Physical activity pattern and its relationship with overweight and obesity in saudi children

Full-Day Physical Activity and Sedentary Behaviour Levels of Typically Developing Children and Adolescents in the Middle East: A Systematic Review

Physical activity (PA) and sedentary behaviour (SB) are important components of physical behaviour associated with long-term health outcomes. Environmental and cultural factors may influence physical behaviour. To explore full day PA and SB in children and adolescents (2-18 years old) in the Middle East, a systematic literature review was performed including 183 journal articles. A wide range of PA and SB outcomes were reported, in some cases making synthesis of results difficult. As a consequence, results were generally reported narratively (MVPA time, total PA, SB time). Meta-regression of daily step count revealed females took 4600 fewer steps than males, with 3000 fewer steps on weekdays than weekends, and overweight individuals taking 2800 fewer steps/day. Steps decreased with age. Meta-regression for TV viewing time demonstrated an increase by 0.04 h per year of age. Even though environmental and cultural conditions may be different, PA and SB of children and adolescents in the Middle East were largely comparable to those of Europeans and North Americans. The wide range of data collection instruments used (both self-report questionnaire and body-worn devices) and heterogeneity of data made synthesis of reported data across studies very difficult, suggesting a need for greater standardisation of data collection methods.

Behavioral Determinants of Physical Activity Among Secondary School Students Aged 14-15 Years in Cambodia

BACKGROUND

There is little known about physical activity (PA) behaviors and its determinants in Cambodian adolescents, particularly with regard to the home and school settings. Therefore, we aimed to investigate these behaviors and determinants on their PA.

METHODS

The samples collected were from 168 high school students, aged 14-15 years. They were requested to complete the self-report PA questionnaire. Time spent in PA during weekday and weekend by school location and gender, and determinants on PA were analyzed. Differences in the mean values of the PA levels (in minutes) during weekday and the weekend between genders, and between school locations were analyzed using independent sample t tests. The percentage of students' perceptions on the determinants were calculated. Chi-squared test was used to compare the differences in prevalence of students' activities during their free time with respect to school location and gender.

RESULTS

The majority of the parents (86.9%-98.2%) demonstrated strong support for their children for academic work. Rural students spent an average time of moderate-to-vigorous PA greater than their counterparts from the urban areas during their weekend days (329.1 vs 239.2 min, respectively). Moderate to vigorous PA was likely to be higher during the weekends compared with weekdays among the boys (387.9 vs 361.4 min, respectively). Girls were more likely to spend their time on moderate to vigorous PA during the weekdays compared with the weekends (205.4 vs 180.5 min, respectively).

CONCLUSION

Consideration should be given to gender, school location, free time, and the environmental setting for the contextualization of more effective PA interventions with Cambodian youths.

Systemic and Oral Health Parameters in Eutrophic and Overweight/Obese Adolescents: A Cross-Sectional Study

To date, studies focusing on oral health in obese adolescents have provided controversial data. The aim of this cross-sectional study was to investigate systemic and oral health parameters in eutrophic and overweight/obese adolescents. In total, 100 adolescents, mean aged 13.33 ± 2.04 years, were divided into two groups: 59 overweight/obese adolescents in the study group (SG) and 41 eutrophic-weight adolescents in the control group (CG). Chi-squared and Fisher exact tests were performed to compare dichotomous and categorical variables between the two groups. The subjects in the SG (mean aged 13.21 ± 2.21) reported a body mass index (BMI) of 29.05 ± 4.09 kg/m², corresponding to over 95° percentile for both genders, and the subjects in the CG (mean aged 13.49 ± 1.77) reported a BMI of 18.26 ± 4.81 kg/m², corresponding to 25° percentile for both genders. In the SG, the serum level of 25-hydroxy-vitamin D was significantly lower (p-value < 0.001), whereas fasting blood glucose (p = 0.006), waist circumference, and hip circumference were significantly higher (p-value < 0.001). Plaque Index (PI), Plaque Control Record (PCR), Oral Hygiene Index (OHI), Gingival Index (GI), and Gingival bleeding index (GBI) depicted a significantly worse level of oral health in the SG. Moreover, the number of subjects with caries was significantly higher in the SG. Nutritional and physical activity status according to the Mediterranean Diet Quality Index for children and teenagers (KIDMED test) and the International Physical Activity Questionnaire (IPAQ-Adolescent) were reported to be significanlty better in the CG. In light of our results, obesity and poor oral health coexist in a cohort of adolescents. A screening of oral health status should be considered in obese subjects to focus resources on therapeutic interventions aiming at improving oral health.

