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Abdullah Almaqhawi,1 Razan Anwar Alabdulqader,2 Nurah Abdullatef Alkhteeb,2 Fai Ibrahim Alomair,2 Sarra Riyadh Alhassan,2 Jawad S Alnajjar2 1Department of Family and Community Medicine, College of Medicine, King Faisal University, Al Hofuf, Saudi Arabia; 2College of Medicine, King Faisal University, Al Hofuf, Saudi ArabiaCorrespondence: Abdullah Almaqhawi, Department of Family Medicine and Community, College of Medicine, King Faisal University, P.O. Box No. 400, Al-Ahsa, 31982, Saudi Arabia, Email Aalmuqahwi@kfu.edu.saPurpose: This study aims to investigate the possible impacts of fasting on physical activity and weight loss in adult users of glucagon-like peptide-1 (GLP-1) agonists, specifically semaglutide and tirzepatide, using qualitative methods to gain in-depth insights into participants’ experiences and perceptions.Patients and Methods: A qualitative study was conducted at the Polyclinic at King Faisal University, Al-Ahsa, Saudi Arabia, during and after Ramadan in 2024, along with the completion of International Physical Activity Questionnaires (IPAQs). The semi-structured interviews and the IPAQ were used to assess physical activity levels. A thematic narrative and framework analysis were used to analyze the data, and a descriptive analysis was performed on the IPAQ data. All participants provided their informed consent, and ethical approval was acquired. A total of 14 interviews were conducted. Five refined themes and 3 sub-themes were identified. The findings were presented in accordance with the COREQ (consolidated criteria for reporting qualitative research) guidelines.Results: Ten participants, aged 18– 59, were included in the study. Half used semaglutide, four used tirzepatide, and one used both, primarily for blood glucose regulation and weight reduction. The average body mass index (BMI) decreased from 35.246 to 34.155. However, a paired t-test showed this change was not statistically significant, suggesting that Ramadan fasting did not significantly impact BMI in participants.Conclusion: The research indicated that the combination of GLP-1 agonists and physical activity influenced weight loss during fasting in Ramadan among the participants. These findings suggest that combining these medications with increased physical activity and fasting can effectively reduce BMI and improve overall health outcomes for individuals managing weight and chronic diseases over an extended duration.Keywords: physical activity, glucagon-like peptide-1 agonists, semaglutide, tirzepatide, weight loss, Ramadan, qualitative study, thematic analysis

الملخص: أهداف البحث: أجريت هذه الدراسة لاستكشاف العوائق والميسرات المحتملة للنشاط البدني لدى النساء السعوديات اللواتي يعشن في منطقة شرق ميدلاندز بالمملكة المتحدة. طرق البحث: أجريت مقابلات جزئية الهيكلة مع نساء سعوديات يعشن حاليا في شرق ميدلاندز بالإضافة إلى استكمال استبانات دولية حول النشاط البدني. تم تسجيل المقابلات ونسخها رقميا وتحليلها باستخدام نهج موضوعي سردي؛ تم تحليل بيانات الاستبانات وصفيا. تم إجراء ما مجموعه 12 مقابلة. تم تحديد 5 موضوعات مصقولة و 19 موضوعا فرعيا. النتائج: تظهر نتائج هذا البحث أن المناخ الجذاب، وتوافر المساحات المفتوحة، وسهولة الوصول إلى الصالة الرياضية، والتكلفة المنخفضة، ونمط الحياة المستقل كطلاب، والعادات الغذائية، والنقل الفعال، وثقافة المملكة المتحدة كميسرين للنشاط البدني، وانخفاض توافر الصالات الرياضية للنساء فقط، وعدم مشاركة مدربي اللياقة البدنية، وانخفاض الاهتمام بالفئات العمرية المختلفة كعوائق للنشاط البدني في شرق ميدلاندز بين النساء السعوديات. الاستنتاجات: على الرغم من أن النتائج من النساء السعوديات، فإنه من منظور المشاركات أنه يمكن اتخاذ إجراءات أكثر ملاءمة لزيادة الوعي بمزايا النشاط بين النساء بشكل عام. بالاعتماد على نموذج تقديم الخدمة على أساس مراحل التغيير وإشراك أصحاب المصلحة المعنيين في تطوير وتنفيذ التدخلات الفعالة، يجب تطوير الاستراتيجيات والسياسات لتعزيز مشاركة النساء السعوديات والمغتربات من البلدان الأخرى في النشاط البدني بالمملكة المتحدة . Abstract: Objective: This study was conducted to explore the potential barriers to and facilitators of physical activity in Saudi Arabian females living in the East Midlands region of the United Kingdom. Methods: A qualitative study was conducted with Saudi Arabian females currently living in the East Midlands, along with the completion of International Physical Activity Questionnaires (IPAQs). The Semi-structured interviews were digitally recorded, transcribed, and analysed using a narrative thematic approach; IPAQ data were descriptively analysed. A total of 12 interviews were conducted. Five refined themes and 19 sub-themes were identified. Results: The results of this research showed that attractive climate, availability of open spaces, easy gymnasium accessibility, low cost, independent student lifestyles, food habits, efficient transportation, and UK culture serve as facilitators, while reduced availability of individual women-only gyms, non-engaging fitness instructors and reduced attention to different age groups serve as barriers to physical activity for Saudi Arabian females in the East Midlands. Conclusions: Although the results concerned Saudi Arabian females in the East Midlands, the participants' perspectives showed that more appropriate action could be taken to raise awareness of the advantages of being active among females in general. Drawing on a service delivery model based on the stages of change and including relevant stakeholders in developing and implementing effective interventions, strategies and policies must be developed to promote the participation of Saudi Arabian females and female expats from other countries in physical activity in the UK.

