Prevalence of obesity and overweight in Palestine: a systematic review

Abstract

BackgroundOverweight and obesity are increasing at an alarming rate in developed countries and developing countries like Palestine. Obesity (body mass index [BMI]≥30) and overweight (BMI 25·0–29·9) predispose to several non-communicable diseases (NCDs) such as diabetes, hypertension, and cardiovascular diseases. Obesity prevalence studies in different age groups and locations across Palestine are very varied in their methods, participants, settings, or results. We aimed to assess the prevalence of obesity and overweight among children (18 years of age and under), adults (over 18 years of age), and people with NCDs in Palestine. MethodsWe conducted a systematic search and review of literature in PubMed, Embase, Scopus, CINAHL, and the Cochrane Library (from inception to Dec 3, 2016) for articles reporting obesity or overweight prevalence among Palestinians. We included all original, population-based studies, irrespective of their design or publication status, language, or age of participants. Studies were included if they used BMI, waist circumference, or waist–hip ratio as their measurement tool. Two authors independently screened titles, abstracts, and full texts for eligibility, then extracted relevant data and assessed the risk of bias. We pooled prevalence estimates of obesity and overweight using random effect models and reported the prevalence (with 95% CI) for children, adults, and people with NCDs separately. FindingsOf 773 citations retrieved, we included 38 eligible articles. The pooled prevalences of obesity and overweight were 6% (range 4–10%; I2=98%) and 15% (13–17%; I2=92%) in children; 18% (11–29%; I2=98%) and 30% (24–38%; I2=97%) in adults; and 49% (35–64%; I2=98%) and 40% (31–50%; I2=96%) in people with NCDs. All studies had a moderate to high risk of bias, especially selection bias. Most studies had incomplete reporting of STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist items, especially for source of bias (95%), study limitations (60%), and funding (80%). InterpretationThe prevalences of obesity and overweight in Palestine are high compared with those of some other developing nations, such as Tunisia, especially among adults and people with NCDs. However, the results should be interpreted cautiously in light of the high heterogeneity encountered in most studies. Our findings suggest that strategies are required to reduce obesity, and future research needs to identify the most effective interventions for combatting obesity in Palestine. FundingNone.