Saudi Cultural Missions Theses & Dissertations

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    Effects of Ketogenic Diets on Body Composition in Adults with Obesity and Overweight – Systematic Review of Randomized Controlled Trials
    (Saudi Digital Library, 2025) Alotaibi, Sultana; Brown, Adrian; Kalea, Anastasia
    Effects of Ketogenic Diets on Body Composition in Adults with Obesity and Overweight – Systematic Review of Randomized Controlled Trials Abstract (250 words): Background/Objectives: Even though ketogenic diets (KD) are gaining more attention in weight management, their effects on body composition as a standalone treatment remain uncertain. The aim of this review was to evaluate the effects of KD (<50g/day of carbohydrate) as the sole intervention for over 12 weeks on body composition outcomes in adults living with overweight/obesity. Methods: Three different databases (Cochrane library, Embase, and Ovid Medline) were searched following PRISMA guidelines for randomized controlled trials (RCT’s) published in the last twenty years. Studies were included if they reported at least one of the following outcomes [fat mass (kg or %), lean mass (kg or %), fat-free mass “FFM” (kg), bone mass content (kg) or /density (g/cm2)]. Screening was performed using Rayyan website. Data were extracted and synthesized narratively exploring dietary composition heterogeneity, confirmation of ketosis, and data analyses. Risk of bias (RoB) was assessed using Cochrane RoB2 tool. Results: Eight studies met our criteria, all of them had concerns on risk of bias. Studies showed that KD had greater effects in decreasing body fat and lean mass compared to other interventions; however, these effects tend not to be significant. There were no effects on FFM and bone mass, but long-term studies were limited. Conclusions: KD appear to effectively decrease fat mass but may negatively affect lean mass especially in the short term. Future studies should aim for controlling carbohydrate and protein intake to confirm the impacts of KD on body composition in the long term.
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    The Effect of Green Tea Supplementation on Overweight and Obese Women of Reproductive Age (18–50 Years): A Systematic Review
    (Saudi Digital Library, 2025) Almutairi, Omar; Sue, Azam-Ali
    Background: Overweight and obesity among women of reproductive age pose substantial health risks. Green tea (GT), rich in catechins such as epigallocatechin-3- gallate, has been proposed as an adjunct to lifestyle interventions for weight management. However, evidence across studies, mainly due to variability in dose, formulation and co-interventions, remains inconclusive. Objective: This systematic review aimed to evaluate the impact of GT supplementation on anthropometric and metabolic outcomes in women of reproductive age 18–50 years who suffer from overweight/obesity. Methodology: A systematic search (2010 onwards) of PubMed and MEDLINE (Ovid) identified 663 records; after removing 286 duplicates, 377 titles/abstracts were screened and 50 full texts assessed. Seven randomised controlled trials (RCTs) met the inclusion criteria (women 18–50 years, BMI ≥ 25 kg/m²; GT tablets/capsules/powder; 4–12 weeks). The primary outcomes were changes in body weight, body mass index (BMI) and waist circumference (WC); secondary outcomes included lipid profile, blood pressure and fasting blood glucose. Risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. Results: Across the seven RCTs (n = 255), GT supplementation was associated with modest reductions in body weight (−1.8 to −5.7 kg) and BMI (−0.7 to −1.8 kg/m²), with some evidence of decreases in WC. Effects were most pronounced when supplementation was combined with structured exercise. Trials prescribing isocaloric, energy-restricted diets to both groups often showed minimal between-group differences, underscoring the primacy of energy deficit. Effects on triglycerides and low-density lipoprotein were heterogeneous and often aligned with training rather than GT itself; fasting glucose generally showed no meaningful between-group differences. Conclusion: GT supplementation appears to provide small but potentially meaningful benefits for weight management in overweight and obese women of reproductive age, particularly when combined with exercise. However, heterogeneity in dose, intervention design and study quality limits definitive conclusions. Larger, longer-term RCTs are required to determine whether these short-term benefits translate into sustained improvements in anthropometric and cardiometabolic health.
