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  1. Ahmad Bahathig A, Abu Saad H
    Int J Environ Res Public Health, 2022 Sep 08;19(18).
    PMID: 36141585 DOI: 10.3390/ijerph191811314
    This cluster-randomized study aimed to evaluate the effects of an intervention focused on physical activity, nutrition, and body image perception among girls in intermediate schools in Saudi Arabia. A seminar was delivered to the mothers of the girls in the experimental group. The experimental group then attended six interactive sessions within 3 months featuring physical activity, nutrition, and body image perception, followed by a 3-month follow-up period. A total of 138 respondents (68 in the experimental group and 70 in the control group) completed the intervention. Each participant's body mass index-for-age z-score and waist circumference were measured, and they completed a physical activity, sedentary behavior, and body image perception questionnaires before and after the intervention and at the follow-up. The intervention was evaluated using within- and between-groups generalized estimating equations. There were no significant changes in the respondents' body mass index-for-age z-score or waist circumference (p > 0.05). However, immediate significant improvements were seen in physical activity, sedentary behavior, and body image satisfaction among the experimental group, and these improvements remained at follow-up (p < 0.001). These differences were more significant among the experimental group than among the control group. We found this intervention effective. Future studies can adapt this intervention for adolescent boys and extend its duration to improve the body mass index outcome.
  2. Bahathig A, Abu Saad H
    East Mediterr Health J, 2023 Aug 31;29(8):638-649.
    PMID: 37698219 DOI: 10.26719/emhj.23.090
    BACKGROUND: Lifestyle changes in Saudi Arabia have affected the dietary intake of adolescents, who now consume more unhealthy foods.

    AIMS: We assessed the dietary intake of female Saudi Arabian adolescents living in Arar.

    METHOD: In this randomised cluster study, female students were selected randomly from assigned schools to form the intervention (n = 68) and control (n = 70) groups. Initially, a 60-minute seminar was held for mothers of students in the intervention group. Subsequently, 6 90-minute sessions were held over 3 months for the intervention group on topics such as food groups, healthy and unhealthy eating, body image and physical activity. The data were analysed using generalized estimating equations.

    RESULTS: The interaction effect (group by time) between the groups revealed statistically significant differences for dairy products (P < 0.001), sweetened beverages (P < 0.001), sweetened baked goods (P = 0.022) and fruits and vegetables (P < 0.003). The intervention significantly increased the intake of dairy products (P < 0.001) and fruits and vegetables (P = 0.003). It reduced the intake of sweetened beverages (P < 0.001) and sweetened baked goods (P = 0.010) in the intervention group.

    CONCLUSION: This intervention showed a grater positive effect on the intervention than the control group; it increased dietary intake of dairy products, fruits and vegetables, and reduced intake of sweetened beverages and sweetened baked goods among the intervention group participants. We recommend similar nutrition interventions among other young Saudi Arabian population groups to prevent obesity and other diseases.

  3. Zarei M, Mohd Taib MN, Zarei F, Abu Saad H
    Nurs Midwifery Stud, 2013 Dec;2(4):97-102.
    PMID: 25414886
    BACKGROUND: Good nutrition, a balanced diet and regular physical activity are foundations of good health. Research has found that dietary patterns change dramatically following the arrival of students in a foreign country. However, nutritional status of Iranian students studying oversea has never been investigated.

    OBJECTIVES: The objective of this study was to determine factors associated with body weight status of Iranian postgraduate students in Universiti of Putra Malaysia (UPM).

    MATERIALS AND METHODS: A cross-sectional study was conducted to determine the body weight status of 210 Iranian postgraduate students aged between 22 and 55 years in University of Putra Malaysia. The associations between body weight status and socio demographics factors and also lifestyle factors (smoking and physical activity) were assessed. Anthropometric factors (height, weight, BMI and waist and hip circumferences) were measured. Chi-square, Spearman Rho and Pearson tests were used for data analysis.

    RESULTS: From a total of 210 postgraduate students 110 were females, and 100 males. No significant correlation was observed between smoking and BMI (P = 0.4). However, statistically significant correlations were observed between gender (P = 0.007), physical activity (P = 0.02), using protein (P = 0.005), carbohydrate (P = 0.002), fat (P = 0.001), fiber (P = 0.003), vitamin C (P = 0.04), calcium (P = 0.005), waist circumference (P = 0.02), hip circumference (P = 0.001), Waist to Hip Ratio (P = 0.002), and BMI.

    CONCLUSIONS: The nutritional behavior of university students was poor. Therefore, it is essential to encourage young people, including university students to enrich their diets with milk, beans, fruit, and vegetables to decrease the risks of nutrition related disorders.