Physical activity, sedentary behaviors, and breakfast eating as factors influencing BMI in Saudi students, aged 10 to 15 years

BACKGROUND

Eating less and moving more are the simplest and most common strategies to combat excessive weight. Several other lifestyle factors can also contribute to maintaining a healthy weight.

OBJECTIVES

The present study examined the effects of breakfast frequency, duration and quality of sleep, daily physical activity, sedentary behaviours, and school transportation on the BMI of Saudi students, aged 10-15 years.

MATERIALS AND METHODS

This study included 981 students (240 girls (24.46%) [66 children (27.5%) and 174 adolescents (72.5%)] and 741 boys (75.54%) [441 children (59.51%) and 300 adolescents (40.49%)]). For each participant, height, weight, and body composition were obtained using bioelectric impedance analysis. A questionnaire focussing on lifestyle behaviours over the last seven days was also completed by each student. Multiple comparisons were performed to test for significant differences between the groups, stratified by sex, age, and BMI. Stepwise multiple regression analysis was used to determine the variables that significantly affected BMI.

RESULTS

The overall prevalence of overweight and obesity in boys was 12.82% and 25.1%, and in girls, 10.42% and 5.42%, respectively. Most participants used cars or buses as transportation to and from school (100% of girls and 83% of boys). Breakfast was skipped mainly by male participants. Boys tended to sleep more than girls during school days (488.90 ± 74.33 vs. 467.76 ± 78.75 min. night-1). They were more active (2.58 ± 0.69 vs. 2.34 ± 0.82), used laptops more frequently (2.46 ± 1.51 vs. 1.90 ± 1.63), and played more video games (3.12 ± 1.43 vs. 1.2875 ± 1.36) than girls. However, girls were less sedentary (2.63 ± 0.76 vs. 2.9±.79), watched more TV (3.65 ± 1.155 vs. 2.73 ± 1.48) and used their smartphones more (3.6625 ± 1.3 vs. 3.28 ± 1.44) than boys.

CONCLUSIONS

This study revealed significant associations between BMI and breakfast intake, physical activities, and sedentary behaviours. Of these, using laptops and playing video games were the key sedentary activities that influenced BMI.Key messagesA significantly higher prevalence of overweight and obesity was noted among boys compared to girls in private school students, aged 10-15 years, in Al-Ahsa governorate, Eastern Province of Saudi Arabia.Boys slept more than girls on school days, and they were more active, used laptops more frequently, and played more video games than girls. Girls were less sedentary, watched television more often, and used smartphones more frequently than boys.Among private school students aged 10-15 years in Al-Ahsa governorate, Eastern Province of Saudi Arabia, BMI was significantly associated with breakfast intake frequency, physical activity, and sedentary behaviours, among which using laptops and playing video games were the sedentary activities that most influenced BMI.

Effect of Intermittent Fasting, Probiotic-Fermented Camel Milk, and Probiotic-Fermented Camel Milk Incorporating Sukkari Date on Diet-Induced Obesity in Rats

Obesity causes metabolic syndrome disorders that are detrimental to health. The current study examined the effects of intermittent fasting (IF), fermented camel milk (FCM), and fermented camel milk incorporating 10% Sukkari date (FCM-D) on weight loss, blood profile, and antioxidant status in obese rats for 6 weeks. Subsequently, leptin and adiponectin levels and histopathological examination of adipose tissue were carried out. Results showed that IF with FCM or FCM-D decreased body weight by 0.92 and −5.45%, respectively. IF alone lowered non-fasting blood glucose (NFBG) and fasting blood glucose FBG after 6 weeks, whereas adding FCM or FCM-D reduced NFBG after 4 weeks. Intermittently fasting obese rats given FCM or FCM-D had the lowest blood glucose levels (BGL). The hypolipidemic effects of IF, FCM, and FCM-D on obese rats reduced triglycerides (TG), cholesterols (CHO), and their derivatives. FCM-D with IF presented a superior effect on lipid profile. A reduction rate of 40, 37, 66, and 40% for TG, CHO, low-density lipoprotein (LDL-c), and very low-density lipoprotein (VLDL-c), respectively, and an increase in HDL-C by 34% were noticed. Reductions of 40, 37, 66, and 40% for TG, CHO, LDL-c, and VLDL-c, respectively, and a 34% rise in high-density lipoprotein (HDL-C) were noted. Combining IF with FCM or FCM-D lowered the atherogenic index (AI) by 42% and 59%, respectively. Remarkably, treating rats with FCM+IF or FCM-D+IF effectively attenuated leptin and adiponectin levels. Malondialdehyde (MDA) was significantly decreased in a type-dependent manner. Implementing FCM-D or FCM with IF significantly attenuated reduced glutathione (GSH), superoxide dismutase (SOD), MDA, and catalase (CAT) levels. The most efficient treatment was giving FCM-D with IF. Histopathologically, adipocyte lipolysis increases free fatty acids (FFAs) and promotes inflammation. Only IF+FCM-D indicated no histopathological alteration except for a few focal areas of a few inflammatory cell infiltrations in the parenchyma. In conclusion, combining IF and Probiotic-FCM or Probiotic-FCM-D effectively accelerated weight loss, attenuated metabolic markers, and reversed histopathological alterations. Thus, IF combined with Probiotic-FCM or Probiotic-FCM-D is highly recommended for weight loss, strengthening antioxidative status, and preventing health disorders.

