Obesity Medicine 18 (2020) 100198

Contents lists available at ScienceDirect

Obesity Medicine
journal homepage: www.elsevier.com/locate/obmed

Original research

Predictors of overweight and obesity among employees of Sadara Chemical T

Company in the Kingdom of Saudi Arabia
Nizar Jaouaa,∗, Alexander Woodmanb, Mellissa Withersc
a
Department of Mathematics and Natural Sciences, Prince Mohammad Bin Fahd University, Khobar, Saudi Arabia
b
Deanship of Postgraduate Studies and Research, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
c
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, United States

A R T I C LE I N FO A B S T R A C T

Keywords: Rapid economic growth, improved living standards, and immense urbanization in the Kingdom of Saudi Arabia
BMI (KSA) have affected nutritional habits and physical activity. Recent increases in physical inactivity, sedentary
Employee behaviours, consumption of caloric-dense diets, and sugar-sweetened beverages have led to overweight and
Logistic regression obesity and non-communicable diseases (NCDs). This study's objectives are to 1) determine current prevalence of
Obesity
and risk factors for obesity, and 2) predict the probability of obesity among full-time employees of Sadara, the
Sadara
largest chemical company in KSA. In 2019, a written survey in both Arabic and English was administered to 505
Saudi Arabia
Workplace wellness Sadara employees randomly selected from five Sadara locations. A number of factors possibly associated with
BMI were examined using Chi-Square test: age, physical activity, screen watching, childhood region, nationality,
fat intake, sugar intake, family size, household income, and consumption of meal-replacement bars. Logistic
regression was performed to compare the trends and predict conditional probabilities of obesity. The sample was
92% male, 61% Saudi, from the Eastern Province of KSA, with a mean age of 34 years. Employees aged 30–39
years were found to have 1.8 times greater odds for obesity than the youngest employees (below 30 years). More
specifically, those aged 30–39, who grew up in the Eastern Province, who had low physical activity and long
periods of watching electronic screens had the highest probability of obesity (more than 66%). Workplace
wellness programs that focus on lifestyle habits could help reduce the high prevalence of overweight and obesity
and associated NCDs in KSA.

1. Introduction transition in terms of the burden of disease - from communicable dis-

Increasing rates of overweight and obesity are now global crises.
The World Health Organization (WHO) reported that obesity has more
than doubled globally since 1980. As of 2014, 39% of adults were
overweight and 13% were obese (World Health Organization, 2015).
Overweight and obesity increase the risk of a multitude of health pro-
blems, such as cardiovascular diseases, diabetes, and cancer (World
Health Organization, 2015).
Currently, the countries of the Middle East are experiencing health
challenges relating to increasing rates of overweight, obesity, and as-
sociated non-communicable diseases (NCDs). The rise of overweight
and obesity in the Kingdom of Saudi Arabia (KSA) are concerning;
about 67.5% of males and 69.2% of females in the KSA are overweight
and 29.5% of males and 39.5% females are considered to be obese
(World Health Organization, 2016).
In recent decades, many developing countries have witnessed a
eases to higher rates of NCDs. This transition impacts not only on the
health of the population but create economic hazards from the in-
dividual to national levels (Withers and McCool, 2018). The high costs
of obesity and related NCDs can cause significant financial difficulties
for individuals and families, as well as employers and the healthcare
system as a whole. Additionally, the indirect costs - productivity losses
due to illness and disability, sickness absence, early retirement or
mortality relating to overweight, obesity, and other NCDs-account for
51% to 59% of total costs of healthcare system and employers (Dee
et al., 2014).
Obesity and absenteeism have a complex connection to NCDs and
productivity loss. Several studies have found that employing large
numbers of workers with overweight, obesity, and related NCDs can
reduce productivity by up to 60%, largely due to reduced work capacity
and absenteeism (Pronk, 2009; Van Vilsteren et al., 2015). For example,
employees who are overweight or obese may have to temporarily or

