Nutrition, weight status and physical activity in Saudi Arabia : : with special focus on women

Sammanfattning: 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.