The Potential Effects of Dietary Antioxidants in Obesity: A Comprehensive Review of the Literature.

Obesity has become a global health concern, with its prevalence steadily increasing in recent decades. It is associated with numerous health complications, including cardiovascular diseases, diabetes, and certain types of cancer. The aetiology of obesity is multifactorial, involving genetic, environmental, and lifestyle factors. In recent years, oxidative stress has emerged as a potential contributor to obesity and its related metabolic disorders. Dietary antioxidants, which can counteract oxidative stress, have gained significant attention for their potential role in preventing and managing obesity. This comprehensive review aims to explore the impact of dietary antioxidants on obesity and its associated metabolic dysregulations, discussing the underlying mechanisms and highlighting the potential therapeutic implications.

Malnutrition is associated with increased disease risk in older people in the Makkah region of Saudi Arabia: A cross-sectional study.

Introduction: There is little research on the nutritional status of older people in Saudi Arabia. This study investigated the factors associated with the nutritional status of older people in the Makkah region, Saudi Arabia. We hypothesized that older people who are at risk of malnutrition are at higher risk of different diseases. Materials and methods: This cross-sectional study surveyed 271 people aged ≥60 years from October 2021 to January 2022. We collected data on demographics, body mass index, the Geriatric Depression Scale-Short Form, Geriatric Oral Health Assessment Index, Mini Nutritional Assessment, Eating Attitudes Test, and Household Dietary Diversity score. Results: Among the 271 participants, 13.3% were malnourished and 53.9% were at risk of malnutrition. The oral health (P < 0.001), depression (P < 0.001), and eating disorder (P < 0.002) scores were significantly associated with malnutrition. Congestive heart failure, asthma, peripheral vascular disease, Alzheimer's disease, and hypertension were more prevalent among malnourished participants-this supports our original hypothesis. The HDD score showed no significant differences between men and women. Conclusion: Malnutrition was associated with overweight or obesity, poor oral health, and depression. Older people in the Makkah region, Saudi Arabia, had a high risk of malnutrition.

Effects of a Smartphone App on Fruit and Vegetable Consumption Among Saudi Adolescents: Randomized Controlled Trial.

BACKGROUND: Dietary patterns and nutritional status during adolescence have a direct effect on future health outcomes. OBJECTIVE: This study aimed to promote fruit and vegetable intake among adolescents using a smartphone app called MyPlate. METHODS: This randomized intervention study was conducted in an urban area of Jeddah, Saudi Arabia. We included 104 adolescents aged 13 to 18 years, who were randomized into intervention (n=55) or control (n=49) arms. We examined the effects of MyPlate on fruit and vegetable intake over 6 weeks in the intervention group. Pre- and postintervention questionnaires were used in the intervention and control groups. RESULTS: The control group showed a significant increase in fruit consumption scores between baseline (1.15, SD 0.68) and postintervention (1.64, SD 0.98; P=.01), but no significant difference in vegetable consumption scores was observed before (1.44, SD 0.97) and after intervention (1.55, SD 0.90; P=.54). However, there was no significant difference between scores at baseline and after 6 weeks of using the smartphone app for fruit (1.48, SD 0.99 and 1.70, SD 1.11, respectively; P=.31) or vegetables (1.50, SD 0.97 and 1.43, SD 1.03, respectively; P=.30) in the intervention group. Our findings showed no significant impact of using a smartphone app on fruit and vegetable consumption. CONCLUSIONS: These findings suggest that a smartphone app did not significantly improve fruit and vegetable intake among adolescents. TRIAL REGISTRATION: ClinicalTrials.gov NCT05692765; https://clinicaltrials.gov/ct2/show/NCT05692765.

Associations between dietary intake, physical activity, and obesity among public school teachers in Jeddah, Saudi Arabia.

