Saudi Adolescents Research Articles

Nutritional Behaviour of Adolescents and the Impact of Covid-19 on A Diet in Saudi Arabia

Background In recent decades, changes in food consumption among adolescents in Arabic speaking countries, including The Kingdom of Saudi Arabia (KSA), has resulted in increased burden of overweight and obesity. COVID-19 related restrictions have further impacted lifestyle and diet among adolescents in KSA. Aim The present study aimed to assess the knowledge, attitude, behaviour and dietary patterns of adolescents and the impact of the COVID-19 pandemic related restrictions on these behaviours. Methods A cross-sectional study was conducted in six intermediate schools among 1500 adolescents (11-15 years) via an anonymous online survey. The Chi Square test was used to compare gender stratified nutritional knowledge, attitude and behaviour of adolescents and the impact of COVID-19 related restrictions. To determine the factors associated with nutritional change during COVID-19 lockdown, logistic regression was employed using the categorisation of nutritional change during COVID-19 restrictions versus no change in univariate and multivariate analyses. Results A good level of nutrition-related knowledge and attitude was demonstrated both by female and male students, with 66% and 57% of participants scoring above the median of the total possible knowledge and attitude score, respectively. After adjusting for all variables, higher nutrition knowledge score predicted students to be less likely to report increased food consumption during COVID-19 restrictions, whereas students with higher nutrition attitude scores and with a higher risk of increased food consumption were more likely to increase food consumption during COVID-19 restrictions. Conclusions Unhealthy dietary habits among Saudi adolescents are of paramount public health concern and the COVID-19 restriction period exacerbated the pre-pandemic nutrition-related unhealthy behaviours. Therefore, school-based interventions aiming to promote healthy lifestyles and the wellbeing of Saudi adolescents and use of qualitative recall dietary diary is also crucial to develop programs that prevent unhealthy lifestyles in adolescents in Saudi Arabia.

Relation between asthma clinical presentation and diet patterns among adolescents living in Saudi Arabia: Evidence from national school-based study

Background: Dietary intervention based on evidence-based guidelines should be introduced into the clinical management of Asthmatic patients to promote overall health benefits and disease control. However, there is limited evidence in the Saudi medical literature. Objective of the study: To assess the association between diet patterns and asthma symptoms in Saudi adolescents. Subjects and Methods: In total, 4086 Saudi adolescents were recruited for the study. Data for this study were sourced from a national survey conducted by the Saudi Ministry of health. Results: 13.3% (n=543) of adolescents reported current wheeze in the past 12 months. The results showed that almost half of all adolescents reported unhealthy diet consumption on most or all days and a healthy diet was consumed at least twice per week in a third of them. The most important clinically relevant finding was a positive association between high weekly consumption of an unhealthy diet with asthma symptoms. Conclusion: Our findings suggest that the positive impact of diet on asthma control is encouraging. A healthy diet including fruits, vegetables, and fish, is implicated in the mitigation of asthma symptoms and severity.

Cyberbullying and cybervictimization on digital media platforms: the role of demographic variables and parental mediation strategies

This study aimed to investigate adolescents’ perspectives on different parental mediation strategies in adolescent cyberbullying and cybervictimization. It also investigated the roles of the adolescent’s age and gender as moderators. An online survey was conducted among 387 Saudi adolescents aged 12–17 years. The results show that decreases in active, restrictive, internet safety, and monitoring strategies were significantly associated with increases in cyberbullying. However, only restrictive and internet safety strategies were significant contributors to cybervictimization, both of which followed the same pattern of a negative relationship between the mediation strategy and cybervictimization. Furthermore, the internet safety strategy had a significant three-way interaction with age and gender in associating with cyberbullying, while the restrictive strategy had a significant three-way interaction with age and gender in associating with cybervictimization.

Deviant peer affiliation as a mediating variable in the relationship between family cohesion and adaptability and internet addiction among adolescents.

