Assessment of calcium intake and recognition of calcium-rich food sources among the Saudi population.

Calcium is an essential skeletal mineral, and calcium deficiency has a negative impact on bone health. We conducted an online questionnaire to assess the intake and knowledge among the Saudi population. The survey included 950 participants, with 51.1% demonstrating poor knowledge of calcium sources and a mean intake lower than the recommended level. INTRODUCTION: Calcium is an essential mineral and one of the most prevalent in the body. Chronic insufficient calcium intake increases the risk of osteopenia, osteoporosis, and bone fracture. PURPOSE: This study aimed to assess the Saudi population's calcium intake and knowledge of calcium sources as well as to identify factors associated with inadequate calcium intake. METHODS: This cross-sectional study was conducted across Saudi Arabia using an online questionnaire distributed randomly through social media channels. The questionnaire was a validated tool that was previously developed and used by the original author to assess knowledge of calcium food sources and estimate calcium intake in the Saudi population. If an individual answered more than 11 questions correctly, calcium knowledge was considered adequate. Calcium intake was considered sufficient or insufficient based on the recommended dietary allowance (RDA) of 1000 mg/day. RESULTS: The survey included male and female Saudi citizens and residents aged 14 years or older. A total of 950 respondents aged 9-70 completed the questionnaire. A total of 62.9% of the respondents were 26-50 years old. Of the participants, 64.2% were female, 71.7% were married, and 61.9% had a diploma or a bachelor's degree. Of these, 63.8% were from the central region, and 97.6% were from Saudi Arabia. For those aged 9-18, the average calcium consumption was 577 mg/day, whereas it was 479 mg/day for those aged 19-50. The average intake was 479 mg/day for males aged 51-70 (EAR = 1000 mg/day) and 438 mg/day for females (EAR = 1200 mg/day). These calcium consumption values were significantly lower than the estimated average requirement (EAR) and RDA (p < 0.01). Correct response rates for the 19 calcium intake knowledge items ranged from 23.4 to 94.7%. Among the participants, 48.9% had significant calcium intake knowledge, as indicated by a score of > 11 out of 19 correct responses. Age, sex, marital status, educational attainment, and residence were significantly correlated with adequate knowledge of calcium. Demographic characteristics such as age, marital status, and residence were associated with sufficient calcium intake in the study. CONCLUSION: The study findings revealed that a significant proportion (51.1%) of participants demonstrated inadequate knowledge regarding calcium food sources. Additionally, the mean calcium intake was found to be lower than the RDA of 1300 mg/day for males and females 14-18 years old and 1000 mg/day for males and females 19-50 years old and males 51-70 years old; however, the RDA for females 51-70 years old is 1200 mg/day, suggesting an urgent need for interventions aimed at enhancing both calcium knowledge and intake.

Use of the Osteoporosis Self-Assessment Tool as a Screening Tool for Osteoporosis in Saudi Postmenopausal Women.

BACKGROUND: Osteoporosis is commonly referred to as the "silent disease," as bone loss is gradual and asymptomatic. In older women and men, osteoporosis can lead to increased bone fragility, thus increasing the risk of fractures. These fractures are associated with healthcare costs, physical disabilities, impaired quality of life, and mortality. Therefore, the study's main objective was to assess the applicability of the osteoporosis self-assessment tool (OST) in predicting osteoporosis in Saudi postmenopausal women who are 60 years of age and older and to give a thorough understanding of how such a method can aid in the early diagnosis of osteoporosis in Saudi Arabia and give physicians enough time to treat it.  Methods: This study was done at King Abdulaziz Medical City, Riyadh, Saudi Arabia, where we included postmenopausal Saudi women 60 years of age and older who took the bone mineral density (BMD) test in the family medicine department. The approximate target population in this group, between the years 2016 and 2022, was 2969 patients. All data was taken from the BestCare database at King Abdulaziz Medical City in Riyadh. Data were typed in an Excel sheet (Redmond, USA), then transferred to the R Studio software. The data collection method was chart review, so no informed consent was needed from patients. Names and medical record numbers were not stored.  Results: The study included 2969 participants. According to the bone mineral density (BMD) T score results, 490 participants (16.5%) were normal, 1746 participants (58.8%) had osteopenia, and 733 participants (24.7%) suffered from osteoporosis. BMD T scores for normal, osteopenia, and osteoporosis participants were -0.6 (-0.9, -.3), -1.8 (-2.1), and -3 (-3.5, -2.7), consecutively. Estimated OSTI scores for those patients were 2 (0, 4), 1 (-2, 3), and -1 (-4, 1), consecutively. According to the OSTI score for normal participants, 4.29% were classified as being at high risk of osteoporosis. A high risk of osteoporosis was identified in 0.74% of those with osteopenia. 27.83% of osteoporosis patients were classified as being at high risk of osteoporosis. To differentiate normal individuals from those with osteopenia, the cutoff value with optimal sensitivity was 3.5. At such a cutoff value, the test sensitivity was 81.04%. To differentiate normal participants from those with osteoporosis, the cutoff value with optimal sensitivity was 2.5. At such a cutoff value, the test sensitivity was 86.49%. To differentiate osteopenia from osteoporosis patients, the cutoff threshold with optimal sensitivity was 1.5. At such a threshold, sensitivity was 78.44%.  Conclusion: OSTA is a simple and validated tool that can identify subjects at increased risk of osteoporosis. Its use could facilitate a more cost-effective use of BMD; by avoiding measurements in low-risk groups.