Objective: We aimed to assess the dietary intake of certain food groups in a representative sample of public-school teachers living in Jeddah city. We also, examined the association of dietary intake with physical activity and obesity among schoolteachers. Methods: The study was a cross-sectional online survey, conducted among 640 (177 male, 463 female) schoolteachers aged between 20 and 62 years old and working in public primary, intermediate, and high schools in Jeddah. Measurements included gender, weight, height, body mass index (BMI), health problems, and lifestyle behaviours, including physical activity levels, smoking status, and dietary intake. Results: Based on gender, number of non-smoking women (94%) was higher than number of non-smoking men (57.1%) (P < 0.001). However, men were more active than women (P = 0.03). Regarding BMI, there were more overweight men than women, while obese women numbered more than men (P = 0.003). There was no significant difference in dietary intake between men and women except that men consumed more soft drinks than women (P = 0.002). Lower physically active schoolteachers were less likely to consume salad (OR = 0.6, 95% CI 0.4-0.9; P = 0.02), vegetables (OR = 0.6, 95% CI 0.3-0.9; P = 0.01), beans and legumes (OR = 0.4, 95% CI 0.2-0.7; P = 0.005), wholegrain bread (OR = 0.6, 95% CI 0.4-0.9; P = 0.03), dairy products (OR = 0.6, 95% CI 0.4-0.9; P = 0.01), snacks (OR = 0.5, 95% CI 0.2-0.8; P = 0.01), and fish (OR = 0.4, 95% CI 0.2-0.9; P = 0.04) compared to those with high levels of physical activity. Only fruit intake was considered statistically significant (OR = 0.4, 95% CI 0.3-0.7; P = 0.003). The study found a relationship between the BMI of schoolteachers and food intake. Obese schoolteachers had lower consumption of fruits (OR = 0.3, 95% CI 0.2-0.7; P = 0.007) and white meat (OR = 0.5, 95%CI 0.3-0.9; P = 0.03) than schoolteachers in the normal weight group. Conclusion: The high prevalence of physical activity, dietary intake and body weight among Saudi teachers is a major public health concern. The present study identified several lifestyle factors associated with body weight that may represent valid targets for the prevention and management of obesity among Saudi school teachers. Promoting active lifestyles and healthy diets would be primary targets for obesity prevention.

Gender differences in knowledge, attitudes, and practices with respect to type 1 diabetes among Saudi public-school teachers.

BACKGROUND: Children with type 1 diabetes mellitus (T1DM) need carefully monitoring even during school hours to avoid emergencies. Hence, it is crucial for teachers to have appropriate knowledge and positive attitudes toward diabetes to effectively manage the disease and its complications. This study aimed to compare the knowledge, attitudes, and practices with respect to T1DM among Saudi male and female public-school teachers living in Jeddah and to identify the associated factors. METHODS: A cross-sectional study was conducted among primary, intermediate, and secondary public-school teachers working in Jeddah, Saudi Arabia between October 2021 and March 2022. Data were collected through an online survey. The survey included information on the socio-demographics of school teachers, the presence of chronic diseases, teachers' health behaviours, and knowledge, attitude, and practice with respect to T1DM. RESULTS: This study included 378 school teachers. The majority of school teachers from both genders were married, held a bachelor's degree, and aged 45-54 years. Male school teachers were married (P = 0.02), held postgraduate certificates (P < 0.001), smoked cigarette and shisha (P < 0.001), and were physically active (P < 0.001) compared to female school teachers. Regarding teachers' knowledge of T1DM, it was found that female teachers were significantly more knowledgeable of T1DM children's and its symptoms than male teachers (P = 0.03; P = 0.01, respectively). However, male teachers were more willing to accommodate T1DM students in their classes and attend programs to support T1DM students as compared to female teachers (P = 0.004; P = 0.004, respectively). Moreover, the study showed poor practice scores for T1DM. In addition, the knowledge, attitudes, and practice scores toward T1DM were significantly associated with advanced age (P = 0.002), and extended years of teaching experience (P ≤ 0.002). Also, diabetic teachers had the highest knowledge (P = 0.03) and attitude (P = 0.02) scores compared to non-diabetic teachers. Male teachers who were married (P = 0.002), shisha smokers (P = 0.01), and had never practiced activity (P = 0.03) had better attitudes and practices toward T1DM. Similarly, female teachers who held bachelor's certificates had better attitudes toward T1DM (P = 0.02). CONCLUSION: The present study revealed moderate knowledge, favorable attitudes, and poor practices related to T1DM among school teachers in Jeddah. It is crucial for policymakers to provide school teachers with training for necessary diabetes care for diabetic students.