∗
Corresponding author.
E-mail address: njaoua@pmu.edu.sa (N. Jaoua).

https://doi.org/10.1016/j.obmed.2020.100198
Received 15 November 2019; Received in revised form 17 February 2020; Accepted 17 February 2020
2451-8476/ © 2020 Elsevier Ltd. All rights reserved.
N. Jaoua, et al. Obesity Medicine 18 (2020) 100198

permanently leave their jobs because of poor health, and others who company grounds and provides routine healthcare as well as annual
continue working may have a reduced work capacity. The longitudinal check-ups for the entire staff (Sadara, 2018). The management has been
association between obesity and absenteeism was explored by Reber successful in the reduction of work-related injuries and diseases, both
et al. (2018) among employees in Germany. The study found that obese within and outside of the workplace (Sadara, 2018).
employees take a higher number of sick leave days compared to their
non-obese co-workers. Schulte et al. (2008) suggested that obesity “has 3. Methods
been shown to affect the relationships between exposure to workplace
hazards and disease or injuries. It may also be a co-risk factor for them.” A total of 505 employees (42 females, 463 males) was randomly
The association between obesity and productivity loss was also de- selected at Sadara chemical company headquarters in 2019 to complete
scribed by Pollack and Cheskin (2007) in a literature review of 12 a survey on lifestyle practices. The participants constituted a re-
studies which found that the risk of development other diseases in presentative sample made up of 60.6% Saudi and 39.4% non-Saudi
obese employees is higher than in non-obese. Further, overweight and employees, with ages ranging from 18 to 62 years. The written, self-
obese employees on average take more sick leave and spend less time at administrated survey collected information on socio-demographic
work (Schmier et al., 2006; Pollack and Cheskin, 2007). characteristics and lifestyle habits, such as level of physical activity,
Workplace wellness programs can have tremendous benefits for and dietary intake. The survey was pre-tested by a randomly selected
employees but also for employers. Around the world, corporations are group of students at the Prince Mohammad bin Fahd University (PMU).
now promoting health and wellness of their employees. While addres- This study was approved by the Institutional Review Board of PMU. All
sing the obesity epidemic can benefit employers, the development and participants provided written informed consent.
implementation of workplace wellness programs can be challenging The data were analysed with the use of the SPSS statistics software
and requires strong leadership and investment (Marsh et al., 2018; program. The BMI was determined for each participant based on the
Mattke et al., 2013; Woodman and Jaoua, 2018). Marsh et al. (2018) ratio of their weight (in kilograms) to the square of their height (in
conducted 17 semi-structured interviews with senior executives from meters). The results were then converted into four BMI categories with
mining, transport, agriculture, manufacturing, farming, hospitality, and the following cut-points for BMI: < 18.5 kg/m2 underweight,
construction companies, to assess the potential impact of workplace 18.5–24.9 kg/m2 normal weight, 25.0–29.9 kg/m2 overweight, and ≥
wellness programs. All of the senior executives agreed that employers 30 kg/m2 obese, as specified by WHO standards (World Health
play a vital role in promoting the health and welfare among employees Organization, 2018). Several variables, such as gender, age, fat and
and in the workplace culture. However, they were primarily concerned sugar intakes, weekly amount of exercise, family size and income, were