The aim of this study was to investigate the mediating role of deviant peer affiliation in the relationship between family functioning, specifically family cohesion and family adaptability, and internet addiction among Saudi adolescents. A sample of 946 Saudi Arabian adolescents with a mean age of 18.5 years (SD = 3.06) was obtained using snowball sampling. Path analysis using structural equation modeling was conducted. The results indicated significant negative relationships between family cohesion and internet addiction and between deviant peer affiliation and family cohesion, and a significant positive relationship between family adaptability and internet addiction. In accordance with prior research, we found a significant positive relationship between deviant peer affiliation and internet addiction, but in terms of mediation, deviant peer affiliation mediated only the relationship between family cohesion and internet addiction. In conclusion, it is important for the effectiveness of interventions and preventive programs that aim to address deviant peer affiliation and internet addiction in adolescents to enhance the well-being of their family systems.

Effect of Caffeinated Energy Drink Consumption on Cardio-Reproductive Profile among Adolescent Saudi Men

Effect of Caffeinated Energy Drink Consumption on Cardio-Reproductive Profile among Adolescent Saudi Men

Effect of Caffeinated Energy Drink Consumption on Cardio-Reproductive Profile among Adolescent Saudi Men

Effect of Caffeinated Energy Drink Consumption on Cardio-Reproductive Profile among Adolescent Saudi Men

Predictors of runaway behavior in adolescent Saudi girls

The phenomenon of girls running away from home is an increasingly widespread social challenge confronted by families, welfare agencies, and governmental organizations in Jeddah, Saudia Arabia. This study compared runaway girls and a control group on various measures and investigated the predictors of runaway behavior among Saudi adolescent girls. A sample of young adolescent girls (N = 77, aged between 14 and 21 years) included a purposive sample of runaways (N = 33), comprised of all the girls living in a social care home in Jeddah who had left their homes at least once, and a control group (N = 44) selected via cluster sampling. The participants were assessed using a demographic questionnaire, the Family Cohesion Scale, and the Basic Psychological Need Satisfaction Scale. Inter-group differences were apparent and differences were also found based on the circumplex model. The results of the stepwise discriminant analysis showed six variables (family cohesion, age, education, number of sisters, number of brothers, and birth order) that remained and explained 80.82% of group membership variation. Lack of family cohesion, along with several demographic variables, can lead to complicated emotional attitudes among adolescent girls which trigger runaway behavior. Although runaway youth services must continue to stay focused on safety and short-term residential care, the underlying causal factors must be identified as well.

An Adolescent With Munchausen's Syndrome: A Case Report

Munchausen syndrome is factitious disorders with unknown etiology. It is characterized by fabrication of signs or symptoms of the disease, as well as alteration of laboratory investigations. People with this syndrome pretend that they are sick and tend to seek treatment at different hospitals. We report this 15-year-old adolescent Saudi girl who came to endocrinology clinic with recurrent hypoglycemic attacks for the last 6 months. Laboratory showed exogenous insulin administration by the patient herself. Munchausen syndrome was diagnosed and patient was referred to psychiatry for follow up.

RETRACTED ARTICLE: Self-perception of malocclusion among Saudi adolescents using the aesthetic component of the IOTN

This study was carried out to assess the self-perception of dental appearance among Saudi adolescents in Qassim province using aesthetic component (AC) of the index of orthodontic treatment need (IOTN) to compare it with an orthodontist’s rating and whether the age and gender had any influence on it. A sample of 600 randomly selected school adolescents comprising 297 (49.5%) males and 303 (50.5%) females with age range of 12–17 years old were included in the study. The AC of the IOTN, was the instrument used to measure the perception of malocclusion by both the school adolescents and the orthodontist. t test and Chi-square statistics were used to analyze the data with statistical significance set at P < 0.05. Majority of the students (86.7%) scored themselves as having an attractive dentition with no need of orthodontic treatment. There was a significant difference between the orthodontists' rating and the students' rating (P < 0.05). Further, the gender was not found to be statistically significant in relation to the self-perception of treatment need (P = 0.123), while the age was found to be statistically significant (P < 0.001). A significant difference was found between the orthodontists' rating and the students' ratings of the attractiveness of their occlusions. The age was found to influence the self-perception of orthodontic treatment need, whereas the gender was not found to have any influence. Therefore, for effective orthodontic treatment plan, the self-perception of dental appearance must be taken into consideration to ensure patient satisfaction.

