Investigation of cost and availability of gluten-free food in Jeddah, KSA.

Objective: The prevalence of celiac disease (CD) in KSA is progressively increasing. Consistent adherence to a gluten-free (GF) diet is the only effective CD treatment. The availability and cost of GF food are important factors in adherence to a GFD. The objective of this study was to investigate the cost and availability of GF food in a sample of local stores and supermarkets across Jeddah province in KSA. Method: Eleven supermarkets in Jeddah, KSA, ranging from high budget/quality supermarkets to low-budget stores, were visited. Eight food categories were evaluated, including flour, breakfast cereals, breads, pastas, and snacks (e.g., biscuits, cookies, snack bars, and chips). The availability and cost of GF and gluten containing (GC) items within these food categories were recorded. Each item included in these food categories was counted, and the overall average price was calculated. Results: A total of 233 GF and 24 GC products were found. Supermarket 1 had the highest availability of GF foods (n = 90), followed by supermarket 2 (n = 34), supermarket 3 (n = 30), supermarket 4 (n = 23), supermarket 5 (n = 21), supermarket 6 (n = 18), supermarket 7 (n = 9), and supermarket 8 (n = 8). The median price per 100 g was significantly greater for GF than GC products (p < 0.05). The cost of GF products was significantly higher than that of GC products (p < 0.05); consequently, GF foods were twice as expensive as their GC counterparts. Conclusion: The availability of GF products was limited, and GF products were more expensive than standard GC products. High cost and limited availability are major roadblocks to GFD adherence among people with CD. Governmental organizations must cooperate with healthcare providers and food industries to ensure that GF foods are widely available and affordable for people with CD, to minimize financial pressure and improve health quality.

Predictors of Maternal Knowledge, Attitude, and Practices Toward Vitamin D Supplements in Saudi Infants and Toddlers.

OBJECTIVES: To assess maternal knowledge, attitude, and practices toward vitamin D supplements in Saudi infants and toddlers. In addition, we investigated predictors of maternal knowledge, attitude, and practices related to vitamin D supplements. METHODS: Cross-sectional data of 156 Saudi infants and toddlers were collected from mothers via online survey. Data collected included sociodemographics, maternal knowledge, attitude, and practices toward vitamin D supplements. RESULTS: Our data show a limited maternal knowledge toward vitamin D. Maternal knowledge and attitude as well as maternal knowledge and practices were not correlated. Spearman correlation between maternal attitude and practices was positively low (rs= 0.47). Child's age and family monthly income predicted maternal knowledge towards vitamin D. Maternal age and maternal education level predicted maternal attitude toward vitamin D supplements. Order of the child, maternal age, and maternal employment status predicted maternal practices toward vitamin D supplements in infant and toddlers. CONCLUSIONS FOR PRACTICE: Maternal knowledge, attitude, and practices toward vitamin D supplements can be predicted by certain sociodemographic characteristics. Interventions that focus on improving maternal knowledge, attitude, and practices toward vitamin D supplements are urgently needed.

Associations between dietary intake, physical activity, and obesity among public school teachers in Jeddah, Saudi Arabia.

Objective: We aimed to assess the dietary intake of certain food groups in a representative sample of public-school teachers living in Jeddah city. We also, examined the association of dietary intake with physical activity and obesity among schoolteachers. Methods: The study was a cross-sectional online survey, conducted among 640 (177 male, 463 female) schoolteachers aged between 20 and 62 years old and working in public primary, intermediate, and high schools in Jeddah. Measurements included gender, weight, height, body mass index (BMI), health problems, and lifestyle behaviours, including physical activity levels, smoking status, and dietary intake. Results: Based on gender, number of non-smoking women (94%) was higher than number of non-smoking men (57.1%) (P < 0.001). However, men were more active than women (P = 0.03). Regarding BMI, there were more overweight men than women, while obese women numbered more than men (P = 0.003). There was no significant difference in dietary intake between men and women except that men consumed more soft drinks than women (P = 0.002). Lower physically active schoolteachers were less likely to consume salad (OR = 0.6, 95% CI 0.4-0.9; P = 0.02), vegetables (OR = 0.6, 95% CI 0.3-0.9; P = 0.01), beans and legumes (OR = 0.4, 95% CI 0.2-0.7; P = 0.005), wholegrain bread (OR = 0.6, 95% CI 0.4-0.9; P = 0.03), dairy products (OR = 0.6, 95% CI 0.4-0.9; P = 0.01), snacks (OR = 0.5, 95% CI 0.2-0.8; P = 0.01), and fish (OR = 0.4, 95% CI 0.2-0.9; P = 0.04) compared to those with high levels of physical activity. Only fruit intake was considered statistically significant (OR = 0.4, 95% CI 0.3-0.7; P = 0.003). The study found a relationship between the BMI of schoolteachers and food intake. Obese schoolteachers had lower consumption of fruits (OR = 0.3, 95% CI 0.2-0.7; P = 0.007) and white meat (OR = 0.5, 95%CI 0.3-0.9; P = 0.03) than schoolteachers in the normal weight group. Conclusion: The high prevalence of physical activity, dietary intake and body weight among Saudi teachers is a major public health concern. The present study identified several lifestyle factors associated with body weight that may represent valid targets for the prevention and management of obesity among Saudi school teachers. Promoting active lifestyles and healthy diets would be primary targets for obesity prevention.

