Assessment of prediabetes knowledge among adults in Al-Madinah, Saudi Arabia.

Background: Prediabetes is a serious health condition which can be treated with changes to lifestyle behaviour. It is a significant warning sign of being at high risk of developing type 2 diabetes. This study aims to assess knowledge of prediabetes and its associated risk factors in the community of Al-Madinah, Saudi Arabia (SA). Methods: A cross-sectional study was conducted among adult respondents in Al-Madinah in 2022. A sample size of 397 participants completed a validated self-administrated survey and data were analysed using descriptive statistics (numbers, percentages, mean and standard deviation). Results: Of the 397 participants who responded to the survey, 56.7% were aged between 21 and 25 years old, with more than half (51.9%) being male and the majority being more educated (72%). Among the participants, 14.1%, 34.3% and 51.5% had a high, moderate and poor knowledge of prediabetes, respectively. Overall, there was a statistically significant association between age (>25 years old) (p = 0.003), gender difference (p = 0.006), and prediabetes knowledge. Conclusion: Knowledge of prediabetes is important in the prevention of type 2 diabetes. The population of Al-Madinah demonstrated a low level of prediabetes knowledge; therefore, the design and implementation of community-based intervention programmes with an emphasis on raising prediabetes awareness is crucial. Policymakers, organisations and partnerships will be required to develop a well-designed and effective programme.

Adolescent Obesity Prevention in Saudi Arabia: Co-identifying Actionable Priorities for Interventions.

Background: Childhood obesity is a serious issue in the Kingdom of Saudi Arabia, but there is no known community intervention. The aim of the study was to use a participatory approach to obtain the perspectives of students, school staff and Ministry of Education (MoE) representatives and parents on important and feasible intervention opportunities for school-based obesity prevention for adolescent girls. Method: The study was conducted in two intermediate schools for girls (13-15 years old) in Jeddah that were purposefully identified with the support of the MoE. Group concept mapping, a mixed method approach, was conducted with 19 adults which included staff from the MoE and schools, school canteen suppliers and mothers. Adults generated statements in response to two prompts (P); P1 "The factors influencing adolescent obesity in Saudi are..." and P2 "The content of school-based programmes should focus on...." Photovoice-enhanced concept mapping was used with students (n = 15 students) to capture adolescent perspectives on what influences their dietary and physical activity habits. Students generated statements' using their own photographs. Stakeholders, both adult and students, sorted the statements into themes and rated each statement for relative importance and feasibility. Multidimensional scaling and hierarchical cluster analyses were used to produce concept maps with the input from students and adults. Result: Adults generated 35 statements in response to P1 and identified five themes that influenced adolescent obesity including "Home Environment," "Lifestyle," "School Environment," "Community," "Biology." They generated 42 statements in relation to P2 and identified four themes including "Ministry of Education Support," "School Environment," "Public health programmes" and "Wider environmental influences." Students generated 42 statements from 39 pictures. They identified five themes that influenced their dietary and physical activity habits-"Role of Government," "School Environment," "Home Environment," "Retail Environment" and "Cultural Practices." Both groups identified several common important and feasible actions with a strong emphasis on improving the school environment, in particular food provision, with MoE support. Exemplar corresponding statements from adults were "Offer healthy foods in the canteen," "Remove chocolates and sweets" and "Educate children about healthy foods" and from students were "Offer fruit and vegetables in the canteen," "Remove chocolates from the canteen," "Healthy meals should not expensive." Lack of correspondence related to students' emphasis on access to both healthy foods and physical activity in schools and the wider environment (e.g. retail environments), while adults emphasized school-based education and food provision. After further consultations, both stakeholder groups agreed on improving access to healthy foods in the canteen. Conclusions: Students and school and MoE staff jointly agreed that a canteen-based intervention was important and feasible to improve dietary habits and thus help to prevent obesity among adolescent girls. This was the first time a participatory approach was used with students for intervention development in Saudi Arabia. A co-development approach may have value to improve their school food environments.

Global cities and cultural diversity: challenges and opportunities for young people's nutrition.

Childhood obesity is a common concern across global cities and threatens sustainable urban development. Initiatives to improve nutrition and encourage physical exercise are promising but are yet to exert significant influence on prevention. Childhood obesity in London is associated with distinct ethnic and socio-economic patterns. Ethnic inequalities in health-related behaviour endure, underpinned by inequalities in employment, housing, access to welfare services, and discrimination. Addressing these growing concerns requires a clearer understanding of the socio-cultural, environmental and economic contexts of urban living that promote obesity. We explore opportunities for prevention using asset based-approaches to nutritional health and well-being, with a particular focus on adolescents from diverse ethnic backgrounds living in London. We focus on the important role that community engagement and multi-sectoral partnership play in improving the nutritional outcomes of London's children. London's children and adolescents grow up in the rich cultural mix of a global city where local streets are characterised by diversity in ethnicities, languages, religions, foods, and customs, creating complex and fluid identities. Growing up with such everyday diversity we argue can enhance the quality of life for London's children and strengthen their social capital. The Determinants of young Adult Social well-being and Health longitudinal study of about 6500 of London's young people demonstrated the positive impact of cultural diversity. Born to parents from over a hundred countries and exposed to multi-lingual households and religious practices, they demonstrated strong psychological resilience and sense of pride from cultural straddling, despite material disadvantage and discrimination. Supporting the potential contribution of such socio-cultural assets is in keeping with the values of social justice and equitable and sustainable development. Our work signals the importance of community engagement and multisectoral partnerships, involving, for example, schools and faith-based organisations, to improve the nutrition of London's children.