about such issues as chemical storage, safe tractor driving, safety examined to determine their significance and the possible effect on
clothing, and the health issues that often result from inadequate safety BMI. Chi-square test was used to determine the significance of the as-
guidelines. Many considered health and welfare as the personal re- sociation between BMI and 10 key variables. Logistic regression was
sponsibility of each individual as opposed to the corporation's, espe- used to examine predictors for obesity in this sample.
cially when the workers were contractors and subcontractors. Fenton
et al. (2014) studied workplace wellness programs in several different 4. Results
industries, including the construction and retail industries and found
that the implementation of workplace wellness programs was asso- 4.1. Descriptive characteristics of the sample
ciated with the level of responsibility of management towards their
employees, the desire to make a positive impact on employee health As seen in [Table 1], the sample was 92% male, 61% Saudi, mostly
and welfare, as well as goals of improving business efficiency and from the Eastern Province of the KSA, with a mean age of 34 years old.
performance (Fenton et al., 2014). The connection between NCDs and The mean height was 1.68 m and the mean weight was 65 kg for fe-
reduced productivity makes investment in human capital essential. males and 75 kg for males. On average, females were close to being
considered overweight while males were slightly overweight (mean
2. The healthcare structure for the employees of Sadara, Saudi
Arabia Table 1
Socio-demographic characteristics of sample (n = 505).
Many Middle Eastern corporations have recently implemented
Characteristics Categories n (%) Mean SDa
workplace wellness programs, largely motivated by potential loss of
employee productivity due to illness. One example is Sadara Chemical Gender Female 42 (8.3) – –
Company, which was established in 2011 as a joint venture between the Male 463 (91.7)
Saudi Arabian Oil Company (Sadara) and the Dow Chemical Company Age (years) < 30 214 (42.4) 34 10
30–39 168 (33.3)
(Dow) in the KSA. The company is one of the largest chemical com- 40–49 92 (18.2)
plexes in the world (Sadara, 2018). Sadara currently employs 5,624 ≥50 31 (6.1)
direct employees. In addition, Solvay, a third-party collaborator, has Nationality Saudi 306 (60.6) – –
639 employees and Marafiq, the providers of desalination water used Non-Saudi 199 (39.4)
Height (m) Female 1.64 0.09
for human and work processes in plants, has 437 employees. The
Male 1.68 0.09
number of contractors working in construction of Sadara facilities was Weight (kg) Female 65 15.12
more than 90,000. The number of labour contractors is 9,812. Ap- Male 75 18.53
proximately 92.61% of Sadara's employees who are based in the KSA BMI (kg/m2) Female 24.3 4.56
are Saudi nationals (Sadara, 2018). The company is actively collabor- Male 26.6 6.30
Family size ≤3 85 (16.8) 7 4
ating with the Gulf Petrochemical and Chemical Association (GPCA)'s 4–6 197 (39.0)
Responsible Care Committee, which is dedicated to bringing the highest 7–9 137 (27.1)
standards of operational safety and environmental sustainability into all ≥10 86 (17.0)
procedures. Additionally, the founders of Sadara believe that: “its fi- Family's Monthly Income (1,000 SAR/ <5 143 (28.3) 11 6
month) 5–9.999 77 (15.2)
nancial bottom line is dependent upon pursuing sustainable solutions in
10–14.999 162 (32.1)
the areas of environment, health and safety that are in harmony with ≥15 123 (24.4)
the requirements of nature and human society.” (Sadara, 2018). It has
a
implemented numerous safety standards. A hospital is located on SD: Standard Deviation.