Snacking pattern of college students in Saudi Arabia: a cross-sectional study.

BACKGROUND: Although unhealthy snack foods are commonly consumed by college students, snacking patterns among college students have not been comprehensively examined in Saudi Arabia. In our study, we aimed to investigate snacking patterns among Saudi college students and to assess sociodemographic data that affect adherence to these snacking patterns. METHODS: Between January 2021 and March 2021 in Jeddah, Saudi Arabia, an online survey was conducted with 662 college students from a Saudi university. The survey included sociodemographic questions and a short food frequency questionnaire (FFQ) regarding the consumption of common snack foods. Snacking patterns were generated from the FFQ using the factor analysis method. RESULTS: Factor analyses generated seven snacking patterns, which explained 64.5% of the variance in snacking. Students in their early academic years (1-3 years) had a higher score for the convenience snack and fast-food pattern (0.22 ± 0.48 and 0.31 ± 0.52, respectively) than senior students (4-6 years) (P = 0.03 and 0.04, respectively). Healthy snacks patterns were higher among students at higher income levels (P = 0.006) and active students (P < 0.001) than among students at low- or mid-income levels and inactive students. Higher adherence to the beverages pattern was observed among male students (P = 0.03), active students (P = 0.01), and students with obesity than their counterparts (P = 0.02). The dairy products pattern was higher among male students (P = 0.04), students at higher income levels (P = 0.04), and students with obesity (P = 0.03) than their counterparts. CONCLUSIONS: Most snacking patterns identified among the study participants were considered unhealthy. Adherence to healthy snacks is influenced by physical activity and family income. These findings may be helpful in the future for developing adequate nutrition education programs that promote health by adhering to healthy snack choices in this critical age group. Further studies are needed to confirm these findings and to investigate snacking patterns among other age groups in Saudi Arabia.

Impact of the Intake of Snacks and Lifestyle Behaviors on Obesity among University Students Living in Jeddah, Saudi Arabia.

Unhealthy eating habits increase the risk of obesity. This study investigated the association between obesity and the intake of snacks and lifestyle behaviors among university students in Saudi Arabia. The study included 662 students aged 18-29 years, studying at King Abdulaziz University. An online survey collected data on sociodemographic characteristics, height, and weight, to calculate body mass index (BMI), lifestyle behaviors, dietary habits, and snack intake. The prevalence of overweight and obese students was 18.6% and 12.7%, respectively. Sociodemographic characteristics and lifestyle behaviors had insignificant effects on obesity. Obese students consumed two meals daily and more cereals during breakfast. Non-obese students consumed more beverages at breakfast and had their daily meals with their families. The frequency of intake of snacks had an insignificant effect on obesity. However, obese students had a significantly higher intake of potato chips, popcorn, and biscuits, while non-obese students had a significantly higher intake of salads compared with obese students. Students consumed significantly less fruit and vegetables, chocolate, biscuits, nuts, and dairy products as snacks when inside the university compared to outside. To reduce obesity among students, universities should ensure access to healthy snacks, and provide health education programs to encourage healthy eating habits and lifestyles.

Sociodemographic Characteristics and Dietary Choices as Determinants of Climate Change Understanding and Concern in Saudi Arabia.

