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Talukdar R, Ravel V, Barman D, Kumar V, Dutta S, Kanungo S. Prevalence of undernutrition among migrant, refugee, internally displaced children and children of migrated parents in lower-middle-income countries: A meta-analysis of published studies from last twelve years. Diabetes Metab Syndr 2024; 18:102976. [PMID: 38508036 DOI: 10.1016/j.dsx.2024.102976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND AND AIMS This review aims to estimate the prevalence of undernutrition among migrants, refugees, internally displaced children, and children of migrated parents living in lower-middle-income countries. METHODS PubMed, Scopus, Science-Direct, CINAHL-Plus, & Google Scholar were searched for peer-reviewed evidence published between January 2010 to March 2023. Two researchers independently examined the studies and retrieved the data. The internal and external validity of the studies was assessed using the NIH quality assessment tool, and a checklist adapted from Downs & Black, Bracht & Glass, and Del Siegle's guidelines. A random effect model was chosen to pool the estimates. Subgroup analysis, Meta-regression, and sensitivity analysis were done to explore the source of heterogeneity and the robustness of estimates. RESULTS Among the 1978 records initially searched, 21 studies were selected for analysis. The pooled prevalence estimates for stunting, wasting, and underweight were estimated to be 29.39% (Confidence Interval [CI] 21.69-37.73; I2 99%; p < 0.01), 12.76% (CI 7.84-18.68; I2 99%; P < 0.01), and 24.05% (CI 16.17-32.94; I2 100%; p < 0.001) respectively. Among different WHO regions, all three undernutrition estimates were higher in LMICs belonging to the Southeast Asian region (Stunting 37.62%; wasting 14.28% and underweight 31.24%). Undernutrition among migrant Indian children was 43.55%, 18.71%, and 37.45% respectively. High heterogeneity was noted across all estimates with I2-value >90%. Sensitivity analysis across indicators showed the stability of our estimates. CONCLUSIONS The extent of undernutrition, particularly wasting was high among migrant/refugee children living in lower-middle-income countries. Measures should be taken to strengthen the government-subsidized public food distribution system, increase healthcare outreach, and ensure public health insurance coverage among the migrant population.
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Affiliation(s)
- Rounik Talukdar
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
| | - Vanessa Ravel
- ICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, India.
| | - Diplina Barman
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
| | - Vivek Kumar
- Deepak Foundation, Katni, Madhya Pradesh, India.
| | - Shanta Dutta
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
| | - Suman Kanungo
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
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A. Assaf E, Al Sabbah H, Al-Jawadleh A. Analysis of the nutritional status in the Palestinian territory: a review study. Front Nutr 2023; 10:1206090. [PMID: 37533576 PMCID: PMC10391640 DOI: 10.3389/fnut.2023.1206090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/19/2023] [Indexed: 08/04/2023] Open
Abstract
Background Food insecurity, occupation, and poverty contribute to the poor nutritional status of Palestine. This review study aimed to analyze the nutritional status in the Palestinian Territory by analyzing published data from 2011 to 2023. Method Searching for relevant publications yielded 67 studies. Based on reviewing these studies, five major themes were identified: low birth weight, breastfeeding, obesity and overweight, protein-energy malnutrition, and micronutrient deficiency. Results Based on the review of these studies, five major themes were identified, namely, low birth weight, breastfeeding, obesity and overweight, protein-energy malnutrition, and micronutrient deficiency. Based on the literature, the prevalence rate of exclusive breastfeeding was 24.4% in the Gaza Strip, compared to a national rate of 39.9% in 2020. Smoking, anemia in mothers, diet during pregnancy, and indoor pollution were associated with low birth weight. One-fifth of the boys and girls were stunted by 2 years of age in the Gaza Strip, and girls were more stunted than boys. The prevalence rates of underweight, overweight, and obesity among school children in the West Bank were 7.3%, 14.5%, and 15.7%, respectively. Age, gender, and living area were significant predictors of being overweight among school children. The prevalence rates of overweight and obesity among adults in Palestine were 57.8% and 26.8%, respectively. Obesity is associated with a family history, chronic diseases, and low physical activity among adults. Exclusive breastfeeding was below the WHO recommendations, while significant rates of obesity and overweight were found among children and adults. Iron-deficiency anemia (IDA) among pregnant women and children remains a challenging public health issue, while other micronutrient deficiencies are high among children. Conclusion This review emphasizes the need for multi-sectoral interventions to address malnutrition and nutritional shifts. It identifies gaps and addresses nutrition-related issues in the Palestinian Territory, which can serve as a basis for guiding United Nations agencies and governments in formulating evidence-based policies and strategies for prioritizing nutritional interventions to meet sustainable development goals.
