reliable tool for assessing mental health literacy in the Saudi Arabian general population. However, further research is needed to refine the measurement tool and understand the complex relationships between mental health literacy and other mental health-related concepts. This will contribute to the development of targeted interventions and policies aimed at improving mental health literacy and promoting mental well-being in the Saudi Arabian population and beyond.

Cultural adaptation and validation of the mental illness associated stigma scale for Arabic-speaking population in Saudi Arabia.

Objective: This research aimed to culturally adapt and validate the MIAS scale for Arabic-speaking individuals within the Saudi Arabian general population, with an emphasis on cultural, societal, and individual nuances. Methods: An initial pilot testing with a small group ensured the scale's clarity. Subsequently, two cross-sectional studies involving 189 participants to assess structural validity of the Arabic MIAS scale, and 38 participants to assess the test-retest reliability. Descriptive statistics, Cronbach's α, Intraclass Correlation Coefficient (ICC), and Confirmatory Factor Analysis (CFA) were employed for data analysis. Results: The Arabic MIAS scale demonstrated good internal consistency and acceptable test-retest reliability (ICC α = 0.631). A three-factor model emerged (CFI = 0.890, TLI = 0.845, RMSEA = 0.094), including "Outcomes," "Negative Stereotypes," and "Recovery," closely mirroring the original study's structure. one item was excluded from the model since it didn't align with any of the three factors. Conclusion: The study contributes a culturally adapted, validated, non-condition-specific tool to gauge public attitudes toward mental health stigma in an Arabic context. It highlights the need for culturally sensitive stigma research and interventions and underscores the importance of improving such tools for cross-cultural applicability and comparability.

Consistency and Sensitivity Evaluation of the Saudi Arabia Mental Health Surveillance System (MHSS): Hypothesis Generation and Testing.

BACKGROUND: Public health surveillance systems should be evaluated periodically, and the evaluation should include recommendations for improving the system's quality and efficiency. Each surveillance system may have a unique situation in which evaluating its quality depends on its methodology, aims, and other factors, such as the frequency of repeating the survey in the case of survey-based surveillance. OBJECTIVE: As the consistency of the surveillance system to capture demographic data and its sensitivity to monitor the intended health-related event are important indicators of the quality of the surveillance system, the aim of this article is to evaluate the Saudi Arabia Mental Health Surveillance System (MHSS) in terms of consistency and sensitivity via the scientific hypothesis testing process. METHODS: The quality of the MHSS was assessed by examining (1) the consistency of the main demographic variables and (2) the sensitivity to changes in score between the 2 mental health screening tools used in the MHSS and between the 3 waves collected in 3 consecutive months. The assessment uses all data collected via the MHSS between May 2020 and July 2020. The first null hypothesis predicted there were differences between the distributions of the demographic variables between the 3 waves. The second predicted there were no differences between the scores of the Patient Health Questionnaire 9 (PHQ-9) and the Generalized Anxiety Disorder 7-item scale (GAD-7) between the 3 waves. RESULTS: In terms of sampling variables (age, gender, and region), there were no significant differences between the 3 waves in age, using one-way ANOVA, nor in gender and region, using the chi-square test. In addition, there were no significant differences between the 3 waves in all other demographic variables, except in the income variable. However, in terms of the PHQ-9 score, the one-way ANOVA (F2,12334=8.05; P<.001) showed significant differences between waves. Similarly, significant differences between waves were found in the GAD-7 score (F2,12334=7.09; P=.001). CONCLUSIONS: The MHSS showed a consistent distribution of the sample demographic variables, while being sensitive to the changes in mental health scores across waves. The MHSS can generate an acceptable level of consistency and sensitivity to monitor mental health trends. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/23748.

Public Awareness of the Association between Periodontal Disease and Systemic Disease.