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    The effect of obesity surgery on taste, brain function and structure
    (Saudi Digital Library, 2025) Alalsheikh, Alhanouf; Goldstone, Tony; anderMiras, Alex
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    The Role of Nerve Growth Factor in Diabetic Cardiomyopathy
    (Auburn University, 2025) Jafari, Hassan Ali; Jeganathan, Ramesh
    Obesity and type 2 diabetes mellitus (T2DM) are characterized by increased levels of circulating fatty acids, resulting in metabolic abnormalities in the heart. Emerging data has demonstrated that cardiac dysfunction, including diabetic cardiomyopathy (DCM), is linked to obesity and T2DM. Nerve growth factor (NGF), a neurotrophic factor, plays pro-survival and anti-apoptotic roles in cardiomyocytes. Therefore, the first study aimed to investigate the effects of NGF on myocardial insulin resistance, oxidative stress, apoptosis, and inflammation. In vitro study using H9c2 cell lines showed that high-glucose treatment induced myocardial insulin resistance. Combining palmitic acid and high-glucose treatment increased oxidative stress and activated apoptotic and inflammatory markers in cardiomyocytes. We also found that NGF administration prevented diabetic cardiomyopathy by inhibiting myocardial insulin resistance, oxidative stress, cardiac apoptosis, and inflammation via activation of the PI3K/Akt. The second part of the dissertation work aimed to clarify the role of mitochondrial dysfunction in the development of DCM and to examine the effects of NGF on mitochondrial dynamics, biogenesis, and mitophagy in obese and T2DM mouse models. Our western blot results showed no significant differences in mitochondrial dynamics and biogenesis proteins in all groups. However, cardiac mitophagy was suppressed in diabetic mice. Notably, intranasal NGF administration showed no effects on mitochondrial function. In summary, NGF administration prevented obesity- and T2DM-induced diabetic cardiomyopathy in vitro but not in vivo. These results suggest that the cardioprotective effects of NGF may depend on the delivery route of NGF. Further research is needed to clarify its effectiveness in diabetic heart using different NGF delivery routes.
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    The Effectiveness of School-Based Nurse Intervention in Managing Obesity among Students Aged 6-18 years old
    (University of Glasgow, 2024-07-29) Almuqeet, Balssam; Rosemary, Mullen
    Abstract Background: Schools play a crucial role in shaping healthy lifestyles; however, school nurses are often excluded from obesity intervention programs. In 2022, 390 million children aged 5-19 were overweight and 160 million were obese, therefore effective methods of intervention are more important than ever. Aims: This review aims to explore the effectiveness of school-based nurse interventions in managing obesity among school-aged students from 6-18 years old. Methods: A comprehensive literature search of Medline Ovid, CINAHL, Cochrane library, and PubMed databases identified randomised controlled trials and quasi experimental studies from the last ten years. The inclusion criteria included school students aged from 6-18 years, interventions delivered by nurses in school, and reported outcome measures on weight or BMI. Studies that were not experimental designs were excluded. Joanna Briggs critical appraisal tools were used to appraise methodological quality. Results: Seven studies met the eligibility criteria. Interventions delivered by school nurses included educational sessions, physical activity programs, and dietary guidance. The measurable outcomes included improvements in dietary behaviour, decreases in BMI, and increases in physical activity levels among students. None of the studies used blinding, some studies did not clearly report the attrition rate. Despite these limitations, all studies used appropriate study designs and applied rigorous statistical analyses. Six out of seven studies reported significant improvement in dietary habits, five studies found an increase in physical activity levels among the students, and four studies observed a decrease in BMI. Conclusions: The findings of the review suggest that school-based nurse interventions are effective in managing obesity among school students. Future research should include objective measures and use longitudinal designs to assess the sustainability and impact on BMI.