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Affiliation(s)
- Enas A. Assaf
- Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Haleama Al Sabbah
- Department of Public Health, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Ayoub Al-Jawadleh
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
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Getacher L, Wondafrash Ademe B, Belachew T. Lived Experience and Perceptions of Adolescents on Prevention, Causes and Consequences of Double Burden of Malnutrition in Debre Berhan City, Ethiopia: A Qualitative Study. Int J Gen Med 2023; 16:337-356. [PMID: 36726362 PMCID: PMC9885773 DOI: 10.2147/ijgm.s398330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Background The coexistence of undernutrition, overweight, and obesity within the same households and populations is recognized as the Double Burden of Malnutrition (DBM). A paradigm shift thinking is needed to mitigate its impact. School adolescents are the most vulnerable groups to DBM. However, lived experiences and perceptions on prevention, causes, and consequences of DBM were not well studied. Therefore, this study aims to explore the lived experiences and perceptions of adolescents about the prevention, causes, and consequences of DBM in Ethiopia. Methods A qualitative research method using phenomenology design was conducted among 20 purposively selected participants from private and government schools from June 3 to July 10, 2022. The further sampling process was guided by a saturation of ideas. In-depth and key informant interviews were conducted to collect the data. The most recent version of Open code 4.03 was utilized to generate meaningful codes, subthemes, and themes. The results were displayed using thematic analysis and respondents' well-spoken verbatims. Results The study explored the perceptions of adolescents on the causes, prevention, and consequences of DBM. The main causes of DBM identified were poor dietary and drinking habits, poor knowledge and attitude about nutrition, low financial income, unemployment, food insecurity, poor feeding culture, physical inactivity, poor food management, educational and school-related issues, national-related issues, frequent use of ultra-processed foods, and frequent out of home eating. The majority of students were not aware of how DBM will affect their health and academic performance over the long run. Conclusion The findings showed that despite school adolescents' variations in knowledge, lived experience, attitude, and perceptions, most of them have a poor understanding of the causes, consequences, and prevention mechanisms of the double burden of malnutrition. The results suggest the need for instituting double-duty interventions that have a double impact on the prevention of DBM.
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Affiliation(s)
- Lemma Getacher
- School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Beyene Wondafrash Ademe
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Joulaei H, Keshani P, Ashourpour M, Bemani P, Amiri S, Rahimi J, Aliakbarpour M, Salehi-Abargouei A. The prevalence of stunting among children and adolescents living in the Middle East and North Africa region (MENA): A systematic review and meta-analysis. J Glob Health 2022; 11:04070. [PMID: 35003712 PMCID: PMC8711751 DOI: 10.7189/jogh.11.04070] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Given the strategic importance of the MENA, the state of war and inequity in the region and its effect on malnutrition which leads to mortality and reduced economic development in this region, the current study purposed to examine the prevalence of stunting as an indicator of chronic malnutrition in the MENA region, with consideration given HDI, rural/urban area, and war-involved countries. Methods The electronic databases of PubMed, SCOPUS, Web of science, and Embase were systematically searched, and English-language articles published between January 1, 2009 and December 31, 2019 were included in this study. The POLIS (population, outcome, location, indicator, study design) criteria were used to perform the systematic review, and studies involving children 2 to 18 years of age were selected. Results Fifty-eight (n = 2 202 869) were included based on the study's inclusion criteria. The prevalence of stunting in children in the total MENA region was 22.0% (95% confidence interval (CI) = 20.4-23.6; I2 = 99.92%, P < 0.0001). The studies included in the meta-analysis were analyzed by subgroups. The pooled prevalence of stunting in children aged 2-5 years old and children aged 6 and older was 25.7% and 16.5%, respectively. The pooled prevalence of stunting was 34.1% in rural and 12.4% in urban areas. The pooled prevalence of stunting according to HDI was 30.1%, 28.5%, 13.1%, in low, medium, and high HDI countries, respectively. Furthermore, the pooled prevalence of stunting according to war status was 28.5% in war-involved countries vs 20.6% in others. Conclusions High prevalence of malnutrition was seen based on stunting indicator in the meta-analysis study in the MENA region, and this issue became more pronounced when the data was divided into subgroups based on age, residential area, and HDI. Inequality regarding social, economic, and political factors leads to significant malnutrition in the mentioned region.