Physical Activity and Sedentary Behaviors in Primary School Children in Saudi Arabia during the COVID-19 Pandemic: Association with Parents' Behaviors

During the COVID-19 pandemic, a few studies used accelerometers to assess physical activity (PA) and sedentary behavior in the family context. This study aimed to assess children and parents' moderate and vigorous physical activity (MVPA) and sedentary time, as well as their relationship in MVPA and sedentary time. Data were collected from 30 parent-child dyads during the COVID-pandemic for seven days, using a hip-worn accelerometer. Children and parents engaged in 65.6 and 34.6 min/day in MVPA and 442.2 and 427.9 min/day sedentary, respectively. There was no evidence of gender difference in MVPA and sedentary between boys and girls. Male parent spent more time in MVPA than female parents. A total of 50% of children and 53.3% of parents met the recommended PA. Children's MVPA and sedentary time were both correlated with that of their parents. Adjusted linear regression showed that only child MVPA was negatively associated with their parents' MVPA. There is evidence that multi-level interventions involving parents and children are more effective than interventions focusing on a single group. This study also provides evidence to support the link between MVPA and sedentary time between parents and children. Generalization of the findings is difficult due to the bias of self-selection sample.

Lower fitness levels, higher fat-to-lean mass ratios, and lower cardiorespiratory endurance are more likely to affect the body mass index of Saudi children and adolescents

Background

Several studies suggest that health-related physical fitness may play a prominent role in preventing obesity in children and adolescents.

Objectives

The present study examined fitness levels using five components of health-related fitness in Saudi students aged 10-17 years (fat-to-lean mass ratio, cardiorespiratory endurance, upper body strength and endurance, abdominal muscle strength and endurance, and flexibility). Subsequently, the association between BMI and a health-related fitness index (HR-PFI) based on the five fitness components was investigated.

Methods

The study was conducted on 1,291 students with a mean age of 12.95 ± 1.72 years. Participants included 1,030 boys aged 12.80 ± 1.79 years, with 479 young boys (11.24 ± 0.81b years), and 551 adolescents (14.16 ± 1.21 years). Moreover, the study examined 261 girls averaging 13.54 ± 1.2 years old, with 66 young girls (11.92 ± 0.27 years), and 195 teenage girls (14.09 ± 0.85 years). Each participant's health-related fitness level was assessed by the following tests: Bioelectrical Impedance Analyzer (BIA) for body composition, one-mile run/walk test for cardiorespiratory endurance, curl-up test for abdominal muscle strength and endurance (AMSE), push-up test for upper body strength and endurance (UBSE), and back-saver sit-and-reach test for flexibility.

Results

The overall prevalence of overweight and obesity was 10.4 and 24.7% in boys and 10 and 8.4% in girls, respectively. The mean Z-scores of performances decreased from the underweight to the obese groups. BMI was positively associated with the ratio of fat mass to lean mass and negatively associated with cardiorespiratory endurance in the overall group of participants as well as in the subgroups by sex and age categories. BMI was also negatively associated with flexibility and HR-PFI in the total group, UBSE, AMSE, and HR-PFI in prepubertal boys, and UBSE in prepubertal girls. The coefficient of determination values was 0.65 in the total group, 0.72 in prepubertal boys, 0.863 in adolescent boys, 0.956 in prepubertal girls, and 0.818 in adolescent girls.

Conclusions

Overall health-related physical fitness, fat-to-lean mass ratio, and cardiorespiratory endurance are the factors that most affect BMI in Saudi students aged 10 to 17.

