Sources of free sugar in the diet of Saudi children.

Introduction: Data concerning sources of free sugar (FS) in the diet of Saudi children are limited. Identification of the top sources of FS would permit to develop tailored interventions that aid in meeting the recommendations of the World Health Organization for FS (≤ 25 g/day). This study aimed to investigate sources of FS in children's diet. Methods: A cross-sectional data of healthy children ages between 6 and 12 years who reside in Saudi Arabia were gathered from their mothers using online platforms (WhatsApp, Facebook, and X) (n = 424; 210 boys and 214 girls). An interview was conducted through the phone with the mother and her child to collect data pertaining FS intake using a validated food frequency questionnaire. Results: The primary sources of FS were Sweetened Beverages, followed by Sugars, Sweet Bakery Products, Other Desserts, and Candies, of which the added sugar consisted mostly of its total sugar. The consumption of FS coming from solid food sources for the highest quartile of children almost doubled the amount of FS coming from liquid food sources. Compared to boys, girls in the top quartile of FS intake consumed significantly higher amounts of solid sugars (p = 0.030). Only the intake of FS coming from Sweetened Beverages was associated negatively with age of children (p = 0.032). Discussion: Public health interventions should emphasize the necessity of reducing the consumption of the top sources of FS to practically achieve the recommendations of FS intake.

Behaviors Related to Limiting Fat Intake among Young Adults in Saudi Arabia.

Young adults tend to frequently consume foods that are high in fat. Efforts to limit the consumption of fat among the Saudi population have been initiated; however, data concerning current behaviors related to limiting fat intake are lacking. We aimed to explore behaviors related to limiting fat intake and to investigate the association with fat intake among young adults in Saudi Arabia. In this cross-sectional study, a total of 305 students aged ≥19 years were recruited from Taibah University, Madinah. Face-to-face interviews were conducted to collect data concerning sociodemographic status, behaviors related to limiting fat intake, and fat intake. The median score of behaviors related to limiting fat intake was significantly higher among females and supplement users compared to other groups. Healthy weight, overweight, and obese students reported a significantly higher score of behaviors related to limiting fat intake, compared to underweight students. Males who reported making an effort to limit the consumption of fatty foods consumed less total fat, saturated fat, monounsaturated fat, and polyunsaturated fat, while those who reported reading the nutrition fact labels of food products consumed more polyunsaturated fat. Females who reported reading nutrition fact labels consumed less saturated fat. Efforts to limit fat intake have been noted especially among females; however, these efforts were not linked to fat intake among young adults in Saudi Arabia.

Predictors of Maternal Knowledge, Attitude, and Practices Toward Vitamin D Supplements in Saudi Infants and Toddlers.

OBJECTIVES: To assess maternal knowledge, attitude, and practices toward vitamin D supplements in Saudi infants and toddlers. In addition, we investigated predictors of maternal knowledge, attitude, and practices related to vitamin D supplements. METHODS: Cross-sectional data of 156 Saudi infants and toddlers were collected from mothers via online survey. Data collected included sociodemographics, maternal knowledge, attitude, and practices toward vitamin D supplements. RESULTS: Our data show a limited maternal knowledge toward vitamin D. Maternal knowledge and attitude as well as maternal knowledge and practices were not correlated. Spearman correlation between maternal attitude and practices was positively low (rs= 0.47). Child's age and family monthly income predicted maternal knowledge towards vitamin D. Maternal age and maternal education level predicted maternal attitude toward vitamin D supplements. Order of the child, maternal age, and maternal employment status predicted maternal practices toward vitamin D supplements in infant and toddlers. CONCLUSIONS FOR PRACTICE: Maternal knowledge, attitude, and practices toward vitamin D supplements can be predicted by certain sociodemographic characteristics. Interventions that focus on improving maternal knowledge, attitude, and practices toward vitamin D supplements are urgently needed.

Appetite as a predictor of malnutrition in end-stage renal disease patients in Saudi Arabia.

BACKGROUND AND OBJECTIVES: Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) are at high risk for malnutrition. This study aimed to 1) Investigate the prevalence of malnutrition among CKD patients undergoing maintenance HD; 2) Assess level of knowledge and appetite among patients; 3) Identify potential predictors of malnutrition. METHODS AND STUDY DESIGN: This cross-sectional study included 71 CKD patients on HD who were recruited from two principal outpatient dialysis centers located in Jeddah, Saudi Arabia. Data were collected using an interviewer-administered questionnaire which included sociodemographic and health characteristics, nutritional status (assessed using the Patient-Generated Subjective Global Assessment [PG-SGA]), biochemical data, nutritional knowledge, and appetite status (assessed using Council of Nutrition Appetite Questionnaire [CNAQ]). RESULTS: Forty-four percent of patients included in this study were malnourished, and over half of the patients had limited nutritional knowledge and appetite. Hemoglobin level and the CNAQ score were found to be independently negatively associated with the PG-SGA score (B: -1.03 [95% confidence interval (CI): -1.99, - 0.08] and B: -0.37 [95% CI: -0.64, -0.11], respectively). CONCLUSIONS: Renal healthcare professionals should assess the nutritional status of HD patients and identify barriers to adequate nutrition. Patients with poor appetite should specifically be targeted for nutrition-focused evaluation and management.

Maternal Knowledge, Attitude and Practices toward Free Sugar and the Associations with Free Sugar Intake in Children.

