Lifestyle and Dietary Behaviors among Saudi Preschool Children Attending Primary Health Care Centers, Eastern Saudi Arabia

Prevalence of Functional Gastrointestinal Disorders and Associated Risk Factors Among Preschool Children in the City of Jeddah and Surrounding Areas: A Cross-Sectional Study

Background/Objectives: Functional gastrointestinal disorders (FGIDs) affect children's daily activities and overall performance due to gastrointestinal symptoms. This study assesses the prevalence and types of FGIDs in children living in Jeddah City and its countryside. It also examines factors that contribute to the incidence of these disorders and their impact on children's lifestyles. Methods: This cross-sectional study was conducted among 285 mothers of preschool children enrolled in kindergartens during the academic year 2020-2021. The Rome IV Diagnostic Questionnaire was sent out online through kindergartens to be filled out by the children's mothers. The questionnaire assessed the prevalence of FGIDs subjectively through symptoms and their frequency. Results: Among the 285 participants, 9% (n = 27) fit the diagnostic criteria for FGIDs. Common FGIDs included functional constipation, 3.5% (n = 10); postprandial distress syndrome, 2.4% (n = 7); functional abdominal pain-not otherwise specified, 1% (n = 3); and functional epigastric pain, 0.7% (n = 2). Significant risk factors for developing FGIDs among the children in the sample included being a preterm baby (p < 0.01), being previously diagnosed with a gastrointestinal condition (p < 0.010), having a family history of diarrhea or nausea and vomiting (p < 0.001 and p < 0.01, respectively), skipping lunch at kindergarten (p < 0.01), and having pre-existing food allergies (p < 0.01). Conclusions: FGIDs were prevalent among 9% of children in Jeddah City and its countryside. Functional constipation was the most common disorder. Factors associated with FGIDs in children included preterm birth, being previously diagnosed with a GI condition, a family history of gastrointestinal conditions, irregular eating habits, and food allergies.

Knowledge, attitude and purchasing behavior of Saudi mothers towards food additives and dietary pattern of preschool children

Background

There are over 506 children's products containing one or more types of additives. Maternal awareness of these additives is essential for the health of preschool-aged children, as this period is vital for children's growth and development. This study aims to assess the knowledge, attitudes, and purchasing behaviors related to food additives among mothers living in the western region of Saudi Arabia, as well as the dietary patterns of preschool children.

Method

A cross-sectional study was conducted using an online survey with a convenience sample of 521 mothers of preschool-aged children (3-5 years old). The survey gathered data on the child's age, number of children, the youngest child's weight and height, food intolerance, tooth decay, as well as the dietary patterns of preschool children. It also assessed the mother's knowledge, attitude, and purchasing behaviors related to food additives.

Results

The study found that 46.6% of mothers demonstrated good knowledge of food additives, while 56.0% demonstrated fair attitudes and 78.5% good purchasing behavior regarding additives. Additionally, the majority of mothers reported favorable dietary patterns for their preschool-aged children. "Biscuits and crackers" had the highest consumption frequency (4.98 ± 1.50), with 36.7% of children consuming them once daily, while "Soft beverages" had the lowest consumption frequency (2.73 ± 2.04), with 46.6% of children never consuming them. Statistically significant differences were identified between mothers' knowledge and their age, education level, occupation status, and economic status (p < 0.05). ANOVA results also indicated a statistically significant difference between mothers' attitudes and occupation status (p < 0.05). Furthermore, there were significant positive correlations between mothers' knowledge of food additives and their attitudes (r = 0.293) and purchasing behaviors (r = 0.284) related to additives.

Conclusion

The findings suggest that mothers possess a relatively good level of knowledge of food additives and hold fair attitudes toward them, tending to result in healthier purchasing behaviors and dietary practices for their preschool-aged children. To increase awareness, nutrition intervention programs are required across various socio-economic groups of mothers in the western region of Saudi Arabia. These programs can significantly contribute to promoting healthier dietary practices for preschool-aged children and improving overall family health and well-being.

Assessing the Body Composition of "Picky Eaters" Using Body Impedance Analysis: An Experience From a Tertiary Care Center

BACKGROUND

Picky eating might be associated with a higher risk of being underweight and poor growth. This study aimed to investigate if picky eaters aged between three and 12 years showed differences in height, weight, and body composition compared to their non-picky peers using a body impedance analysis (BIA).

