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Nutrition, weight status and physical activity in Saudi Arabia: with special focus on women
Karolinska Institutet.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The prevalence of obesity and physical inactivity in the Kingdom of Saudi Arabia (KSA) has been escalating to levels that are threatening the public health of the entire KSA population, especially the female population. However, both physical activity (PA) education and research have only focused to a limited extent on women’s health status.

Objectives: The overall aim of this thesis was to increase our knowledge on the current health situation of both a hospital-based and a healthy female population in the KSA with regard to nutritional status, habits, practices, and PA.

Methods: This thesis contains four Papers (I–IV) whose data were collected in the southwestern region of the KSA. A total of 166 hospital patients (60 women and 106 men) were screened regarding their nutritional status, 15 registered nurses were interviewed, and 663 female university students self-reported their PA levels and nutritional habits and had their anthropometrics measured. The data were analyzed using SPSS (Papers I, III, and IV) and latent content analysis (Paper II).

Findings: Significantly more women (29%) than men (10%) were found to be obese in Paper I. There was no significant difference in the prevalence of patients at risk for undernutrition between women and men (40% vs. 38%), but significantly more women than men received care targeting undernutrition in the hospital-based study population. Individual interviews with nurses in Paper II showed that nurses were “bridging malnutrition and physical inactivity” by identifying “potentials to provide good nutrition and PA” to the patients and their relatives and by stating their “ability to provide patients with good nutrition and PA”. The majority (57.0%) of the female participants in Papers III and IV were of normal weight, 19.2% were underweight, and 23.8% were overweight/obese. The mean body mass index (BMI) of the students in relation to high, moderate, and low levels of PA was 23.0, 22.9, and 22.1, respectively. Significant associations were found between PA and marital status, the mother’s education level, the participant’s BMI, and residential proximity to parks and recreational facilities. Several variables were found to correlate with dietary habits, underweight, and overweight/ obesity. Of special interest were the negative and positive associations between the number of siblings and the participants’ BMI and dietary habits.

Interpretations: The results of these studies emphasize the coexistence of underweight and overweight/obesity among both healthy persons and hospital patients. The total prevalence of overweight/obesity among both hospital patients and female university students is higher in the KSA compared to other international settings. Furthermore, the fact that patients at risk of undernutrition or with manifest undernutrition do not get adequate nutritional care is understandable given our results showing that the interviewed nurses were not given the authority to provide the nutritional care that they thought necessary.

Conclusions: This thesis suggests that the promotion of PA and nutritional education for women should be a major target for policy makers as well as public health practitioners and researchers. The goal for such activities would be to prevent the inevitable health complications related to poor dietary habits and lack of PA.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet , 2014. , 61 p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hkr:diva-13456Libris ID: 16309033ISBN: 978-91-7549-329-9 (print)OAI: oai:DiVA.org:hkr-13456DiVA: diva2:784341
Available from: 2015-01-29 Created: 2015-01-29 Last updated: 2015-01-29Bibliographically approved
List of papers
1. Undernutrition risk, overweight/obesity, and nutritional care in relation to undernutrition risk among inpatients in southwestern Saudi Arabia: a hospital-based point prevalence study
Open this publication in new window or tab >>Undernutrition risk, overweight/obesity, and nutritional care in relation to undernutrition risk among inpatients in southwestern Saudi Arabia: a hospital-based point prevalence study
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2011 (English)In: Journal of Nutritional Disorders & Therapy, Vol. 1, no 2, 104- p.Article in journal (Refereed) Published
Abstract [en]

Background:

Undernutrition is a problem in institutional care, where 20–46% of all inpatients are classified as being “at nutritional risk”. This study explores the prevalence of undernutrition risk and overweight/obesity and the targeting of nutritional care in relation to undernutrition risk among inpatients in southwestern Saudi Arabia.

Methods:

A cross-sectional, point prevalence study was carried out in a Central hospital in southwestern Saudi Arabia. The subjects were inpatients, over the age of 18 who had their nutritional status assessed. Moderate/high undernutrition risk was defined as the occurrence of at least two of: weight loss, low BMI, and/or eating difficulties. Overweight/obesity was graded by using Caucasian and Asian cut-offs for BMI.

Results:

Out of 219 patients 166 (76%) agreed to participate (106 men and 60 women) with a significantly higher drop-out among women (n=35, 37% vs. men n=18, 14%). There was no significant difference in the prevalence of moderate/high undernutrition risk between men and women (40% vs. 38%) but more women (29% or 40%, depending on cut-off) than men (10% or 23%) were obese. Among patients at moderate/high undernutrition risk, more women (61%) than men (31%) were served small portions.

