Double Burden of Undernutrition and Obesity in Palestinian Schoolchildren: A Cross-Sectional Study
Salwa Massad1, Richard J Deckelbaum2, Mehari Gebre-Medhin3
1Palestinian National Institute of Public Health and Juzoor for Health and Social Development, Ramallah, West Bank, Palestine salwamassad@gmail.com.
Insights
The double burden of malnutrition, including underweight and obesity, affects Palestinian schoolchildren. Factors like food insecurity, parental unemployment, and sedentary behaviors are linked to these conditions, necessitating integrated interventions.
Area of Science:
- Public Health
- Pediatric Nutrition
- Malnutrition Studies
Background:
- The double burden of malnutrition (coexistence of underweight and overweight) is a significant issue in developing nations.
- Limited data exists on factors contributing to this dual burden in Palestinian children.
Purpose of the Study:
- To investigate the factors associated with undernutrition and overnutrition among schoolchildren in the West Bank.
- To understand the prevalence and determinants of malnutrition in Palestinian children aged 5-16.
Main Methods:
- A cross-sectional survey was conducted in 22 schools in the West Bank, involving 1484 schoolchildren.
- Binary logistic regression analysis was employed to identify associated factors.
- Food insecurity was measured using a hunger index.
Main Results:
- Prevalence rates included 7% stunting, 3% underweight, 12% overweight, and 6% obesity.
- Undernutrition was linked to male sex, maternal unemployment, and household food insecurity.
- Overweight/obesity correlated with older age, television viewing, and inversely with sports participation.
Conclusions:
- Palestinian schoolchildren face significant risks from the simultaneous occurrence of undernutrition and obesity.
- Interventions must address both undernutrition and obesity, emphasizing balanced nutritional strategies.
Background:
The coexistence of underweight and overweight (double burden) remains a major problem in many developing countries. Little is known about the factors associated with the double burden of malnutrition in Palestinian children.
Objective:
To assess factors associated with undernutrition and overnutrition in 1500 schoolchildren aged 5 to 16 years, in the West Bank.
Methods:
We surveyed a sample of 22 schools run by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the Palestinian government. Binary logistic regression was used to examine the factors associated with malnutrition. The hunger index, a composite score from 8 questions, was used to measure food insecurity.
Results:
In the 1484 children enrolled in UNRWA and government schools in the West Bank, the prevalence of stunting was 7% and underweight 3%. Around 12% of students were overweight and 6% obese. The hunger index was negatively associated with height for age. Factors associated with being underweight were male sex, mother being unemployed, and households not having enough food to eat for at least 2 days in the previous month. Factors associated with obesity were older age and time spent watching television. When overweight and obesity were combined in the analysis, they were inversely associated with increasing number of days spent playing sports.
Conclusion:
Our results show that the important nutritional risks for school-age children in the West Bank would seem to be the simultaneous occurrence of undernutrition and obesity. The study highlights the need to balance obesity management and prevention with interventions to tackle undernutrition.
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