Awareness and practice regarding use of digital devices and ocular health among Saudi adolescents.

PURPOSE:To review the knowledge of ocular health and practices of digital device usage among adolescent Saudi Arabia population.METHODS:This cross-sectional web-based survey was conducted in 2021 at a university in central Saudi Arabia. We asked questions regarding demographics, knowledge related to computer vision syndrome (CVS), and the use of digital devices for participants’ daily activities. The acceptable grades of knowledge (“excellent” and “good”) and practice scores were associated with the determinants using the nonparametric method of analysis.RESULTS:Of 521 participating students, knowledge about CVS and its relation to digital device usage were excellent in 41 students (7.9%), good in 161 (39%), poor in 300 (57.6%), and very poor in 19 (3.6%). Twenty-eight (5.4%) students scored an “excellent” grade on practices for digital device usage, 216 (41.4%) scored “good,” and 277 (53.2%) scored “poor.” The knowledge score median was 1.0 (interquartile range 1.0; 2.0), and the practice score median was 6.0 (4.0; 9.0). Health studies students had better knowledge than other students (P = 0.004). Smartphone users had worse knowledge than users of other devices (P = 0.017). Females (P < 0.001) and health studies students (P = 0.004) were significantly associated with acceptable practices of using digital devices.CONCLUSIONS:Awareness of ocular health because of abuse of digital devices was poor among participating students. The practice of digital device use was not healthy and needed improvement through preventive measures and counseling.

Dyslipidemia Among Saudi Adolescents: A Nationally Representative Cross-Sectional, Multistage Stratified Cluster Sample Survey (The Jeeluna Study)

Dyslipidemia Among Saudi Adolescents: A Nationally Representative Cross-Sectional, Multistage Stratified Cluster Sample Survey (The Jeeluna Study)

Assessment of the knowledge, practice, and attitude toward acne vulgaris among Saudi adolescents and adults

Background: The third most common skin condition worldwide is acne vulgaris. This condition affects both sexes, with peak prevalence among teenagers and young adults. This study aimed to assess the attitude and behavior of the participants regarding acne and its treatment, and to identify the factors that affect the knowledge, practice, and attitude among adolescents and adults. Methods: A cross-sectional study was conducted involving 1,134 participants in Saudi Arabia between January 7 2021 and February 20 2021. An electronic-based questionnaire of 53 questions was used to collect data from people in Saudi Arabia. Data were analyzed by Statistical Package for the Social Sciences 25. The chi-square test was used to determine the association between qualitative variables. Results: Multiple factors play a role in malpractice and bad attitudes: educational, financial, and cultural. The data show poor knowledge about acne vulgaris, especially for those younger than 21 years old, as they present just above half of the participants with poor knowledge (50.8%); at the educational level, those who had the highest percentage of good knowledge were postgraduates (52.3%), and the highest percentages of poor knowledge were the participants with high-school-level education (65.3%). As for knowledge, the internet was the source that our participants relied on (58.9%), followed by doctors, relatives, and friends. Conclusion: This study indicates poor knowledge and malpractice toward acne vulgaris among the Saudi Arabian population. The data provide a benchmark on the general level of knowledge, attitude, and practices, which can be used to formulate an awareness program.

