Thwib Suleiman, Qasrawi Radwan, Issa Ghada, Amro Malak, Abu Ghoush Razan, Saghir Sabri, Mujahed Doa'a, Nemer Maysaa, Halaika Mousa, Badrasawi Manal, Al-Jawaldeh Ayoub, Elmadfa Ibrahim, Nasreddine Lara, Abu Al-Halawa Diala, Nimer Maisan
Department of Computer Sciences, Al Quds University, Jerusalem P144, Palestine.
Department of Computer Engineering, Istinye University, 34010 Istanbul, Turkey.
Children (Basel). 2025 May 29;12(6):703. doi: 10.3390/children12060703.
: The growth patterns of children and adolescents are influenced by multiple factors. This study employed structural equation modeling (SEM) to determine the primary factors influencing the growth of Palestinian children and adolescents in the West Bank (WB). : A cross-sectional survey conducted in 2022 in the WB collected data from 1400 households, of which 500 with children aged 5-17 years and were selected for analysis. The survey assessed household food insecurity, socioeconomic status (SES), parental health history, nutritional awareness, food consumption patterns, and nutrient intake. The latent construct "Child Growth" was measured using Body Mass Index-for-age Z-score (BAZ), height-for-age Z-score (HAZ), and Mean Adequacy Ratio (MAR). SEM was employed to examine the interrelations among latent variables and their observed indicators. : Mineral intake showed the strongest direct effect on child growth (β = 0.812, < 0.001), followed by food availability (β = 0.492), vitamin intake (β = 0.481), SES (β = 0.439), and macronutrient intake (β = 0.383). MAR exhibited the highest factor loading as a growth indicator, while HAZ had limited significance, suggesting its chronic nature. SES influenced growth both directly and indirectly through its effects on food availability and dietary intake pathways. Strong correlations between nutritional knowledge and nutrient classes reflect the interrelationship between behavioral and biological determinants. : Both structural and immediate nutritional factors influence child growth. In Palestinian youth, mineral intake, food security, and SES have the greatest influence. These findings offer a framework for understanding the growth determinants of Palestinian youth in the WB and support the development of targeted interventions to improve dietary quality and overall nutritional status.
儿童和青少年的生长模式受多种因素影响。本研究采用结构方程模型（SEM）来确定影响约旦河西岸（WB）巴勒斯坦儿童和青少年生长的主要因素。2022年在约旦河西岸进行的一项横断面调查从1400户家庭收集了数据，其中500户有5至17岁儿童并被选作分析对象。该调查评估了家庭粮食不安全状况、社会经济地位（SES）、父母健康史、营养意识、食物消费模式和营养素摄入量。潜在结构“儿童生长”通过年龄别体重指数Z评分（BAZ）、年龄别身高Z评分（HAZ）和平均充足率（MAR）来衡量。采用结构方程模型来检验潜在变量及其观测指标之间的相互关系。矿物质摄入量对儿童生长的直接影响最强（β = 0.812，< 0.001），其次是食物可得性（β = 0.492）、维生素摄入量（β = 0.481）、社会经济地位（β = 0.439）和宏量营养素摄入量（β = 0.383）。MAR作为生长指标的因子载荷最高，而HAZ的意义有限，表明其具有慢性性质。社会经济地位通过对食物可得性和饮食摄入途径的影响直接和间接地影响生长。营养知识与营养素类别之间的强相关性反映了行为和生物学决定因素之间的相互关系。结构和直接营养因素均影响儿童生长。在巴勒斯坦青年中，矿物质摄入量、粮食安全和社会经济地位影响最大。这些发现为理解约旦河西岸巴勒斯坦青年的生长决定因素提供了一个框架，并支持制定有针对性的干预措施以改善饮食质量和总体营养状况。