2
N. Jaoua, et al. Obesity Medicine 18 (2020) 100198

those who reported more than 3 h of weekly physical activity (see

[Fig. 2]). Overall, the differences in BMI by amount of physical activity
were highly significant (p < 10−5).

4.2.2. Childhood region

Fig. 1. Distribution of Sadara employees by weight category (n = 505).
BMI of 24.3 and 26.6 respectively). The mean size of the family was
seven people (often including grandparents) with a range of 1–41. The
mean family monthly income was 11,000 (SAR) with a range of 1,000
to 25,000 (SAR).
4.1.1. Prevalence of underweight, normal weight, overweight and obesity
[Fig. 1] shows the prevalence of underweight, overweight and
obesity in this sample; 3.4%, 28.5%, and 21.2% respectively. About
47% were considered to be normal weight.
4.2. Factors associated with BMI
As shown in [Table 2], those who grew up in the Eastern region had
the highest prevalence of obesity (25%) but the highest percentage of
overweight were those who grew up outside the Eastern Province
(38%). These differences were statistically significant (p ≈ 0.001).
Considering both BMI and physical activity, as shown in [Fig. 2],
Easterners had higher prevalence of obesity across all physical activity
categories, as compared to those who grew up outside KSA as well as
the overall sample. For example, 44.2% of Easterners with less than 1 h
per week of physical activity were obese, compared to 32.6% of the
total sample with a similar level of physical activity. Additionally, the
gaps in obesity between the three exercise-based groups seemed to be
the largest among Easterners, demonstrating a higher effect of physical
activity on the obesity status among these employees.
4.2.3. Screen watching
As shown in [Table 2], one in four participants reported spending at
least 6 h per day watching screens such as computers and televisions.
These employees were, by far, the most likely to be obese (36.5%),
compared to those who had between 2- and 6-h daily screen time
(14.1%) and those watching less than 2 h daily (19.8%). However, they
held the lowest prevalence of overweight (21%), compared to the other
groups (32% and 30% respectively). Overall, the differences in BMI by
screen-watching were highly significant (p < 10−4).

A number of factors possibly associated with BMI were examined
using Chi-Square test. These included age, physical activity, screen
watching, childhood region, nationality, fat intake, sugar intake, family
size, household income, and consumption level of meal-replacement
bars. Based on a significance level set at a p-value of 0.05 or less, the test
revealed five statistically significant factors as described below.
4.2.4. Age
As seen in [Table 2], the lowest prevalence of obesity (17%) was
found among the youngest employees (under 30) and the highest (26%)
was found among the oldest (50 or more), who also had the highest rate
of overweight (39%). The differences in BMI by age were statistically
significant (p ≈ 0.036).

4.2.1. Physical exercise 4.2.5. Nationality

As shown in [Table 2], among the total sample, 34.7% reported
exercising less than 1 h per week, 35.4% exercised between 1 and 3 h
per week and 20.8% reported 3 or more hours of weekly exercise. The
most active participants also had the highest overweight rate (32.4%).
However, 32.6% of the least active were obese, compared to 18.7% of
those who exercised between 1 and 3 h per week, and only 7.6% among
Of Saudis, which represented about 60% of the total sample, 24.2%
were overweight and 22.2% were obese, compared to 35.5% over-
weight and 19.6% obese among non-Saudis. These differences were
statistically significant (p ≈ 0.038). Considering age and nationality
together (see [Fig. 3]), among Saudis, the youngest employees (under
age 30) were the least obese (16%) and the oldest (aged 50 years or

Table 2
Factors associated with BMI of Sadara employees.
Body Mass Index Status

Obese Overweight Other Total Chi2 Test

Factor Category n (%) n (%) n (%) n (%) p-value

Physical activity (hours/week) <1 57 (32.6) 50 (28.6) 68 (38.9) 175 (34.7) 0.000009
1– < 3 42 (18.7) 60 (26.7) 123 (54.7) 354 (35.4)
≥3 8 (7.6) 34 (32.4) 63 (60.0) 105 (20.8)
Screen watching (hours/day) <2 26 (19.8) 39 (29.8) 66 (50.4) 131 (25.9) 0.00004
2– < 6 35 (14.1) 78 (31.5) 135 (54.4) 248 (49.1)
≥6 46 (36.5) 27 (21.4) 53 (42.1) 126 (25.0)
Childhood region Eastern Province 39 (25.2) 40 (25.8) 76 (49.0) 155 (30.7) 0.001
Other Province 27 (23.5) 18 (15.7) 70 (60.9) 115 (22.8)
Outside KSA 34 (19.1) 67 (37.6) 77 (43.3) 178 (35.2)
Age (years) < 30 36 (16.8) 59 (27.6) 119 (55.6) 214 (42.4) 0.0356
30–39 41 (24.4) 39 (23.2) 88 (52.4) 168 (33.3)
40–49 22 (23.9) 34 (37.0) 36 (39.1) 92 (18.2)
≥50 8 (25.8) 12 (38.7) 11 (35.5) 31 (6.1)
Nationality Saudi 68 (22.2) 74 (24.2) 164 (53.6) 306 (60.6) 0.0376
Non-Saudi 39 (19.6) 70 (35.2) 90 (45.2) 199 (39.4)
Total 107 (21.2) 144 (28.5) 254 (50.3) 505 (100)

