Nouf A. Alghamdi

Objectives: Phenylketonuria (PKU) is associated with detrimental impacts on factors contributing to the etiology of obesity, and metabolism disorders. Therefore, we hypothesized that physicians and dietitians demonstrate a sufficient level of nutritional knowledge of the PKU type diet. The aim of this study is to assess understanding of the PKU diet in relation to current guidelines among dietitians and metabolic physicians in Saudi Arabia. Methods: This study involved 238 participants, primarily Saudi and non-Saudi dietitians and metabolic physicians working in Saudi Arabia, who asked to complete an electronic questionnaire assessing their nutritional knowledge of the PKU diet. The questionnaire evaluated participants’ knowledge across three PKU diet domains, their opinions on diet and patient body composition and their understanding of the ‘traffic light system’ of food categorization. Results: A total of 181 participants completed the questionnaire. The assessment of knowledge revealed a correct score of 46%; that is, more than half of the participants scored below 50%. While the most correctly answered question concerned the importance of adhering to the PKU diet among patients with PKU (93% answered correctly), the least correctly answered question (6% answered correctly) required participants to recognize that female PKU patients have more pronounced differences in body composition. More than that 85% of the study participants agreed that PKU patients have difficulty complying with the PKU diet. There was varied familiarity with the ‘traffic light system’ of food item categorization. Key concerns for poor dietary compliance included social and financial challenges, alongside the diet’s unpalatability. Conclusion: Dietitians and metabolic physicians demonstrate a moderate level of understanding regarding the nutritional management of patients with PKU, establishing the need for enhanced educational focus for both groups.

Introduction: Sleep plays a vital role in daily functioning and well-being, yet insufficient sleep is a growing global concern influenced by modern lifestyles. Methods: This study examined the relationship between dietary habits, and sleep quality among 1,041 Saudi adults using self-administered questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and a nutrition behavior questionnaire. Results: The key findings included that 77.4% of participants had poor sleep quality (PSQI > 6). Females reported worse sleep efficiency, more disturbances, and greater daytime dysfunction than males. Dietary patterns revealed low consumption of fruits (38.2%), vegetables (28%), fish (38.9%), and legumes (38%), and high consumption of starches (41%), poultry (26.4%), and sweets (29.9%). Positive associations were found between sleep efficiency and fruit, fish, and legume intake, while high starch, sweets, and dairy consumption correlated with poorer sleep quality, longer sleep latency, and increased daytime dysfunction. Gender-specific analysis showed distinct dietary effects. In males, fruits, vegetables, dairy, and legumes improved sleep quality, whereas starches and sweets negatively affected it. In females, sweets negatively affected sleep quality and latency, while fish consumption improved sleep efficiency and reduced dysfunction. Discussion: The study highlights the connection between diet and sleep, suggesting that individualized dietary interventions could help enhance sleep quality. However, limitations, such as self-reported data and confounding factors, call for further research using objective measures.

Compulsive exercise is a condition characterized by uncontrollable exercise behaviour that may lead to severe and harmful physical and psychological consequences. Indeed, compulsive exercise is among the early symptoms of eating disorders that may affect different age groups. Globally and among Arab countries, compulsive exercise is common, while the screening methods used to assess compulsive exercise are limited. Thus, the Compulsive Exercise Test (CET) has emerged as a tool to assess cognitive, behavioural, and emotional factors related to compulsive exercise. The CET is a self-report, Likert-type scale comprising five distinct subscales. The increase in the CET scores is more likely associated with worsened pathology. Since the Arab countries lack such an assessment tool, we aimed to translate the CET into Arabic, validate the translated version, confirm the factor structures, and assess the internal consistency of the different subscales. Herein, we used the forward–backward translation method as recommended by the World Health Organization (WHO). The overall validity index of the translated version showed a score higher than 0.78, while the scale-level content validity index based on the average calculating method (S-CVI/Ave) and the agreement method (S-CVI/UA) were 0.91 and 0.58, respectively. Moreover, we recruited 399 Arabs living in Saudi to measure the internal consistency, and the value of the substantive internal consistency with Cronbach’s α was 0.81. Subsequently, four of the Arabic-CET subscales had substantive internal consistency with Cronbach’s α values higher than or equal to 0.70. Furthermore, the exploratory factor analysis results supported the substantial use of the five-subscale model. Taken together, our study supports using the Arabic-CET version to measure exercise compulsiveness among Arabs.

Walking is widely recognized as one of the most common and effective forms of physical activity, particularly for older adults. This study examined the comparative effects of two types of walking interventions, including supervised group-based intervention (SGBI) and non-supervised individual-based intervention (NSIBI), on frailty syndrome, cognitive functions or skills, and health-related quality of life among sedentary older Saudi individuals. A 15-week double-blinded, randomized controlled trial (RCT) including three groups (two were intervention groups while the other was the control group) was conducted among older adults who were inactive to examine the effect of different forms of walking interventions on frailty syndrome, cognitive functions, and health-related quality of life. A total of 107 participants, including 65 males and 42 females, were divided into three groups, which include SGBI, NSIBI, and the control group. Frailty syndrome was measured using the physical performance test (PPT), while cognitive function and health-related quality of life were assessed using the Mini-mental State Examination (MMSE) and the Short Form 36 (SF 36) health survey questionnaire. One-way repeated measures analysis of variance (ANOVA) and one-way analysis of covariance (ANCOVA) with the pre- and post-tests were performed for within- and between-group differences. while post-test data for the control group participants were absent due to the change in elderly center regulation, and they were excluded from the analysis. Hence, the comparison was stated only between the intervention groups. Both of the intervention groups (SGBI and NSIBI) showed significant within-subject differences in the Physical Function subscale of the health-related quality of life scale only, with F(1,20) = 23.03, p < 0.001, and F(1,18) = 27.22, p < 0.001, respectively. On the other hand, the Physical Performance Test revealed significant [F(2,51) = 9.21, p < 0.001] between-group differences in the post-test based on the baseline values. In addition, the average step count of older adults was increased from 4000 steps per session to around 7000 steps per session in the intervention group. The average heart rate of the NSIBI group did not show a visible change, and the resting heart rate of both groups showed a slightly declining trend throughout the intervention period. The walking intervention significantly increased participants’ physical function, which is a component of health-related quality of life and physical performance (frailty level), along with average daily step counts for older adults in Saudi Arabia. Regular engagement in the recommended level of walking is strongly advisable for Saudi Arabian older adults to maintain their overall quality of life at this stage.