The purpose of this study was to assess overweight and obesity rates among male college students in KSA and to correlate their body weight status and composition with their eating habits. The current data demonstrated that more than one third of the students were above the normal body weight. Overweight students represented 21.8% of the sample whereas, 15.7% were obese. These findings were consistent with the results of similar studies in other Middle East and some Western countries. In Lebanon, the prevalence of overweight and obesity among male college students was 37.5% and 12.5%, respectively [20
]. In Kuwait the corresponding percentages were 32% and 8.9% [29
], while in the United States and the United Arab Emirates overweight and obese accounted for about 35% of the male college students [19
]. In contrast, only 7.9% of Iranian male college students were above the normal body weight [32
]. That rate decreased to 2.9% among Chinese college students with a percentage of obesity as low as 0.4 [23
]. Despite the small sample sizes and the fact that self-reported height and weight were used in some of the above mentioned studies, their findings still reflect differences in the severity of obesity problems among young adults across nations.
Recently, obesity has been defined in terms of adiposity, rather than the relation of body weight to height and, in turn, body composition became a more desirable determinant of obesity than BMI [33
]. That goes well with our results which confirmed that 38.4% of students are obese according to their BF% compared to 15.7% on basis of their BMI. The present work also demonstrated that the total body fat exceeded its normal values in more than half of the participants and the VFL was elevated in more than one fifth of them. Compared to those of similar studies, our results also revealed that normal, overweight and obese Saudi college students have on average more fat in their bodies than their Lebanese fellows [20
], and their average BF% was higher than that in USA male college students of different ethnicities [35
]. Moreover statistical analysis of the current data showed linear relationship between BF% and VFL among students. Health threatening values of VFL (≥ 10) were only found in subjects with very high BF% (≥ 25) and showed up in all obese and more than one fourth of overweight students. In literature, visceral fat has been closely linked to non-communicable diseases such as type II diabetes mellitus and coronary heart disease [36
]. Therefore, urgent dietary management going hand in hand with regular medical follow up should be considered to overcome or, at least, minimize the risk of the above mentioned diseases in Saudi college students with high VFL [38
The results of our study showed that most of the students have irregular meals with two main meals per day. With the exception of dates, which are a staple food in KSA, the majority of the students eat vegetables and fruits twice per week in maximum. As well, about half of the students eat fried foods three times per week in minimum. These habits need to be corrected using educational programs to promote healthy eating habits in KSA. On the other hand, most of the students take breakfast and snacks daily, eat with their families, are aware of the balanced nutrition and never smoke or drink alcohol. These habits ought to be encouraged. Comparing our results with equivalent studies from Lebanon and China [20
], for students of the same gender, revealed diversity in eating habits among male college students in different societies. Most of Saudi students (63.3%) eat irregular meals while 64.6% of Lebanese and 81.6% of Chinese male students take regular meals. About half of Saudi students have breakfast daily compared to one third of Lebanese and two thirds of Chinese students. In KSA and Lebanon most of students (55.7% and 47.9% respectively) eat only two meals per day. In contrast, the vast majority of Chinese students (74.3%) eat meals thrice a day. Eating snacks was a daily habit in about one third of Saudi, half of Lebanese and only about one tenth of Chinese college students. Vegetables and fruits consumption was uncommon habit among Saudi students. On the other hand, 83.5% of Chinese and 56.3% of Lebanese male students consume vegetables three times or more per week. Moreover, 49% of Lebanese students eat fruits at the same rate. Most Saudi and Lebanese students eat with family, while most Chinese students eat alone.
It is well documented that vegetables and fruits are low in energy density because of their high water and fiber content. Therefore, adding them to a diet reduces its overall energy intake, thus, helping in weight management [39
]. However, the current data showed insignificant (P > 0.05) correlation between BMI, BF% or VFL on one hand and vegetables and fruits consumption on the other hand. That could be explained by two factors; 1) inadequate intake of these foods and 2) the unhealthy habits entitled in their consumption. Eating raw vegetables and fruits in the course of a meal is uncommon among Saudi population. In addition, the vegetables content in most of the traditional Saudi dishes (e.g. Kabsa, Margog, Mandy) is too small to have an impact on the overall energy density of the diet. Moreover, fruits are usually taken as a dessert at the end of meals, thus, losing their "satiety effect" that tends to lower the overall energy intake of the diet. The term "snack" refers to all foods and drinks taken outside the context of the three main meals [40
]. Although increased snacks consumption is often accused for increased prevalence of obesity, yet, a clear cut relation between snacking and BMI is still unsettled. Spanos and Hankey [41
] examined the habitual meal and snaking patterns of university students and found no correlation between BMI and snacking. On the other hand, de Graaf [40
] reported that snacks consumption may contribute to a positive energy balance and increased body weight. Contrarily, results of the present study revealed an inverse relationship between BMI and snacks eating rate. That can be explained by the high-calorie larger meals taken by the students in absence of snacks. This is supported by several epidemiological studies, as cited by Bellisle et al [42
], which revealed an inverse relationship between habitual frequency of eating and BMI, leading to the assumption that increased eating of both meals and snacks frequency i.e. "nibbling meal pattern" helps in avoidance of obesity rather than the "gorging meal pattern". Moreover, a recent study on rats demonstrated that obesity development is associated with increased Calories per meal rather than per day, suggesting that the large size of meal, but not the overnutrition, could be responsible for obesity [43
]. Similarly, significant inverse correlations were detected between both BMI and VFL, and the frequency of eating with family. This could be due to the fact that students, eating away from home, depend mainly on fast food high in Calories and fats and low in vegetables and fruits. This is supported by the results of earlier studies which reported that diets of the university students living away from the family are characterized by a number of undesirable practices affecting their healthy lifestyles. Significant decrease in the consumption of fruits, fresh and cooked vegetables, seafood and pulses together with increased intake of sugar and fast foods were the major dietary changes reported for university students living away from the family home. In addition, it has been suggested that the lack of experience in planning meals, and assuming responsibility for food purchasing and preparing for the first time are the main factors underlying the unhealthier dietary choices of these students [44
]. Moreover, a unique finding in the present work was the significant inverse correlation between VFL and dates eating frequency. Dates are one of the main fruits frequently consumed by Saudis as snacks between meals and prior to main meals on social gatherings. It is well known that consuming the whole fruits promotes satiety and reduces energy intake at the next meal [39
]. This may explain the inverse correlation between VFL and the frequency of dates consumption.