The Effects of a Physical Activity, Nutrition, and Body Image Intervention on Girls in Intermediate Schools in Saudi Arabia

BACKGROUND

This cluster-randomized study aimed to evaluate the effects of an intervention focused on physical activity, nutrition, and body image perception among girls in intermediate schools in Saudi Arabia. A seminar was delivered to the mothers of the girls in the experimental group. The experimental group then attended six interactive sessions within 3 months featuring physical activity, nutrition, and body image perception, followed by a 3-month follow-up period. A total of 138 respondents (68 in the experimental group and 70 in the control group) completed the intervention. Each participant's body mass index-for-age z-score and waist circumference were measured, and they completed a physical activity, sedentary behavior, and body image perception questionnaires before and after the intervention and at the follow-up. The intervention was evaluated using within- and between-groups generalized estimating equations. There were no significant changes in the respondents' body mass index-for-age z-score or waist circumference (p > 0.05). However, immediate significant improvements were seen in physical activity, sedentary behavior, and body image satisfaction among the experimental group, and these improvements remained at follow-up (p < 0.001). These differences were more significant among the experimental group than among the control group. We found this intervention effective. Future studies can adapt this intervention for adolescent boys and extend its duration to improve the body mass index outcome.

Physical activity across days of week, video games, and laptop use are more likely to influence weight gain among Saudi Youth

Purpose

The purpose of this study was to determine the extent and prevalence of daily PA and the sedentary behavior during inactive spare-time among young Saudis and their effect on overweight and obesity.

Methods

A total of 357 students completed all stages of this study. They included 282 boys aged 11.95 ± 0.73 years (213 children aged 11.62 ± 0.506 years and 69 adolescents aged 13.16 ± 0.373 years) and 75 girls (16 children aged 11.94 ± 0.236 years and 59 adolescents aged 13.47 ± 0.626 years). For each participant, height and weight were measured, and BMI was calculated. A questionnaire asking about daily PA and sedentary habits during the previous 7 days was also used. Multiple comparisons were performed to test for differences between groups by sex and age category, and stepwise multiple regression analysis was used to determine which variables significantly affected BMI.

Results

The overall prevalence of overweight and obesity was 17.02 and 28.37% in boys and 9.33 and 0% in girls, respectively. The patterns of PA were changing within elements and between sexes. Both groups of boys were more active than girls during breakfast and lunch periods (p < 0.001 for all). A significant difference in favor of boys was also observed between the two groups of boys and the group of adolescent girls regarding after-school physical activity (p < 0.05 for all). Prepubescent boys reported being generally less active during the previous 7 days than their female counterparts and adolescent peers. Sedentary behaviors did not differ between all groups. Playing video games and using laptops were the parameters significantly associated with BMI.

Conclusions

This study noted that the prevalence of overweight and obesity was more pronounced in boys than in girls. However, boys were more active but had the same degree of sedentary behavior as girls. Physical activity across the days of weekly, video games, and laptop use were the parameters that most affected BMI.

Family promotion of children's healthy lifestyles during the COVID-19 pandemic in light of Saudi Vision 2030

Objective

This study aims to determine the role of the family in promoting an active and healthy lifestyle for children aged 3-12 years during the COVID-19 pandemic in the Qassim region in light of Saudi Arabia's Vision 2030 program.

Background

This study is important in defining the role of the family in promoting an active lifestyle for children during the COVID-19 pandemic because the family is primarily responsible for promoting a healthy lifestyle for children.

Method

We evaluated responses of 320 parents completing an online survey about their children's physical health during the pandemic.

Results

The results showed a low level of children's physical activity and excessive use of electronic devices. Late bedtimes were evident and defined as midnight or later. As well, however, families knew the necessary information about COVID-19 and maintained the children's preventive measures. The families were aware of the child's consumption of a healthy diet. They helped the child complete studies through distance education. The families supported the child's psychological well-being and helped them develop some entertainment plans.

Conclusions

Although the family plays an important role in promoting the active and healthy lifestyle of the child, there is still a need for more awareness regarding the child's practice of physical activity, healthy sleep habits, and correct use of electronic devices.

Implications

Programs should be established to increase family awareness of the guidelines of the World Health Organization and the Saudi Ministry of Health regarding the child's physical activity, sleep habits, and the use of electronic devices.