Periodontal disease is associated with other non-communicable diseases including diabetes mellitus, coronary heart disease and atherosclerosis, hypertension, and respiratory tract infections. This association merits careful study of the general population's awareness level in order to leverage the current state of science to improve general health and quality of life. This study included 502 residents of Saudi Arabia who received computer-assisted interviews to fill up the survey. Results indicated a low level of awareness among the study population regarding the association of periodontal disease to diabetes mellitus, coronary heart disease and atherosclerosis, hypertension, and respiratory tract infections. A higher level of awareness was noticed with individuals with periodontal disease, themselves or a member of their family having a systemic disease, and who have a specialized person or scientific article as their source of information. This observed low level of awareness deserves the attention of public health authorities to prioritize programs that increase the awareness, improve health, and reduce burden of systemic diseases of high prevalence, morbidity, and mortality.

Exploring the Association Between Physical Activity and Risk of Mental Health Disorders in Saudi Arabian Adults: Cross-sectional Study.

BACKGROUND: The relationship between physical activity and mental health, especially the symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD), has received increasing attention in recent years. OBJECTIVE: The aim of this study was to explore the association between fulfilling the World Health Organization (WHO) global recommendations on physical activity and the risk and symptoms of MDD and GAD in the Saudi population. METHODS: This study was a secondary analysis of data from a large nationwide cross-sectional survey conducted via phone interviews in June and July 2020. In this study, a proportional quota sampling technique was used to obtain an equal distribution of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. The main mental health screening tool used for the risk of MDD was the Patient Health Questionnaire-9 (PHQ-9). Risk of GAD was measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. Participants self-reported whether they fulfill the WHO global recommendations on (1) moderate-intensity aerobic physical activity (MIPA) and (2) vigorous-intensity aerobic physical activity (VIPA). The results were then analyzed based on the following two categories: fulfilling the WHO global recommendations or not. RESULTS: The data analysis included 8333 participants recruited in the main study between June and July 2020. The response rate was 81.45% (8333/10,231). Of them, 50.3% (4192/8333) were female, and the mean age was 36.5 years, with a median age of 36 years and a range from 18 to 90 years. The average total PHQ-9 score was 5.61, and the average total GAD-7 score was 4.18. For men, the average total PHQ-9 and GAD-7 scores were associated with fulfilling recommendations for MIPA; however, there were no associations for VIPA in both sexes. Fulfilling the WHO's recommendations for MIPA was associated with considerably fewer depressive symptoms in six of the nine items in the PHQ-9. Moreover, fulfilling recommendations for MIPA was associated with considerably fewer anxiety symptoms in six of the seven items in the GAD-7. However, fulfilling recommendations for VIPA was significantly associated with more depressive symptoms in one of the PHQ-9 items ("Thoughts that you would be better off dead or thoughts of hurting yourself in some way;" P<.001). CONCLUSIONS: This study has shown that fulfilling guidelines on MIPA is associated with less overall risk of MDD and GAD in males and fewer depressive and anxiety symptoms generally in a nonclinical population. In the general population, an increase in MIPA may improve well-being and general mental health.

Food Taste, Dietary Consumption, and Food Preference Perception of Changes Following Bariatric Surgery in the Saudi Population: A Cross-Sectional Study.

BACKGROUND: Bariatric surgery is known as the most effective treatment resulting in long-term weight loss for obesity. However, behavioral changes, including food preference, food allergies, and consumption, between groups of patients who underwent bariatric surgery in comparison with people who did not have bariatric surgery have not been fully discussed in the literature. OBJECTIVE: The aim of this article is to describe patient-reported changes of perception related to food preferences, consumption, and food allergies in participants who underwent bariatric surgery and to compare their food consumption with participants who did not have bariatric surgery in Saudi Arabia. METHODOLOGY: This study is a secondary analysis of the Sharik Diet and Health National Survey (SDHNS) conducted in July 2021. Quota sampling was utilized to generate balanced distributions of participants by age and gender across all administrative regions of Saudi Arabia. Data collection included sociodemographic information (age, gender, and educational level), as well as food habits and the consumption of various food categories. RESULTS: Of the 6267 potential participants contacted in 2021 from the 13 administrative regions of Saudi Arabia, 5228 successfully completed the interview, with a response rate of 83.4%. Gender was distributed equally among the total participants in the sample. The prevalence of bariatric surgeries in Saudi Arabia was estimated at around 4.1% of the total sample. More than 36% of people who had bariatric surgery experienced food taste changes, and around 15% reported a decrease in allergic reactions to food. Moreover, 68.1% had food preference changes, either starting to favor a new food or no longer favoring one. There was a significant association between consuming more red meat, chicken, and energy drinks and a decreased consumption of grains and rice among those who had the bariatric surgery compared with those who did not. CONCLUSIONS: This study found that more than two-thirds of people who had bariatric surgery self-reported food taste and food preference changes. More studies should be performed on the Saudi population, including clinical follow-up, to better understand these changes.