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Affiliation(s)
- Hassan Joulaei
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahkameh Ashourpour
- Department of Nutrition Sciences, School of Health, Larestan University of Medical Sciences, Larestan, Iran.Emam Reza Teaching Hospital, Larestan University of Medical Sciences, Larestan, Iran
| | - Peyman Bemani
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sanaz Amiri
- Department of Epidemiology, Health School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamileh Rahimi
- Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohsen Aliakbarpour
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Department of nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Amer S, Kateeb E. Factors related to dietary habits, energy drink consumption, and physical activity in marginalized Palestinian schools: A cross-sectional study. Health Promot Perspect 2021; 11:329-336. [PMID: 34660228 PMCID: PMC8501479 DOI: 10.34172/hpp.2021.42] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 06/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The current study assessed different dietary habits, energy drinks intake, body mass index (BMI) and physical activity and associated factors among Palestinian adolescents attending marginalized schools. Methods: A cross-sectional study targeted a random sample of 1480 students in the sixth andninth grades attending 20 marginalized public schools in the West Bank area of the occupied Palestinian Territories (oPt). Students were interviewed in-person by trained senior dental students about their dietary habits, physical activity, fathers’ employment and mothers’ level of education. Weight and height were measured, and BMI percentile was calculated. Descriptive statistics were generated for the study’s main variables and the dependent variables were compared by grade, gender, mothers’ level of education and father’s employment. Results: A total of 1282 students (98% response) completed the questionnaire. Of them, 6% were ‘underweight’ (fifth percentile or under) and 34% were ‘overweight’ or ‘obese’ (85thpercentile or over). Ninth graders had more added sugar than 6th graders (P=0.002), less frequent milk consumption (P<0.001), more frequent energy drink consumption (P=0.001),and less physical activity (P<0.0001). Frequency of carbonated and sweetened drink consumption was associated with being overweight or obese (P=0.016, P=0.001). Frequency of carbonated drinks consumption was higher among children of mothers with a high school level of education or less (P<0.001). In addition, children of mothers educated to high school level or below were associated with being underweight (P=0.05). Conclusion: Dietary habits and physical activity get worse between the ages of 12 and 15. Mothers’ level of education is an important factor in being overweight or underweight. Energy drink consumption among boys and milk consumption among girls are two challenges that need to be addressed urgently and adequately.
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Affiliation(s)
- Sami Amer
- MIT Media Lab, Massachusetts Institute of Technology, 77 Massachusetts Avenue Cambridge, MA 02139, USA
| | - Elham Kateeb
- Oral Health Research and Promotion Unit, Faculty of Dentistry, Al-Quds University, Jerusalem, State of Palestine
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Ghattas H, Jamaluddine Z, Akik C. Double burden of malnutrition in children and adolescents in the Arab region. THE LANCET CHILD & ADOLESCENT HEALTH 2021; 5:462-464. [PMID: 34143961 DOI: 10.1016/s2352-4642(21)00162-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/14/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107 2020, Lebanon.
