{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:56:00Z","timestamp":1793382960379,"version":"4.5.0"},"reference-count":36,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This cross-sectional study aimed to estimate the prevalence of obesity and its association with diabetes and hypertension among beneficiaries in the National Guard Health Affairs system of Saudi Arabia. We included individuals aged 17 years and older, and patients were classified as diabetic or hypertensive if they had any visit during the 4 years where the primary diagnosis was one of those conditions or they were taking diabetes or hypertension medications. The association between obesity (body mass index \u226530) and diabetes and hypertension were evaluated using a multiple logistic regression model, adjusting for age, gender, nationality, and region. A total of 616,092 individuals were included. The majority were Saudi nationals (93.1%). Approximately 68% of the population were either obese (38.9%) or overweight (29.30%). Obesity was more prevalent among Saudi nationals (39.8% vs. 26.7%, p &lt; 0.01) and females (45.3% vs. 31.2%, p &lt; 0.01). Obesity was independently associated with diabetes mellitus (OR = 2.24, p &lt; 0.01) and hypertension (OR = 2.15, p &lt; 0.01). The prevalence of obesity in the study population was alarming and more pronounced among women. Our findings call for efforts to intensify preventive measures to reduce obesity and associated conditions. Using electronic records to examine the impact of interventions to reduce obesity and chronic conditions may help monitor and improve population health.<\/jats:p>","DOI":"10.3390\/ijerph182312361","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T05:23:02Z","timestamp":1638163382000},"page":"12361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia"],"prefix":"10.3390","volume":"18","author":[{"given":"Suliman","family":"Alghnam","sequence":"first","affiliation":[{"name":"Population Health Section-King Abdullah International Medical Research Centre (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4588-7410","authenticated-orcid":false,"given":"Saleh A.","family":"Alessy","sequence":"additional","affiliation":[{"name":"Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh 11673, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Bosaad","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Pittsburg, Pittsburg, PA 15261, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Population Health Section-King Abdullah International Medical Research Centre (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim I.","family":"Al Alwan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Endocrinology, King Abdulaziz Medical City, King Abdullah Specialist Children\u2019s Hospital, Ministry of National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"College of Medicine, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2413-6637","authenticated-orcid":false,"given":"Ali","family":"Alqarni","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Centre, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Alahsa 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riyadh","family":"Alshammari","sequence":"additional","affiliation":[{"name":"School of Public Health, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Al Dubayee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Endocrinology, King Abdulaziz Medical City, King Abdullah Specialist Children\u2019s Hospital, Ministry of National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"College of Medicine, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9427-7240","authenticated-orcid":false,"given":"Majid","family":"Alfadhel","sequence":"additional","affiliation":[{"name":"Medical Genomic Research Department, King Abdullah International Medical Research Centre, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"Genetics and Precision Medicine Department (GPM), King Abdullah Specialist Children\u2019s Hospital, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,24]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2020, January 09). Obesity and Overweight. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_2","unstructured":"(2021, November 11). 108 Million People In The World Face Severe Food Insecurity\u2014Situation Worsening. Available online: https:\/\/www.wfp.org\/news\/108-million-people-world-face-severe-food-insecuritysituation-worsening."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1467-789X.2010.00750.x","article-title":"The prevalence and trends of overweight, obesity and nutrition-related non-communicable diseases in the Arabian Gulf States","volume":"12","author":"Ng","year":"2011","journal-title":"Obes. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/S0140-6736(11)60813-1","article-title":"The global obesity pandemic: Shaped by global drivers and local environments","volume":"378","author":"Swinburn","year":"2011","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Garawi, F., Ploubidis, G.B., Devries, K., Al-Hamdan, N., and Uauy, R. (2015). Do routinely measured risk factors for obesity explain the sex gap in its prevalence? Observations from Saudi Arabia Disease epidemiology\u2014Chronic. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-1608-6"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1023\/A:1025177108996","article-title":"Overweight and obesity in Saudi Arabian adult population, role of socio- demographic variables","volume":"22","author":"Bamgboye","year":"1997","journal-title":"J. Community Health"},{"key":"ref_7","unstructured":"WHO (2003). A Framework for Surveillance: The WHO STEPwise Approach to Surveillance of Noncommunicable Diseases (STEPS), World Health Organization."},{"key":"ref_8","unstructured":"World Health Organization (2021, April 03). Noncommunicable Diseases (NCD) Country Profiles. Available online: https:\/\/www.who.int\/nmh\/countries\/2018\/sau_en.pdf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/cen.12667","article-title":"Obesity, adipokines and cancer: An update","volume":"83","author":"Lee","year":"2015","journal-title":"Clin. Endocrinol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/S0140-6736(05)67483-1","article-title":"Obesity","volume":"366","author":"Haslam","year":"2005","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E174","DOI":"10.5888\/pcd11.140236","article-title":"Obesity and associated factors\u2014Kingdom of Saudi Arabia, 2013","volume":"11","author":"Memish","year":"2014","journal-title":"Prev. Chronic Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"i2156","DOI":"10.1136\/bmj.i2156","article-title":"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","volume":"353","author":"Aune","year":"2016","journal-title":"BMJ"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"26","DOI":"10.5888\/pcd11.140176","article-title":"Burden of disease, injuries, and risk factors in the Kingdom of Saudi Arabia, 1990\u20132010","volume":"11","author":"Memish","year":"2014","journal-title":"Prev. Chronic Dis."