Research addressing factors related to free sugar (FS) consumption among children in Saudi Arabia is lacking. We aimed to evaluate maternal knowledge, attitude, and practices toward FS and the associations with children's intake of FS. This cross-sectional study included 424 Saudi children aged 6-12 years and their mothers. Data related to maternal knowledge, attitude, and practices were collected using an online survey. Data concerning children's habitual intake of FS were collected through phone interviews using a validated food frequency questionnaire. Limited knowledge on FS was observed among mothers of children [median 7.00 [interquartile range 6.00-8.00] out of 11.0. Maternal knowledge was not correlated with maternal attitude or practices toward FS. Maternal knowledge towards FS did not predict children's intake of FS, whereas maternal attitude and practices toward limiting the consumption of FS predicted lower intake of FS among Saudi children, particularly the FS consumed from solid food sources (B: -5.73 [95% confidence interval (CI): -9.79 to -1.66]) and (B: -6.85 [95% CI: -11.9 to -1.80]), respectively. Despite the limited knowledge pertaining to FS among mothers in Saudi Arabia, they were making efforts to limit their children's consumption of FS.

Consumption of Free Sugar Predicts Nutrient Intake of Saudi Children.

Data concerning the association between free sugar intake and nutrient intake in children in the Middle East are not available. This study aimed to explore the association between the consumption of free sugar and nutrient intake among Saudi children. A cross-sectional study included 424 Saudi children ages between 6 and 12 years old and their mothers. An online survey collected sociodemographic data from mothers. Trained data collector personal contacted mothers to arrange for a phone interview in order to collect 24-h dietary recall to assess the dietary intake of children. Only 0.90% of children consumed free sugar within the recent recommendation of the World Health Organization (WHO) of <5% of total energy intake, whereas 10.6% of children consumed free sugar <10% of total energy intake. The percentage of free sugar intake was negatively associated with total energy intake. Multiple linear regression analysis of free sugar consumption and nutrient intake adjusted for children's age and sex indicated that a higher percentage of free sugar intake significantly predicted lower intake of saturated fat, fiber, sodium, potassium, calcium, iron, zinc, and vitamin B12. Excessive intake of free sugar predicted a lower intake of many essential nutrients. Interventions that aim to reduce the intake of free sugar are urgently needed in order to improve diet of growing children. Future research to explore top food sources of free sugar is needed to establish effective interventions that aim to limit free sugar intake among children.

Development of a Food Frequency Questionnaire for Assessing Habitual Intake of Free Sugar Among Children in Saudi Arabia.

The World Health Organization emphasizes the urgency to assess and limit the intake of free sugar (FS) among individuals in order to prevent several non-communicable diseases. However, data regarding intake of FS are lacking in Saudi Arabia and in the Middle East. A reliable valid tool is needed to assess children's habitual intake of FS. Thus, we aimed to develop and validate a food frequency questionnaire (FFQ) that assesses children's habitual intake of FS in Saudi Arabia. In this cross-sectional study, 424 healthy Saudi children ages 6-12 years were included using river sampling method. Sociodemographic data and contact information were collected from mothers using an online survey. Dietary data were collected using 24-h dietary recalls (reference method) and a semi-quantitative FFQ through phone interviews. Items and food groups included in the initial draft of the FFQ were adopted from previous work. Content validity was done to the FFQ with total of 12 food groups and 41 food items. Next, a pilot study was conducted to estimate the sample size needed for the study and to ensure that all items reported in the 24-h dietary recalls were included in the final draft of the FFQ. Finally, data were collected to assess the validity and reliability of the FFQ at the population level. Mean intake of FS assessed by the FFQ was significantly higher than that assessed by the 24-h dietary recalls. Spearman's correlation between total FS assessed by the FFQ and 24-h dietary recall was positively low (r s = 0.30, p < 0.001). The coefficient alpha indicated an acceptable level of internal consistency (α = 0.74, p < 0.001). Test-retest reliability for total FS intake assessed by the FFQ was positively high (r s = 0.82). A slight agreement between FS intake assessed by the FFQ and the 24-h dietary recall was seen among the study sample (κ = 0.21, p < 0.001). The newly developed FFQ was found to be reasonably valid in assessing children's habitual intake of FS in Saudi Arabia. Validating the instrument among older population in Saudi Arabia is warranted.

Food neophobia and pickiness among children and associations with socioenvironmental and cognitive factors.

Food neophobia and picky eating are common behaviors exhibited among children that may impact their nutritional health. Due to the limited data available regarding food neophobia and pickiness in Saudi Arabia, this study aimed to estimate the prevalence of picky eating and food neophobia among Saudi children and to examine the association of socioenvironmental and cognitive factors with food neophobia and pickiness. The study included 216 healthy children with no known allergy, aged 3-7 years old, recruited from six schools in Jeddah, Saudi Arabia. A questionnaire was utilized to collect sociodemographic information from parents. Food neophobia and pickiness were evaluated using 2 separate scales. Socioenvironmental factors that may contribute to the development of food neophobia and pickiness were evaluated, such as breastfeeding duration and weaning practices, parental strategies, peer modeling, and social facilitation. Sensory sensitivity and disgust were also evaluated to assess the association with cognitive factors. Linear regression analysis with 95% confidence intervals was used to test the associations with the selected socioenvironmental and cognitive factors. The majority of children showed moderate to severe food neophobia and pickiness (98.6% and 89.8%, respectively). The socioenvironmental factors of peer modeling and selected parental strategies were found to have a significant association with food neophobia and pickiness. Assessed cognitive factors were found to be associated with food neophobia and pickiness. Future studies investigating causes of food neophobia and food pickiness among children are warranted.