| | | | - Chaza Akik
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107 2020, Lebanon
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AbuKishk N, Gilbert H, Seita A, Mukherjee J, Rohloff PJ. Under-five malnutrition among Palestine refugee children living in camps in Jordan: a mixed-methods study. BMJ Glob Health 2021; 6:bmjgh-2021-005577. [PMID: 34348932 PMCID: PMC8340287 DOI: 10.1136/bmjgh-2021-005577] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/23/2021] [Indexed: 01/07/2023] Open
Abstract
Background Jordan hosts the largest Palestine refugee population in the world. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) is the primary healthcare provider for Palestine refugees. To better inform UNRWA’s health programme, we conducted this study to assess the prevalence and determinants of malnutrition among Palestine refugee children in Jordan and to analyse caregiver perceptions of food insecurity and structural barriers to accessing food. Methods A cross-sectional study was conducted with a randomly selected sample of 405 households, for children under 5 years old in two refugee camps in Jordan, Jerash and Souf. Sociodemographic, food insecurity, diet quality and child anthropometric data were collected. Also, twenty in-depth interviews were conducted with children’s caregivers, along with two focus group discussions with UNRWA staff. Results Out of the 367 participants, the prevalence of stunting was 23.8% in Jerash and 20.4% in Souf (p=0.46), and overweight was 18.2% versus 7.1%, respectively (p=0.008). However, high food insecurity in Jerash was 45.7% and 26.5% in Souf (p=0.001), with no significant difference after multivariable adjustment. Qualitative perspectives saw food insecurity and low-quality children’s diets as largely mediated by job and income insecurity, especially marked in Jerash due to the lack of Jordanian citizenship. Conclusion We found a moderate-to-high prevalence of stunting and overweight levels among Palestine refugee children, which are three times higher than the 2012 Demographic and Health Survey data for Jordanian non-refugee children. High rates of household food insecurity were closely tied to households’ lack of essential civil and economic rights. We call for international collective efforts to expand economic livelihoods for Palestine refugees and to support UNRWA’s ongoing operations.
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Affiliation(s)
| | - Hannah Gilbert
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Joia Mukherjee
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter J Rohloff
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Center for Research in Indigenous Health, Maya Health Alliance Wuqu' Kawoq, Tecpan, Guatemala
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AbuKishk N, Turki Y, Saleh S, Albaik S, Hababeh M, El-Khatib Z, Kassim N, Arab H, Abu-Diab K, Zeidan W, Seita A. Anaemia prevalence in children newly registered at UNRWA schools: a cross-sectional study. BMJ Open 2020; 10:e034705. [PMID: 32967866 PMCID: PMC7513562 DOI: 10.1136/bmjopen-2019-034705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 05/16/2020] [Accepted: 07/22/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Children entering first grade at the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) schools in West Bank, Gaza, Lebanon, Jordan and Syria complete a comprehensive medical examination at UNRWA health centres (HCs) as a requirement for their acceptance. Our study aimed to assess anaemia prevalence and undernutrition indicators among new entrant school children during their preschool medical examination. SETTINGS In 2017, we conducted a cross-sectional study in 59 UNRWA HCs, targeting children entering first grade at UNRWA schools in four of UNRWA's countries of operation (known as fields), namely Gaza, West Bank, Syria and Lebanon. PARTICIPANTS 2419 completed the study. Boys and girls living inside or outside Palestine refugee camps were included. Verbal consent was obtained from their parents. PRIMARY AND SECONDARY OUTCOME MEASURES Sociodemographic and anthropometric data on each child were collected. Underweight (weight-for-age z-score <-2 SD), stunting (height-for-age z-score <-2 SD), thinness (body mass index-for-age z-score <-2 SD) and obesity (body mass index-for-age z-score >+2 SD) were examined according to WHO growth indicators (5-10 years). RESULTS 2419 students (1278 girls and 1141 boys) aged 6.1±0.4 years were examined. The prevalence of anaemia (haemoglobin (Hb) <11.5 g/L) was 25.0% (Gaza: 29.3%; West Bank: 22.0%; Syria: 30.0%; Lebanon: 18.3%). The mean Hb level was 12.0±0.9 g/L. The overall prevalence of stunting, thinness and underweight was 3.2%, 3.5% and 5.6%, respectively, with the highest levels found in Syria (4.3%, 6.3% and 10.1%, respectively). The highest prevalence of overweight was in Lebanon (8.6%), and the lowest was in Gaza (2.6%). Significant differences were found among fields with regard to undernutrition indicators (p=0.001). Also, children with anaemia had significantly higher prevalence of being underweight (5.2%) in comparison with those without anaemia (p=0.001). CONCLUSIONS The prevalence of anaemia among the surveyed children increased to 25.0%, compared with the previous study conducted by UNRWA in 2005 (19.5%). Thus, it is recommended that Hb testing be included in the medical examination of new entrant school children attending UNRWA schools.