Gender differences in knowledge, attitudes, and practices with respect to type 1 diabetes among Saudi public-school teachers.

BACKGROUND: Children with type 1 diabetes mellitus (T1DM) need carefully monitoring even during school hours to avoid emergencies. Hence, it is crucial for teachers to have appropriate knowledge and positive attitudes toward diabetes to effectively manage the disease and its complications. This study aimed to compare the knowledge, attitudes, and practices with respect to T1DM among Saudi male and female public-school teachers living in Jeddah and to identify the associated factors. METHODS: A cross-sectional study was conducted among primary, intermediate, and secondary public-school teachers working in Jeddah, Saudi Arabia between October 2021 and March 2022. Data were collected through an online survey. The survey included information on the socio-demographics of school teachers, the presence of chronic diseases, teachers' health behaviours, and knowledge, attitude, and practice with respect to T1DM. RESULTS: This study included 378 school teachers. The majority of school teachers from both genders were married, held a bachelor's degree, and aged 45-54 years. Male school teachers were married (P = 0.02), held postgraduate certificates (P < 0.001), smoked cigarette and shisha (P < 0.001), and were physically active (P < 0.001) compared to female school teachers. Regarding teachers' knowledge of T1DM, it was found that female teachers were significantly more knowledgeable of T1DM children's and its symptoms than male teachers (P = 0.03; P = 0.01, respectively). However, male teachers were more willing to accommodate T1DM students in their classes and attend programs to support T1DM students as compared to female teachers (P = 0.004; P = 0.004, respectively). Moreover, the study showed poor practice scores for T1DM. In addition, the knowledge, attitudes, and practice scores toward T1DM were significantly associated with advanced age (P = 0.002), and extended years of teaching experience (P ≤ 0.002). Also, diabetic teachers had the highest knowledge (P = 0.03) and attitude (P = 0.02) scores compared to non-diabetic teachers. Male teachers who were married (P = 0.002), shisha smokers (P = 0.01), and had never practiced activity (P = 0.03) had better attitudes and practices toward T1DM. Similarly, female teachers who held bachelor's certificates had better attitudes toward T1DM (P = 0.02). CONCLUSION: The present study revealed moderate knowledge, favorable attitudes, and poor practices related to T1DM among school teachers in Jeddah. It is crucial for policymakers to provide school teachers with training for necessary diabetes care for diabetic students.

Food Security Status, Coping Strategies, and Health of Women's Welfare Society Beneficiaries in Jeddah, Saudi Arabia: A Facility-Based Study.

This study assessed the food security status of low-income women in Jeddah, Saudi Arabia in addition to their coping strategies, health, and well-being. A cross-sectional study was conducted on 113 women receiving food assistance from a women's welfare society. Data were collected using in-person structured interviews. Overall, 50% of the women were food-insecure. Compared with food-secure women, food-insecure women were more likely to utilize many coping strategies. The mean score of coping strategies was significantly greater among food-insecure women, than that of food-secure women (21.0 ± 5.35 and 10.2 ± 5.78, respectively; p < .001). Food-insecure women were also more likely to report poor mental and overall health compared to food-secure women (p = .008 and p < .001, respectively). However, there was no significant difference in life satisfaction between both food security groups (p = .260). Low-income women may use several strategies to cope with food insecurity, which may affect mental and overall health. Further research is needed on the effect of food insecurity on health and well-being of low-income groups in Saudi Arabia. Qualitative data are also needed to better understand the reasons of food insecurity and preventing poor health outcomes among disadvantaged populations in Saudi Arabia.

Changes in eating habits and lifestyle during COVID-19 curfew in children in Saudi Arabia.