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    Knowledge, perception, and experience with Ketogenic Diet for the treatment of overweight and obesity among adults: a systematic review
    (University Of Sheffield, 2024-07-30) Alghamdi, Ghaday; Akparibo, Robert
    Background: during the past decades, the prevalence of obesity has significantly increased around the globe, leading to increased demand for dietary interventions for weight reduction. Among these, ketogenic diet (KD) has gained great attention among adults and has been proposed as a promising option to achieve significant weight loss in a short period of time. Aim: to evaluate and critically appraise the current observational data exploring knowledge, perception, and experience of individuals using KD for weight loss, including their adherence to the diet. Methods: relevant studies were identified through five electronic databases: Web of Science, Medline via Ovid, CINAHL, Scopus, and PsycInfo, which sufficiently covered all key disciplines for the review. Eligible studies included observational studies published from 2020 to 2024, in English language, and exploring adults’ knowledge, perception, and experience with KD to manage their weight. Quality of the included studies was assessed using the AXIS appraisal tool for cross-sectional studies (CSSs). A narrative synthesis was carried out to summaries and interpret the results. Results: five studies were included in the review. The quality of studies varied: three studies were of high quality, one was of moderate quality, and one was of low quality. All of the five studies assessed adults’ knowledge and perception of KD for weight management, and three explored their current/ previous experience with the diet. In general, the overall knowledge level of participants was “good” except for one study that reported inadequate level of knowledge. The majority of participants agreed that KD is a popular weight loss intervention but argued about how safe and easy it is to be followed in the long term and that it should always be followed under medical supervision. Participants’ experience with KD showed effective weight loss outcomes with slight variations in adherence duration. The minimum duration for following KD was less than a month, and the maximum duration was six months, leading to weight regain among some participants. Conclusions: the findings conclude that KD has been an effective weight loss strategy if followed under medical supervision. However, adherence level to the diet was low, which increased the chance of weight regain. Future research: robust studies are required to evaluate KD’s potential long-term health implications, as well as assess KD effectiveness for the treatment of overweight and obesity including its sustainability.
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    Knowledge, perception, and experience with Ketogenic Diet for the treatment of overweight and obesity among adults: a systematic review
    (University Of Sheffield, 2024-05-08) Alghamdi, Ghaday; Akparibo, Robert
    Background: during the past decades, the prevalence of obesity has significantly increased around the globe, leading to increased demand for dietary interventions for weight reduction. Among these, ketogenic diet (KD) has gained great attention among adults and has been proposed as a promising option to achieve significant weight loss in a short period of time. Aim: to evaluate and critically appraise the current observational data exploring knowledge, perception, and experience of individuals using KD for weight loss, including their adherence to the diet. Methods: relevant studies were identified through five electronic databases: Web of Science, Medline via Ovid, CINAHL, Scopus, and PsycInfo, which sufficiently covered all key disciplines for the review. Eligible studies included observational studies published from 2020 to 2024, in English language, and exploring adults’ knowledge, perception, and experience with KD to manage their weight. Quality of the included studies was assessed using the AXIS appraisal tool for cross-sectional studies (CSSs). A narrative synthesis was carried out to summaries and interpret the results. Results: five studies were included in the review. The quality of studies varied: three studies were of high quality, one was of moderate quality, and one was of low quality. All of the five studies assessed adults’ knowledge and perception of KD for weight management, and three explored their current/ previous experience with the diet. In general, the overall knowledge level of participants was “good” except for one study that reported inadequate level of knowledge. The majority of participants agreed that KD is a popular weight loss intervention but argued about how safe and easy it is to be followed in the long term and that it should always be followed under medical supervision. Participants’ experience with KD showed effective weight loss outcomes with slight variations in adherence duration. The minimum duration for following KD was less than a month, and the maximum duration was six months, leading to weight regain among some participants. Conclusions: the findings conclude that KD has been an effective weight loss strategy if followed under medical supervision. However, adherence level to the diet was low, which increased the chance of weight regain. Future research: robust studies are required to evaluate KD’s potential long-term health implications, as well as assess KD effectiveness for the treatment of overweight and obesity including its sustainability.
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    Attenuated growth during early postnatal life protects offspring from obesity and a fatty liver.
