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.

Arabic translation and cultural adaptation of sedentary behavior, dietary habits, and preclinical mobility limitation questionnaires: A cognitive interview study.

BACKGROUND: Developing global evidence on the influence of health-related behaviors (e.g., sedentary behavior, diet) and mobility limitations on health requires global consortia from diverse sets of countries. Thus, the purpose was to translate and culturally adapt (i) the Sedentary Behavior Questionnaire (SBQ); (ii) the Dietary Habits Questionnaire adapted from the Survey of Health, Aging and Retirement in Europe (SHARE) study; (iii) the Preclinical Mobility Limitation questionnaire for use in the Saudi Arabian context. METHOD: 50 adult Saudi participants (mean age 41.7±9.6, 48% female) participated in this study. We followed a systematic cross-cultural adaptation process that involved forward translation, synthesis, back-translation, expert panel, and pre-testing (cognitive interviewing). Four rounds of cognitive interviews were held with 40 participants for the SBQ, SHARE questionnaire, and the Preclinical Mobility Limitation questionnaire, an additional round was needed for the Preclinical Mobility Limitation questionnaire. Descriptive data (means ± standard deviations and frequencies with percentages) were reported for characteristics. RESULT: With some minor changes to the questionnaires, the SBQ, Dietary Habits, and Preclinical Mobility Limitation questionnaires were translated and cross-culturally adapted into Arabic. 100% of the participants confirmed that the resulting Arabic versions of the SBQ, Dietary Habits questionnaire, and Preclinical Mobility Limitation questionnaires were appropriate and fully understandable for Arabic speakers in communicating the intended meanings of the items in each. For example, item SBQ1, 'Watching television (including videos on VCR/DVD)' was changed to 'Sitting and watching television or videos (including smartphones, tablets)'. CONCLUSION: The SBQ, Dietary Habits questionnaire, and Preclinical Mobility Limitation questionnaire were successfully cross-culturally adapted into Arabic and are now ready for use in Saudi Arabian.

Determining independence and associations among various cardiovascular disease risk factors in 9-12 years old school-children: a cross sectional study.

BACKGROUND: Cardiovascular disease (CVD) risk assessment of children typically includes evaluating multiple CVD risk factors some of which tend to correlate each other. However, in older children and young adolescents, there are little data on the level of independence of CVD risk factors. The purpose of this study was to examine the relationships among various CVD risk factors to determine the level of independence of each risk factor in a sample of 5th-grade public school students. METHOD: A cross-sectional analysis of 1525 children (856 girls and 669 boys; age: 9-12 years) who participated in baseline CVD risk assessment for the (S)Partners for Heart Health program from 2010 - 2018. Thirteen CVD risk factor variables were used in the analysis and included blood lipids [low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglycerides], resting systolic and diastolic blood pressure (BP); anthropometrics [height, weight, body mass index (BMI), % body fat, waist circumference (WC)]. Additionally, acanthosis nigricans (a marker insulin resistance and diabetes), and cardiorespiratory fitness (VO2 ml/kg) was estimated using the PACER. Descriptive statistics, bivariate Pearson correlations, and principal component analysis were used to determine the relationships among these variables and the independence. RESULTS: Parallel analysis indicated two components should be extracted. Among the two components extracted, WC, % body fat, and BMI loaded highest on component 1, which explained 34% of the total variance. Systolic BP and diastolic BP loaded predominantly on component 2 and accounted for 17% of the variance. Cardiorespiratory fitness, acanthosis nigricans, HDL, and triglycerides loaded highest on the first component (loadings between 0.42 and 0.57) but still suggest some non-shared variance with this component. Low-density lipoprotein had low loadings on each component. Factor loadings were stable across sex. CONCLUSION: Among the various CVD risk indicators, measures of adiposity loaded highest on the component that explained the largest proportion of variability in the data reinforcing the importance of assessing adiposity in CVD risk assessment. In addition, blood pressure loaded highest on the second component, suggesting their relative independence when assessing CVD risk. The data also provide support and rationale for determining what CVD risk factors to include- based on resource needs. For example, researchers or public health programs may choose to assess WC instead of lipid profile for cardiovascular related problems if ease of assessment and cost are considerations.

The Relationship between Accelerometry, Global Navigation Satellite System, and Known Distance: A Correlational Design Study.