BACKGROUND/OBJECTIVES: Curfew due to the coronavirus disease 2019 (COVID-19) pandemic could influence health behaviors in people, especially in children, who can easily acquire unhealthy eating habits. This study aimed to investigate the effect of COVID-19 on weight, health behaviors including eating habits, physical activity, and sedentary behavior in children aged 6-15 years in Saudi Arabia. SUBJECTS/METHODS: We conducted a cross-sectional online survey that included 280 children aged 6-15 years in Saudi Arabia during the COVID-19 curfew. The survey included questions on sociodemographic characteristics, anthropometric measures, and health behaviors including eating habits, physical activity, and sedentary behavior. RESULTS: We observed a significant difference in the body mass index before and after the COVID-19 pandemic (P < 0.001). Children significantly tended to skip breakfast, along with a decreased intake of dairy products and fast food (P < 0.001). Moreover, children were less physically active and significantly tended to be involved in leisure screen-based activities, including watching TV and use of computer/games (P < 0.001). CONCLUSIONS: This study provides evidence for the negative influences of the COVID-19 curfew on health behaviors, including eating habits, physical activity, and sedentary behavior in children in Saudi Arabia.

The influence of a gluten-free diet on health-related quality of life in individuals with celiac disease.

BACKGROUND: Adherence to a gluten-free diet (GFD) and food insecurity (FI) may influence health-related quality of life (HRQOL) in individuals with celiac disease (CD). This study aimed to investigate the association between adherence to a GFD, FI, and HRQOL in individuals with CD. METHODS: This cross-sectional study included 97 adults (mean age: 34 ± 9 years) diagnosed with CD. The participants were on a GFD for more than 6 months. Sociodemographic characteristics and medical history were assessed. Adherence to a GFD, FI, and HRQOL were assessed using validated questionnaires. RESULTS: Most participants (73%) adhered to a GFD, and 62% were experiencing FI. Individuals with CD faced difficulty in accessing GF foods due to the high cost (90%) and limited availability (79%). The mean overall HRQOL score was 60. Scores on the physical and mental health domains were 69 and 47, respectively. Adherence to a GFD was significantly associated with FI (P = 0.02), while there was no association between adherence to a GFD and HRQOL measures (P > 0.05). Participants facing FI had lower scores in emotional well-being and mental health domains, and overall HRQOL (P < 0.05). CONCLUSIONS: The findings of the present study demonstrate that FI influences adherence to a GFD, and that FI is associated with HRQOL in terms of both emotional well-being and mental health.

Knowledge and Practices Related to Salt Intake among Saudi Adults.

In Saudi Arabia, data regarding salt-related knowledge and practices are still lacking. This cross-sectional study aimed to investigate salt-related knowledge and practices and associated factors in Saudi adults. Data on the following variables were collected from 467 participants living in Madinah or Jeddah via face-to-face interviews: demographics, anthropometrics (height and weight), blood pressure (assessed using a digital sphygmomanometer), salt-related knowledge, and practices related to salt intake. Salt-related knowledge and practices were limited among the study participants; however, they were not correlated (rs = 0.10). Multiple linear regression analysis revealed that salt-related practices were negatively associated with sodium intake and positively associated with body mass index (BMI) (p < 0.001 and p = 0.001, respectively), whereas salt-related knowledge was not associated with sodium intake, blood pressure, or BMI. Salt-related knowledge is limited and not linked to practices related to salt intake in Saudi adults. Interventions are needed to increase the accessibility of low-sodium food options and improve practices limiting sodium intake to prevent the occurrence of salt-related diseases among adults in Saudi Arabia.

Food insecure student clients of a university-based food bank have compromised health, dietary intake and academic quality.

AIM: University and college students in wealthy countries may be vulnerable to financial food insecurity. If food insecure students have suboptimal health, their ability to learn and excel in their education could be compromised. This Canadian study examined the relationship of food security status to diet and self-perceived health and academic quality among students receiving emergency food hampers from the Campus Food Bank at University of Alberta. METHODS: A convenience sample of 58 students completed a survey. RESULTS: Of participating students, 10.3% were food secure, 44.8% were moderately food insecure and 44.8% were severely food insecure. Overall, 32.8% rated their general health as fair/poor, 27.6% rated their mental health as fair/poor and 60.3% indicated at least one adverse academic outcome of not having enough money for food. Compared to other participating students, students with severe food insecurity had a greater likelihood of fair/poor general health (odds ratios (OR) 4.03, 95% confidence intervals (CI) 1.10-14.78); fair/poor mental health (OR 4.96, 95% CI 1.28-19.19); being unable to concentrate in class or during an exam (73.1% vs 40.6%, χ2 = 6.12, P = 0.013); relying on food hampers (34.6% vs 9.7%, χ2 = 5.57, P = 0.018); and, consuming fewer daily fruits, vegetables and legumes (2.12 vs 2.97 cup equivalents, P = 0.009). CONCLUSIONS: Food insecurity compromises students' health, diet and academic quality. Campus food banks are not the solution to student hunger. Governmental and university-based programmes and policies are needed to improve the food security situation of university students.