    (The University of Aberdeen, 2024-07-23) Hasaballah, Khulod; Kolb, Andreas
    Early life nutrition significantly impacts adult metabolic health, particularly protein supply during pregnancy and lactation, affecting susceptibility to metabolic syndromes like obesity, type II diabetes, fatty liver, and cardiovascular disease. This thesis used a mouse model of delayed postnatal growth to evaluate the impact of early nutrition on adult metabolic health. Programmed mice nursed by a casein-deficient mother only grow to 50% of their body weight by the end of lactation. During adolescence, the programmed mice reach about 80% of the weight of control animals but then retain that lower weight throughout life. The reduced postnatal growth results in a partial resistance to high-fat diet-induced obesity and full protection against fatty liver. Chapter 3 found that programmed mice increased the expression of energy expenditure markers Dio2 and PGC1a in brown adipose tissue at a conventional house temperature of 20 °C. They also showed increased UCP1 expression and adiponectin expression. In a second experiment, at a thermal house temperature of 30 °C, PGC1a expression increased in brown adipose tissue, subcutaneous white adipose tissue, and epididymal white adipose tissue. Ucp1 gene expression was also increased in BAT and sWAT, with a reduction in response to a high-fat diet. Programed mice showed increased adiponectin expression and decreased leptin expression. chapter 4 found that a microarray study found that early nutrition significantly impacted the expression of FGF21, Elovl5, Insig2, and Erg1 in programmed mice, which is associated with lipid metabolism and metabolic health. This difference was observed in programmed mice compared to wild-type mice. Quantitative PCR confirmed the findings, suggesting protection against obesity and fatty liver. In chapter 5 found that in vitro experiments using HepG2 liver cells demonstrated that the casein amino acid composition enhances lipid storage in liver cells compared to other amino acid compositions such as soy, microalgae, and cell culture medium.
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    Anticipation of the Positive Effect of Changing Food Markting in Saudi Arabia
    (Bournemoith University, 2023-09-06) Harith, Wallaa; Hartwell, Heather
    The hospitality sector contributes significantly to the community health. The food environment in retailers, restaurants and coffee shops can shape individuals' eating habits. Thus, the Saudi Food and Drug Ministry considers transforming food environment in the country in order to boost health. Nevertheless, Saudi Arabia has a high number of noncommunicable diseases attributed mostly to less healthy eating habits. In actual fact, interventions in grocery retailer outlets, becomes a popular strategy to nudge healthier purchasing. Product placement, for instance, is one of the most popular forms of retail intervention used to stimulate consumers to make healthier decisions, thereby reducing the numbers of obesity and its complications as it has reached an epidemic stage in Saudi Arabia. This dissertation, therefore, analyses the association between product placement of food in retail outlets and dietary behaviour and purchasing of these products. This study applies a semi-structured interview approach in light of the lack of existing publications addressing the impact of product placement on people dietary habits and health outcomes specifically in my geographical location. The findings indicate that food environment in retail outlets significantly impacts consumers' choices. This study has found that the product placement technique positively promotes and increases healthy food consumption which subsequently boosts health; it also stimulates costumers to buy products deemed to be healthy. Several motivations, including the placing, price, appearance and promotion, may encourage consumers to buy the food product.
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    Rapid Evaluation of Saudi Arabia’s Nutritional Labelling Policy
    (University College London, 2024) Al Shaber, Joud; Beard, Emma
    Background: Unhealthy weight is a major global health issue. It's particularly severe in Saudi Arabia (SA) where over 35% of adults are classified as obese. SA’s response has included policies for healthier living, featuring nutritional labelling to help consumers make informed food choices. Aims: This dissertation aims to conduct a rapid systematic review to evaluate the different labelling strategies. Findings will then be used to make evidenced-based recommendations to the existing nutritional labelling policies in SA. Methods: Systematic reviews were first identified from the World Obesity Federation. A rapid search was also conducted in PubMed and Embase from 2021 until January 2024 to identify any recent systematic reviews which may not have been identified by the World Obesity Federation. Search queries included categories on intervention (e.g., nutrition logo, Nutrition Facts, traffic light) and reviews. Online searches were complemented by hand-searching of reference lists as well as the first 20 “related articles” in PubMed for each included systematic review. Gray literature was searched on Google. Results: Sixteen reviews were found. Many identified a positive impact of warning labels, traffic light systems, and color-coded labels on consumer behaviour. However, efficacy depended on several design features (e.g. size, colour and placement) and was increased when part of a multi-component intervention including education and awareness campaigns. Considering SA’s rudimentary nutritional labelling system, the review suggests the adoption of more accessible and interpretative labels, coupled with public health campaigns and pricing strategies, to steer consumers towards healthier alternatives. Conclusion: Evidence from various countries indicate that interpretative labels, such as traffic light systems and warning labels, successfully promote healthier food selections. Subsequent research should concentrate on the enduring impacts of these labelling strategies within Saudi Arabia's distinct socio-cultural setting, investigating demographic variances and the potential role of digital tools in boosting label utilization and understanding.
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