|Year : 2016 | Volume
| Issue : 1 | Page : 13-19
Prevalence of obesity among Saudi board residents in Aseer Region, Saudi Arabia
Abdullah Ali Alzahrani1, Yahia Mater Al-Khaldi2, Awad S Alsamghan3
1 Ministry of Health, Postgraduate Family Medicine Program, Al-Baha Region, KSA
2 Department of Family Medicine, General Directorate of Health Affairs, Aseer Region, KSA
3 Department of Family and Community Medicine, Faculty of Medicine, King Khalid University, Abha, KSA
|Date of Web Publication||29-Jun-2016|
Dr. Abdullah Ali Alzahrani
Postgraduate Family Medicine Program, Al-Baha Region
Source of Support: None, Conflict of Interest: None
Background: Obesity is a risk factor for many chronic diseases and some malignancies. It became as international epidemic, particularly in Western and Gulf countries. Objectives: To determine the prevalence of obesity and overweight among resident physicians in the postgraduate training programs of Saudi Board in Aseer Region, KSA. Subjects and Methods: This cross-sectional study was conducted during October to November 2013. Data were collected through a questionnaire developed by the researchers, which included the demographic data, weight and height measurements, and dietary habit using food frequency questionnaire. The first researcher met all the respondents and measured their weight and height, then every subject was asked to fill the self-administered questionnaire. Results: Out of 255 invited residents, 82.7% participated in this study. The mean age of the respondents was 27.9 ± 2.6 years. Almost two-thirds of them (66.8%) were males. Majority of them (96.2%) were Saudi. Overweight and obesity were reported among 36% and 23.2% of the residents, respectively. Obesity was significantly higher among male than female resident physicians (31.9% vs. 7.1%), P < 0.001. Taking of potatoes chips, sweets, pizza, never drinking skimmed milk, and never drinking semi-skimmed milk were significantly associated with obesity among resident physicians. Conclusion: Frequency of overweight and obesity was high among Saudi Board residents in Aseer Region and significantly higher in male than female physicians. Taking of potatoes chips, sweets, pizza, never drinking skimmed milk, and never drinking semi-skimmed milk were significantly associated with obesity among resident physicians.
Keywords: Dietary habit, obesity, resident physicians
|How to cite this article:|
Alzahrani AA, Al-Khaldi YM, Alsamghan AS. Prevalence of obesity among Saudi board residents in Aseer Region, Saudi Arabia. Saudi J Obesity 2016;4:13-9
| Introduction|| |
Obesity is becoming a worldwide problem affecting all levels of society and is being described as a global epidemic.  Obesity in adults was defined as body mass index (BMI) ≥30 kg/m2. BMI was calculated as weight in kilograms divided by height in meters squared, rounded to one decimal place. 
In Saudi Arabia, obesity is becoming one of the most important public health problems.  Based on the National Nutrition Survey of 2007, the prevalence of obesity in the KSA was 23.6% in women and 14% in men. The prevalence of overweight in the community was determined to be 30.7% for men as compared to 28.4% for the women.  Mahmood et al. conducted a study to identify the predictors of obesity among postgraduate trainee doctors working in a tertiary care hospital of public sector at Karachi, Pakistan. Frequency of overweight and obesity among doctors was 31.6% and 28.2%, respectively. Predictors of obesity among doctors include taking lunch outside home, snacks between meals, tea, physical activity, increase duration of training, family history of obesity, and male gender. Taking lunch outside home, snacks and tea intake between meals, increase duration of training, family history of obesity, male gender, and lack of physical activity were found to be the predictors of obesity among doctors. 
As we face a growing obesity crisis, the need for increased focus on healthy eating habits becomes more and more prominent. Canadian physicians report an average daily consumption of 4.8 servings of fruits and vegetables, with over half of physicians eating the minimum five recommended servings, while this figure is higher than that in the general population. 
Physicians who eat a healthy diet themselves are more likely to counsel their patients about the importance of proper nutrition; furthermore, this counseling is more likely to be effective at inciting positive behavioral changes in patients. Because of this link, it would be extremely valuable to initiate programs promoting proper nutrition among physicians and advocating the benefits of diets rich in fruits, vegetables, and unprocessed whole foods.  This study aims to determine the prevalence of obesity and overweight among resident physicians in the postgraduate training programs of Saudi Board in Aseer Region, KSA.
| Subjects and Methods|| |
This cross-sectional study was carried out from October to November 2013 among resident physicians in the postgraduate training programs (Saudi Board) in Aseer Region. Aseer lies in Southwestern part of Kingdom of Saudi Arabia. Three hospitals are accredited by Saudi council for health specialties as postgraduate training centers for resident physicians to get the Saudi Board in many specialties. These hospitals are Aseer Central Hospital, Abha General Hospital, and King Fahad Military Hospital. In addition, there are six family medicine training centers in Aseer Region.