METHODS

This cross-sectional study was conducted between March 1, 2022, and July 31, 2022, on children aged three to 12 years who presented to the outpatient pediatric clinics at Al Habib Ar Rayyan in Riyadh, Saudi Arabia. Body composition was measured using BIA after manually inserting the height, gender, and age into the machine, where body mass index (BMI), fat mass, and skeletal muscle mass were recorded. Participants were classified as under/normal/over for each body composition measurement.

RESULTS

A total of 2234 children were entered into the final data analysis. Our analysis showed that 1917 (85.8%) were Saudis and 1117 (50%) were males. The mean age of participants was 6.08±2.01 years and 1151 (51.5%) were in the pre-school age. The reported prevalence of picky eaters was 1684 (75.4%), of whom, 606 (27.0%) were selective eaters, 365 (16.2%) were low appetite eaters, and 723 (32.2%) were both selective and low appetite eaters. Being underweight was significantly more common among the picky eaters 487 (28.9%) compared to those non-picky eaters 55 (10.0%) (p<0.001). Significantly, 1280 (76%) picky eaters had below-average skeletal muscle mass compared to 151 non-picky eaters (27.5%) (p<0.001). The low appetite picky eater group had more under skeletal muscle mass children 277 (75.9%) compared to the selective picky eater group 412 (68.0%) (p=0.009). Additionally, the low appetite group possessed lower muscle ratios (p=0.012) and were more underweight than the selective group (p<0.001). Furthermore, the low appetite group showed a higher percentage of children below the 3rd percentile in the height for age category (p=0.003) compared to the selective group.

CONCLUSION

This study is the first of its kind in Saudi and globally to evaluate body composition using BIA among children. The study showed that picky eating is more associated with underweight children and low muscular mass. Despite the normal BMI, height, and weight of a picky eater, their skeletal muscle mass might be less than average, which could be associated with an increased risk of morbidity.

Gut microbiota analyses of inflammatory bowel diseases from a representative Saudi population

BACKGROUND

Crohn's diseases and ulcerative colitis, both of which are chronic immune-mediated disorders of the gastrointestinal tract are major contributors to the overarching Inflammatory bowel diseases. It has become increasingly evident that the pathological processes of IBDs results from interactions between genetic and environmental factors, which can skew immune responses against normal intestinal flora.

METHODS

The aim of this study is to assess and analyze the taxa diversity and relative abundances in CD and UC in the Saudi population. We utilized a sequencing strategy that targets all variable regions in the 16 S rRNA gene using the Swift Amplicon 16 S rRNA Panel on Illumina NovaSeq 6000.

RESULTS

The composition of stool 16 S rRNA was analyzed from 219 patients with inflammatory bowel disease and from 124 healthy controls. We quantified the abundance of microbial communities to examine any significant differences between subpopulations of samples. At the genus level, two genera in particular, Veillonella and Lachnoclostridium showed significant association with CD versus controls. There were significant differences between subjects with CD versus UC, with the top differential genera spanning Akkermansia, Harryflintia, Maegamonas and Phascolarctobacterium. Furthermore, statistically significant taxa diversity in microbiome composition was observed within the UC and CD groups.

CONCLUSIONS

In conclusion we have shown that there are significant differences in gut microbiota between UC, CD and controls in a Saudi Arabian inflammatory bowel disease cohort. This reinforces the need for further studies in large populations that are ethnically and geographically diverse. In addition, our results show the potential to develop classifiers that may have add additional richness of context to clinical diagnosis of UC and CD with larger inflammatory bowel disease cohorts.

Preschoolers' and Mothers Dietary Practices and Compliance with the 24-h Movement Guidelines: Results of Oman's National Nutrition Survey

Introduction: Little is known on the nutritional and lifestyle variables of preschool children in Oman. This study analyzed data of the 2017 Oman National Nutrition Survey to assess the prevalence and interrelationships between dietary and movement variables among preschool children, aged 2–5 years. Methods: Household visits of a nationally representative sample evaluated mothers and children’s dietary, sleep and physical activity practices; media exposure; and anthropometric and sociodemographic variables. Results: Dyads of mothers and pre-school children aged 2–5 years (n = 1771) were assessed. Childhood overweight/obesity was prevalent in 2% of the sample. Over 54% of children consumed sweetened items and/or French fries or chips at least once daily. Over 65% of children had fruits and/or vegetables once daily or less. Mothers had healthier dietary and movement habits compared to their offspring. Compliance with media exposure was the lowest among mothers and children. Multivariate regression revealed children’s increased sweet intake was the only significant predictor of excess weight in children. Conclusion: This study revealed a low prevalence of overweight/obesity among preschool children in Oman. Children had an acceptable compliance with sleeping recommendations, yet limited adherence to media exposure, activity, added sugar and fruits and vegetables guidelines.