A Comparison of Characteristics and Food Insecurity Coping Strategies between International and Domestic Postsecondary Students Using a Food Bank Located on a University Campus.

PURPOSE: We compared food insecurity status, coping strategies, demographic characteristics, and self-rated health of international and domestic postsecondary students requesting emergency food hampers from a campus food bank (CFB). METHODS: We collected data from a cross-sectional convenience sample of domestic and international students who accessed the CFB at the University of Alberta. RESULTS: Food insecurity was prevalent (international students: n = 26/27 (96.2%), domestic students: n = 31/31 (100%)). Compared with their domestic peers, international students were less likely to rate their mental health negatively (14.8% vs 38.7%, P = 0.04). The primary income source was government loans (54.8%) for domestic students and research assistantships (33.3%) for international students. To cope with not having enough money for food, the majority of both student groups delayed bill payments or buying university supplies, applied for loans or bursaries, purchased food on credit, or worked more. International students were less likely to ask friends or relatives for food (48.1% vs 77.4%, P = 0.02). CONCLUSIONS: Domestic and international students mostly used similar coping strategies to address food insecurity; however, they paid for their education using different income sources. Distinct strategies for international and domestic students are required to allow more students to cover their educational and living expenses.

The Impact of School Gardening on Cree Children's Knowledge and Attitudes toward Vegetables and Fruit.

PURPOSE: School-based interventions may increase children's preferences for vegetables and fruit (V&F). This Canadian study measured changes in Indigenous First Nations schoolchildren's V&F knowledge, preferences, and home consumption following the implementation of a gardening and V&F snack program. METHODS: At baseline, 7 months, and 18 months, children in grades 1-6 (i) listed at least 5 V&F they knew, (ii) tasted and indicated their preferences towards 9 vegetables and 8 fruit using a 6-point Likert scale, and (iii) indicated their home consumption of 17 V&F. RESULTS: At all 3 time points, 56.8% (n = 66/116) of children provided data. Children listed a greater number of V&F at 18 months (4.9 ± 0.1) than at baseline (4.5 ± 1.0) or 7 months (4.7 ± .07) (F(1.6,105.6) = 6.225, P < 0.05). Vegetable preferences became more positive between baseline (37.9 ± 9.3) and 7 months (39.9 ± 9.2), but returned to baseline levels at 18 months (37.3 ± 8.7) (F(1.6,105.8) = 4.581, P < 0.05). Fruit preferences at 18 months (42.7 ± 3.0) were greater than at baseline (41.1 ± 4.3) and at 7 months (41.9 ± 5.1) (F(1.7,113.3) = 3.409, P < 0.05). No change in V&F consumption occurred at home. CONCLUSIONS: Despite improvements in V&F knowledge and preferences, home consumption of V&F did not occur. Complementing school-based programs with home-based components may be needed to influence V&F intake of children.

How do Student Clients of a University-based Food Bank Cope with Food Insecurity?

PURPOSE: To describe the food security status, food insecurity coping strategies, characteristics, and experiences of student clients of the Campus Food Bank (CFB) at the University of Alberta in Edmonton, Alberta, Canada. METHODS: A convenience sample of 58 students completed a survey from April 2013 to April 2014. Food security status was determined using the "Adult Food Security Survey Module". RESULTS: Ninety percent of CFB student clients who participated in this study were food insecure, which included both moderately and severely food insecure groups. The most prevalent coping strategies for food insecurity included applying for a loan or bursary (86.2%), seeking employment or working more hours (84.5%), and purchasing food using a credit card (77.6%). Participants were a diverse mix of students, including graduate students (50.0%), international students (46.6%), and caregivers of children (24.1%). The most common primary sources of income were government student loans (29.3%) and research assistantships (20.7%). Most participants (82.8%) liked the food they received from the food bank. CONCLUSIONS: Food insecurity is highly prevalent among student clients of this university-based food bank. Students used a variety of coping strategies to increase their disposable income, highlighting the need for additional strategies to alleviate food insecurity among vulnerable students.