All resident physicians (255) were invited to participate in the study by completing the study questionnaire. They worked in the following specialties: general medicine, pediatrics, family medicine, community medicine, radiology, general surgery, orthopedics, urology, dermatology, obstetrics and gynecology, and otorhinolaryngology.
A self-administered questionnaire was applied for data collection. It included demographic data (age, gender, marital status, nationality, residency level, and specialty), weight, and height measurements (weight and height were measured by the first investigator and filled in the questionnaire). Nutritional assessment done by food frequency questionnaire,  which is a valid simple tool,  that measures the frequency of essential common meals.
Weight was measured by an electronic valid balance in kilograms. It was measured as the subject wears the ordinary clothes. Extra clothes were removed before measurements. Height was measured by valid machine in meters. Footwear was removed before measurement. BMI assesses the body weight relative to height. It was calculated as weight in kilograms divided by height in meters squared, rounded to one decimal place.
Obesity in adults was defined as BMI ≥30 kg/m2, whereas BMI from 25 to 29.9 kg/m2 was considered overweight, BMI from 18.5 to 24.9 was considered normal, and BMI <18.5 kg/m2 was considered underweight. 
Before conducting the study, informed consent was taken from all the participants, then all the participants had the right not to participate in the study or to withdraw from the study before completion. The researcher explained the purpose of the study to all participants. Confidentiality and privacy were guaranteed for all participants.
The Statistical Package for Social Sciences (SPSS) software, Version 20, was used for data entry and analysis. Descriptive statistics (e.g., number, percentage, mean, range, and standard deviation) and analytic statistics using Chi-square test were applied. P < 0.05 was considered to be statistically significant.
| Results|| |
The total number of the resident physician invited to participate in the study was 255; of them, 211 responded by returning completed questionnaire giving a response rate of 82.7%.
[Table 1] depicts demographic characteristics of participants, most of the residents (76.3%) were in the age group of 26-30 years. Their mean age was 27.9 ± 2.6 years. Almost two-thirds of them (66.8%) were men. Majority of them (96.2%) were Saudis. More than half of them (53.6%) were married. Almost one-third of them (30.8%) were in the first residency level, whereas 17.6% were in the fourth residency level. More than a quarter of them (28.0%) were specialized in family medicine, whereas 17.1% and 15.2% were specialized in internal medicine and pediatrics, respectively.
|Table 1: Personal characteristics of Saudi Board residents, Aseer Region, KSA, 2013 |
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As obvious from [Figure 1], overweight and obesity were reported among 36% and 23.2% of the residents, respectively.
|Figure 1: Distribution of Saudi Board residents in Aseer Region according to categories of body mass index, KSA, 2013|
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[Table 2] shows that obesity was more significantly reported among male than female resident physicians (31.9% vs. 7.1%), P < 0.001. Other personal characteristics of Saudi resident physicians (age, nationality, marital status, residence level, and specialty) were not significantly associated with their categories of BMI.
|Table 2: Association between personal characteristics of Saudi Board residents in Aseer Region and their categories of body mass index, KSA, 2013 |
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[Table 3] presents some of the important nutritional habits of Saudi Board residents in Aseer Region.
|Table 3: Nutritional habits of Saudi Board residents in Aseer Region, 2013 |
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- More than half of them (51.2%) reported never taken low fat milk whereas 72% and 68.7% of them reported never taken semi-skimmed and skimmed milk, respectively
- Orange juice was taken in a frequency of 1-3/week among 40.3% of them
- Fruit drink without sugar was never taken by more than half of them (55%), whereas fruit drink with sugar was taken in a frequency of 1-3/week by 37% of them
- Similarly, soft drink without sugar was never taken by more than two-thirds of them (69.2%), whereas soft drink with sugar was taken in a frequency of 4-6/week by 28.9% of them
- Boiled potatoes were taken in a frequency of 4-6/week by 11.8% of the Saudi residents compared to 16.6% of potato chips. In addition, boiled potatoes were never taken in a frequency of more than four times per day, whereas a potato chip was taken in that frequency by 4.3% of the respondents
- Fresh vegetables and fruits were never taken by 8.1% and 7.6% of the residents, respectively, whereas they were taken in a high frequency (≥4 times/day) by 10.4% and 11.8% of them, respectively
- Whole meal bread was taken in a frequency of four to six times/week by almost one-third of them (33.2%)
- Fish was never taken by 14.2% of the residents, whereas it was taken in a low frequency (one to three times per month) by more than half of them (57.8%)
- Pizza was taken in a frequency of 1-3/week by more than a quarter (28%) of the Saudi residents
- Sweets and chocolates were taken in a frequency of 1-3/week by almost one-third of the residents (34.6% and 33.2%, respectively)
- Similarly, savory snacks were taken in a frequency of 1-3/week by almost one-third of them (32.2%), whereas they were taken in a high frequency (≥4 times/day) by 5.2% of them.
