Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia.

BACKGROUND: Understanding the inter-relationships between lifestyle factors in youth is important with respect to the development of effective promotional programmes for healthy eating and active living. The present study aimed to explore the associations of dietary habits (DH) with physical activity (PA) and screen time (ST) among Saudi adolescents aged between 15 and 19 years of age relative to gender. METHODS: Data were obtained from the Arab Teens Lifestyle Study, a school-based multicentre lifestyle study conducted in 2009/2010 in three major cities in Saudi Arabia. A multistage stratified cluster random sampling technique was used. The number of participants with complete data for DH and PA was 2886 and the respective number for DH and ST was 2822. Assessment included weight, height, body mass index, total daily ST (television viewing, video/computer games and Internet use), PA and DH using self-reported questionnaires. RESULTS: Females were significantly more sedentary and less active than males (P < 0.001). Two-way analysis of covariance, controlling for age, showed significant (P < 0.05) gender by PA and gender by ST interactions for several DH. Logistic regression analyses revealed significant associations of higher PA with a higher consumption of fruit, vegetables, milk, French fries/potato chips and energy drinks, whereas higher ST was significantly associated with a higher consumption of sugar-sweetened drinks, fast foods, cake/doughnuts and energy drinks. CONCLUSIONS: Healthful dietary habits were associated mostly with PA, whereas sedentary behaviours, independent of PA, negatively impacted upon eating behaviours. The low PA levels and high sedentary levels of Saudi females represent a great concern. The results reported in the present study have important implications for both youth public health policies and intervention programmes.

Lifestyle correlates of self-reported sleep duration among Saudi adolescents: a multicentre school-based cross-sectional study.

BACKGROUND: Lifestyle factors are important determinants of adequate sleep among adolescents. However, findings on sleep duration relative to lifestyle factors are conflicting. Therefore, this study examined the association of self-reported sleep duration with physical activity, sedentary behaviours and dietary habits among Saudi adolescents. METHODS: A multicentre school-based cross-sectional study was conducted in three major cities in Saudi Arabia. The sample included 2868 secondary-school students (51.9% girls) aged 15-19 years, randomly selected using a multistage stratified cluster sampling technique. In addition to anthropometric measurements, sleep duration, physical activity, sedentary behaviours and dietary habits were assessed using self-reported questionnaire. RESULTS: Several lifestyle factors were associated with sleep duration in adolescents. While controlling for some potential confounders, the findings showed that high screen time [>5 h/day; adjusted odds ratio (aOR) = 1.505, 95% confidence interval (CI) = 1.180-1.920, P = 0.001] and low (aOR = 1.290, 95% CI = 1.064-1.566, P = 0.010) to medium (aOR = 1.316, 95% CI = 1.075-1.611, P = 0.008) physical activity levels were significantly related to daily sleep of 8 h or longer. Furthermore, having low intake of breakfast (<3 day/week compared with 5 days or more per week) decreased the odd of having adequate sleep duration by a factor of 0.795 (95% CI = 0.667-0.947, P < 0.010). CONCLUSIONS: Short sleep duration (<8 h/day) among Saudi adolescents 15-19 year olds was significantly associated with several lifestyle factors. Intervention programs aiming for improving sleeping habits among adolescents need to consider such potential association of lifestyle variables with sleep duration.

Dietary habits and physical activity levels in Jordanian adolescents attending private versus public schools.

The present study examined differences in dietary habits and physical activity levels between students attending private and public high schools in Jordan. A total of 386 secondary-school males and 349 females aged 14-18 years were randomly recruited using a multistage, stratified, cluster sampling technique. Dietary habits and physical activity level were self-reported in a validated questionnaire. The prevalence of obesity was significantly higher among adolescents in private (26.0%) than in public schools (16.7%). The frequency of breakfast intake was significantly higher among adolescents in private schools, whereas French fries and sweets intake was significantly higher in public schools. Television viewing showed a significant interaction with school type by sex. A higher rate of inactivity was found among students attending private schools. Despite a slightly better overall dietary profile for students in private schools, they had a higher rate of overweight and obesity compared with those in public schools.

Anthropometric characteristics and obesity among adolescents in the United Arab Emirates.

