Saudi Cultural Missions Theses & Dissertations
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Item Restricted 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, AnastasiaEffects 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.8 0Item Restricted 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-AliBackground: 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.10 0Item Restricted Rapid Evaluation of Saudi Arabia’s Nutritional Labelling Policy(University College London, 2024) Al Shaber, Joud; Beard, EmmaBackground: 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.29 0Item Restricted Body Weight and Mortality Risk in Community-Dwelling Older Adults(Monash University, 2024-02-21) Alharbi, Tagrid Abdullah; Owen, Alice; Freak Poli, Rosanne; Ryan, Joanne; Gasevic, DanijelaBackground: Overweight and obesity, generally defined by body mass index (BMI) ≥ 25 kg/m² or large waist circumference (abdominal obesity), is increasingly prevalent among older adults worldwide, however studies of excess weight and the link with mortality risk in older adults have reported mixed findings. Weight change may be a better indicator of mortality risk in older individuals, but large community-based longitudinal studies of older individuals are needed. Aims: To systematically review the association between weight change and all-cause mortality risk in adults aged ≥ 65 years, and to examine the association of weight status, abdominal obesity and weight change with the risk of mortality in community-dwelling older adults aged ≥ 65 years. Methods: A systematic review and meta-analysis conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to examined the evidence that weight change (loss, gain and fluctuation, measured by weight or BMI) is associated with all-cause mortality. Secondary data analysis was performed using longitudinal data on community-dwelling individuals from the ESPIRIT (France, N=2,017) and ASPREE/ALSOP sub-studies (Australia, N=14,853). The association of self-reported weight loss, objectively measured weight change (loss and gain), weight status, and abdominal obesity with all-cause mortality over a 17-year follow-up period in the ESPIRIT study was explored using Cox proportional-hazard regression. To broaden understanding of the association between BMI in early (at age 18 years) and later (age ≥70 years) adulthood, and their impact on later-life mortality (over a median of 4.7 years in the ASPREE/ALSOP sub-study), Cox proportional-hazard regression was applied. Furthermore, the socio-demographic, lifestyle, and clinical characteristics associated with change in weight status between early (age 18 years) and late (age ≥ 70 years) adulthood were identified. Results: From the systematic review, weight change, particularly weight loss, was found to be associated with a 59% increased risk of mortality compared to stable weight. Longitudinal data analyses found that abdominal obesity was linked to a 49% increased mortality risk compared to non-abdominal obesity, but being overweight was associated with a 20% decreased risk compared to a normal BMI. Self-reported weight loss of >3 kg at baseline was associated with a 52% increase in mortality risk for men only; but both men and women with ≥ 5% objectively measured weight loss had a 24% increased risk of all-cause mortality. Obesity at 18 years, but not in older age, was associated with a 35% increased risk of mortality in later life. Compared to participants with a normal BMI, obesity at both early adulthood and later life was associated with 99% increase in the risk of all-cause mortality. Obesity in early and/or late adulthood was also associated with a higher risk of adverse clinical risk characteristics. Conclusion: Weight change and weight status are important predictors of mortality risk in older adults. These results highlight the importance of healthcare providers monitoring weight in older adults to detect weight loss at it is early stages, enabling more effective interventions aimed at maintaining stable weight and reducing risk of premature mortality.47 0