Climate change poses a global threat to public health. This study investigated the understanding of, and concern over, climate change in Saudi Arabia and examined the associations with sociodemographic characteristics and dietary choices. This cross-sectional study consisted of 280 participants recruited via an online survey. Of the study participants, 45% demonstrated a sufficient understanding of climate change, and 56% were highly concerned about climate change. Male sex, medium-high monthly income, high education, and governmental employees were determinants of sufficient understanding of and great concern over climate change. Participants who exhibited a high understanding of climate change score demonstrated significantly higher consumption of vegetables (3.47 ± 0.98) and vegetable oils (3.26 ± 1.07) than participants with a low understanding score (3.31 ± 0.96 and 3.00 ± 1.01, respectively) (p ≤ 0.01). Additionally, participants with higher concern of climate change scores exhibited lower consumption of red meat (p = 0.0001), poultry (p = 0.003), margarine (p = 0.02), and soy products (p = 0.04). The study revealed a poor understanding of, but great concern over, climate change. The intake of non-climate-friendly food was typically higher than that of climate-friendly food. These findings are critical for developing strategies to enhance awareness of climate change and encourage people to consume climate-friendly food to mitigate climate change and improve public health.

Association of two types of dietary pattern scores with cardiovascular disease risk factors and serum 25 hydroxy vitamin D levels in Saudi Arabia.

BACKGROUND: Cardiovascular disease (CVD) is a main cause of mortality and disability worldwide. One of the key factors in the soaring prevalence of CVD globally has been nutrition transitions and changes in dietary patterns. OBJECTIVE: This study investigated the association between two diet scores, namely, a high-fat dietary (HFD) pattern score and a Mediterranean diet (MedDiet) score, and CVD risk factors (obesity, hypertension, total cholesterol, and blood glucose) and serum 25 hydroxy vitamin D (25[OH]D) levels. METHODS: Three hundred twenty-one participants were included in this study. Fasting blood tests were collected from all participants for biochemical measurements. Blood pressure and anthropometric measurements were also taken. A validated, semi-quantitative food frequency questionnaire was used to collect data on participants' dietary intake. Dietary scores for the HFD pattern were calculated based on recommended food groups. MedDiet scores were calculated based on a previously validated method that contains 14 questions related to MedDiet. Both diet scores were classified into tertiles. Linear regression analyses were performed to assess the statistical significance of the tertile groups. RESULT: A significant association was found between HFD score and obesity when comparing the lowest tertile (27.3±4.6 kg/m2) of HFD scores with the medium tertile (29.2±5.7 kg/m2; P = 0.02). A higher HFD score was significantly associated with lower 25(OH)D levels (P = 0.02). In addition, a significant association was observed between MedDiet scores and 25(OH)D levels, with an increase in MedDiet score resulting in an increase in 25(OH)D levels (P = 0.01). Furthermore, a significant negative association between MedDiet scores and low-density lipoprotein levels was reported only in participants with CVD (P = 0.03). CONCLUSION: The results of this study revealed that HFD and MedDiet scores might have a role in the development of CVD and vitamin D deficiency among the Saudi Arabian population. Further studies are required using diet scores to assess the quality of dietary patterns and their association with an increased risk of diseases in Saudi Arabians.

Snacking patterns throughout the life span: potential implications on health.

Eating outside the three main meals - in other words, snacking - is a part of the dietary pattern of individuals in all stages of life. The quality and pattern of snacking have an impact on health during the life span. Thus, the aim of this review was to evaluate various patterns and health outcomes of the snacking habits of different demographical groups, from children to the elderly, throughout their life span. We discuss the snacking pattern among children and adolescents, which is characterized by consuming high energy foods with low nutrient value, and which is associated with increased risk of obesity. During university years, study stress and lack of time were obstacles to a healthy dietary pattern involving nutritious snacks, although awareness of the importance of healthy snacks was higher in this group than among younger age groups. Employment status and skipping regular meals were important factors affecting snacking quality and patterns in adulthood. Unhealthy snacks, high in energy, sugar, and salt and low in nutrients, were demonstrated to have a negative impact on individuals' health, such as oral health, blood pressure, obesity, and diabetes. In conclusion, encouraging individuals to consume healthy snacks that are high in nutrients through education to help them plan for their snacks is important to enhance health and reduce disease risk.