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Affiliation(s)
- Nada AbuKishk
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Yassir Turki
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Suha Saleh
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Shatha Albaik
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Majed Hababeh
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | | | | | - Hasan Arab
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | | | - Wafaa Zeidan
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Akihiro Seita
- Health Department, UNRWA HeadQuarters, Amman, Jordan
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Massad S, Gebre-Medhin M, Dary O, Abdalla M, Holleran S, Karmally W, Bordelois P, Khammash U, Deckelbaum RJ. Micronutrient status of Palestinian school children following salt and flour fortification: a cross-sectional study. BMC Nutr 2020; 6:38. [PMID: 32864153 PMCID: PMC7448451 DOI: 10.1186/s40795-020-00367-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 07/30/2020] [Indexed: 12/02/2022] Open
Abstract
Background In 1996 and in 2006, Palestine initiated salt iodization and multiple micronutrient fortification of wheat flour, respectively as a strategy to prevent deficiencies of these nutrients. In 2009, we assessed the impact of these interventions on the health and nutritional status of schoolchildren residing in the West Bank. Methods We surveyed a sample of 22 schools run by the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the Palestinian Government. We randomly selected students from the first (mean age 6.7 years [SD 0.5]), sixth (11.8 years [0.6]), and ninth grades (14.8 years [0.6]). Data were obtained from 1484 (99%) of 1500 students planned for enrollment. Results Our results suggest that iodine intake appears adequate and there was essentially no iodine deficiency. As to the status of other micronutrients, the main nutritional micronutrient risks for schoolchildren in the West Bank continue to be low serum levels of iron, zinc, and vitamin B-12; folate levels were seemingly high. The overall prevalence of anemia was 9.6%, but there were pockets of anemia in certain districts. Almost 42% of the anemia in our sample was explained by iron deficiency. There were significant differences in iron deficiency between girls and boys, 29.5% vs. 15.7%, respectively (p = 0.0001). There were no cases of lead toxicity in the studied sample. Conclusions Wheat flour and salt fortification has had a major influence on improving the micronutrient status of Palestinian children, for some but not all micronutrients. The recommended key blood and biochemical parameters to be incorporated in the surveillance system are iron, zinc, and vitamin B12.
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Affiliation(s)
- Salwa Massad
- Juzoor for Health and Social Development, Ramallah, 970 Palestine
| | - Mehari Gebre-Medhin
- Department of Women's and Children's Health, Pediatrics, University Hospital, SE-751 85 Uppsala, Sweden
| | - Omar Dary
- USAID Bureau of Global Health, Washington, DC USA
| | - Marwah Abdalla
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Steve Holleran
- Institute of Human Nutrition, Columbia University, New York, NY 10032 USA
| | - Wahida Karmally
- Irving Institute for Clinical and Translational Research, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Paula Bordelois
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Umaiyeh Khammash
- Juzoor for Health and Social Development, Ramallah, 970 Palestine
| | - Richard J Deckelbaum
- Institute of Human Nutrition, Columbia University, New York, NY 10032 USA.,Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032 USA
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Al-Lahham S, Jaradat N, Altamimi M, Anabtawi O, Irshid A, AlQub M, Dwikat M, Nafaa F, Badran L, Mohareb R, Haji R, Aqqad T, Jayyab S, Ghosh BA, Taher R, Al Zabadi H. Prevalence of underweight, overweight and obesity among Palestinian school-age children and the associated risk factors: a cross sectional study. BMC Pediatr 2019; 19:483. [PMID: 31818270 PMCID: PMC6902423 DOI: 10.1186/s12887-019-1842-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/19/2019] [Indexed: 01/28/2023] Open
Abstract
Background Childhood obesity is rising in developed and developing countries, while childhood underweight is rising mainly in developing countries. Childhood underweight has been shown to increase a child’s risk of rapid weight gain. Overweight and obese children are more likely to become obese adults, which increases the risk of type-II diabetes and cardiovascular diseases. Studies concerning obesity among Palestinian children are scarce. The prevalence of obesity among Palestinian children has increased from 3 to 6% within 5 years in comparison to the worldwide rise from 1 to 7%, within 41 years. We aim to determine the current prevalence of underweight, overweight and obesity among Palestinian school-age children and to assess the role of dietary and sociodemographic factors. Methodology A cross sectional study was conducted in Palestine in 2017. A total of 1320 school-age children and their 2640 corresponding parents were recruited. A written questionnaire was filled out by the parents. Anthropometric indices were measured and categorized according to the Center for Disease Control and prevention (CDC). Results The mean ± SD age of the children was 9.5 ± 1.5 years and 48.8% were females. The prevalence of underweight, overweight and obesity among the children was approximately 7.3% (95% CI = 5.9–8.8%), 14.5% (95% CI = 12.7–16.6%) and 15.7% (95% CI = 13.8–17.8%) respectively. Multinomial logistic regression analysis demonstrated a significant correlation of waist circumference, age, gender and living place with the body mass indexes of the students. Conclusion Our findings highlighted the accelerated increase in the prevalence of underweight, overweight and obesity (37.5%) among Palestinian children within a very short time in comparison to the globe. Therefore, Interventions aiming to prevent obesity and underweight at an early stage might be vital to avoid obesity later in life and its health-related co-morbidities, e.g. type-II diabetes and cardiovascular diseases.
