Factors related to dietary habits, energy drink consumption, and physical activity in marginalized Palestinian schools: A cross-sectional study

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.