Saudi Cultural Missions Theses & Dissertations
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Item 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.24 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.45 0