Ghabashi, Mai Adil;
(2023)
Preschool obesity in the Kingdom of Saudi Arabia; Determinants and Feasibility of a Healthy Lifestyle Intervention.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background: The Kingdom of Saudi Arabia (KSA) ranks among the world’s top 10 countries for obesity prevalence. However, little is known about the associated risk factors in young Saudi preschool children. Thus, as a first step, a systematic review was conducted as part of this PhD project. A high prevalence in young children was confirmed; however, the number of studies investigating risk factors was limited. Lifestyle interventions addressing preschool obesity in the KSA are lacking. Aims: This thesis aimed to improve understanding of the determinants of obesity in Saudi preschool children. It further aimed to develop a culturally tailored lifestyle intervention to address the problem in this age group and evaluate its feasibility in the KSA. Methods: A mixed methods approach was used. Four studies were conducted to achieve these aims. Results: Several modifiable risk factors for preschool overweight and obesity in the KSA were identified by the risk factors study. For example, the BMI z-score was 0.4 units higher per unit increase on the fast-food preference scale (p=0.02), 0.2 z-scores higher in children who watched TV for more than one hour compared to those that watched for a shorter duration (p=0.003), and 0.6 z-scores higher in children who received informal care (e.g. by grandparents) compared to children who received parental care (p=0.003). In addition, the qualitative research found that the obesogenic environment and cultural norms in the KSA were identified as risk factors for preschool obesity in the KSA. Feedback from both studies was used to carry out a cultural adaptation of the Trim Tots intervention to make it acceptable to the Saudi population. The feasibility of the adapted intervention was confirmed using a pilot RCT. The intervention was also found to be helpful in increasing the daily intake of fruits and vegetables by 0.5 portions/day (p=0.01) and 0.6 portions/day (p=0.008) respectively. Conclusion: A culturally adapted intervention for obesity prevention in Saudi preschool children was feasible. Further evaluation of the feasibility and testing efficacy of the intervention in a wider population is needed.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Preschool obesity in the Kingdom of Saudi Arabia; Determinants and Feasibility of a Healthy Lifestyle Intervention |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10163836 |
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