High Adherence to the Mediterranean Diet Is Associated with a Reduced Risk of Obesity among Adults in Gulf Countries.

The Mediterranean diet (MedDiet) is considered as a good example of a healthy dietary pattern that has protective effects on obesity. The aim of the present study was to assess the adherence of adults from three Gulf countries (Saudi Arabia, Oman, and Kuwait) to the MedDiet and its association with obesity risk. A cross-sectional study was conducted on 961 men and women (75.7%) aged 20-55 years old. Waist circumference (WC), and hip circumference (HC) were measured waist/hip ratio (WHR) and body mass index (BMI) were calculated. A validated 14-item Questionnaire was used to measure adherence to MedDiet. The mean of the adherence to MedDiet score was 5.9 ± 2.03 for the total sample. An inverse association was observed between the adherence to MedDiet and BMI after adjusting for potential confounders (p = 0.0003 in total participants, and p = 0.001 in women only). A protective effect was seen with a higher adherence to the MedDiet on HC, suggesting that a greater adherence to the MedDiet was associated with a decreased HC (p = 0.04 in total participants, and p = 0.01 in women only). In conclusion, low adherence to the MedDiet among participants from three gulf countries was associated with increased obesity indicators, BMI, and HC.

Association of apolipoprotein E gene polymorphisms with blood lipids and their interaction with dietary factors.

BACKGROUND: Several candidate genes have been identified in relation to lipid metabolism, and among these, lipoprotein lipase (LPL) and apolipoprotein E (APOE) gene polymorphisms are major sources of genetically determined variation in lipid concentrations. This study investigated the association of two single nucleotide polymorphisms (SNPs) at LPL, seven tagging SNPs at the APOE gene, and a common APOE haplotype (two SNPs) with blood lipids, and examined the interaction of these SNPs with dietary factors. METHODS: The population studied for this investigation included 660 individuals from the Prevention of Cancer by Intervention with Selenium (PRECISE) study who supplied baseline data. The findings of the PRECISE study were further replicated using 1238 individuals from the Caerphilly Prospective cohort (CaPS). Dietary intake was assessed using a validated food-frequency questionnaire (FFQ) in PRECISE and a validated semi-quantitative FFQ in the CaPS. Interaction analyses were performed by including the interaction term in the linear regression model adjusted for age, body mass index, sex and country. RESULTS: There was no association between dietary factors and blood lipids after Bonferroni correction and adjustment for confounding factors in either cohort. In the PRECISE study, after correction for multiple testing, there was a statistically significant association of the APOE haplotype (rs7412 and rs429358; E2, E3, and E4) and APOE tagSNP rs445925 with total cholesterol (P = 4 × 10- 4 and P = 0.003, respectively). Carriers of the E2 allele had lower total cholesterol concentration (5.54 ± 0.97 mmol/L) than those with the E3 (5.98 ± 1.05 mmol/L) (P = 0.001) and E4 (6.09 ± 1.06 mmol/L) (P = 2 × 10- 4) alleles. The association of APOE haplotype (E2, E3, and E4) and APOE SNP rs445925 with total cholesterol (P = 2 × 10- 6 and P = 3 × 10- 4, respectively) was further replicated in the CaPS. Additionally, significant association was found between APOE haplotype and APOE SNP rs445925 with low density lipoprotein cholesterol in CaPS (P = 4 × 10- 4 and P = 0.001, respectively). After Bonferroni correction, none of the cohorts showed a statistically significant SNP-diet interaction on lipid outcomes. CONCLUSION: In summary, our findings from the two cohorts confirm that genetic variations at the APOE locus influence plasma total cholesterol concentrations, however, the gene-diet interactions on lipids require further investigation in larger cohorts.

