Knowledge, Attitude and Practice Regarding Dietary Fiber Intake Among Palestinian Adolescents in The West bank

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فتحي, غدير
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An-Najah National University
There is documented evidence that correlates obesity and non-communicable diseases with poor food choices and sedentary lifestyles among adolescents worldwide. Low intake of fruits and vegetables, high consumption of fast food, and low dietary fiber consumption are among the reported food choices. Despite the documented health benefit of dietary fiber consumption; the awareness about the importance of dietary fiber in health is poorly studied and reported among Palestinian adolescents. This study aims to determine the level of knowledge, attitude, and practice about dietary fiber among Palestinian adolescents in governmental schools in the West Bank, and to identify the associated factors that may influence their cognizance and practices. Methods A total of 818 school adolescents were randomly selected from 5 different districts in the West Bank: Nablus, Salfit, Jenin, Tulkarm, and Hebron. The main age of the targeted participants was 14.26±0.79 ranged (13- 15) years. Moreover, a newly developed validated questionnaire was used to determine the level of knowledge (16 MCQ), attitude (3 levels Likert scale, 14 items), and dietary fiber practices (3 levels Likert scale, 10 items). Furthermore, Socio-demographic data, medical history, and lifestyle were collected. Nutritional status assessment was performed by using anthropometric measurements. Obesity, overweight, normal weight, and underweight were defined using using the World Health Organization cut off points. Face and content validity was done for the newly developed questionnaire, followed by a pilot study. The reliability test showed acceptable Cronbach alpha; knowledge items 0.82, attitude 0.69, and practices 0.72. Results This study showed an insufficient score of knowledge, in which the overall mean of the nutrition knowledge score was (7.04 ±2.45) out of 16. Nutrition knowledge was significantly associated with gender, economic status, and father's education level. The mean knowledge score was significantly (p= 0.007) higher among females (7.26 +2.35) than in males (6.79+2.54). A statistically (p=0.031) lower level of knowledge was associated with students who came from low-income families (6.65±2.65). Students who have highly educated parents scored significantly (p= 0.00) higher levels in fiber-related knowledge as compared to other groups (7.49+2.46). There was a notable relationship between the four items of dietary habits and gender, for instance, males showed significant dietary habits such as eating regular meals (p=0.02), eating breakfast daily (p=0.00), and drinking enough water more than ten cups (0.05) compared to females. There was no vital relationship between the weight status indicated by BMI and dietary knowledge or practices, nor was there a significant relationship between the total score of knowledge and dietary practices except in two items. However, there were significant differences between males and females in fiber-related dietary practices and attitudes. What’s more, there was a significant relationship for most items of attitude and knowledge, also a significant relationship with three items of fiber-related knowledge and practices. Conclusion The study revealed overall insufficient knowledge about dietary fiber, with a statistically significant higher level among females as compared to males. The dietary habits of the study sample showed a considerable prevalence of unhealthy dietary practices.