The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia
Abstract
:1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- World Health Organization (WHO). Obesity and Overweight. Available online: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (accessed on 9 January 2020).
- 108 Million People In The World Face Severe Food Insecurity—Situation Worsening. Available online: https://www.wfp.org/news/108-million-people-world-face-severe-food-insecuritysituation-worsening (accessed on 11 November 2021).
- Ng, S.W.; Zaghloul, S.; Ali, H.I.; Harrison, G.; Popkin, B.M. The prevalence and trends of overweight, obesity and nutrition-related non-communicable diseases in the Arabian Gulf States. Obes. Rev. 2011, 12, 1–13. [Google Scholar] [CrossRef]
- Swinburn, B.A.; Sacks, G.; Hall, K.D.; McPherson, K.; Finegood, D.T.; Moodie, M.L.; Gortmaker, S.L. The global obesity pandemic: Shaped by global drivers and local environments. Lancet 2011, 378, 804–814. [Google Scholar] [CrossRef]
- Garawi, F.; Ploubidis, G.B.; Devries, K.; Al-Hamdan, N.; Uauy, R. Do routinely measured risk factors for obesity explain the sex gap in its prevalence? Observations from Saudi Arabia Disease epidemiology—Chronic. BMC Public Health 2015, 15, 524. [Google Scholar] [CrossRef] [Green Version]
- Al-Nuaim, A.A.; Bamgboye, E.A.; Al-Rubeaan, K.A.; Al-Mazrou, Y. Overweight and obesity in Saudi Arabian adult population, role of socio- demographic variables. J. Community Health 1997, 22, 211–223. [Google Scholar] [CrossRef]
- WHO. A Framework for Surveillance: The WHO STEPwise Approach to Surveillance of Noncommunicable Diseases (STEPS); World Health Organization: Geneva, Switzerland, 2003. [Google Scholar]
- World Health Organization. Noncommunicable Diseases (NCD) Country Profiles. 2018. Available online: https://www.who.int/nmh/countries/2018/sau_en.pdf (accessed on 3 April 2021).
- Lee, C.H.; Woo, Y.C.; Wang, Y.; Yeung, C.Y.; Xu, A.; Lam, K.S.L. Obesity, adipokines and cancer: An update. Clin. Endocrinol. 2015, 83, 147–156. [Google Scholar] [CrossRef] [Green Version]
- Haslam, D.W.; James, W.P.T. Obesity. Lancet 2005, 366, 1197–1209. [Google Scholar] [CrossRef]
- Memish, Z.A.; El Bcheraoui, C.E.; Tuffaha, M.; Robinson, M.; Daoud, F.; Jaber, S.; Mikhitarian, S.; Al Saeedi, M.; AlMazroa, M.A.; Mokdad, A.H.; et al. Obesity and associated factors—Kingdom of Saudi Arabia, 2013. Prev. Chronic Dis. 2014, 11, E174. [Google Scholar] [CrossRef] [Green Version]
- Aune, D.; Sen, A.; Prasad, M.; Norat, T.; Janszky, I.; Tonstad, S.; Romundstad, P.; Vatten, L.J. BMI and all cause mortality: Systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants. BMJ 2016, 353, i2156. [Google Scholar] [CrossRef] [Green Version]
- Memish, Z.A.; Jaber, S.; Mokdad, A.H.; AlMazroa, M.A.; Murray, C.J.L.; Al Rabeeah, A.A.; El Bcheraoui, C.; Daoud, F.; Tuffaha, M.; Murphy, T.; et al. Burden of disease, injuries, and risk factors in the Kingdom of Saudi Arabia, 1990–2010. Prev. Chronic Dis. 2014, 11, 26. [Google Scholar] [CrossRef] [Green Version]
- Global Burden of Disease Compare Tool. Available online: https://vizhub.healthdata.org/gbd-compare/ (accessed on 10 September 2021).
- Institute for Health Metrics and Evaluation Country Profile, Saudi Arabia. 2017. Available online: http://www.healthdata.org/saudi-arabia (accessed on 3 April 2021).