Anthropometric measurements and the prevalence of overweight and obesity were studied in 661 adolescents aged 12-17 years from Dubai, United Arab Emirates. Mean values for height and weight increased steadily with age in both sexes. Mean values for waist circumference ranged from 70.8-76.6 cm in males and 64.0-68.8 cm in females. Hip circumference varied from 84.8-91.2 cm in males and 84.9-91.2 cm in females. Body mass index was generally higher in males than in females (range 21.9-23.6 kg/m2 and 19.8-24.1 kg/m2 respectively). The overall prevalence of overweight and obesity was 19.3% and 21.6% in males and 12.3% and 19.5% in females. This study confirms the high incidence of overweight and obesity in Dubai adolescents.

Dietary habits associated with obesity among adolescents in Dubai, United Arab Emirates.

AIM: to study the association between the dietary habits and behavioural factors with the increased risk of obesity amongst adolescents in Dubai, United Arab Emirates (UAE). METHOD: A cross-sectional study was carried out among 661 adolescents (324 boys and 337 girls) aged 12 to 17 years selected by means of a multistage stratified random sampling technique. RESULTS: The highest percentage of obesity was observed at 14 years of age in boys (30.5%) and at 13 years of age in girls (35.4%). There was a significant association between the frequency of eating breakfast (P =0.048), snacking between breakfast and lunch (P = 0.044), and obesity in girls but not in boys. A high risk of obesity was associated with eating breakfast at school in both boys (OR = 3.0; CI 1.1-8.3) and girls (OR = 3.4; CI 1.6-7.4). Fast foods showed a significant association with obesity in girls (P = 0.007), but not in boys (P = 0.745). The risk of obesity was higher in boys who ate fast foods at home (OR = 1.3; CI 0.5-3.2) but less in girls (OR = 0.2; CI 0.1-1.0). CONCLUSION: Intervention programs focused on promoting changes in lifestyles, food habits and increasing physical activity need to be implemented at the earliest.

Lifestyle and the risk of acute myocardial infarction in a Gulf Arab population.

BACKGROUND: Recent statistics indicate that acute myocardial infarction (AMI) is becoming very common in the State of Bahrain. A population-based case-control study was carried out to explore the importance of lifestyle in the occurrence of AMI in Bahrain among those aged 30-79 years. METHODS: Seventy consecutive cases with a first episode of AMI were identified from a register, which included all hospital admissions, during the period 1 February 1992 to 31 July 1992, and compared with 516 subjects obtained from a random sample of the same community. Multiple logistic regression was used to control for demographic variables as well as for the mutual confounding effects of the investigated risk factors. RESULTS: Of the patients with first-time AMI, 64% did not walk regularly for exercise compared with 34% of community controls (adjusted odds ratio [OR] = 3.06, 95% confidence interval [CI]: 1.24-5.15). In all, 12% of community controls has a history of hypertension and 9% had diabetes. The comparative figures for AMI patients were 44% for hypertension (adjusted OR = 5.04, 95% CI: 2.82-9.00) and 22% for diabetes (adjusted OR = 3.28, CI: 1.73-6.20). Cigarette smoking and infrequent consumption of fruits and vegetables also appeared to be associated with an increased risk of AMI. CONCLUSION: There is scope for lifestyle change in reducing AMI risk, by changes in physical activity, smoking and dietary habits. In addition, measures to control hypertension and diabetes should be given a high priority in any national health policy to prevent AMI.

Effect on lipid metabolism of beet fibre in desert nomads with low habitual fibre intake.

The present study was conducted to test the efficacy of fibre supplementation for hypercholesterolaemia in subjects from the desert Nomads. Ten males (53 +/- 8 years of age) participated in this study which consisted of three phases: baseline-1 period (2 weeks) in which subjects were on their normal, habitual dietary intake, followed by a period of fibre supplementation (5 weeks) in which subjects were supplemented with 26 g fibre/d, and baseline-2 period (4 weeks) in which fibre supplement was withdrawn. Fibre supplementation resulted in a significant decrease in levels of total serum cholesterol (10 per cent decrease, P less than 0.005 during the second week; and 13.4 per cent decrease, P less than 0.0005 during the fifth week) and LDL-cholesterol (14.3 per cent decrease, P less than 0.01 during the second week; and 16.8 per cent decrease, P less than 0.005 during the fifth week. The LDL/HDL ratio dropped 5.2 per cent (P less than 0.005) during the second week and 10.4 per cent (P less than 0.0001) during the fifth week of the fibre supplementation period. Concentrations of serum triglycerides decreased 4.8 per cent (not significant) during the second week and 9.5 per cent (P less than 0.01) during the fifth week. Daily intake of nutrients, body weight, and HDL-cholesterol levels did not change significantly. We conclude that, in populations such as the desert Nomads, where dietary manipulation and/or therapeutic options are quite limited, fibre supplementation may provide an alternative and effective therapy for the control of hypercholesterolaemia.

