Saudi Cultural Missions Theses & Dissertations
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Item Restricted Associations Between Living Arrangements, Changes in Lifestyle and Anthropometric Traits During the First Year of University(Saudi Digital Library, 2026) Alharbi, Ferdous; Speakman, John; Hambly, CatherineIntroduction: The transition into university is often accompanied by lifestyle changes that can influence weight and health behaviours, with evidence highlighting increased risk of weight gain during the first academic year. While the “Freshman 15” theory, coined in the United States of America (USA), has been widely discussed, referring to an average weight gain of around 6.8 kg (15 lb) during the first year of university, findings remain inconsistent, and less is known about how different living arrangements may shape these changes. This thesis examines the associations between living arrangements, lifestyle behaviours, and anthropometric changes among first-year university students, and compares these with patterns observed in non-university peers. Methods: Two longitudinal observational studies were conducted. Study 1 followed 78 participants at baseline, three, and eight months after entering University (across one academic year), including those living at home, in private accommodation, in halls of residence (University accommodation), and non-university peers. Study 2 tracked 40 of these participants in halls, private accommodation, and at home as they transitioned to the second year. Anthropometric traits (body weight (BW), body mass index (BMI), body fat percentage (BF%), waist-to-hip ratio (WHR), and weight-for-age percentile (W/A)) were recorded. In addition, lifestyle behaviours (diet, physical activity, sleep, and stress) were assessed using questionnaires, complemented by objective assessments from the ActiGraph GT9X Link accelerometer (physical activity and sleep). Dietary intake was assessed via Intake24’s online 24-hour dietary recall tool and reassessed after excluding misreported records. Results: Most changes in weight, body composition and lifestyle behaviours occurred within groups across the academic year, with students living away from home showing the largest increases in weight, BMI and WHR. Although between-group differences were generally limited, living arrangements influenced the timing and magnitude of changes in diet, physical activity, sleep and stress, and WHR remained consistently higher among students in halls compared with those living at home or in private accommodation. Non-university participants also experienced behavioural and BF% changes, indicating that many challenges were not exclusive to university students. In the follow-up study after one year at university, similar within-group patterns persisted, suggesting that early behavioural and anthropometric changes tended to continue over time. Students who started university in halls and in private accommodation showed further increases in weight and BMI across the 12-month follow-up, while those living at home remained comparatively stable. Conclusions: These findings demonstrate that early lifestyle and body composition changes among young adults are shaped more by within-group patterns than by large differences between accommodation types. By integrating self-reported and objective measures across two longitudinal studies, this thesis provides clearer evidence on how diet, physical activity, sleep and stress evolve from university entry through the first full academic year and after one year at university. The thesis directly addressed its research objectives and answered all research questions by identifying when behavioural and anthropometric changes occur, which groups are most affected, and how living arrangements influence these trajectories over time. The results highlight areas that may benefit from future preventive efforts to support students’ health during the transition into university, such as improving food environments in halls, supporting affordable healthy eating for students living away from home, expanding access to physical activity opportunities, strengthening stress-management and sleep-support resources during this life stage.25 0Item Restricted Effectiveness of childhood obesity prevention interventions in the Middle East. A systematic review(Saudi Digital Library, 2023-11-28) Alsaadi, Ghadeer; Papadaki, AngelikiIntroduction Childhood obesity is considered a critical health concern in the Middle East due to its escalating prevalence and adverse impact on the community. To address this epidemic, this review aims to assess the effectiveness of school-based interventions conducted in the Middle East on obesity- related outcomes, physical activity levels, and dietary habits and evaluate the interventions’ cost-effectiveness analyses where data are available. Methods This systematic review conducted an electronic comprehensive search on the 2nd of June, 2023, using the databases PubMed, Embase, Medline, and Web of Science. School-based interventions, both single and multi-component, utilising a randomised control trial study design, implemented among primary school-aged children or adolescents aged 4-19 years old, assessing (BMI, body fat percentage, waist circumference, physical activity levels, or dietary habits) as the intervention’s targeted outcomes, and conducted in the Middle East were included in this review. Results Seven RCTs were examined in this review, of which five had dietary and physical activity components; one was a dietary intervention, and the last was a physical activity intervention. All assessed RCTs effectively reported at least one positive finding of the school-based intervention on the targeted outcomes. Post- intervention between-group differences were found in the likelihood of changing to normal weight status, improved nutritional quality, increased physical activity levels, and reduced weight. Additionally, intervention groups reported physical activity levels increase, dietary habits improvement, a reduction in the likelihood of being overweight or obese, a reduction in BMI Z-score, and a reduction in waist circumference. Post-intervention self-efficacy and nutritional knowledge increased in the intervention groups (p<0.001), which served as potential mediators. Conclusion Overall, findings from this review support the promising effects of school-based interventions on improving obesity-related outcomes, physical activity levels, and dietary habits. Further studies should be conducted to confirm the findings while measuring the intervention’s cost-effectiveness analysis.19 0Item Restricted The Association Between Lifestyle Behaviour, including Physical Activity and Dietary Habits, and their relationship with Hypertension in a UK Population Sample(Saudi Digital Library, 2023-08-14) Fakeeh, Mohammed; Nicholl, BarbaraBackground: high blood pressure is a crucial contributor to the development of cardiovascular disease and a significant public health concern that affects millions of people globally. There has been growing discussion about hypertension among adults and the role that lifestyle factors play in this condition. There is a high level of physical inactivity and poor dietary choices in the United Kingdom (UK), both of which might contribute to hypertension. Objective: This study aimed to investigate the association between lifestyle factors – including physical activity and dietary habits – and sociodemographic factors and their associations with high blood pressure using a UK Biobank sample. Methods: Participants from the UK Biobank were included (N = 230,087) who had self- reported hypertension. The chi-squared test was utilised for categorical variables and the Mann–Whitney U test was utilised for continuous variables to compare dietary, sociodemographic and physical activity-related variables between groups with and without hypertension. Multivariable logistic regression analysis was used to establish whether there was an association between hypertension (the dependent variable) and physical activity and dietary habits, including the consumption of tea, coffee, beef, salt added to food, raw salad and vegetables (the independent variables). We then adjusted for a wide range of potential covariates (age, sex, Townsend scale score, body mass index (BMI), smoking status and alcohol consumption). The analysis was carried out using R software (v. 4.2.1). Results: The findings indicate an association between hypertension and physically active individuals compared to those reporting low physical activity levels (odds ratio (OR): 1.13, 95% confidence interval (CI) (1.10–1.16), p < 0.001). In contrast, dietary habits varied. Tea and beef consumption were found to have significant associations with hypertension ((OR tea – light to moderate: 1.05, 95% CI (1.02–1.09), p = 0.002); OR beef – once a week: 1.10, 95% CI (1.06– 1.14), p < 0.001), while consumption of coffee and salt added to food had negative associations with hypertension ((OR coffee – light to moderate: 0.90, 95% CI (0.88–0.93), p < 0.001); OR salt –usually: 0.82, 95% CI (0.80–0.84), p < 0.001). The analysis of sociodemographic factors revealed that older people and males were likelier to experience hypertension than younger people and females, respectively ((OR age – 60–71 years: 4.09, 95% CI (3.96–4.22) p < 0.001); (OR sex – male: 1.34, 95% CI (1.32–1.37), p < 0.001). On the Townsend scale, those in quintiles Q3–Q5 had greater exposure to hypertension than those in quintile Q1-Q2 (OR: 1.09, 95% CI (1.04–1.14), p = 0.001). Overweight and obese people and smokers were significantly likelier to experience hypertension than those with a healthy weight ((OR BMI – overweight: 1.91, 95% CI (1.86–1.97), p < 0.001); OR BMI – obese: 4.14, 95% CI (4.02–4.26), p < 0.001) and those who never smoked (OR smoking – previous: 1.11, 95% CI (1.09–1.14), p < 0.001). Finally, the consumption of raw salad, vegetables and alcohol demonstrated no significant associations with hypertension. Conclusion: This study highlights the associations between lifestyle behaviours, including physical activity and dietary habits, and their relationships with hypertension in a sample from the UK Biobank. Evidently, lifestyle behaviours are crucial to hypertension. However, some associations emerged in unexpected directions, suggesting that further research in this area should be conducted using longitudinal data.15 0