Conclusions:

There is a need to increase awareness about nutrition among nurses, to implement nutritional guidelines and to do more research regarding overweight/obesity among the female population. Motivational strategie  need to be developed to focus on increasing the Saudi female participation in research.

Keyword
Nutrition, eating, MEONF, MEOF, Saudi Arabia
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-8867 (URN)10.4172/jndt.1000104 (DOI)
Available from: 2012-01-10 Created: 2012-01-10 Last updated: 2015-01-29Bibliographically approved
2. Nurses bridging malnutrition and physical inactivity: nurses’ views and experiences of caring for malnourished patients in surgical settings in Saudi Arabia – A qualitative study
Open this publication in new window or tab >>Nurses bridging malnutrition and physical inactivity: nurses’ views and experiences of caring for malnourished patients in surgical settings in Saudi Arabia – A qualitative study
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2014 (English)In: BMC Nursing, Vol. 13, no 29Article in journal (Refereed) Published
Abstract [en]

Background

Although the occurrence of malnutrition in hospitals is a growing concern, little is known about how hospital staff understand the care that nurses provide to patients with malnutrition. The purpose of this study was to explore nurses’ views and experiences of caring for malnourished patients in Saudi Arabia (KSA).

Methods

Using a qualitative explorative design, fifteen nurses were interviewed as part of a purposive sample hospital staff. The transcripts were analyzed using latent content analysis.

Results

The nurses spontaneously and consistently linked malnutrition with physical inactivity. The two main categories, which emerged, were: ‘Potentials for nurses to provide good nutrition and physical activity’, and ‘Having the ability but not the power to promote proper nutrition and physical activity’. These arose from the subcategories: Good nursing implies providing appropriate health education; Acknowledging the Mourafiq (sitter) as a potential resource for the nursing, but also as a burden; Inadequate control and lack of influence; Cultural diversity and lack of dialog; and Views of women’s weight gain in KSA society.

Conclusions

The nurses felt they have the capacity and passion to further improve the nutrition and activity of their patients, but obstacles in the health care system are impeding these ambitions. The implications for nursing practice could be acknowledgement of the nurses’ views in the clinical practice; culturally adjusted care, improved communication and enhanced language skills.

Keyword
Malnutrition, Physical activity, Saudi Arabia, Nursing, Nurse’s views
National Category
Nursing
Identifiers
urn:nbn:se:hkr:diva-13458 (URN)10.1186/1472-6955-13-29 (DOI)
Available from: 2015-01-29 Created: 2015-01-29 Last updated: 2016-12-01Bibliographically approved
3. Female university students’ physical activity levels and associated factors: a cross-sectional study in southwestern Saudi Arabia
Open this publication in new window or tab >>Female university students’ physical activity levels and associated factors: a cross-sectional study in southwestern Saudi Arabia
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2013 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 10, no 8, 3502-3517 p.Article in journal (Refereed) Published
Abstract [en]

Background: The high prevalence of physical inactivity in Saudi Arabia is a growing challenge to public health. This study aimed to examine the prevalence of physical activity (PA) and associated factors among female university students. Methods: This cross-sectional study involved 663 randomly selected female university students who completed the Arab Teens Life Style questionnaire. Data included measurements of anthropometric, socioeconomic and environmental factors, as well as self-reported PA. Ordinal regression was used to identify associated factors with low, moderate and high PA levels. Results: The mean age of participants was 20.4 years (SD 1.5). Mean BMI of the students in relation to PA were 23.0, 22.9, 22.1 for high, moderate and low levels of activity, respectively. The analysis revealed significantly higher PA levels among married students, those with high educated mothers, and those who lived far from parks, and lower activity levels among underweight students. Conclusions: This study raises four important determinants for female university students’ PA levels. These factors could be of great importance in the endeavor to prevent the health-threatening increase in physical inactivity patterns and thus non-communicable diseases and obesity where the focus should be on the specific situation and needs of women in Saudi Arabia.

Keyword
epidemiologic methods, Middle East, women’s health, Saudi Arabia, physical activity, female university students, cross-sectional studies, socioeconomic factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hkr:diva-10903 (URN)10.3390/ijerph10083502 (DOI)000330526700026 ()
Available from: 2013-08-13 Created: 2013-08-13 Last updated: 2015-01-29Bibliographically approved
4. Associated factors to female university students’ dietary habits and body weight in Saudi Arabia
Open this publication in new window or tab >>Associated factors to female university students’ dietary habits and body weight in Saudi Arabia
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(English)Article in journal (Refereed) Submitted
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hkr:diva-13459 (URN)
Available from: 2015-01-29 Created: 2015-01-29 Last updated: 2015-01-29Bibliographically approved

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