From [Table 4], it is illustrated that resident physicians who reported taking of semi-skimmed milk were less likely to be obese than those who never take semi-skimmed milk (rates of obesity were 19.2% and 25.2%, respectively). This difference was statistically significant, P < 0.05.
|Table 4: Association between intake of liquid foods and categories of body mass index among Saudi Board residents in Aseer Region, KSA, 2013 |
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Similarly, resident physician who reported taking of skimmed milk were less likely to be obese than those who never take skimmed milk (rates of obesity were 15.9% and 26.9%, respectively). This difference was statistically significant, P < 0.05.
Frequency of intake of other liquid food (fruits with or without sugar, soft drinks with or without sugar, orange juice, and full fat or low fat milk) were not significantly associated with obesity among resident physicians.
From [Table 5], it is shown that the intake of potatoes chips was associated overweight and obesity among resident physicians (38.3% and 26.1% vs. 25% and 7.1%, respectively, P = 0.004).
|Table 5: Association between intake of hard foods and categories of body mass index among Saudi Board residents in Aseer Region, KSA, 2013 |
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The intake of pizza was also associated with higher rate of overweight and obesity among resident physicians (38.3% and 24.2% vs. 13.3% and 13.3%, respectively, P = 0.022).
Similarly, the intake of sweets was also associated with higher rate of overweight and obesity among resident physicians (38.7% and 23.7% vs. 7.1% and 21.4%, respectively, P = 0.026).
The intake of other hard foods (boiled potatoes, vegetables, fruits, whole meal bread, fish, chocolate, and savory snacks) was not significantly associated with obesity among resident physicians.
| Discussion|| |
This study determined the prevalence of obesity and overweight among Saudi Board residents in Aseer Region. Approximately, 23.2% of the Saudi residents in Aseer Region were obese and 36% were overweight. In a study conducted in Pakistan among the postgraduate trainees, the prevalence of obesity was approximately 28.2%.  In this study, the prevalence of obesity among male residents was higher than females residents, which is contrary to other studies which found the females at greater risk for obesity. ,, The lower rate of obesity among female residents in the this study could be due to that female doctors were more cautious about their weight status than males, due to society perceptions which encourage females to be slender. This assumption was supported by the observation that only 34.8% of males were normal as compared to 50% of females in this studied sample. In comparing with our finding, other studies reported higher rates of obesity among males than females,  even in gulf countries.  In terms of eating habits, we did not find an association of obesity with snacks intake between meals. This finding is not consistent with results from other studies which have shown the association of savory snacks with obesity. , The usual snacks include biscuits, chips, or soft drinks which are rich in calories and lead to obesity. Resident physicians usually do not follow healthy eating habits, because they may spend a long time out of their home also almost half of them were singles. They often select fast-food due to its palatability, availability, and convenience. A previous survey by the American Dietetic Association indicated that obesity or being severely overweight is a fast-food related issue.  The healthy people 2010 objectives include a focus on nutrition and obesity prevention.  In this study, data analyses of resident physicians' eating habits revealed that the unhealthy eating habit was noticed in some food items. Eating fresh vegetables and fruits four times or more daily was reported among 10.4% and 11.8% of them, respectively. More than a quarter of them (28%) of them eat pizza in a frequency of 1-3/week. Almost a third of them eat sweets and chocolates in a frequency of 1-3/week. In addition, eating of pizza, potatoes chips, and sweets was associated with higher rates of overweight and obesity among them. Daily intake of snacks was reported by almost a quarter of them. Frequent snacking and eating potatoes chips can adversely affect physician health status, given the abundance of energy dense and high fat ingredients they contain.
| Conclusion|| |
Frequency of overweight and obesity was high among Saudi Board residents in Aseer region and significantly higher in male than female physicians. Taking of potatoes chips, sweets, pizza, never drinking skimmed milk, and never drinking semi-skimmed milk were significantly associated with obesity among resident physicians. Residents in postgraduate studies should be aware about their health through practicing healthy lifestyles including well balanced diet and regular physical activities.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]