  4. Abu Saad H, Low PK, Jamaluddin R, Chee HP
    PMID: 32824361 DOI: 10.3390/ijerph17165947
    Physical inactivity and sedentary lifestyle have been linked to the occurrence of non-communicable diseases. This study's purpose was to determine physical activity levels and sedentary behaviours among primary healthcare workers in Perak, Malaysia, as well as associated factors. A cross-sectional study was conducted at 12 health clinics in Perak, Malaysia, to determine physical activity levels, sedentary behaviours and factors associated with physical inactivity among primary healthcare workers. Each respondent completed a self-administered questionnaire relating to socio-demographic characteristics, including anthropometric measurements such as body mass index, waist circumference and body fat percentage, and the English and Malay version of the Global Physical Activity Questionnaire. A total of 261 primary healthcare workers participated in this study; 45.6% were classified as physically inactive, spending a median of five hours daily engaged in sedentary behaviours. In terms of metabolic equivalent min per week, male workers had significantly higher physical activity than females. Self-reported health status and longer sitting times were significantly associated with physical inactivity. Logistic regression showed that poor health status was 1.84 times less likely to be associated with physical activity (p = 0.036, Confidence Interval = 1.04-3.24). Due to the high prevalence of physical inactivity, action is needed to increase physical activity among healthcare workers.
  5. Mohd Ashri MH, Abu Saad H, Adznam SNΆ
    Nutrients, 2021 Jun 29;13(7).
    PMID: 34210072 DOI: 10.3390/nu13072248
    The use of dietary supplements is prevalent among many groups worldwide. However, few studies have examined their use among government employees. The aim of this cross-sectional study was to determine the association among sociodemographic characteristics, body weight status, and energy intake with dietary supplement use among government employees in Putrajaya, Malaysia. Simple random sampling was used to select a sample of 460 government employees from six ministries in Putrajaya, Malaysia. The data used in this study were collected through anthropometric measurements (height, weight, % body fat, waist and hip circumferences), a self-administered questionnaire (sociodemographic characteristics and dietary supplements use), and an interviewer-administered questionnaire (24-hour dietary recall; fruit and vegetable intake). The results indicated that the prevalence of dietary supplement use was 55.4%, with vitamin C (38.4%) being the most popular type of dietary supplement. Health issues (80.8%) were the most common reason for usage, internet (59.2%) was the main source of information, and pharmacies (71.8%) were the most indicated places to purchase dietary supplements. A multivariate analysis showed that participants who were female, married, had better monthly income, lived within a smaller household size, had a normal body mass index, classified as having unhealthily high body fat percentage, did not skip breakfast, and consumed at least five servings of fruits and vegetables per day were significantly more likely to use dietary supplements. In conclusion, health-conscious groups were more prone to consume dietary supplements, and due to the high prevalence of dietary supplement use, dissemination of accurate scientific information regarding dietary supplements is highly recommended among government employees.
  6. Esmaili H, Mohd Yusof R, Abu Saad H, Ghaemian A, Darani Zad N
    Ecol Food Nutr, 2015;54(1):4-19.
    PMID: 25347717 DOI: 10.1080/03670244.2014.930031
    This study aimed to identify the association of dietary patterns with sociodemographic and health-related characteristics among coronary artery disease patients. In this cross-sectional study, the participants were 250 patients coronary artery disease aged ≥ 40 years old. Data collection was done using questionnaires related to sociodemographics, health-related factors, and food-frequency intake information. Three dietary patterns (traditional, western, and healthy) were obtained using principal component analysis. The result showed that dietary patterns were associated with sociodemographic and health-related factors. According to the result, all the factors were taken very seriously when planning a promotional program for healthy lifestyle in prevention of CAD.
  7. Chin KH, Sathyasurya DR, Abu Saad H, Jan Mohamed HJ
    Int J Endocrinol Metab, 2013;11(3):167-74.
    PMID: 24348588 DOI: 10.5812/ijem.8298
    The Malaysian Health and morbidity Survey (2006) reported the highest prevalence of type 2 diabetes mellitus (T2DM) among the Indian population compared to the Malay and Chinese populations. Many studies have supported the important role of adiponectin in insulin-sensitizing, which is associated with T2DM. These studies have raised a research question whether the variation in prevalence is related to the adiponectin concentrations or the lifestyle factors.
  8. Hatami M, Mohd Taib MN, Jamaluddin R, Abu Saad H, Djazayery A
    Appetite, 2013 Jan;60(1):27-32.
    PMID: 23103548 DOI: 10.1016/j.appet.2012.10.014
    OBJECTIVE: Several studies indicated that techniques to change body weight and appearance were prevalent and different among adolescents. The aim of the study, therefore, was to assess differences in frequency and type of body change techniques used among adolescents by sex and body weight status.