Self-medication among Saudi students and adolescents: a systematic review

Self-medication among Saudi students and adolescents: a systematic review

Contact Lens Use Patterns and Safety Determinants among Adolescents in Western Saudi Arabia

Background: Besides medical use, cosmetic contact lens (CL) use, associated with several ophthalmological risks, is gaining substantial popularity, especially among the young. Objective: This study aimed to estimate eye risk extent related to CL use among adolescents and understand the association between risk level and CL use patterns and adherence to hygiene and maintenance instructions. Method: A population-based, cross-sectional study was conducted among adolescents aged 14–19 years residing in the Western region of Saudi Arabia. A structured online questionnaire was used to explore the demographic data, CL use patterns, levels of adherence to safety behaviors in CL use, and experienced eye complaints. Result: Of 350 participants, 248 (70.9%) used CLs. There was an overwhelming female predominance (93.1%) among users, with occasional, cosmetic, and combined cosmetic-medical uses without prescription or follow-up being the most frequent pattern. Practices in CL hygiene and care were unsatisfactory, with poorer adherence to maintenance instructions. Clinically significant complications (CSC), defined as the presence of at least one of the clinically significant symptoms or any two other symptoms, were reported in 38.7% of CL users (95% CI = 32.6%–45.1%). CSC risk independently increased after 5 years of use (OR = 3.59, 95% CI = 1.51–8.52) and in double-purpose use (OR = 3.34, 95% CI = 1.52–7.37) by reference to cosmetic use only, while adherence levels to CL removal during sleep (OR = 0.21, 95% CI = 0.05–0.92) and not using CLs after the expiration date (OR = 0.28, 95% CI = 0.11–0.73) were protective factors against CSC. Conclusion: Young Saudi adolescents are highly exposed to unregulated CL use with significant ophthalmological risks. This has several clinical, public health, and policy-making implications. Keywords: Contact lenses, habits, teenagers, Jeddah, cosmetic, refractive

The prevalence and nutritional status of adolescent Saudi girls with disordered eating.

This study on adolescents was intended to assess the prevalence of disordered eating attitudes and the nutritional status of adolescent girls in Saudi Arabia. Disordered eating attitudes and behaviour were assessed using the EAT-26. The type of eating disorder (ED) was determined using Diagnostic statistical manual of mental disorders, fifth edition. The nutritional status of the adolescent girls was determined by measuring their weight and height twice using standard protocols. The BMI-for-age and height-for-age were defined using WHO growth charts. Comparisons between adolescent girls with and without EDs were conducted using SPSS version 26. Eating disorders (EDs) were prevalent among 10⋅2 % of these girls. Other specified feeding or EDs were the most prevalent ED (7⋅6 %), followed by unspecified feeding or eating disorder (2⋅4 %). Anorexia nervosa was common among 0⋅3 % of the girls. The eating disordered adolescents were either overweight (7⋅7 %), obese (10⋅3 %), stunted (7⋅7 %) or severely stunted (2⋅6 %). ANOVA revealed that the BMI-for-age was influenced by age (P = 0⋅028), the type of ED (P = 0⋅019) and the EAT-26 (P < 0⋅0001). Pearson's correlation showed that the EAT-26 score increased significantly with the BMI (r 0⋅22, P = 0⋅0001), height (r 0⋅12, P = 0⋅019) and weight (r 0⋅22, P = 0⋅0001). The early detection of EDs among adolescents is highly recommended to reduce the risk associated with future impaired health status. Nutrition professionals must target adolescents, teachers and parents and provide nutritional education about the early signs and symptoms of ED and the benefits of following a healthy dietary pattern.

Anthropometric Measurements, Sociodemographics, and Lifestyle Behaviors among Saudi Adolescents Living in Riyadh Relative to Sex and Activity Energy Expenditure: Findings from the Arab Teens Lifestyle Study 2 (ATLS-2).

