Manuscritos medievales y pre-renacentistas

A previous study by Roberts and Marvin (2011) affirmed the role the environment plays as key determinant of dietary behaviours and physical activity levels among individuals. In addition, low levels of education provide greater restriction on opportunities for parents to provide the needed guidance on the right dietary choice for their children (El‐ Hazmi and Warsy, 2002). Until recently, the focus has been on individual-level determinants, such as a person’s diet and level of engagement in physical activities, perception, knowledge, and

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motivation to lose weight. However, these individual-level factors do not take into account the many complex environmental influences on a person’s behaviour (Abuzaid, 2012; Al Dhaifallah et al., 2015).

As was shown through the understanding of dietary habits, participants generally expressed individual perceptions of how daily physical activities can also help improve their body shape and general health while also decreasing obesity, which was demonstrated to be a major contributing factor in 9-16 years olds’ obesity problems. This knowledge and subsequent responses were presented through three very specific subcategories that all contributed to the greater foundation of children’s perceptions on daily activities that could affect their own weight and health. These subcategories were as follows: firstly, personal daily physical activities; secondly, physical activities at school; and thirdly, physical activities outside of school.

4.10.2.2.1. Access to Physical Activities

It is possible to argue that having knowledge of what exercise one’s body requires and the levels considered unsatisfactory can have some impact on obesity prevention. According to Al-Hazzaa, (2007) the insinuation is that individual perception would enhance and make possible the sustainment of obesity awareness and the efficiency of possible interventions. It may also help in maintaining health development, and hence can be implanted within school health units using the MOE. Within this study all the participants indicated that they were potentially knowledgeable of what exercise their bodies required and what amount would constitute an unsatisfactory level of physical activity. Indeed, walking, running and the going to gym were commonly stated throughout the answers as the most beneficial forms of exercise that a person could undertake on a regular basis. Accordingly, one respondent (PR3) noted that:

“an active lifestyle needs to include engaging in active exercise and walking too. One needs to be involved in lot of physical movements and not too much lying around”,

while a separate remark showed that in order to be fit, “a person does need to engage in a lot of running”. Meanwhile, another comment stated that it was highly beneficial to “exercise a lot during the day .”

Indeed, other statements demonstrated the participants were already aware of the need to undertake certain forms of exercise, which showed a perception of what was most beneficial. They provided statements indicating their willingness to engage in exercises such as, “going to the gym about two or three times a week and doing exercises at home when you don’t go to

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the gym,” was one provided answer that detailed an understanding of what the human body

requires in relation to physical activity. Likewise, a separate statement said that “walking and running, and by doing that more than once a week” would also help a person’s health and

weight. Whether their assertions reflect what they really do is something that has not been explored further during the course of the interview with each participant.

4.10.2.2.2. Physical Activities and School Environmental Factors

With the amount of time spent at school for any child between the ages of 9 and 16, it is imperative that they are presented with the possibility to exercise their bodies as well as their minds during their school days (Hills, et al., 2011). It would be a way of stimulating obesity awareness and implementing physical intervention and development that could remain registered and not relied upon at home. In a previous study by Taha (2005) looking at knowledge and patterns of physical activity among school children, it became evident that the majority of the respondents demonstrated good knowledge on the health benefits of physical activity.

The participants stated that “basketball and football” are the main forms of physical activity,

while one particular student stated the most popular as, “basketball and football in school as they do different activity lessons each week”. However, another respondent stated that, “it

[exercise] is usually different every day”. Furthermore, a major factor that emphasised the

need for the implementation of physical awareness and understanding in obesity awareness stemmed from the detail regarding the duration of time spent undertaking physical activity. Most of the responses point to the relatively short time of involvement in exercise ranging from…….: “45 minutes a week on average”, “ten minutes every day”, “these are about 45

[minutes]’. These three particular answers were specific examples of a general trend that described insufficient time dedicated to physical activity.

Nonetheless, even though many students refrained from stating whether they perceived this amount of time to be sufficient for the development of their bodies, others did state that there were specific reasons why they would not do it, “I don’t spend any time on this because it’s too hot to do this at school”. This was one reason that could be understood in a hot country

such as Saudi Arabia. However, students at such a young age can prove to be highly self- conscious, which makes it difficult for them to exercise in front of their counterparts. For instance, one provided answer was, “I don’t like playing sports at school; I don’t like when other people look at me”. However, many students do understand that the amount of time

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spent on physical education is not enough, as they stated many times, “no it [the amount of dedicated time] is not enough.”