    METHODS: A sample of 758 adolescents aged 12-18 years were recruited from private and public schools in Tehran. Information about socio-demographic background and body change techniques were collected via a self-administered questionnaire.

    RESULTS: A high percentage of adolescents used body change techniques frequently to alter their body appearance. Girls changed normal eating pattern significantly (p=0.007) to lose weight more frequently than boys while boys used this method significantly (p=0.01) to gain weight more frequently than girls. Overweight/obese adolescents exercised significantly to change muscle size (p=0.03) and changed normal diet to lose weight (p<0.001) more frequently than normal weight adolescents. The relation between sex and body weight status with body change techniques (p<0.0) implied that male and female adolescents especially overweight/obese adolescents were frequently trying to change their body appearance.

    CONCLUSION: Significant differences existed in using body change techniques according to sex and body weight status and these should be considered in obesity prevention programs for adolescents.

  9. Ahmad Bahathig A, Abu Saad H, Md Yusop NB, Mohd Shukri NH, El-Din MME
    PMID: 34444210 DOI: 10.3390/ijerph18168461
    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.
  10. Hashim SA, Mohd Yusof BN, Abu Saad H, Ismail S, Hamdy O, Mansour AA
    Clin Nutr ESPEN, 2021 Oct;45:141-149.
    PMID: 34620310 DOI: 10.1016/j.clnesp.2021.07.024
    BACKGROUND & AIMS: The study aimed to evaluate the effectiveness of the Simplified Diabetes Nutrition Education (SDNE) on glycemic control and other diabetes-related outcomes in patients with type 2 diabetes mellitus (T2DM).

    METHODS: This a randomized controlled trial (RCT) randomized 208 patients with T2DM [mean age = 48.8 ± 11.8 years, Glycated Hemoglobin (HbA1c) = 9.5 ± 2.4%, and Body Mass Index = 28.0 ± 5.6 kg/m2] to intervention group (n = 104) or control group (n = 104). Participants in the intervention group received a weekly diabetes nutrition module based on the health belief model for 12 weeks in addition to the usual care whereas the control participants were given the usual care. We evaluated HbA1c and diabetes-related outcomes (metabolic parameters, dietary intake, and physical activity level) at baseline, 12 weeks, and 22 weeks. Health beliefs, diabetes knowledge, and health literacy were also evaluated.

    RESULTS: After 22 weeks, HbA1c improved significantly in the intervention group (-1.7%) from the baseline value, compared to the control group (+0.01%) (p 

  11. Hashim SA, Barakatun-Nisak MY, Abu Saad H, Ismail S, Hamdy O, Mansour AA
    Nutrients, 2020 Oct 15;12(10).
    PMID: 33076406 DOI: 10.3390/nu12103152
    While the role of medical and nutrition factors on glycemic control among adults with type 2 diabetes mellitus (T2DM) has been well-established, the association between health literacy (H.L.) and glycemic control is inconsistent. This study aims to determine the association of H.L. and nutritional status assessments with glycemic control in adults with type 2 diabetes mellitus. A total of 280 T2DM respondents (mean (SD) age = 49.7 (10.3) years, Glycated hemoglobin (HbA1c) = 9.9 (2.6) %, and Body Mass Index = 32.7 (15.1) kg/m2) were included in this study. A short-form Test of Functional Health Literacy in Adults (S-TOFHLA) assessed the H.L. levels. Nutritional status assessments included client history, glycemic control, anthropometric, and biochemical data. The mean (S.D.) H.L. score was 45.7 (24.6), with 56% of the respondents had inadequate H.L. Inadequate H.L. was more common among those females; housewives, low education, received oral antidiabetic therapy, and shorter diabetes duration. Respondents with inadequate H.L. were significantly older and had higher HbA1c than those with marginal and adequate H.L. Meanwhile, respondents with inadequate and marginal H.L. levels had significantly higher total cholesterol, LDL-cholesterol, and systolic blood pressure than the respondents with adequate H.L. Low H.L. scores, self-employment status, received dual antidiabetic therapy (insulin with oral agents), received insulin alone, and had higher fasting blood glucose explained about 21% of the total variation in HbA1c (adjusted R2 = 0.21; p < 0.001). Respondents with inadequate H.L. had poor glycemic control. The H.L. scores, together with nutritional status assessments, were the factors that predicted poor glycemic control among adults with T2DM.
    Study site: Faiha Specialized Diabetes, Endocrine, and Metabolism Centre (FDEMC), Basrah, Iraq
  12. Huei Phing C, Abu Saad H, Barakatun Nisak MY, Mohd Nasir MT
    J Exerc Sci Fit, 2017 Dec;15(2):55-62.
    PMID: 29541133 DOI: 10.1016/j.jesf.2017.07.003
    Background/Objective: Our study aimed to assess the effects of physical activity interventions via standing banners (point-of-decision prompt) and aerobics classes to promote physical activity among individuals with metabolic syndrome.