Anaemia among 6 year old children in the United Arab Emirates.

OBJECTIVE: The aim of this study is estimating the prevalence of anaemia among 6 year old children in United Arab Emirates (UAE). DESIGN: Cross-sectional study. SUBJECTS: All new entries school children aged 6-6.9 years in six Emirates of UAE for the school year 1994/1995. The total children included were 11,800 (92% of total entries). MEASUREMENTS: Haemoglobin concentration in blood. Anaemia was determined using WHO criteria (< 12 g/dl). RESULTS: The total prevalence of anaemia was 31%. Boys were more susceptible than girls (P < 0.001), and national children were more likely to have anaemia than non-nationals (P < 0.001). CONCLUSIONS: Although the prevalence of anaemia has declined during 1981-1995, the current percentage of anaemia does not match with high socio-economic status and high coverage of health care in UAE.

The effects of sugar-beet fibre supplementation for five weeks on zinc, iron and copper status in human subjects.

The present study was conducted to evaluate the effects of fibre supplementation on zinc, iron and copper status in human subjects. Ten males (53 +/- 8 years of age) participated in this study which consisted of three phases: baseline-1 period (2 weeks) in which subjects were on their normal, habitual dietary intake, followed by a period of fibre supplementation (5 weeks) in which subjects were supplemented with 26 g dietary fibre/d, and baseline-2 period (4 weeks) in which fibre supplement was withdrawn. Parametric measurements of zinc, iron and copper status were conducted on weeks 1,2 (zero-time), 7 and 11. Results showed that fibre supplementation for 5 weeks did not cause any significant change in the status of zinc (measured by concentration of zinc in plasma and urine and alkaline phosphatase activity), iron (measured by packed cell volume (PCV%), HB, transferrin saturation % and ferritin), or copper (measured by plasma copper concentration and erythrocyte superoxide dismutase activity). We conclude that consumption of sugar-beet fibre added to the daily diet does not constitute any risk with respect to zinc, iron and copper nutriture.

Prevalence of overweight and obesity among Bahraini adolescents: a comparison between three different sets of criteria.

OBJECTIVE: The aim of this study is to determine the prevalence of overweight and obesity among Bahraini adolescents using three different sets of criteria/standards. DESIGN: Cross-sectional prevalence study. SETTING: Intermediate and secondary schools in Bahrain. SUBJECTS: The study included a population-representative sample of 506 Bahraini students (249 males and 257 females) between 12 and 17 y of age. The sample was selected using multistage stratified random sampling technique. MEASUREMENT: Anthropometric measurements including weight, height and triceps and subscapular skinfolds were taken on the adolescents. Age was verified against school records. To minimize inter-observer error, weight and height were taken by one person while skinfold was taken by two trained persons (one for each sex). RESULTS: The overall prevalence of obesity among Bahraini boys and girls was high, especially in girls. Obesity was highest (21% in males and 35% in females) when the WHO recommended criteria of BMI for age and skinfolds for age percentiles were applied and lowest (15% in boys and 18% in girls) when the age and sex specific BMI cut-off values of Cole et al were used. Compared with those of WHO criteria, estimates of overweight and obesity prevalence obtained with Must et al and Cole et al were generally close. CONCLUSIONS: Our data revealed a much higher prevalence rate of obesity in the Bahraini adolescent population than was previously reported, especially among girls. The BMI reference values of Must et al and that of Cole et al gave relatively similar estimates and appear to be more practical for use in surveys aimed at estimating the prevalence of overweight and obesity among adolescents than the WHO recommended composite criteria.

Breastfeeding patterns in the Arabian Gulf countries.