The Assessment of the Prevalence and Disability Severity of Musculoskeletal Pain in Patients With Multiple Sclerosis in Saudi Arabia.

Background Multiple sclerosis (MS) is an autoimmune disease of the nervous system that causes chronic demyelination over time and may lead to physical disability. MS-related pain may be musculoskeletal, paroxysmal, or persistently neurogenic in nature. The most common type of pain is musculoskeletal discomfort, which is typically brought on by muscle weakening, stiffness, and generalized imbalance as the condition progresses. Pain often manifests after prolonged immobilization of muscles, tendons, and ligaments. Aim We aimed to evaluate the prevalence and severity of musculoskeletal pain (MSP) among MS patients in Saudi Arabia. Methodology A quantitative cross-sectional study was conducted. Patients with confirmed MS in Saudi Arabia were invited to participate in the study during the duration from April 2022 to May 2022. Data were collected using an electronic collection tool. The study tool was checked to ensure the content validity and clarity of the Arabic and English versions. Results A total of 360 MS patients were included. Patients' ages ranged from 18 to 65 years with a mean age of 34.9±13.2 years old. Exactly 229 (63.6%) patients were females. A total of 104 (28.9%) patients complained of relapsing-remitting MS, 34 (9.4%) complained of primary progressive MS, and 16 (4.4%) complained of secondary progressive MS. A total of 138 (38.3%) patients had the disease for less than five years, and 14 (3.9%) had the disease for more than 21 years. Exactly 124 (34.4%) MS patients complained of high disability due to MSP, while 236 (65.6%) had low disability. Conclusions This study demonstrates that one out of each three patients with MS complained of pain with high disability associated with pain. Old age, comorbidities, long disease duration, and a family history of MS were significant determinants of associated disability severity.

Assessment of calcium intake and perception of calcium-rich food among healthcare students at King Saud bin Abdulaziz University for Health Science (KSAU-HS).

BACKGROUND: Calcium is an essential mineral compound and one of the most abundant minerals in the human body. A long-term low calcium intake predisposes the bones to fractures, osteopenia, and osteoporosis. This study was conducted to assess calcium intake and knowledge of calcium-related information among healthcare students in King Saud bin Abdulaziz University for Health Sciences (KSAU-Hs). METHODS: This cross-sectional survey was conducted using a self-administered questionnaire that has been distributed as a soft copy of 289 participants aged 19 years or older and studied at KSAU-Hs. The questionnaire had three sections assessing demographical data, calcium knowledge, and calcium intake. The knowledge outcome variables were good and poor, and participants were categorized as good knowledge if they answer 11 or more of the 18 questions, while the intake outcome variables were sufficient and insufficient intake based on the Recommended Dietary Allowance (RDA) of 1000 mg. RESULTS: Among all variables, 91.7% of the participants were found to be having an insufficient intake, and 74% were classified to be poor knowledge. As for knowledge, the highest score under the "Good" category were females 32.7% compared to males 22.2%, P = 0.05. The average intake of calcium was 497 mg/day. In terms of sufficient calcium intake, males scored 11.9% compared to females who scored 1.9% with a P value of 0.00. CONCLUSION: The results of this study have shown that there are significantly insufficient calcium intake and poor knowledge about calcium among healthcare students. The results indicate the urge to improve calcium intake and calcium knowledge among the healthcare students.