3
N. Jaoua, et al. Obesity Medicine 18 (2020) 100198

Fig. 2. Prevalence of obesity by amount of exercise and childhood region among Sadara sample.

given employee category and conditional probabilities can be estimated

Fig. 3. Prevalence of obesity by age and nationality among Sadara sample.
above) were the most obese (30%). As for non-Saudis, the second
youngest group (30–39 years) had the highest prevalence of obesity
(22%) and the second oldest group (40–49 years) held the lowest rate
(15%).
5. Logistic regression
As seen in [Table 2], the amount of physical activity per week was
by far the factor which most influenced the BMI (p < 10−5), followed
by screen watching and childhood region, which were found to have a
highly significant effect on BMI (p ≈ 0.00004 and 0.001 respectively).
Two other factors, namely age and nationality, were shown to be much
less influent on BMI (p ≈ 0.036 and 0.038 respectively). A logistic
regression of obesity status, involving the first four factors, was found to
be statistically highly significant (p < 10−9) [Table 3]. Indicates the
predicted odds ratios for obesity based on the regression analysis re-
port.
As shown in [Table 3], the trends of obesity can be compared for a
for the obesity, in particular the highest and the lowest ones. Indeed,
whereas those who spend 6 h or more per day watching electronic
screens would have close to four times greater odds of obesity than less
sedentary ones (two to 6 h per day), those who exercise very little (less
than 1 h per week) are expected to have 2.3 times more odds for obesity
than those who exercise moderately (between one and 3 h per week),
but about 8.3 times greater odds than the most active participants (3 h a
week or more). Those aged 30–39 are 1.8 times more likely to be obese
than the youngest (under 30). Those who grew up in the Kingdom of
Saudi Arabia are about 1.5 times (for Eastern) and 1.3 times (for non-
Eastern) more likely to be obese than those raised outside the Kingdom.
On the other hand, the probability of obesity can be determined using
the logistic regression equation which serves as a multiple linear model
for the Log odd denoted by L:
p ⎞
L:=ln ⎜⎛ ⎟ ≈ c+ ∑ bi xi
⎝ 1 − p⎠ i (1)
where p, c , bi , x i respectively denote the probability of obesity, the
coefficients given in [Table 3] (column B), and the code values (1 or 0)
of the involved predictors.
From equation (1), one can estimate the probability p of obesity as
follows:
1 ⎛
p≈
1 + e−L ⎜L ≈ c+ ∑ bi xi ⎞⎟
⎝ i ⎠ (2)
As the probability increases with the Log odd, its maximum and
minimum values are attained respectively at the highest and lowest
values of the amount L, which are obtained by optimizing the coeffi-
cients bi for each category. Consequently, the likeliest employees to be

Table 3
Summary of logistic regression analysis predicting obesity.
Predictor Category B S.E. Sig.* Odds Ratio (95% CI)

Amount of Exercisea < 1 h/w 0.81 0.26 0.0016 2.26 (1.36–3.74)

≥3 h/w −1.34 0.42 0.0015 0.26 (0.11–0.60)
Amount of Screen Watchingb < 2 h/d 0.19 0.32 0.5577 1.20 (0.65–2.24)
≥6 h/d 1.37 0.28 < 10−5 3.94 (2.27–6.86)
Childhood Regionc Eastern Province 0.43 0.30 0.1598 1.53 (0.85–2.78)
Other Saudi province 0.29 0.30 0.3334 1.34 (0.74–2.41)
Aged 30–39 0.60 0.28 0.0318 1.81 (1.05–3.12)
40–49 0.47 0.33 0.1596 1.59 (0.83–3.05)
≥50 0.26 0.50 0.5977 1.23 (0.49–3.44)
Constant −2.47 0.35 < 10−11 0.08

* Statistical significance: set at a p-value of 0.05 or less (confidence level: 0.05).

a
Reference amount interval for exercise: 1 – < 3 h/week.
b
Reference time interval for screen-watching: between 2 and < 6 h/day.
c
Reference group for childhood region: Outside KSA.
d
Reference age group: < 30.

