Sammendrag
Background: Data on adolescent nutritional status in Palestine are not available, although adolescents represent one-fourth of the Palestinian population. Nutritional needs of adolescents as a group have been largely ignored not only by health care providers but also by health policy makers. To be able to meet their nutritional needs, we need to assess the current nutritional situation of this group.
Objective: To collect information about nutritional status and related lifestyle factors of school adolescents as basis for future intervention by the Palestinian ministry of health and other health providers.
Design: A cross-sectional epidemiological study, using a multistage cluster sampling technique was carried out on 942 adolescents aged 12-15 years attending 10 preparatory schools at grades 7-9 and their parents in Gaza city, Jabalia village and Jabalia refugee camp.
435 (46.2%) were boys and 507 (53.8%) were girls, about 1/3 from each grade. The subjects were divided into three main age groups: 34.5% were at the age 12-12.9, 33.7% were at age 13-13.9 and 31.8% were at age 14-14.9. The NCHS/WHO reference data on height, weight and age were used to estimate the prevalence of underweight, overweight, obesity and stunting. Haemoglobin test by finger prick method was used to assess the prevalence of anemia. Questionnaires also were used to study the relationship between nutritional status and socio-demographic status, as well as other tools were used to collect the study related data such as, FFQ and quiz.
Results: The prevalence of underweight was 4.9%, overweight was 12.8%, obesity was 5.5% and stunting was 9.6%, the latter being higher among boys than girls. The prevalence of anemia was 48.1%. It was higher among girls than boys 51.4% and 44.2% respectively. Higher consumption in starch items was found compared to other important food items such as animal products, mainly meat, and dairy products as well as fruits and vegetables. Food frequency intake seems to be positively related to socio-economic status for all food groups.
However no relationship was found between the frequency intakes of the different food groups and BMI, except for starchy items that were negatively associated with BMI. Poverty and low level of education in parents was associated with the high prevalence of chronic
malnutrition (stunting). Adolescents lifestyle seemed to be affected by the urbanization as well as the political situation. A high sedentary lifestyle and physical inactivity was observed in this study. A relatively high number of dieting adolescents and skipping meals patterns was also observed. The prevalence of smoking was found to be relatively high in adolescents at this age.
Conclusion: Stunting, overweight/obesity and anemia are considered public health problems among the adolescents in Gaza and immediate actions to improve the nutritional status of this age group should be taken. Multi-sector coordination between different ministries and community NGOs in order to improve the nutritional status of the adolescents in Palestine should take place. The Nutrition
Department in the Ministry of Health should take the leading role and initiate this and take the initiative to develop a national plan which aims at improving the nutritional status and maintain well-being of young children and adolescents.