Objective: In the Kingdom of Saudi Arabia (KSA), non-communicable diseases (NCDs) cause 73% of deaths, with high body mass index (BMI) as the leading risk factor. Among adolescents, 79% reported physical inactivity (PA), 30% and 10% were living with overweight/obesity and prediabetes, respectively. Little is known about the influence of school environments in shaping healthy eating (HE) and PA behaviours. This study addressed this gap through two steps: (1) Documentary review of obesity prevention policies, (2) Assessing the school environment in relation to HE and PA. Design: The documentary review consisted of two parts; Part 1: Web-searching literature, hand-searching targeted websites, and stakeholder consultations to confirm the literature findings. Part 2: School-based environmental audit employing the ISCOLE tool and the Saudi Ministry of Education Regulations for School Canteens policy. Setting: Three female high schools were selected from differing economic deprivation levels in Riyadh, KSA. Participants: ISCOLE questionnaires were completed by the researcher in conjunction with a staff member; photo-documentation and observations were made. Results: Seventeen obesity prevention policies were identified; stakeholder consultations identified one additional policy document, and assessment highlighted challenges in policy implementation. The audit revealed notable differences between schools in HE and PA provisions Conclusion: In KSA, female high schools face significant challenges regarding a school environment that supports both HE and PA. These challenges include the absence of HE provisions and lack of suitable PA facilities, coupled with a gap between policy and practice. Understanding the school context will help support the development of future obesity prevention school-based interventions.
Aldukair et al. (Sat,) studied this question.