},{"key":"ref_14","unstructured":"(2021, September 10). Global Burden of Disease Compare Tool. Available online: https:\/\/vizhub.healthdata.org\/gbd-compare\/."},{"key":"ref_15","unstructured":"(2021, April 03). Institute for Health Metrics and Evaluation Country Profile, Saudi Arabia. Available online: http:\/\/www.healthdata.org\/saudi-arabia."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100868","DOI":"10.1016\/j.ehb.2020.100868","article-title":"Evaluating Saudi Arabia\u2019s 50% carbonated drink excise tax: Changes in prices and volume sales","volume":"38","author":"Alsukait","year":"2020","journal-title":"Econ. Hum. Biol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Sof\u00eda Rinc\u00f3n-Gallardo, P., Zhou, M., Gomes, F.D.S., Lemaire, R., Hedrick, V., Serrano, E., and Kraak, V.I. (2020). Effects of menu labeling policies on transnational restaurant chains to promote a healthy diet: A scoping review to inform policy and research. Nutrients, 12.","DOI":"10.3390\/nu12061544"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"589","DOI":"10.26719\/2014.20.10.589","article-title":"Trends and future projections of the prevalence of adult obesity in Saudi Arabia, 1992\u20132022","volume":"20","author":"Pearce","year":"2014","journal-title":"East. Mediterr. Health J."},{"key":"ref_19","first-page":"439","article-title":"Centers for Disease Control and Prevention (CDC) Using electronic clinical quality measure reporting for public health surveillance","volume":"64","author":"Wall","year":"2015","journal-title":"Morb. Mortal. Wkly. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.2105\/AJPH.2013.301220","article-title":"Electronic health records and US public health: Current realities and future promise","volume":"103","author":"Friedman","year":"2013","journal-title":"Am. J. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bailey, L.C., Milov, D.E., Kelleher, K., Kahn, M.G., Del Beccaro, M., Yu, F., Richards, T., and Forrest, C.B. (2013). Multi-Institutional Sharing of Electronic Health Record Data to Assess Childhood Obesity. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0066192"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s12170-020-00642-8","article-title":"Obesity and Cardiovascular Risk in the Arab Gulf States","volume":"14","author":"AlAbdulKader","year":"2020","journal-title":"Curr. Cardiovasc. Risk Rep."},{"key":"ref_23","unstructured":"(2021, November 09). Diabetes Medication. Available online: https:\/\/www.diabetes.org\/healthy-living\/medication-treatments\/oral-medication\/what-are-my-options."},{"key":"ref_24","unstructured":"(2021, October 11). 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."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"853","DOI":"10.2105\/AJPH.2017.303813","article-title":"Innovations in population health surveillance: Using electronic health records for chronic disease surveillance","volume":"107","author":"Perlman","year":"2017","journal-title":"Am. J. Public Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1097\/PHH.0000000000001097","article-title":"Chronic Disease Surveillance Using Electronic Health Records From Health Centers in a Large Urban Setting","volume":"27","author":"Figgatt","year":"2021","journal-title":"J. Public Health Manag. Pract."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Al-Sumaih, I., Johnston, B., Donnelly, M., and O\u2019Neill, C. (2020). 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., 20.","DOI":"10.1186\/s12902-020-00562-z"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"437","DOI":"10.4103\/0256-4947.57165","article-title":"Performance of Body Mass Index in Predicting Diabetes and Hypertension in the Eastern Province of Saudi Arabia","volume":"29","author":"Almajwal","year":"2009","journal-title":"Ann. Saudi Med."},{"key":"ref_29","first-page":"34","article-title":"Prevalence of overweight and obesity based on the body mass index; A cross-sectional study in Alkharj, Saudi Arabia","volume":"17","author":"Shubair","year":"2018","journal-title":"Lipids Health Dis."},{"key":"ref_30","first-page":"2040622319878997","article-title":"The prevalence of obesity and overweight, associated demographic and lifestyle factors, and health status in the adult population of Jeddah, Saudi Arabia","volume":"10","author":"Bahijri","year":"2019","journal-title":"Ther. Adv. Chronic Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Alhabib, K.F., Batais, M.A., Almigbal, T.H., Alshamiri, M.Q., Altaradi, H., Rangarajan, S., and Yusuf, S. (2020). Demographic, behavioral, and cardiovascular disease risk factors in the Saudi population: Results from the Prospective Urban Rural Epidemiology study (PURE-Saudi). BMC Public Health, 20.","DOI":"10.1186\/s12889-020-09298-w"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1515\/reveh-2015-0008","article-title":"Obesity and public health in the Kingdom of Saudi Arabia","volume":"30","author":"DeNicola","year":"2015","journal-title":"Rev. Environ. Health"},{"key":"ref_33","unstructured":"(2021, January 04). Saudi Arabia Vision 2030, Healthcare Transformation, Available online: https:\/\/www.vision2030.gov.sa\/v2030\/vrps\/hstp\/."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Bakhsh, M.A., Khawandanah, J., Naaman, R.K., and Alashmali, S. (2021). The impact of COVID-19 quarantine on dietary habits and physical activity in Saudi Arabia: A cross-sectional study. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-11540-y"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Aggarwal, A., Patel, P., Lewison, G., Ekzayez, A., Coutts, A., Fouad, F.M., Shamieh, O., Giacaman, R., Kutluk, T., and Khalek, R.A. (2020). 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, 15.","DOI":"10.1371\/journal.pone.0232077"},{"key":"ref_36","unstructured":"(2021, August 05). 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."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/23\/12361\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:35:14Z","timestamp":1760168114000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/23\/12361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,24]]},"references-count":36,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["ijerph182312361"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182312361","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,24]]}}}