Aims: We investigated evidence from randomised, placebo‐controlled trials of novel glucose‐lowering therapies; sodium‐glucose co‐transporter‐2 inhibitors (SGLT2i), dipeptidyl peptidase‐4 inhibitors (DPP4i) and glucagon‐like peptide‐1 receptor agonists (GLP‐1RA), on physical function in people with type 2 diabetes (T2D). Methods: PubMed, Medline, Embase and Cochrane library were searched from 1 April 2005 to 20 January 2022. The primary outcome was change in physical function in groups receiving a novel glucose‐lowering therapy versus placebo at the trial end‐point. Results: Eleven studies met our criteria including nine for GLP‐1RA and one each for SGLT2i and DPP4i. Eight studies included a self‐reported measure of physical function, seven with GLP‐1RA. Pooled meta‐analysis showed an improvement of 0.12 (0.07, 017) points in favour of novel glucose‐lowering therapies, mainly GLP‐1RA. These findings were consistent when assessed individually for commonly used subjective assessments of physical function; namely the Short‐Form 36 item‐questionnaire (SF‐36; all investigating GLP‐1RA) and the Impact of Weight on Quality of Life‐Lite (IWQOL‐LITE; all, except one, exploring GLP‐1RA) with estimated treatment differences (ETDs) of 0.86 (0.28, 1.45) and 3.72 (2.30, 5.15) respectively in favour of novel GLTs. For objective measures of physical function (VO2max and 6‐minute walk test (6MWT)) no significant between‐group differences between the intervention and the placebo were found. Conclusions: GLP‐1RAs showed improvements in self‐reported outcomes of physical function. However, there is limited evidence to draw definitive conclusions especially because of lack of studies exploring the impact of SGLT2i and DPP4i on physical function. There is a need for dedicated trials to establish the association between novel agents and physical function. [ABSTRACT FROM AUTHOR]

Summary: Weight‐lowering pharmacotherapies provide an option for weight management; however, their effects on physical activity, function, and cardiorespiratory fitness are not fully understood. We conducted a systematic review and meta‐analysis of randomized controlled trials to investigate the effect of licensed weight loss pharmacotherapies on physical activity, physical function, and cardiorespiratory fitness in individuals with obesity. Fourteen trials met our prespecified inclusion criteria: Five investigated liraglutide, four semaglutide, three naltrexone/bupropion, and two phentermine/topiramate. All 14 trials included a self‐reported measure of physical function, with the pooled findings suggesting an improvement favoring the pharmacotherapy intervention groups (SMD: 0.27; 95% CI: 0.22 to 0.32) and effects generally consistent across different therapies. Results were also consistent when stratified by the two most commonly used measures: The Short‐Form 36‐Item Questionnaire (SF‐36) (0.24; 0.17 to 0.32) and the Impact of Weight on Quality Of Life‐Lite (IWQOL‐Lite) (0.29; 0.23 to 0.35). Meta‐regression confirmed a significant association between pharmacotherapy induced weight loss and improved physical function for IWQOL‐Lite (p = 0.003). None of the studies reported a physical activity outcome, and only one study reported objectively measured cardiorespiratory fitness. Improvements in self‐reported physical function were observed with weight loss therapy, but the effect on physical activity or objectively measured physical function and fitness could not be determined. [ABSTRACT FROM AUTHOR]

Recently, a considerable amount of literature has been concerned with the impact of screen time on physical activity. Furthermore, recent evidence reveals that children under 14 spend an average of 23 hours each week looking at screens, including watching TV and DVDs, playing video games, or using a computer or mobile device. This study aimed to determine the relationship between technology use and physical activity. 277 parents completed an online questionnaire in this cross-sectional investigation. The questionnaire comprised 44 closed-ended questions divided into three sections: demographics, the impact of technology on children, and the Children's Physical Activity Questionnaire (CPAQ). 88 (31.8%) of children reported up to 5 hours of screen time per day, while 189 (68.2%) reported 6 hours or more. According to the CPAQ, 131 (47.3%) children had a low level of physical activity, 96 (34.7%) had a moderate level, and 50 (18.1%) had a high level. There was a strong relationship between parental age and child screen time, with 24.9% of children with screen time greater than 6 hours having parents aged 35-40 years, compared to 28.4% of children with screen time less than 5 hours having parents aged 25-30 years. Inadequate physical activity in children was linked to the number of siblings, ownership of electronic devices, and screen time. Physical activity should be increased through lifestyle changes that the entire family can implement. [ABSTRACT FROM AUTHOR]

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