- Alsukait, R.; Wilde, P.; Bleich, S.N.; Singh, G.; Folta, S.C. Evaluating Saudi Arabia’s 50% carbonated drink excise tax: Changes in prices and volume sales. Econ. Hum. Biol. 2020, 38, 100868. [Google Scholar] [CrossRef] [PubMed]
- Sofía Rincón-Gallardo, P.; Zhou, M.; Gomes, F.D.S.; Lemaire, R.; Hedrick, V.; Serrano, E.; Kraak, V.I. Effects of menu labeling policies on transnational restaurant chains to promote a healthy diet: A scoping review to inform policy and research. Nutrients 2020, 12, 1544. [Google Scholar] [CrossRef]
- Al-Quwaidhi, A.J.; Pearce, M.S.; Critchley, J.A.; Sobngwi, E.; O’flaherty, M. Trends and future projections of the prevalence of adult obesity in Saudi Arabia, 1992–2022. East. Mediterr. Health J. 2014, 20, 589–595. [Google Scholar] [CrossRef]
- Heisey-Grove, D.; Wall, H.K.; Helwig, A.; Wright, J.S. Centers for Disease Control and Prevention (CDC) Using electronic clinical quality measure reporting for public health surveillance. Morb. Mortal. Wkly. Rep. 2015, 64, 439–442. [Google Scholar]
- Friedman, D.J.; Parrish, R.G.; Ross, D.A. Electronic health records and US public health: Current realities and future promise. Am. J. Public Health 2013, 103, 1560–1567. [Google Scholar] [CrossRef]
- Bailey, L.C.; Milov, D.E.; Kelleher, K.; Kahn, M.G.; Del Beccaro, M.; Yu, F.; Richards, T.; Forrest, C.B. Multi-Institutional Sharing of Electronic Health Record Data to Assess Childhood Obesity. PLoS ONE 2013, 8, e66192. [Google Scholar] [CrossRef] [PubMed]
- AlAbdulKader, A.M.; Tuwairqi, K.; Rao, G. Obesity and Cardiovascular Risk in the Arab Gulf States. Curr. Cardiovasc. Risk Rep. 2020, 14, 7. [Google Scholar] [CrossRef]
- Diabetes Medication. Available online: https://www.diabetes.org/healthy-living/medication-treatments/oral-medication/what-are-my-options (accessed on 9 November 2021).
- The Classes of Blood Pressure Medications Include. Available online: https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/types-of-blood-pressure-medications (accessed on 11 October 2021).
- Perlman, S.E.; McVeigh, K.H.; Thorpe, L.E.; Jacobson, L.; Greene, C.M.; Gwynn, R.C. Innovations in population health surveillance: Using electronic health records for chronic disease surveillance. Am. J. Public Health 2017, 107, 853–857. [Google Scholar] [CrossRef]
- Figgatt, M.; Chen, J.; Capper, G.; Cohen, S.; Washington, R. Chronic Disease Surveillance Using Electronic Health Records From Health Centers in a Large Urban Setting. J. Public Health Manag. Pract. 2021, 27, 186–192. [Google Scholar] [CrossRef]
- Al-Sumaih, I.; Johnston, B.; Donnelly, M.; O’Neill, C. The relationship between obesity, diabetes, hypertension and vitamin D deficiency among Saudi Arabians aged 15 and over: Results from the Saudi health interview survey. BMC Endocr. Disord. 2020, 20, 81. [Google Scholar] [CrossRef]