Association of Healthy Diet with Recovery Time from COVID-19: Results from a Nationwide Cross-Sectional Study

The world is still in need of an effective therapy to treat coronavirus disease-19 (COVID-19). This cross-sectional study was conducted on COVID-19 survivors in Saudi Arabia to investigate the influence of a healthy diet on the recovery time from COVID-19. A questionnaire was developed to assess participants' dietary habits, based on the 2015 Dutch food-based dietary guidelines. A total of 738 COVID-19 survivors participated in the study, of whom 237 (32.1%) were hospitalized for COVID-19 treatment while 501 (76.9%) were not hospitalized, and 320 (43.4%) were females and 418 (56.6%) were males. Overall, no significant difference was noted in healthy diet score between males and females; however, this score was significantly lower for Saudis compared to non-Saudis. Among the non-hospitalized patients, eating a more healthy diet was associated with a shorter duration of recovery (p < 0.05) and was significantly affected by gender (15.8 ± 9.3 male vs. 12.1 ± 8.9 female; p < 0.001) and marital status (12.1 ± 8.4 singles vs. 13.7 ± 9.3 married vs. 16.1 ± 11.8 divorced; p < 0.05). In contrast, no significant correlation was found with age or BMI. In this study, a more healthy diet was associated with a shorter duration of recovery from COVID-19. However, further studies are needed to thoroughly investigate the relationship between diet and recovery time from COVID-19.

Impact of smoking cessation, coffee and bread consumption on the intestinal microbial composition among Saudis: A cross-sectional study

The gut microbiota is often affected by the dietary and lifestyle habits of the host, resulting in a better efficacy that favors energy harvesting from the consumed food. Our objective was to characterize the composition of gut microbiota in adult Saudis and investigate possible association with lifestyle and dietary practices. Feces from 104 Saudi volunteers (48% males) were tested for microbiota by sequencing the V3-V4 region of bacterial 16S ribosomal RNA (rRNA). For all participants, data were collected related to their lifestyle habits and dietary practices. The relative abundance (RA) of Fusobacteria was significantly higher in normal weight Saudis (P = 0.005, false discovery rate-FDR = 0.014). Individuals who consumed more coffee presented marginally significant more RA of Fusobacteria (P = 0.02, FDR = 0.20) in their gut microbiota compared to those reporting low or no coffee intake, but the RA of Fusobacteria was significantly higher in smokers compared to non-smokers (P = 0.009, FDR = 0.027). The RA of Fusobacteria was also significantly higher in those reporting daily consumption of bread (P = 0.005, FDR = 0.015). At the species level, the gut microbiota of people who consumed coffee was dominated by Bacteroides thetaiotaomicron followed by Phascolarctobacterium faecium and Eubacterium rectale. Similarly, the gut microbiota of smokers was also enriched by B. thetaiotaomicron and Lactobacillus amylovorus. Smoking cessation, bread and coffee consumption induce changes in the intestinal microbial composition of Saudis. This indicates the significance of diet and lifestyle practices in the determination of the composition of the gut microbiota, which could possibly lead later to changes in metabolic profile and weight.

Gut Microbiota: A Contributing Factor to Obesity

Obesity, a global epidemic of the modern era, is a risk factor for cardiovascular diseases (CVD) and diabetes. The pervasiveness of obesity and overweight in both developed as well as developing populations is on the rise and placing a huge burden on health and economic resources. Consequently, research to control this emerging epidemic is of utmost importance. Recently, host interactions with their resident gut microbiota (GM) have been reported to be involved in the pathogenesis of many metabolic diseases, including obesity, diabetes, and CVD. Around 10(14) microorganisms reside within the lower human intestine and many of these 10(14) microorganisms have developed mutualistic or commensal associations with the host and actively involved in many physiological processes of the host. However, dysbiosis (altered gut microbial composition) with other predisposing genetic and environmental factors, may contribute to host metabolic disorders resulting in many ailments. Therefore, delineating the role of GM as a contributing factor to obesity is the main objective of this review. Obesity research, as a field is expanding rapidly due to major advances in nutrigenomics, metabolomics, RNA silencing, epigenetics, and other disciplines that may result in the emergence of new technologies and methods to better interpret causal relationships between microbiota and obesity.