Levels and Associations of Weight Misperception with Healthy Lifestyle among Adults in Saudi Arabia.

INTRODUCTION: Obesity affects more than one-quarter of adults in Saudi Arabia and is on the rise. A significant proportion of overweight and obese individuals misperceive their weight, and this misperception can affect their likelihood to exercise, consume healthy foods, or change unhealthy dietary habits. This study examines the prevalence of weight misperceptions in a national sample of Saudi adults and explores weight misperception association with sociodemographic factors, behavioral factors, and health status. METHODS: This study was a nationwide cross-sectional survey conducted via phone interviews. A proportional quota sampling technique was used to obtain equal distributions of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. Weight and height were self-reported, and obesity was determined as a BMI ≥30. Participants were asked to describe their current weight as ideal, underweight, overweight, or obese. Misclassification was then compared across groups according to a range of sociodemographic factors, behavioral risk factors, and health indicators. RESULTS: Of the 6,239 participants contacted, 4,709 (75.5%) responded and completed the interview. Of them, 50.1% were female, and the mean age was 36.4 (SD ± 13.55) years. The majority (70.1%) of participants indicated having weighed themselves within the past 30 days. The prevalence of weight misperception in general was 42.0%, and in obese participants, it was 67.6%. In addition, a significant association was observed between weight misperception and obesity, age-group, educational level, diagnosed chronic condition, self-rated health, and sedentary lifestyle. There was no significant association between weight misperception and gender, physical activity, or a nutritional knowledge. CONCLUSIONS: Weight misperception could be used as an indicator of a poor health routine that may lead to negative health outcomes.

Prevalence of Self-Reported Food Allergies and Their Association with Other Health Conditions among Adults in Saudi Arabia.

Food allergies are a potentially life-threatening health issue, and few studies have determined their prevalence throughout Saudi Arabia. The main objective of our study was to estimate the prevalence and distribution of self-reported food allergies, and explore their association with other health conditions among adults in Saudi Arabia. This study was a nationwide cross-sectional survey conducted via phone interviews in June 2020. A proportional quota-sampling technique was used to obtain equal distributions of participants by age and gender across the 13 regions of Saudi Arabia. Self-reported food allergy, height, weight, health conditions, mental health status, and demographic variables were collected. Of the 6239 participants contacted, 4709 (75.48%) participants responded and completed the interview. Furthermore, 50.1% of the participants were female, with a mean age of 36.4 ± 13.5 years (18-90 years). The prevalence of food allergies was 19.7%. The most self-reported food allergies were egg, shellfish and shrimp, and peanuts, with a prevalence of 3.7%, 3.1%, and 3.0%, respectively. There was an association between the presence of food allergies and reported bariatric surgery, asthma, colon disease, and being at risk of depression. Bariatric surgery was significantly associated with lower likelihood of self-reported allergy (OR 1.69, 95% CI 1.22-2.34, p = 0.002). This study revealed, for the first time, a high prevalence of self-reported food allergies among adults in Saudi Arabia in a large nationwide sample, and food allergy association with bariatric surgery, asthma, colon disease, and being at risk of depression. This information is valuable for clinicians and policymakers, particularly in terms of food allergen labeling.