4
N. Jaoua, et al.
Fig. 4. Highest and lowest probabilities of obesity among the employees of Sadara based on a logistic regression model.
obese; namely those aged 30–39, who grew up in the Eastern Province,
work out for less than 1 h/w, and watch electronic screens for at least
6 h/day, have more than two chances in three to be obese. Indeed, the
Log odd for obesity is maximized with this category of employees:
Lmax ≈ −2.47 + (0.6) ∗ (1) + (0.43) ∗ (1) + (1.37) ∗ (1) + (0.81)
∗ (1) = 0.74
and so is the probability of obesity:
1 years were found to have 1.8 times more odds than the youngest (under
pmax (Obese ) ≈ ≈ .676 = 67.6%
1 + e−0.74
However, as shown in [Fig. 4], there is only about 2% chance for the
least likely employees to be obese; the youngest ones (under 30), who
grew up outside KSA, work out for at least 3 h per week, and moder-
ately watch electronic screens (between two and 6 h per day).
6. Discussion
The results of this study shed light on the prevalence and factors
associated with overweight and obesity among employees of the largest
chemical manufacturing corporation in the KSA. We found alarmingly
high levels of overweight and obesity among the sample of 505 parti-
cipants. Based on this representative sample, the prevalence of over-
weight and obesity among all employees were estimated to be 21.2%
and 28.5% respectively. Obesity rates were found to be significantly
higher among those who grew up in the Eastern Province and lowest
among those who were raised outside the KSA (25.2 ± 6.8% vs.
19.1 ± 5.8%).
The prevalence rate is high, as demonstrated in several regions
within the KSA. For example, in Hail the rate is 33.9%, in Al Sharqiya it
is 27.7%, 21.7% in Riyadh, 19.3% in Makkah's, 16.5% in Jeddah, and in
Jisan it stands 11.7% (Aldaqal and Sehlo, 2013). As compared to a
healthy sample, the adolescent group was 5.5 times more likely to have
impaired health-related quality of life. Furthermore, the studies re-
vealed that, in 50%–77% of the sample, obesity tends to continue into
adulthood (Aldaqal and Sehlo, 2013; Jaoua et al., 2018). Consequently,
it increases the risk of developing serious and often life-threatening
conditions. Studies show that this risk will increase to 80% if one parent
is obese (Aldaqal and Sehlo, 2013).
We found that unhealthy BMIs were associated with age, physical
activity, time spent watching electronic screens, and region of residence
during childhood. The latter variable was included because a study by
Wodman and Jaoua (2018) found that among male employees at Saudi
Aramco, employees who grew up in the east of KSA (27%) or who were
raised outside KSA (26%) had higher rates of obesity, in particular
compared to those who spent their childhood in the west of the country
(13%) and to those who grew up in the south of KSA (14%) (Woodman
and Jaoua, 2018). Our study's results mirrored this finding; those who
grew up in the Eastern region had the highest prevalence of obesity
(25%).
Sadara employees between 30 and 39 years of age were more likely
to be obese compared to employees under age 30 (24.4% vs. 16.8%).
The high prevalence of overweight and obesity among individuals in
Obesity Medicine 18 (2020) 100198
their 30s and 40s, is of concern. Low level of physical activity was also a
significant predictor of obesity; the prevalence of obesity was much
higher among those with less than 1 h of physical activity per week
compared to those with at least 3 h of physical activity per week (32.6%
vs. 7.6%). And sedentary behaviours were also found to be predictive of
obesity; those who had 6 h or more daily screen time had significantly
(3) higher rates of obesity than those who spend two to 6 h per day (36.5%
vs. 14.1%).
The logistic regression analysis showed that employees aged 30–39
(4) age 30), and those who grew up in the KSA were about 1.5 times (for
Eastern) and 1.3 times (for non-Eastern) more likely to be obese than
those raised outside the KSA. In addition, the highest and the lowest
conditional probabilities of obesity based on this logistic regression
model were determined (67.6% and 2.2%). More specifically, em-
ployees aged 30–39, who grew up in the Eastern Province, had less than
