Metabolic syndrome (MetS) is one of the main reasons for elevated cardiovascular morbidity and mortality worldwide. Obese and overweight individuals are at high risk of developing these chronic diseases. The aim of this study was to characterize and establish sex-adjusted prevalence of metabolic syndrome and its components. A cross-sectional study was conducted in 2015, 689 (329 men and 360 women) aged 18–65 years from three refugee camps in the West Bank. International Diabetes Federation and modified National Cholesterol Education Program-Third Adult Treatment Panel definitions were used to identify MetS. The overall prevalence of obesity and overweight was high, 63.1%; Obesity (42 and 29.2% in women men; respectively and overweight 25.8 and 28.9% in women and men; respectively. The prevalence of MetS among obese and overweight was significantly higher (69.4%) according to IDF than NCEP definition (52%) (p < 0.002) with no significant differences between men and women using both definitions; (IDF; 71.8% men vs. 67.6% women, and (NCEP/ATP III; 51.9% men vs. 52.2% women). The prevalence of MetS increased significantly with increasing obesity and age when NCEP criterion is applied but not IDF. The prevalence of individual MetS components was: high waist circumference 81.3% according to IDF and 56.5% according to NCEP, elevated FBS 65.3% according to IDF and 56% according to NCEP, elevated blood pressure 48%, decreased HDL 65.8%, and elevated triglycerides 31.7%. Based on gender differences, waist circumferences were significantly higher in women according to both criteria and only elevated FBS was higher in women according to IDF criteria. Physical activity was inversely associated with MetS prevalence according to NCEP but not IDF. No significant associations were found with gender, smoking, TV watching, and family history of hypertension or diabetes mellitus. In this study, irrespective of the definition used, metabolic syndrome is highly prevalent in obese and overweight Palestinian adults with no gender-based differences. The contribution of the metabolic components to the metabolic syndrome is different in men and women. With the increase of age and obesity, the clustering of metabolic syndrome components increased remarkably. More attention through health care providers should, therefore, be given to the adult population at risk to reduce adulthood obesity and subsequent cardiovascular diseases.

Background: University students, who are at risk of eating disorders (ED), are more liable to use cognitive enhancers and psychostimulants to improve their cognitive functions and lose weight. ED in Palestinian male students is a neglected health issue. We aimed to investigate the prevalence and the association between ED and cognitive enhancers, and psychostimulants use among An-Najah National University students (ANNU). Methods: In a cross-sectional study conducted in 2020 at ANNU, 1047 students completed anonymous surveys for cognitive enhancers practice, the Eating Attitude Test-26 (EAT-26), Sick, Control, One, Fat and FOOD (SCOFF) screening tests. Results: The prevalence of ED among ANNU students was 21.2% based on EAT-26 (17.1% in males, 23.8% in females) and 31.5% based on SCOFF (24.0% in males, 36.3% in females). The binary logistic regression revealed that students at risk to have ED were water-pipe smokers (OR: 1.471, p-value 0.047), especially males, while students who were less likely to have ED were males (OR: 0.341, p-value< 0.001), coffee users (OR: 0.581, p-value 0.014) and chocolate users (OR: 0.530, p-value 0.041) than nonusers. Moreover, the risk of ED increased with increasing body mass index (p-value< 0.01). Clinical medical students showed the lowest prevalence (11.1%) compared to preclinical (22.5%), health sciences (23.7%), and non-medical students (20.9%) (p-value 0.059). Conclusion: Our findings highlight water-pipe smoking as a significant health problem in males with ED, which may require unique treatment and prevention strategies. Moreover, coffee and chocolate consumption were associated with decreased risk of ED, only among males. The gender-gap in ED prevalence was very narrow compared to international results. These results prompt the need to focus on both genders in future studies instead of females. They also suggest the urgent need to address ED among Palestinian university students by educating students about mental health, identifying high-risk students, and offering easily accessible psychological help.