The aim of the study was to examine the anthropometric measurements, sociodemographics, and lifestyle behaviors among Saudi adolescents relative to sex and physical activity (PA). A random cross-sectional survey conducted on Saudi adolescents from secondary schools in Riyadh, using a multistage stratified cluster sampling technique. Measurements included demographics, weight, height, waist circumference, PA, sedentary behaviors (SB), sleep duration, and dietary habits using a validated questionnaire. A total of 1262 adolescents (16.4 ± 0.95 years; 52.4% males) were studied. Overweight/obesity was more than 40%. Physical inactivity among adolescents was 53%, which indicates some improvement over the past years, especially among females. More than 80% of adolescents had over three hours/day of screen time, with no significant sex differences. Insufficient sleep was highly prevalent with gender differences. A large proportion of the participants did not consume daily breakfast (65.7%), vegetables (73.2%), fruits (84.2%), or milk/dairy products (62.4%), whereas significant proportions of the adolescents consumed sugar-sweetened drinks, fast food, French fries/potato chips, cake/donuts, and chocolates/candy on at least three days or more per week. It was concluded that non-daily intake of breakfast and vegetables was significantly associated with lower PA. The updated information can aid in effectively planning and implementing promotional programs toward improving the lifestyle behaviors of Saudi adolescent.

The Negative Impact of Tobacco Smoking on Health-Related Quality of Life among Saudi Adolescents During the COVID-19 Pandemic.

Objective:This study aimed to evaluate the impact of cigarette smoking and health-related quality of life among Saudi secondary vocational students during the COVID-19 pandemic. Methods:A convenience sample of 328 answered a web-based self-administered questionnaire based on the Youth Risky Behavior Monitoring System (YRBSS) plus the Short Form 12 (SF-12) were included in the study. The target population included all Saudi students enrolled at the Secondary Industrial Institute in Dammam, Saudi Arabia, during December 2020 and February 2021. Results:Out of the total of 328 male participants, representing a response rate of 38.59%, the highest percentage of respondents were in the first year (45.4%), the mean age of the participants was 17.73 years with a standard deviation (SD) of 1.85 years. The prevalence of current smokers, past smokers, and never smokers accounted for 30.2%, 21.3%, and 48.5%, respectively. First-year students reported relatively high levels of smoking prevalence and low physical scores of health-related quality of life (HRQoL). The overall mean of HRQoL of current smokers, past smokers, and never smokers accounted for 58.60, 58.38, and 63.66, respectively. In addition, current smokers reported a relatively low physical score of HRQoL 55.73. Conclusion:This is the first report to explore the impact of smoking on HRQoL of Secondary Industrial Institute students in Saudi Arabia during the COVID-19 pandemic. The results indicate that smoking has a negative impact on the quality of life of vocational students. Therefore, a health strategies plan may be developed to improve the quality of life for vocational students in Saudi Arabia.

Obesity, Lifestyle Behaviors, and Dietary Habits of Saudi Adolescents Living in Riyadh (ATLS-2 Project): Revisited after a Ten-Year Period.

Objective: Undesirable lifestyle behaviors are associated with many adverse health outcomes. This study revisited the lifestyle behaviors, dietary habits, and overweight/obesity status of Saudi adolescents from Riyadh during the year 2019/2020. We report on the rationale, design, and methodology of the current study and provide preliminary findings of the changes that occurred between the two cross-sectional studies within the span of a ten-year period. Methods: A comparison was made between two cross-sectional studies, one conducted in 2009/2010 and the other in 2019/2020, using the same design, methods, and instruments. A multistage stratified cluster random sampling technique was used to select adolescents attending public and private secondary schools. Measurements included demographics, weight, height, waist circumference, physical activity (using valid questionnaire and accelerometer), sedentary time, sleep duration, and dietary habits. Results: The total number of participants was 1262 adolescents, of which 52.4% were male, with a mean (SD) age of 16.4 ± 0.95 years. About 41% of paternal and 39.1% of maternal education levels were university degrees. Over 37% of the families earned more than SAR 20,000/month. Body mass index and waist circumference of males was larger than that of females and the overall prevalence of overweight/obesity was 40.5% with significance (p < 0.001) difference between males (47.3%) and females (32.8%). Between 2009/2010 and 2019/2020 datasets, there were significant changes in age (p < 0.001), waist circumference (p < 0.001), screen time (p < 0.001), moderate-intensity physical activity (p < 0.001), vigorous-intensity physical activity (p < 0.001), total physical activity (p < 0.001), and consumption of breakfast (p = 0.015) and fruits (p = 0.002). Conclusion: The most notable change between the two studies was a significant reduction in the prevalence of physical inactivity among Saudi adolescents, which was due to increased levels of moderate-intensity physical activity among Saudi females, as a result of recent positive sociopolitical changes occurring in the country over the past four years. The findings provided rich information that can be used to explore trends in overweight/obesity, lifestyle behaviors, and dietary habits among Saudi adolescents over the past ten-year period.