Assessment of Ramadan Education and Knowledge Among Diabetic Patients.

BACKGROUND: During Ramadan, Muslims fast from dawn until dusk for one lunar month every year. Most of the Muslim patients with diabetes are unaware of the potential complications that can occur while fasting, such as hypoglycemia. The aim of this study is to assess the the patient education level and patients' overall awareness of any possible complications that could occur while fasting during Ramadan and to determine how these patients deal with these complications. METHODS: We conducted a cross-sectional study and surveyed diabetic patients about their diabetes-related knowledge over a period of 4 months from the outpatient clinic at the Obesity, Endocrine, and Metabolism Center at King Fahad Medical City. Patients were included if they were ≥16 years and if they had been receiving treatment for at least 1 year before the study, irrespective of the medications used; patients were also asked about the presence or absence of complications. RESULTS: This study included 477 patients (325 women and 152 men). Most patients (297; 62.3%) had type 2 diabetes. The patients' mean age was 39.72 ± 15.29 years, and the mean duration of diabetes was 10.80 ± 5.88 years. During the preceding Ramadan, 76% of patients reported fasting, whereas 58% said that they monitored their blood glucose levels once per day. Hypoglycemic episodes were reported in 60.3% of cases with type 2 diabetes and in 8.3% of cases with type 1 diabetes. Among those who had hypoglycemia, 2.8% of patients with type 1 diabetes and 17.8% with type 2 diabetes broke their fast. Finally, 54% of patients reported that their health care providers offered them instructions on diabetes management during Ramadan. CONCLUSIONS: Ramadan health education in diabetes can encourage, improve, and guide patients to change their lifestyles during Ramadan while minimizing the risk of acute complications.

Vitamin D status correction in Saudi Arabia: an experts' consensus under the auspices of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases (ESCEO).

BACKGROUND: Vitamin D deficiency is common in the Middle East and in Saudi Arabia, in particular. While several international recommendations on the management of vitamin D deficiency have been documented and practiced globally, these recommendations should be adapted to the conditions of the Middle Eastern region. To address this challenge, the Prince Mutaib Chair for Biomarkers of Osteoporosis (PMCO) in King Saud University (KSU), Riyadh, KSA, together with local experts and in cooperation with the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), organized a panel that formulated unified recommendations in the diagnosis and treatment of vitamin D deficiency in the region. METHODS: The selection of local and international experts commenced during the 2nd International Vitamin D Symposium conducted in Riyadh, Saudi Arabia, last January 20--21, 2016. Reviews of the most recent literature were done, and face-to-face meetings were conducted for revisions and final recommendations. RESULTS: Vitamin D sufficiency is defined as circulating serum 25(OH)D ≥50 nmol (≥20 ng/ml) for the general population and vitamin D adequacy as serum 25(OH)D >75 nmol/L l (>30 ng/ml) for the frail and osteoporotic elderly. Despite overwhelming prevalence of vitamin D deficiency, universal screening is not recommended. Recommendations for the general population, children, pregnant/lactating women, post-menopausal women, the elderly, and those with subsequent metabolic diseases were provided. RESULTS: Vitamin D sufficiency is defined as circulating serum 25(OH)D ≥50 nmol (≥20 ng/ml) for the general population and vitamin D adequacy as serum 25(OH)D >75 nmol/L l (>30 ng/ml) for the frail and osteoporotic elderly. Despite overwhelming prevalence of vitamin D deficiency, universal screening is not recommended. Recommendations for the general population, children, pregnant/lactating women, post-menopausal women, the elderly, and those with subsequent metabolic diseases were provided. CONCLUSION: Vitamin D supplementation/correction is advised in all persons whose serum 25(OH)D falls below 50 nmol/l (20 ng/ml), and achieving a target of 75 nmol/l (30 ng/ml) is particularly suited for frail, osteoporotic, and older patients. Conducting well-designed clinical trials in the region that will address economic implications and investigations on the treatment persistence and compliance to vitamin D treatment in the region are encouraged.