Introduction: Due to their stressful lives, Palestinian refugees are prone to use cognitive enhancers (CE) and psychostimulant substances (PS). Recognising health problems associated with CE/PS use can indicate how preventive programs should be directed towards adolescents. Unfortunately, research has not thoroughly investigated the health problems related to tobacco and caffeine products, the most socially acceptable CE/PS among Palestinian refugee adolescents. Methodology: In 2021, schoolchildren from five Palestinian refugee camps (N=271) aged 12-< 16 years agreed to give blood samples and to be interviewed to address the association between metabolic syndrome (MetS) and tobacco smoking, coffee, energy drinks (ED), black tea, and chocolate consumption. MetS was diagnosed based on International Diabetic Federation Criteria. To address the association, we used binary logistic regression models adjusted to age, gender, BMI, and central obesity. Results: The prevalence of MetS was [17 (6.3%)]; (7.4%) in males, (5.1%) in females. The prevalence of substance use was as follows: ED [163 (48.9%)], coffee [255 (76.6%)], black tea [295 (89.1%)], cigarette [35 (10.5%)], waterpipe [59 (17.7%)], and chocolate [309 (93.6%)], with male predominance. Cigarette smokers have increased central obesity (p-value=0.024), and decreased HDL-cholesterol (p-value=0.015) than non-smokers. Similar results were observed for waterpipe smokers besides the increased levels of triglycerides (p-value=0.01). ED consumers have increased central obesity (p-value=0.03) and fast blood sugar (p-value=0.003) than non-consumers. Chocolate consumers have decreased central obesity (p-value=0.008) and increased HDL levels (p-value=0.04) than non-consumers. ED consumers were significantly at higher risk of MetS (OR=9.97, p-value=0.019) than non-consumers and chocolate consumers were at lower risk of MetS (OR=0.14, p-value=0.046) than non-consumers. Waterpipe smokers were at a higher risk of having increased plasma triglycerides than non-consumers (OR=3.4, p-value=0.03). Conclusion: The high prevalence of ED consumption and waterpipe smoking in Palestinian refugee adolescents is problematic. Their use was associated with higher odds of MetS, dyslipidemia, and central obesity, which justifies greater attention.

Tobacco smoking, alcohol use, and illicit drug use are significant health, psychological, and social problems among youth in Palestine. The aim of this study was to provide insight into the extent and the pattern of psychoactive substance use among schoolchildren in the West Bank in Palestine. A cross-sectional study in 16 schools was conducted in 2016. Eight hundred seventy-seven students of 10th grade were chosen randomly. Modified self-administrated questionnaire from Monitor the Future Study and European school survey project on alcohol and other drugs was used. The most current substance used by schoolchildren was tobacco (40.6%), followed by alcohol (3.2%) and illicit drugs (2.0%). Around 59.7, 7.9, and 2.9% of the schoolchildren had tried, at least once in their lifetime, tobacco, alcohol, and illicit drugs, respectively. Moreover, 11.1% of them who had not yet tried a substance intends to smoke tobacco, 1.4% intends to drink alcohol, and 0.3% intends to try illicit drugs. Curiosity and experience was the most frequent motivation for using these substances. The mean age of initiation was 12 years for smoking and 14 years for drinking alcohol or using illicit drugs. Most of the illicit drug users (78.3%) had tried more than one illicit drug or more than one substance at the same time. Cannabis and synthetic cannabinoids followed by amphetamines were the most commonly used drugs. Around 78.8%, 37.6%, and 27.6% agreed that tobacco, alcohol, and illicit drugs, respectively, were easily accessible in their communities. Work was significantly associated with increased risk for substance use across various substances. Many factors had determined the danger of using psychoactive substances by Palestinian schoolchildren including the initiation age, the availability, the type of the substances used, and the frequency of the use, and using multiple substances at the same time. Curiosity and experience, peer pressure, families, and working were the most important motives. Health care professionals, clinicians, and ministries of education, health, and labor have key responsibilities in preventing substance use among youth and need to develop more effective prevention and cessation strategies. The Palestinian National Authority needs to make more efforts in smoking legislation regulating the age of access and smoking for youths and adults.

University students are at higher risk of using psychoactive substances (PS). The aim of this study was to provide insight into the extent and the pattern of PS use among students in four main universities in the West Bank, Palestine. The most frequent lifetime substance uses were smoking tobacco (41.6% for cigarettes and 50% for hookah), drinking alcohol (5.4%), and using illicit drugs (3.0%). The frequency of use was higher among males, with higher income, orphans, or whose parents experienced more conflict in their relationship. Cannabis, synthetic cannabinoids, and amphetamines were the most common used illicit drugs. Factors determined the danger of using PS were the initiation age, availability of money and substances, substances types, frequency of use, and using multiple substances at the same time. Escaping from problems and peer pressure was the most important motives to substances use. Students who manifested a history of violence were significantly more likely being substance users whatever is the substance in question. Overall, PS use is common among Palestinian university students despite them being knowledgeable about the dangers of substance use. The results of this study demonstrate an urgent need for the development of intervention and immediate attention of local authorities.