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Human obesity has become a global phenomenon. The main goal of this study was to investigate the differences in food consumption and physical activity among high school age youth in two diverse geographical locations (urban and rural areas) and the relationship of some of the factors that may lead to overweight and obesity in Saudi Arabia. There were 300 (150 males and 150 females) high school senior grade level students, recruited from the urban city of Riyadh and 300 high school students recruited from the rural areas of Dawadami (150 males and 150 females). Approval for this study was given by the Ministry of Education in Saudi Arabia as well as Human Subjects Approval was granted from University of Nebraska-Lincoln Institutional Review Board (IRB). Data were collected from January to March, 2012. Anthropometric measurements (BMI), demographic questions, activity questions, food intake/food preferences questions, eating attitudes and behavior questions, medical issues, food frequency questionnaire and a 24-hour food recall, were included in the survey of this study. Results showed that the BMI for rural students was significantly lower than urban. In general, daily activity questions show that the majority of urban teens watched more TV, had more computers and played more video games, came to school with a driver, spent more hours driving a car, were more physically active and had less hours of sleep compared to rural students. Food intake and behavior survey indicate that skipping breakfast, eating at school, consuming soft drinks and eating snacks were prevalent for both groups. Eating out at fast food restaurants was higher among urban than rural. The food frequency questionnaire showed that fruits, vegetables, breads and cereals consumption for rural teens was lower than urban, whereas protein and milk or dairy intakes was higher among rural compare to urban. Twenty-four hour food recall analysis indicated that energy, carbohydrate, fat and vitamin C were significantly higher among urban compared to rural students. Results of this research indicate the need for prevention based healthy lifestyle programming in Saudi high schools.
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