PIP: The rapid economic change experienced in the Arab Gulf countries in the past two decades has resulted in a dramatic decline in the number of infants breast fed and the duration of breast feeding. This survey describes the current status of breast feeding in the Arabian Gulf countries in terms of the duration of exclusive breast feeding; initiation, frequency, and duration of breast feeding; bottle feeding practices; breast feeding and fertility; reasons for cessation of breast feeding; and the relationship between breast feeding and gastroenteritis. After a brief discussion of weaning practices, the paper considers factors influencing the decision to breast feed, including mothers age, education, urban-rural residence, and employment status; the influence of house maids and health workers; and the sex of the child. The marketing of baby foods in the area is described, as are various programs to support breast feeding, such as maternity protection, educational activities, marketing activities, support of appropriate weaning practices, workshops and seminars, and research activities. It is concluded that these programs have had very little effect on the promotion of breast feeding in the region for the following reasons: 1) lack of coordination; 2) lack of health regulations covering formulas and baby foods; 3) the encouragement of bottle feeding in private hospitals; 4) insufficient knowledge of managing breast feeding among health personnel; 5) a shortage of studies relating to breast feeding; and 6) insufficient training of health personnel. The institution of a global promotional policy is recommended. Such a policy would include the development of strict regulations covering marketing of substitutes, training of health workers, mass media campaigns, school and university curricula changes, and convincing policy-makers that breast feeding is beneficial.^ieng

Food habits of mothers and children in two regions of Oman.

Several rapid assessment surveys were carried out during the period 1988-1991 to determine the food habit of preschool children, adolescent girls and mothers in Muscat (the capital) and southern region in Oman. Data were collected from health centers, hospitals and households. There have been differences in dietary habits between the people in the two regions. These differences were more evident in breastfeeding practices, meal patterns of adolescent girls and food frequency intake of mothers. Geographical location, occupation of inhabitants, cultural and ethnic factors may be responsible for the variation in dietary habits between the two regions. Several unsound food practices during pregnancy and puerperium were reported in both regions. In general, dietary patterns of mothers and children have changed dramatically during the past two decades. Duration of breastfeeding has declined and infant formula as well as commercial weaning foods were introduced at an early time of infants' lives. The trend of consumption of food for infants, adolescent girls and mothers is in the direction of unhealthier eating habits, as foods rich in fat, cholesterol, refined sugar and salt are commonly consumed. This food pattern may contribute to diet-related chronic diseases such as obesity, diabetes, hypertension, heart disease and dental caries. A nutrition education programme to promote a healthy diet and to correct unsound food beliefs and habits is urgently needed.

Changes in food consumption patterns in Bahrain.

Changes in food consumption in Bahrain can be identified particularly in the second half of seventies with the wake of oil boom. The consumption of traditional foods such as fish and dates have declined, while that of processed foods, fat, eggs, meat, poultry and milk products have risen. The daily per capita intake of animal protein and fat have increased at the expense of carbohydrates. Some factors responsible for this change are increasing income and literacy, food price fluctuations, food subsidy policy, the influence of immigrant food habits, influence of mass media and the changing structure of households. The change in dietary intake has associated with change in health and nutritional problems in the country.

The state of nutrition in Fars, Iran: a review.

Nutritional problems in Fars province, Iran were reviewed. The commonest problems are protein-energy malnutrition, growth retardation, zinc and iron deficiencies. Several factors have contributed to malnutrition in this province such as food habits, low intake of some nutrients, high rate of illiteracy and unsound infant feeding practices. Preventive programmes to control the nutritional disorders should be given a high priority in any health plan. Investigations on causative factors leading to malnutrition are highly recommended.

Dietary habits of athletes in Bahrain.

This study describes the dietary habits of athletes involved in four common sports in Bahrain (football, handball, volleyball and basketball). A sample of 304 athletes was obtained from 14 first class clubs. It was found that 28% of athletes skipped breakfast, and only 39% consumed breakfast daily. Foods eaten before competition were similar to those consumed by other family members, indicating that athletes did not eat any specific diet before events. There were some differences in meal patterns among athletes of various sports. In general, athletes allowed enough time between a meal and competition (2.8-3.1 hours). About half of them consumed water only at restbreak, while the rest consumed fruit drinks, tea and oranges in addition to water. Some (3%) did not consume any fluid. A small proportion of the athletes (4%) used vitamins and protein supplements. Mass media (53.6%) and coaches (20.1%) were the primary sources of nutrition information for athletes. It is suggested that information on nutrition and physical performance should be introduced in all educational programmes for both athletes and coaches.

Breastfeeding and weaning practices in Bahrain: the role of mothers' education.

