Dietary patterns in Saudi Arabian adults residing in different geographical locations in Saudi Arabia and in the UK in relation to heart disease risk

Abstract

The food situation in Saudi Arabia has markedly changed during the last two decades. A nutrition transition is taking place in the country in which traditional foods are being replaced by fast foods high in fat, sugar, and salt. Since one important modifiable risk factor of cardiovascular disease (CVD) is dietary intake is important to monitor these changes in order to estimate the potential effects of this dietary transition as CVD risk. Saudi Arabia has a wide geographical variation with its two major cities located in contrasting regions where local food availability is very different. Therefore, this study was designed to investigate dietary intake in two samples of adults living in different geographic locations (coastal and internal areas) of Saudi Arabia and also, those living abroad (in this case, in Newcastle, UK). 308 Saudi men and women aged 18 - 65 years were recruited from King Abdul-Aziz University, in the coastal city of Jeddah (50 men, 50 women), Umm Al Qura University, in the inland city of Makkah (73 men, 56 women) and those living abroad in Newcastle, UK (32 men, 47 women). All participants completed detailed three consecutive day food records and an assessment questionnaire that included question on lifestyle practices and socioeconomic status. Height and weight, waist and hip circumference were measured in order to calculate body mass index (kg/m2), and waist/hip ratio. The mean (SD) ages of women and men were 31.1 years (7.35) and 32.2 years (8.27), respectively. BMI was lower in men and women from the coastal region 25.1 (2.76) than the inland region 26.3 (3.21), and for Saudis in Newcastle it was 25.6 (4.36) (P < 0.05). Smoking was more prevalent in the internal area (63%) than coastal area (34%) and (26%) in Saudi immigrants (P < 0.001). Men were more physically active than women in three cities. Dietary intake data across the three locations demonstrate that subjects from the coastal city had a significantly lower energy intake and SFA intake but higher intakes of MUFA and PUFA, fibre, selenium and vitamin A (P < 0.05). In contrast they ate significantly less carbohydrates, calcium, magnesium, sodium, potassium and zinc (P < 0.05). Altogether, the diet of internal city resembled the samples in Newcastle more than the coastal city diet because the levels of key nutrient and food intakes, such as energy, SFA, carbohydrates, calcium, magnesium, potassium and vitamin A, were similar. On the other hand, MUFA and PUFA intakes were different between the three cities (P < 0.001). Fatty acids intakes differed markedly between locations, with the coastal diet higher in omega 3 fatty acids 1.3 vs. 0.37 vs. 0.78 g/day compared with internal diet and Saudi immigrants diet, respectively (P < 0.001), while internal area had highest in trans fatty acids intake (P < 0.001). It is concluded that, the results indicate that the prevalence of CVD risk factors in Saudi adults seems to be high. Food intake was statistically significantly correlated with CVD risk factors for the whole study population. There were differences between each location: people living close to the coastal area consumed more fish and therefore more total omega 3 fatty acids relative to individuals living in the internal areas of Saudi Arabia, in Makkah. This higher intake of total omega 3 fatty acids by individuals living in the coastal city of Jeddah may be one of the reasons for the city’s lower rates of CVD. Nutrition education among internal residents is needed for improving diet quality and for increasing consumption of omega 3 fatty acids.