Trends in Obesity and Obesity-Related Risk Factors among Adolescents in Korea from 2009 to 2019

This study was conducted to identify the trends in obesity prevalence among adolescents and changes in the risk factors related to obesity. The study analyzed secondary data obtained from Korean Youth Risk Behavior Web-based Surveys conducted from 2009 to 2019. The Korean Youth Risk Behavior Web-based Survey is an annual survey of a nationwide representative sample of enrolled students aged 13–18 years in middle and high schools in Korea. Linear and trend analyses showed that the prevalence of obesity increased by 0.47% on average annually; this increase was statistically significant. Healthy food intake decreased significantly, but the prevalence of unhealthy food intake and the prevalence of skipping breakfast increased significantly. Vigorous-intensity physical activity, physical activity for over 60 min a day, and muscle-strengthening exercise for more than 3 days a week increased significantly, but so did the adolescents’ sedentary time. Therefore, health care providers and public policymakers need to actively manage adolescent obesity, which has been continuously increasing since 2009. In addition, long-term trends in obesity-related risk factors such as physical activity and dietary behaviors need to be considered in the development of obesity management strategies.

Social Cognitive and Ecological Factors Influence Physical Activity Among Thai Adolescents

BACKGROUND

The aim of this study was to examine the intrapersonal, social, and physical environmental factors associated with physical activity (PA) practice in Thai adolescents.

METHODS

A total of 5536 adolescents aged 14-17 years participated in the survey. Confirmatory factor analyses and structural equation modeling were conducted to determine associations between intrapersonal, social, and physical environmental factors with PA.

RESULTS

The mean age of participants was 15.50 (1.12) years. Community environment had an overall effect on PA (β = 0.08). Perceived family support had direct (β = -0.14) and indirect (β = 0.17) effects on PA through perceived barriers (β = 0.14). Perceived barriers were directly related to PA (β = -0.23) and indirectly (β = -0.16) related to PA through self-efficacy (β = -0.14) and through perceived benefits and self-efficacy (β = -0.02). Perceived usefulness was indirectly related to PA through self-efficacy (β = 0.07). Self-efficacy was directly related to PA (β = 0.43). Girls were more likely to report more perceived barriers (βtotal = 0.13). The model explained 45% of the variance in PA.

CONCLUSION

Self-efficacy and perceived barriers are important intrapersonal factors, whereas perceived family support is an important interpersonal factor for PA among Thai adolescents.

Prevalence of Health Problems Targeted by the National School-Based Screening Program among Primary School Students in Saudi Arabia, 2019

The Saudi Ministry of Health (MOH) established a National School-Based Screening Program (NSBSP) for health screening of schoolchildren. Students from specific grades were systematically screened for several health problems, including obesity, visual and auditory problems, dental cavities, scoliosis, and attention-deficit/hyperactivity disorder (ADHD). This cross-sectional study aimed to determine the prevalence of these health problems among primary school students based on secondary data obtained from the NSBSP. We included 444,259 screened school children from the first and fourth grades of 50% of the selected schools (both private and public) across the Kingdom of Saudi Arabia (KSA) during the academic year 2018-2019. Among them, the most prevalent health problems identified were dental cavities (38.7%), eye refractory errors (10.9%), and overweight and obesity (10.5%); the less prevalent problems included ADHD (2.81%), auditory problems (0.6%), and scoliosis (0.48%). A greater prevalence of most health problems was observed in girls more than boys. The NSBSP successfully aided the detection of health conditions with high and low prevalence among primary school students in the KSA, and thus, the identification of health problems of specific concern. Implementation of effective school health services for the prevention, early detection, diagnosis, and treatment of these health problems are imperative.

Physical Activity Levels of 1053 Omani 4th Grade Children: The Importance of Gender and Sport Team Participation in Achieving 60 Minutes of Daily Moderate-to-Vigorous Physical Activity

Sufficient daily physical activity is associated with many positive mental, physical, and societal benefits in children. Unfortunately, most children worldwide do not achieve recommended levels of daily physical activity (PA), and a majority of evidence is from Western countries and based on subjective measures. This study examined the prevalence and correlates of objectively measured PA levels among Omani children in 2017 (pre-pandemic). A two-stage cluster sampling was used to recruit the 4th grade children across five regions of Oman. A final analytic sample included 1053 children (504 boys, 549 girls) with a mean age of 9.21 years old. PA was objectively measured using a wrist-worn Polar Active Watch during three consecutive school days. Screen-based sedentary behaviors and other PA-related behaviors were subjectively measured. On average, boys were less sedentary and more active, with a greater likelihood of meeting current recommendations when compared with girls. The self-reported time spent in screen-based sedentary behaviors was relatively low for both boys and girls and was not associated with PA; however, sports team participation was associated with a greater likelihood of meeting the current recommendation. The present study provides empirical data on objectively measured PA in Omani children. The gender disparities concerning daily PA, including sports team participation, should receive further attention.