Apolipoprotein E gene polymorphism modifies fasting total cholesterol concentrations in response to replacement of dietary saturated with monounsaturated fatty acids in adults at moderate cardiovascular disease risk.

BACKGROUND: Consumption of ≤10% total energy from fat as saturated fatty acids (SFA) is recommended for cardiovascular disease risk reduction in the UK; however there is no clear guidance on the optimum replacement nutrient. Lipid-associated single-nucleotide polymorphisms (SNPs) have been shown to modify the lipid responses to dietary fat interventions. Hence, we performed a retrospective analysis in 120 participants from the Dietary Intervention and VAScular function (DIVAS) study to investigate whether lipoprotein lipase (LPL) and apolipoprotein E (APOE) SNPs modify the fasting lipid response to replacement of SFA with monounsaturated (MUFA) or n-6 polyunsaturated (PUFA) fatty acids. METHODS: The DIVAS study was a randomized, single-blinded, parallel dietary intervention study performed in adults with a moderate cardiovascular risk who received one of three isoenergetic diets rich in SFA, MUFA or n-6 PUFA for 16 weeks. RESULTS: After the 16-week intervention, a significant diet-gene interaction was observed for changes in fasting total cholesterol (P = 0.001). For the APOE SNP rs1064725, only TT homozygotes showed a significant reduction in total cholesterol after the MUFA diet (n = 33; -0.71 ± 1.88 mmol/l) compared to the SFA (n = 38; 0.34 ± 0.55 mmol/l) or n-6 PUFA diets (n = 37; -0.08 ± 0.73 mmol/l) (P = 0.004). None of the interactions were statistically significant for the other SNPs. CONCLUSIONS: In summary, our findings have demonstrated a greater sensitivity of the APOE SNP rs1064725 to dietary fat composition, with a total cholesterol lowering effect observed following substitution of SFA with MUFA but not n-6 PUFA. Further large intervention studies incorporating prospective genotyping are required to confirm or refute our findings. TRIAL REGISTRATION: The trial was registered at www.clinicaltrials.gov as NCT01478958.

Impact of Lipoprotein Lipase Gene Polymorphism, S447X, on Postprandial Triacylglycerol and Glucose Response to Sequential Meal Ingestion.

Lipoprotein lipase (LPL) is a key rate-limiting enzyme for the hydrolysis of triacylglycerol (TAG) in chylomicrons and very low-density lipoprotein. Given that postprandial assessment of lipoprotein metabolism may provide a more physiological perspective of disturbances in lipoprotein homeostasis compared to assessment in the fasting state, we have investigated the influence of two commonly studied LPL polymorphisms (rs320, HindIII; rs328, S447X) on postprandial lipaemia, in 261 participants using a standard sequential meal challenge. S447 homozygotes had lower fasting HDL-C (p = 0.015) and a trend for higher fasting TAG (p = 0.057) concentrations relative to the 447X allele carriers. In the postprandial state, there was an association of the S447X polymorphism with postprandial TAG and glucose, where S447 homozygotes had 12% higher TAG area under the curve (AUC) (p = 0.037), 8.4% higher glucose-AUC (p = 0.006) and 22% higher glucose-incremental area under the curve (IAUC) (p = 0.042). A significant gene-gender interaction was observed for fasting TAG (p = 0.004), TAG-AUC (Pinteraction = 0.004) and TAG-IAUC (Pinteraction = 0.016), where associations were only evident in men. In conclusion, our study provides novel findings of an effect of LPL S447X polymorphism on the postprandial glucose and gender-specific impact of the polymorphism on fasting and postprandial TAG concentrations in response to sequential meal challenge in healthy participants.