Gender Differences in Sleep and Mental Health among Saudi Adolescents.

Among adolescents, mental health issues (i.e., stress and depressive symptoms) negatively affect sleep. We assessed whether the association between mental health and sleep varied between genders among Saudi adolescents. A total of 2206 school students (grades 7-12) from 40 randomly selected schools in four cities of Al-Qassim province in Saudi Arabia participated in this cross-sectional study. The survey assessed demography, lifestyle, sleep (12-item Medical Outcomes Study Sleep Scale), depression (Depression, Anxiety, Stress Scale (DASS-21)) and stress (10-item Perceived Stress Scale). Adjusted associations with sleep were tested with linear and logistic regressions. Of the sample, 55% were girls, and their average sleep score was lower than that of the boys (58.7 vs. 63.4, p < 0.001). Girls had worse mental health than boys; the proportion of girls with both severe stress and severe depressive symptoms was three times higher than that of the boys (12% vs. 4%, p < 0.001). For both boys and girls, those with severe depressive symptoms only or both severe depressive symptoms and severe stress had significantly lower sleep scores than those who had neither of the two conditions (reference group). On the other hand, among those who had severe stress only, the sleep score was significantly lower for the girls (p = 0.002) than for the boys (p = 0.19). Overall, girls had a significantly lower sleep score and worse mental health than boys. The association between mental health and sleep significantly differed between the sexes. Severe stress was negatively associated with sleep in girls but not in boys.

Relationship between Physical Activity, Sedentary Behavior, and Anthropometric Measurements among Saudi Female Adolescents: A Cross-Sectional Study.

Overweight and obesity are becoming increasingly prevalent among children and adolescents in Saudi Arabia and are an emerging cause of non-communicable diseases (NCDs). Lifestyle factors, such as insufficient levels of physical activity and sedentary behaviors, are responsible for the increased prevalence of NCDs. This study aimed to determine the association between physical activity levels, sedentary behaviors, and anthropometric measurements in Saudi female adolescents. A cross-sectional study was carried out among 399 healthy female adolescent students aged 13–14 years in Arar, Saudi Arabia. The participants were randomly selected from different schools and their anthropometric measurements were determined. The Physical Activity Questionnaire for Older Children (PAQ-C) and the Adolescent Sedentary Activity Questionnaire (ASAQ) were used to assess their physical activity levels and sedentary behaviors, and an analysis was conducted using IBM SPSS software version 25. A multiple linear regression model was used to determine the association between the variables. The majority of the participants had a normal body mass index (BMI; 79.4%) and waist circumference (WC; 62.4%). A total of 74.4% had waist to height ratio (WHtR) < 0.5. About 92.7% of the participants were not meeting PA recommendations of 60 min of moderate to vigorous physical activity daily. The overall mean time spent on sedentary activities was high on both weekdays and weekend days at 357.64 ± 86.29 and 470.51 ± 147.64 min/day, respectively. Moreover, anthropometric measurement (BMI) was positively associated with age and negatively associated with sedentary behavior on weekends, while WHtR was positively associated with age. The multiple linear regression analysis also showed that age and sedentary behavior significantly predicted BMI among the study participants (F (2, 396) = 4.346, p < 0.014) and age was the only significant predictor of WHtR (F (1, 397) = 16.191, p ≤ 0.001). This study revealed that most of the female Saudi adolescents undertook low levels of activity and high levels of sedentary behaviors. Sedentary behaviors were significantly associated with their BMI. Accordingly, an intervention program on healthy lifestyles is important to improve Saudi female adolescents’ lifestyles.