Background: Previous research has explored associations between accelerometry and Global Navigation Satellite System (GNSS) derived loads. However, to our knowledge, no study has investigated the relationship between these measures and a known distance. Thus, the current study aimed to assess and compare the ability of four accelerometry based metrics and GNSS to predict known distance completed using different movement constraints. Method: A correlational design study was used to evaluate the association between the dependent and independent variables. A total of 30 physically active college students participated. Participants were asked to walk two different known distances (DIST) around a 2 m diameter circle (small circle) and a different distance around an 8 m diameter circle (large circle). Each distance completed around the small circle by one participant was completed around the large circle by a different participant. The same 30 distances were completed around each circle and ranged from 12.57 to 376.99 m. Instrumentation: Acceleration data was collected via a tri-axial accelerometer sampling at 100 Hz. Accelerometry derived measures included the sum of the absolute values of acceleration (SUM), the square root of the sum of squared accelerations (MAG), Player Load (PL), and Impulse Load (IL). Distance (GNSSD) was measured from positional data collected using a triple GNSS unit sampling at 10 Hz. Results: Separate simple linear regression models were created to assess the ability of each independent variable to predict DIST. The results indicate that all regression models performed well (R = 0.960−0.999, R2 = 0.922−0.999; RMSE = 0.047−0.242, p < 0.001), while GNSSD (small circle, R = 0.999, R2 = 0.997, RMSE = 0.047 p < 0.001; large circle, R = 0.999, R2 = 0.999, RMSE = 0.027, p < 0.001) and the accelerometry derived metric MAG (small circle, R = 0.992, R2 = 0.983, RMSE = 0.112, p < 0.001; large circle, R = 0.997, R2 = 0.995, RMSE = 0.064, p < 0.001) performed best among all models. Conclusions: This research illustrates that both GNSS and accelerometry may be used to indicate total distance completed while walking.

The Effect of Intensity Soccer Training Sessions on Marked Biochemical Indicators of Blood Acidity of Saudi Young Soccer Players.

Purpose: To assess the effect of low-to-moderate-intensity exercise on specific blood biomarkers and blood acidity in young Saudi Arabian professional soccer players. Methods: A total of 43 professional soccer players participated in the current study. A cross-sectional research method was used to compare the changes in the following blood biomarkers: calcium, magnesium, glucose, anion-gap metabolic acidosis, and carbon dioxide, after a range of low-to-moderate intensity training sessions. Measurements were taken in two soccer training sessions (Day 1, and Day 2). The exercise intensity was estimated by heart rate percentage of maximal heart rate. Wilcoxon signed-rank testing was used to analyze the results. Results: Significant differences were found between and pre-and post-training sessions for anion-gap metabolic acidosis: Day 1: 12.55 vs 15.4 mmol/L; Day 2: 14.15 vs 16.35 mmol/L; and magnesium: Day 1: 0.82 vs 0.74 mmol/L; Day 2: 0.85 vs 0.74 mmol/L. Exercise caused anion-gap metabolic acidosis concentrations to rise post-training; magnesium levels decreased after training sessions on Day 1 and Day 2. Conclusion: The concentrations of anion-gap metabolic acidosis and magnesium were significantly affected by exercise intensity in the subjects, the former rose post-training while the latter fell. More studies are required to investigate the effects of different exercise intensities on other blood biomarkers in soccer players.

Translation and Validation of the Arabic Version of the Capability Assessment for Diet and Activity (CADA) Questionnaire in Saudi University Employed Women.

BACKGROUND: The Capability Assessment for Diet and Activity (CADA) is a questionnaire that was developed in English and designed to measure the practical barriers and opportunities for diet and physical activity. OBJECTIVE: This study aimed to translate, culturally adapt, and validate the CADA questionnaire for the Arabic context in a sample of Saudi women employed at a university. METHODS: The CADA was translated into Arabic using the forward and backward translation process. The Arabic version was then validated with a sample of 125 female Saudi participants. In order to evaluate the psychometric properties of the Arabic version, Spearman's rank correlation coefficient was assessed, and a principal component analysis was performed. RESULTS: The translated CADA had good psychometric quality. The content validity analysis revealed a representativeness score of 99.3% and a degree of clarity of 98.6%, indicating excellent compatibility. The principal component analysis showed a single-factor structure. CONCLUSIONS: The Arabic version of the CADA questionnaire is now available to assess opportunities to achieve a healthy diet and physical activity level as part of health behavior management, which can lead to more effective interventions for improving people's health in Arabic-speaking countries.