Salah Razan Ousama, Ghandour Rula, Husseini Abdullatif
Institute of Community and Public Health, Birzeit University, Birzeit, occupied Palestinian territory.
Institute of Community and Public Health, Birzeit University, Birzeit, occupied Palestinian territory.
Lancet. 2021 Jul;398 Suppl 1:S46. doi: 10.1016/S0140-6736(21)01532-4.
Overweight and obesity are multifactorial conditions that are spreading fast in both developing and developed countries. They are emerging as a major public health threat among children and adolescents, and present a serious morbidity and mortality burden. Adolescence is a critical period in which lifestyle and dietary behaviours are shaped that persist into adulthood. Therefore, adolescents are an ideal study target in terms of estimating the magnitude of the problem, understanding its risk factors and investigating potential effective intervention programmes. This study assesses the prevalence of overweight, obesity, and associated factors among adolescents in Palestinian schools.
Weighted analysis was conducted on data from the Palestinian Micronutrient Survey, a national cross-sectional study carried out in 2013 by the Palestinian Ministry of Health in collaboration with UNICEF. For sample selection, stratified cluster random sampling was used. This school-based survey involved 2400 male and female adolescents aged 15-18 years in government schools in the West Bank and Gaza Strip. Data were analysed at univariate, bivariate, and multivariate levels, by the use of proportions, confidence intervals, and logistic regression. In the original survey, written informed consent was obtained from parents and guardians of the participants. A letter of approval to use the study data was obtained from the Ministry of Health (who own the data). The study was also approved by the Ethics Committee of the Institute of Community and Public Health.
The analysis indicates a prevalence of 23·6% (95% CI 20·6-26·5) for overweight and obesity, with a prevalence of 26·1% in the West Bank and 19·5% in the Gaza Strip. The multivariate analysis revealed that the likelihood of overweight and obesity was significantly higher for adolescents from the West Bank than from the Gaza Strip, for those eating two main meals or less than for those eating three meals, for those who reported a high frequency of vegetable intake, and those who observed a diet for weight loss.
The data suggest that one in every four adolescents is overweight or obese, which is an alarming statistic and calls for attention. The high prevalence can be attributed to different lifestyles, eating behaviours, and dietary intake, which affect energy balance. These factors should be investigated within social, political, and economic contexts, and addressed comprehensively, first at the level of individuals and family, and then at the level of schools and the community. It should be noted that the original study included students in the 10th grade and 11th grade only, whereas adolescence covers a wider age group (10-19 years).
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超重和肥胖是多因素导致的状况，在发展中国家和发达国家都迅速蔓延。它们正成为儿童和青少年中的主要公共卫生威胁，并带来严重的发病和死亡负担。青春期是生活方式和饮食行为形成的关键时期，这些行为会持续到成年。因此，就估计问题的严重程度、了解其风险因素以及调查潜在的有效干预项目而言，青少年是理想的研究对象。本研究评估了巴勒斯坦学校青少年中超重、肥胖及其相关因素的患病率。
对巴勒斯坦微量营养素调查的数据进行加权分析，该调查是巴勒斯坦卫生部与联合国儿童基金会于2013年开展的一项全国性横断面研究。样本选择采用分层整群随机抽样。这项基于学校的调查涉及约旦河西岸和加沙地带公立学校的2400名15 - 18岁的青少年男女。数据通过比例、置信区间和逻辑回归在单变量、双变量和多变量水平上进行分析。在原始调查中，获得了参与者父母和监护人的书面知情同意。从拥有数据的卫生部获得了使用研究数据的批准函。该研究也得到了社区与公共卫生研究所伦理委员会的批准。
分析表明超重和肥胖的患病率为23.6%（95%置信区间20.6 - 26.5），其中约旦河西岸的患病率为26.1%，加沙地带为19.5%。多变量分析显示，约旦河西岸的青少年超重和肥胖的可能性显著高于加沙地带的青少年，吃两顿或更少主餐的青少年高于吃三顿的青少年，蔬菜摄入量高的青少年以及进行减肥饮食的青少年。
数据表明每四个青少年中就有一个超重或肥胖，这一统计数据令人担忧，需要引起关注。高患病率可归因于不同的生活方式、饮食行为和饮食摄入，这些都会影响能量平衡。应在社会、政治和经济背景下对这些因素进行调查，并全面加以解决，首先是在个人和家庭层面，然后是在学校和社区层面。需要注意的是，原始研究仅包括十年级和十一年级的学生，而青春期涵盖更广泛的年龄组（10 - 19岁）。
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