- Almajwal, A.M.; Al-Baghli, N.A.; Batterham, M.J.; Williams, P.G.; Al-Turki, K.A.; Al-Ghamdi, A.J.; Almajwal, A. Performance of Body Mass Index in Predicting Diabetes and Hypertension in the Eastern Province of Saudi Arabia. Ann. Saudi Med. 2009, 29, 437–445. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Al-Ghamdi, S.; Shubair, M.M.; Aldiab, A.; Al-Zahrani, J.M.; Aldossari, K.K.; Househ, M.; Nooruddin, S.; Razzak, H.A.; El-Metwally, A. Prevalence of overweight and obesity based on the body mass index; A cross-sectional study in Alkharj, Saudi Arabia. Lipids Health Dis. 2018, 17, 34. [Google Scholar] [CrossRef] [Green Version]
- Al-Raddadi, R.; Bahijri, S.M.; Jambi, H.A.; Ferns, G.; Tuomilehto, J. The prevalence of obesity and overweight, associated demographic and lifestyle factors, and health status in the adult population of Jeddah, Saudi Arabia. Ther. Adv. Chronic Dis. 2019, 10, 2040622319878997. [Google Scholar] [CrossRef] [PubMed]
- Alhabib, K.F.; Batais, M.A.; Almigbal, T.H.; Alshamiri, M.Q.; Altaradi, H.; Rangarajan, S.; Yusuf, S. Demographic, behavioral, and cardiovascular disease risk factors in the Saudi population: Results from the Prospective Urban Rural Epidemiology study (PURE-Saudi). BMC Public Health 2020, 20, 1213. [Google Scholar] [CrossRef]
- DeNicola, E.; Aburizaiza, O.S.; Siddique, A.; Khwaja, H.; Carpenter, D.O. Obesity and public health in the Kingdom of Saudi Arabia. Rev. Environ. Health 2015, 30, 191–205. [Google Scholar] [CrossRef] [PubMed]
- Saudi Arabia Vision 2030, Healthcare Transformation. Available online: https://www.vision2030.gov.sa/v2030/vrps/hstp/ (accessed on 4 January 2021).
- Bakhsh, M.A.; Khawandanah, J.; Naaman, R.K.; Alashmali, S. The impact of COVID-19 quarantine on dietary habits and physical activity in Saudi Arabia: A cross-sectional study. BMC Public Health 2021, 21, 1487. [Google Scholar] [CrossRef]
- Aggarwal, A.; Patel, P.; Lewison, G.; Ekzayez, A.; Coutts, A.; Fouad, F.M.; Shamieh, O.; Giacaman, R.; Kutluk, T.; Khalek, R.A.; et al. The Profile of Non-Communicable Disease (NCD) research in the Middle East and North Africa (MENA) region: Analyzing the NCD burden, research outputs and international research collaboration. PLoS ONE 2020, 15, e0232077. [Google Scholar] [CrossRef] [PubMed]
- Al-Rabiah Chairs First Meeting of Saudi National Institute of Health. Available online: https://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2020-05-08-001.aspx (accessed on 5 August 2021).
Characteristic Variables | n (%) |
---|---|
Age categories | |
17–25 | 116,656 (18.94) |
26–45 | 264,892 (43) |
46–64 | 152,672 (24.79) |
≥65 | 81,580 (13.25) |
Gender | |
Male | 277,336 (45) |
Female | 338,724 (55) |
BMI/kg × m−2 categories | |
Underweight | 33,324 (5.41) |
Normal | 162,100 (26.32) |
Overweight | 180,431 (29.30) |
Obese | 239,913 (38.96) |
Nationality | |
Saudi | 573,698 (93.12) |
Non-Saudi | 42,102 (6.83) |
Region | |
Central | 338,027 (54.89) |
Western | 178,204 (28.94) |
Eastern | 99,569 (16.17) |
Diabetes mellitus | |
Yes | 113,409 (18.42) |
No | 502,391 (81.58) |
Hypertension | |
Yes | 99,934 (16.23) |
No | 515,866 (83.77) |
Variables | Underweight n (%) | Normal n (%) | Overweight n (%) | Obese n (%) | p-Value |
---|---|---|---|---|---|
Age categories | |||||
17–25 | 20,114(17.24) | 51,716 (44.33) | 24,098 (20.66) | 20,728 (17.77) | <0.01 * |
26–45 | 9713 (3.7) | 74,762 (28.22) | 85,091 (32.12) | 95,326 (35.99) | |