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Affiliation(s)
- Saad Al-Lahham
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine.
| | - Nidal Jaradat
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mohammad Altamimi
- Department of Nutrition and food technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine
| | - Ola Anabtawi
- Department of Nutrition and food technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine
| | - Alma Irshid
- Department of Nutrition and food technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine
| | - Malik AlQub
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Majdi Dwikat
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Fouad Nafaa
- Department of Surgery, Rafidia Hospital, Nablus, Palestine
| | - Lama Badran
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Rawan Mohareb
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Reema Haji
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Tareq Aqqad
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Sadeq Jayyab
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Budour Abu Ghosh
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Rina Taher
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Hamzeh Al Zabadi
- Public Health Department, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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11
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Massad SG, Khalili M, Karmally W, Abdalla M, Khammash U, Mehari GM, Deckelbaum RJ. Metabolic Syndrome among Refugee Women from the West Bank, Palestine: A Cross-Sectional Study. Nutrients 2018; 10:nu10081118. [PMID: 30126177 PMCID: PMC6115782 DOI: 10.3390/nu10081118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/13/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022] Open
Abstract
This study was carried out among Palestinian refugee women in the West Bank to provide data on the prevalence of metabolic syndrome (MetS) and its correlates. Data were obtained from a cross-sectional study of 1694 randomly selected refugee women from the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) health centers throughout the West Bank during June and July 2010. In this cohort, 30% of the refugee women were overweight, 39% were obese, and 7% were extremely obese. Based on World Health Organization (WHO) criteria, the age-adjusted prevalence of MetS was 19.8%. The results of the binary logistic regression analysis indicated that older age and younger marital age were significantly associated with an increased likelihood of MetS in the women. The high prevalence of obesity and MetS mandates the implementation of national policies for its prevention, notably by initiating large-scale community intervention programs for 5.2 million refugees in Palestine, Jordan, Lebanon, and Syria, to tackle obesity and increase the age at marriage.
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Affiliation(s)
- Salwa G Massad
- Institute of Human Nutrition, Columbia University, New York, NY 10032, USA.
| | - Mohammed Khalili
- United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Jerusalem 972, Palestine.
| | - Wahida Karmally
- Irving Institute for Clinical and Translational Research, Columbia University Medical Center, New York, NY 10032, USA.
| | - Marwah Abdalla
- Institute of Human Nutrition, Columbia University, New York, NY 10032, USA.
- Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA.
| | - Umaiyeh Khammash
- Juzoor for Health and Social Development, Ramallah 970, Palestine.
| | - Gebre-Medhin Mehari
- Department of Women's and Children's Health, Pediatrics, University Hospital, SE-751 85 Uppsala, Sweden.
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12
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Aboul-Enein BH, Bernstein J, Kruk J. Professional nutrition journals from Arabic-speaking countries: A regional status. NUTR BULL 2017. [DOI: 10.1111/nbu.12266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
| | - J. Bernstein
- A.T. Still University of Health Sciences; Kirksville MO USA
| | - J. Kruk
- University of Szczecin; Szczecin Poland
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