    Methods: We conducted a cluster randomized controlled intervention trial (16-week intervention and 8-week follow-up). Malaysian government employees in Putrajaya, Malaysia, with metabolic syndrome were randomly assigned by cluster to a point-of-decision prompt group (n = 44), an aerobics group (n = 42) or a control group (n = 103) based on sample size calculation formula. Step counts were evaluated by Lifecorder e-STEP accelerometers for all participants. Metabolic syndrome was defined according to the 'harmonizing' definition, in which individuals who have at least three of the five metabolic risk factors (waist circumference, high-density lipoprotein cholesterol, triglycerides, fasting glucose levels, systolic and diastolic blood pressure) will be classified as having metabolic syndrome. A total of 80% of the enrolled government employees with metabolic syndrome completed the programme. Data were analyzed using SPSS for Windows (version 20, SPSS, Chicago, IL).

    Results: There were significantly higher step counts on average in the aerobics group compared to the control group over assessments. Assessments at baseline, post-intervention and follow-up showed a significant difference in step counts between the intervention and control groups. The greatest reductions in the proportions of individuals with metabolic syndrome were observed in the aerobics group with a reduction of 79.4% in the post-intervention assessment compared to the assessment at baseline.

    Conclusion: The findings of this study suggest that physical activity intervention via aerobics classes is an effective strategy for improving step counts and reducing the prevalence of metabolic syndrome.

  13. A Bahathig A, Abu Saad H, Md Yusop NB, Mohd Sukri NH
    J Taibah Univ Med Sci, 2023 Oct;18(5):976-987.
    PMID: 36890796 DOI: 10.1016/j.jtumed.2023.02.008
    OBJECTIVES: The objective of this study was to develop and validate a Knowledge, Attitude, and Practice Questionnaire (KAPQ) on nutrition, physical activity, and body image for 13-14-year-old female adolescents.

    METHOD: The KAPQ initially consisted of 73 items, covering knowledge (30), attitude (22), and practice (21) related to nutrition, physical activity (PA), and body image (BI). The content and face validity were tested to identify the relevance of the questionnaire items to the content and their relevance to nutrition, PA, and BI. Construct validity was assessed using an exploratory factor analysis (EFA). Internal consistency was determined by Cronbach's α value, and stability was determined based on test-retest reliability.

    RESULTS: Based on the EFA, each scale had several dimensions. The Cronbach's α ranged between 0.977 and 0.888 for knowledge, 0.902 and 0.977 for attitude, and 0.949 and 0.950 for practice. The test-retest reliability revealed that the kappa of knowledge was 0.773-1.000, while the intraclass correlation (ICC) values for attitude and practice were 0.682-1.000 and 0.778-1.000, respectively.

    CONCLUSION: The final KAPQ, which included 72 items, was valid and reliable for assessing the KAP levels for nutrition, PA, and BI of 13-14-year-old female students in KSA.

  14. Mohd Suffian NI, Adznam SN', Abu Saad H, Chan YM, Ibrahim Z, Omar N, et al.
    Nutrients, 2020 Sep 10;12(9).
    PMID: 32927741 DOI: 10.3390/nu12092758
    The ageing process has been associated with various geriatric issues including frailty. Without early prevention, frailty may cause multiple adverse outcomes. However, it potentially may be reversed with appropriate interventions. The aim of the study is to assess the effectiveness of nutritional education and exercise intervention to prevent frailty among the elderly. A 3-month, single-blind, two-armed, cluster randomized controlled trial of the frailty intervention program among Malaysian pre-frail elderly will be conducted. A minimum of total 60 eligible respondents from 8 clusters (flats) of Program Perumahan Rakyat (PPR) flats will be recruited and randomized to the intervention and control arm. The intervention group will receive a nutritional education and a low to moderate multi-component exercise program. To date, this is the first intervention study that specifically targets both the degree of frailty and an improvement in the outcomes of frailty using both nutritional education and exercise interventions among Malaysian pre-frail elderly. If the study is shown to be effective, there are major potential benefits to older population in terms of preventing transition to frailty. The findings from this trial will potentially provide valuable evidence and serve as a model for similar future interventions designed for elderly Malaysians in the community.
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