Healthy food and dietary patterns: a cross-sectional study in Riyadh, Saudi Arabia.

Background: The escalating prevalence of obesity represents a critical public health challenge, especially in Saudi Arabia, where more than 65% of the population is classified as obese. This condition is closely associated with increased mortality and a heightened risk of chronic illnesses such as diabetes and cardiovascular disease. Aim: This study aims to assess the level of awareness and perceptions regarding healthy dietary choices among individuals in Riyadh, Saudi Arabia. Methods: A cross-sectional study was conducted in Riyadh, Saudi Arabia, from December 2024 to February 2025, using a convenience sampling method. Adults aged 18 years and older were invited to participate via an online self-administered bilingual questionnaire. The survey assessed knowledge, perceptions, and barriers related to healthy eating. A total of 385 responses were targeted. The questionnaire was adapted from validated tools and an expert checked the questionnaire for clarity and cultural relevance, and suggestions were used to improve it. Internal consistency (reliability) of the final survey items was assessed using Cronbach's alpha, which was 0.6. Descriptive statistics and linear regression analyses were used to explore the associations between sociodemographic factors and knowledge scores. All analyses were performed using SPSS version 29. Results: After adjusting for confounding variables, being married was significantly associated with higher knowledge of healthy foods (adjusted β = 1.337 [95% CI: 0.097 to 2.576], p = 0.035). Arabic speakers displayed significantly lower knowledge of healthy foods than English speakers (Adjusted β = -1.555 [95% CI: -2.318 to -0.792], p < 0.001). Additionally, individuals with a bachelor's degree or higher had significantly lower knowledge of healthy foods than those with only a high school diploma (Adjusted β = -0.842 [95% CI: -1.651 to -0.034], p = 0.041). Conclusion: This study highlights notable disparities in dietary knowledge across demographic groups in Riyadh, Saudi Arabia. The findings underscore the need for tailored public health strategies that specifically address young adults, Arabic-speaking populations, and individuals with higher educational attainment, who surprisingly demonstrated lower levels of dietary knowledge. Culturally sensitive, language-specific, and age-appropriate educational interventions are critical to improving awareness of healthy eating habits and ultimately reducing the burden of obesity and related health complications in Saudi society. Limitations: The study was done in Riyadh, Saudi Arabia, limiting the generalizability of our findings as nutritional knowledge may vary in other regions of the country. Many people find it challenging to eat healthy in Riyadh due to the city's fast-paced culture, with factors such as time constraints, low motivation, cost, and a lack of support all contributing to poor food choices. Moreover, self-reported data in cross-sectional studies can introduce reporting and recall biases. The use of convenience sampling may have led to selection bias, and factors like comorbidities may limit how well the findings apply to the wider population.