46–64 | 1422 (0.93) | 19,262 (12.62) | 45,564 (29.84) | 86,424 (56.61) | |
≥65 | 2083 (2.55) | 16,370 (20.07) | 25,689 (31.49) | 37,438 (45.89) | |
Gender | |||||
Male | 18,742 (6.76) | 81,624 (29.45) | 90,342 (32.59) | 86,488 (31.20) | <0.01 * |
Female | 14,582 (4.31) | 80,476 (23.77) | 90,089 (26.61) | 153,425 (45.32) | |
Nationality | |||||
Saudi | 32,140 (5.6) | 147,836(25.77) | 165,048 (28.77) | 228,674 (39.86) | <0.01 * |
Non-Saudi | 1192 (2.83) | 14,274 (33.90) | 15,394 (36.56) | 11,242 (26.70) | |
Region | |||||
Central | 17,489 (5.17) | 88,254 (26.11) | 99,079 (29.31) | 133,205(39.41) | <0.01 * |
Western | 11,215 (6.29) | 48,950 (27.47) | 53,012 (29.75) | 65,027 (36.49) | |
Eastern | 4628 (4.65) | 24,906 (25.01) | 28,351 (28.47) | 41,684 (41.86) | |
Diabetes mellitus | |||||
Yes | 1570 (1.38) | 14,736 (12.99) | 32,734 (28.86) | 64,369 (56.76) | <0.01 * |
No | 31,762 (6.32) | 147,374(29.33) | 147,708 (29.40) | 175,547(34.94) | |
Hypertension | |||||
Yes | 1359 (1.36) | 12,927 (12.94) | 28,483 (28.50) | 57,165 (57.20) | <0.01 * |
No | 31,973 (6.20) | 149,183(28.92) | 151,959 (29.46) | 182,751(35.43) |
Adjusted Odds of Diabetes | Adjusted Odds of Hypertension | |||||
---|---|---|---|---|---|---|
Variables | Odds Ratio (OR) | 95% CI | p-Value | Odds Ratio (OR) | 95% CI | p-Value |
Age category | ||||||
17–25 | Reference | |||||
26–45 | 2.34 | 2.26–2.43 | <0.01 * | 3.96 | 3.70–4.23 | <0.01 * |
46–64 | 13.37 | 12.87–13.89 | <0.01 * | 37.71 | 35.37–40.21 | <0.01 * |
≥65 | 27.37 | 26.32–28.45 | <0.01 * | 106.189 | 99.57–113.25 | <0.01 * |
Gender | ||||||
Female | Reference | |||||
Male | 1.06 | 1.05–1.08 | <0.01 * | 1.18 | 1.16–1.20 | <0.01 * |
BMI | ||||||
Normal weight | Reference | |||||
Underweight | 0.78 | 0.74–0.83 | <0.01 * | 0.86 | 0.81–0.92 | <0.01 * |
Overweight | 1.56 | 1.52–1.59 | <0.01 * | 1.45 | 1.41–1.49 | <0.01 * |
Obese | 2.24 | 2.19–2.29 | <0.01 * | 2.15 | 2.09–2.19 | <0.01 * |
Region | ||||||
Central | Reference | |||||
Western | 0.74 | 0.72–0.75 | <0.01 * | 0.62 | 0.61–0.63 | <0.01 * |
Eastern | 0.90 | 0.88–0.92 | <0.01 * | 0.89 | 0.87–0.92 | <0.01 * |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Alghnam, S.; Alessy, S.A.; Bosaad, M.; Alzahrani, S.; Al Alwan, I.I.; Alqarni, A.; Alshammari, R.; Al Dubayee, M.; Alfadhel, M. The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia. Int. J. Environ. Res. Public Health 2021, 18, 12361. https://doi.org/10.3390/ijerph182312361
Alghnam S, Alessy SA, Bosaad M, Alzahrani S, Al Alwan II, Alqarni A, Alshammari R, Al Dubayee M, Alfadhel M. The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia. International Journal of Environmental Research and Public Health. 2021; 18(23):12361. https://doi.org/10.3390/ijerph182312361
Chicago/Turabian StyleAlghnam, Suliman, Saleh A. Alessy, Mohamed Bosaad, Sarah Alzahrani, Ibrahim I. Al Alwan, Ali Alqarni, Riyadh Alshammari, Mohammed Al Dubayee, and Majid Alfadhel. 2021. "The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia" International Journal of Environmental Research and Public Health 18, no. 23: 12361. https://doi.org/10.3390/ijerph182312361