The Dual Burden of Malnutrition and Associated Dietary and Lifestyle Habits among Lebanese School Age Children Living in Orphanages in North Lebanon.

Childhood is a crucial period affecting physical and intellectual development. Although children living in orphanages are among the most vulnerable groups at risk of malnutrition, there is scarcity of data concerning their nutritional status in Lebanon. To investigate these data, a cross-sectional survey was conducted including a sample of 153 institutionalized children aged 5-14 years from all orphanages in Tripoli. Nutritional status was assessed using anthropometric, clinical, and dietary tools. Interpretation of anthropometric data showed that 13.8% were stunted while the prevalence of overweight/obesity was 9.2% according to the World Health Organization (WHO) reference criteria. Physical signs suggesting nutritional deficiencies were detected in about 25% of the sample. Dietary intake evaluation showed that about half of the participants had inadequate dietary intakes of proteins, fruits, and vegetables and 92% had inadequate milk and dairy intakes recommended for their age specific needs. Multivariate regression analysis revealed statistically significant positive association of age, skipping breakfast, and increased screen time with stunting while it showed statistically significant negative association of inadequate protein intake with overweight/obesity. The coexistence of under- and overnutrition among institutionalized children calls for implementation of comprehensive intervention strategies committed to reducing undernutrition while simultaneously preventing overnutrition through improving diet quality and physical activity of these children.