1 h of daily physical activity, and had six or more hours of daily screen
time were found to be the most likely to be obese.
Individuals with unhealthy BMIs are at higher risk for a range of
negative health consequences, including NCDs. Research has shown
that the influence of NCDs on employee health and welfare, the cost of
healthcare, and loss of productivity due to such conditions are clear
stimulators for employers to develop and promote healthy lifestyle and
disease prevention initiatives. Such initiatives can target both preven-
tion and early identification and treatment of NCDs (National Research
Council (US) Panel on Statistics for an Aging Population, 1988). Ad-
ditional efforts to motivate employees to participate in workplace
wellness programs, and to sustain participation over a long term, are
needed. Incentivizing employees to participate by giving them pro-
tected time at work has shown to increase participation (Marsh et al.,
2018). Employers and governments should work together to implement
evidence-based public health interventions to prevent and control NCDs
as outlined by the WHO (WHO, 2017). The report “Tackling NCDs, Best
Buys,” by the WHO, offers a number of ‘best buys’ and interventions to
reduce NCDs (WHO, 2017).
Interventions at the workplace can be cost-effective and achievable.
These interventions have six main objectives: 1) To raise the priority
accorded to the prevention and control of NCDs in global, regional and
national agendas and internationally agreed development goals,
through strengthened international cooperation and advocacy; 2) To
strengthen national capacity, leadership, governance, multisectoral
action and partnerships to accelerate country response for the preven-
tion and control of NCDs; 3) To reduce modifiable risk factors for NCDs
and underlying social determinants through creation of health-pro-
moting environments; 4) To strengthen and orient health systems to
address the prevention and control of NCDs and the underlying social
determinants through people-centred primary health care and universal
health coverage; 5) To promote and support national capacity for high-
quality research and development for the prevention and control of
NCDs; and 6) To monitor the trends and determinants of NCDs and
evaluate progress in their prevention and control (WHO, 2017). The
implementation of these cost-effective strategies can increase knowl-
edge among employees about the importance of physical activity,
5
N. Jaoua, et al.
healthy nutrition, and the effects of overweight and obesity on NCDs
and health and life expectancy.
7. Limitations
This study had some limitations. Firstly, the sample largely con-
sisted of males. Therefore, the results only apply to the male population
of the company. However, this is representative of the demographics of
the Sadara workforce which is 92% male. Secondly, this study was
conducted among employees of one large corporation in the KSA and
the results might not be generalizable to the larger population. Finally,
the survey was self-administered and social desirability bias might have
influenced the responses of participants.
8. Conclusions
The results demonstrate that sedentary lifestyles and physical in-
activity are common among our sample of workers in the KSA. The high
prevalence of overweight and obesity suggests that the population will
likely suffer from an even greater burden of NCDs in the coming years.
The implementation of workplace wellness programs could positively
impact not only individuals, but also families, communities, employers,
and the nation.
CRediT authorship contribution statement
Nizar Jaoua: Investigation, Data curation, Formal analysis,
Conceptualization. Alexander Woodman: Methodology, Project ad-
ministration, Resources, Software, Supervision. Mellissa Withers:
Writing - original draft, Writing - review & editing.
Declaration of competing interest
The authors have no affiliations with or involvement in any orga-
nisation or entity with any financial interest in the subject matter or
materials discussed in the manuscript.
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