Accordingly, schoolgirls within Saudi Arabia struggle to take part in enough physical exercise while at school, as their schools lack the necessary resources and relevant classes/qualifications in contrast to the boys’ schools (Al Hazzaa, 2004). This is mainly due to the religious Islamic beliefs in the country that stop women from actively participating in physical exercise (Al-Rukban, 2003). Hence, factors such as dress codes, restrictions on going outdoors, and conservative norms are the main reasons for the female low physical activity which is reflected among the present study participants.

Based on the submissions from the participants, for those who took part in one form of exercise, positive self-ratings of health as affirmed in their previous response seemed to play some form of influence in their action. Hence there is the need to engage school children in Saudi especially amidst the context of concerns about obesity in society. While the participants hold a positive view about active lifestyle and its need, another view to consider is the role that school-based breakfast and lunch programmes have in promoting healthy eating among children.

4.10.2.2.3. Physical Activities Outside School

Due to the fact that the students are fully aware that they are not completing enough physical activity in school, it would be beneficial if they would compensate for this with exercise outside school. Unfortunately, added interventions for the majority of students in Saudi Arabia appear to be necessary with regard to obesity awareness and fitness development, as most of the respondents noted that they are not sufficiently active; although others did remark that they would be active when they determined it to be necessary. In fact, the progressively active students answered, “[I do] a lot of walking for things like shopping”,

and, “sometimes I do cycling”, and to expand on this, one of the participants PR16 said,

“I like walking maybe about an hour in total as I like to play outside with my friends, and they make up games which I play. Sometimes I go for long walks on my own and sometimes with friends. Maybe about an hour in total as I like to play games with my friends and sometimes I go on a walk. I like going on a walk because it allows me the opportunity to see different things”.

The participant’s responses indicate willingness towards active lifestyle and in general the vast majority of the participants are not completing a recommended level of physical exercise.

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The duration of physical activity was commonly referred to by the respondents and it was always seen to be insufficient and below the 180 minutes recommended for what a developing body requires to curb obesity and improve fitness levels (Trost et al., 2001). Nearly all of the participants stated, “about an hour” as the maximum amount of time a day

they spent doing any form of exercise. One of the participants (PR1) specifically mentioned, “I spend about 15 minutes daily on these physical activities”, while another stated,

“sometimes it’s different but usually about an hour”. However, it was a frequent response that no physical activity was undertaken during the week, as it was mostly only done at weekends. The school curriculum does not take into consideration the provision of physical education, especially in girl’s schools Khalid (2008) and Al-Rukban (2003). This is seen as another setback as to why the respondents reported low engagement in physical activity, especially while in the school environment.

Part of the reason given by many participants for not taking part in any form of active sport outside the school environment is attributed to the weather. For example, PR 13 stated:

“I sometimes take part in outdoor activities, but really not that much because of the weather condition that’s most of the time is very hot for outdoor activities.”

PR3 also opined that the weather is also a factor that hinders activity outdoors,

“Well, not really, not that much. I don’t like it. I don’t like to do it because of the hot weather, I think it’s too hot to do these activities.”

While several hold the view that weather is a hindering factor, there is the need to encourage positive long-term lifestyle changes as early as possible in every child’s life, which include physical exercise in order to curb against the early development of obesity and cardiovascular risk factors (Datar and Nicosia, 2012).

It must be added that although the students did not partake in physical exercise on a regular basis, they still possessed great awareness of its benefits and requirements. Therefore, the implementation of potential interventions could be developed from this knowledge. One particular participant remarked in relation to their own understanding that their physical activity was: “not long; I would say about an hour or just under”. In addition, the majority of

students attributed excuses for a lack of exercise as “tiredness”, “homework”, or “gaming”,

which would increase their levels of sedentary time. Here, the lack of physical activity is a key factor facilitating sedentary lifestyle practices and can be a principal contributor to the prevalence of obesity. Hence this demonstrates that work needs to be done with schools to develop approaches to enable students to exercise under varied conditions.

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4.10.2.3 Theme 3: Influence of Knowledge Attitude and Belief in Existing Obesity Prevention