This rapid assessment survey was undertaken to find out the current practices of infant feeding in Bahrain and the impact of educational level of the mothers on these practices. A total sample of 200 Bahraini mothers of children less than 2 years were interviewed in the health centers. The age of mothers ranged from 18 to 47 years. About one third of mothers (39.8%) initiated breastfeeding at the first hour of delivery, and there was no significant association between education of mothers and initiating of breastfeeding. Most infants were placed in the same bed as their mothers (71%), however the proportion was lower among infants with high education (61.8%) compared to low (73.7%) and middle (72.5%) education mothers. The introduction of foods during the first 3 days of the infant's life as well as the practising of breastfeeding on schedule increased with the increased of educational level of mothers. Highly educated mothers tended to introduce rice, wheat, infant formula and fruit at an earlier age of the infant's life than other education groups. The study demonstrates an improvement in infant feeding practices during the last decade. However, the practice of sound infant feeding was less among highly educated mothers when compared to low and middle education mothers. This is mainly due to socio-economic factors rather than lack of awareness.

Prevalence of risk factors for cardiovascular diseases among men and women in an Arab Gulf community.

A cross-sectional study was conducted to estimate the prevalence of major risk factors for cardiovascular diseases (CVD) among the adult population in Bahrain, an Arab Gulf country. A total sample of 516 subjects aged 30-79 years was selected proportionally from all geographical areas of Bahrain. Findings revealed that current smokers represented 32% of men and 20% of women (P < 0.001). However, a relatively high percentage of women were exposed to inhalation of other family member tobacco smoking compared to men (29% and 44% among men and women, respectively). Obesity, hypertension and diabetes were highly prevalent and significantly more reported among women than men. Of women, 79.6% were overweight or obese compared to 56% of men. Sedentary lifestyle patterns (Lack of physical exercise and daily watching of television) were also highly reported. About 12.1% of men and 15.7% of women did not consume fresh fruits. The corresponding percentages for fresh vegetables were 8.4% and 5.5%, respectively. The prevalence of well established risk factors for CVD such as smoking, obesity, inactivity, diabetes and hypertension were high and indicates the need for a national health policy to prevent and control the CVD.

Nutritional status of adolescent girls in the eastern province of Saudi Arabia.

The aim of this study is to assess the nutritional status of Saudi adolescent girls using weight and height measurements. A cross-sectional sample of 676 girls aged 12 to 19 years were selected from Al-Khober city, in the Eastern Province of Saudi Arabia. At all ages median (50th percentiles) heights of Saudi girls are below the 50th percentiles of the international standards. However, the median weight falls between the 75th and 50th of the standards, which may indicate a trend toward obesity. Using the body mass index for determining the nutritional status of the girls, it was found that 11% of girls were underweight, 61% were normal and 28% were overweight or obese. The findings revealed that adolescent girls in Saudi Arabia face two contrasting nutrition situations, underweight and overweight. Similar findings were reported in other Arabian Gulf countries, indicating the need for intervention programmes to promote better nutrition among school children and adolescents in Saudi Arabia.

Obesity among secondary school students in Bahrain.

The aim of this study is to estimate the prevalence of obesity and factors associated with it in Bahraini secondary school students. A cross-sectional study involving a sample of 825 students (417 boys and 408 girls) aged 15 to 21 years was obtained from secondary schools. Obesity was determined using body mass index (BMI = Wt/Ht2). The findings revealed that 15.6% of boys and 17.4% of girls were either overweight or obese (BMI > or = 25). Family size, parents education, and family history of obesity were significantly associated with obesity among boys, while family history was the only socio-economic factors statistically associated with obesity among girls. Meal patterns such as eating between meals, number of meals per day, and method of eating were not associated with obesity in students. Boys who ate alone were 3 times more likely to be obese than those who ate with family members (odd ratio = 3.4). Measures to prevent and control obesity among children are suggested.

Food consumption patterns of adults in the United Arab Emirates.

The objectives of this study were to determine the food consumption patterns of Emirati men and women over 20 years of age and to explore the association of age and sex with food intake. A proportional random sample of 1,122 men and 1,090 women was obtained from all the seven Emirates of the United Arab Emirates (UAE). The findings showed a significant difference in food frequency intake between men and women, and also between young (20-49 years) and old (50 years and above) subjects. In general the consumption of fresh fruit and vegetables and of milk was low. This is a source of concern as these foods are useful sources of vitamins and minerals. Elderly people were more likely to consume traditional foods such as fish and laban (diluted yoghurt) than young people. Modification of dietary habits should be considered in any nutrition education programme for the public in the UAE.