Objective: To examine the association between nutrition, physical activity, lifestyle, the combined behavior e"ect, and the schoolchildren's academic achievement. Design: Observational and cross-sectional study. Setting: West Bank, Palestine. Participants: A group of schoolchildren (n=1945) in grades 5-9 (11-16 years). Measurements: Students were surveyed about the their ’dietary, physical activity (PA), leisure time activity, and academic achievement. Academic achievement was measured using students' marks in Arabic, English, math, science courses, and the total average score. The linear regression model was conducted to analyze the relationship between dietary, PA, combined behavior, and academic achievement, while adjusted for demographic confounders; body mass index (BMI), and parental education. Results: Findings indicated that healthy nutrition and adequate levels of PA significantly predict achievement scores. In both boys and girls, high academic achievement was associated with a high intake of fruits and vegetables (AOR: 1.1 (0.72-1.68); 1.18(0.81-1.7), and (AOR: 1.21(0.8-1.82); 1.33(0.93-1.91), respectively. In both girls and boys, high academic achievement was associated with low intake of soft drink, beverages (juice with sugar) and energy drink (AOR: (0.75(0.47-1.19), 0.85(0.58-1.27)); (0.99(0.63-1.57), 0.76(0.52-1.12)); (0.66(0.38-1.15), 0.49(0.27-0.89)), respectively. The active and healthy nutrition group scored higher on Arabic, English, math, science, and total average score. Conclusions: There is a strong relationship between healthy nutrition, acceptable PA, and the average academic achievement within schoolchildren. Findings emphasize the importance of linking nutrition, school PA, and health policies for improving cognitive functions and academic performance of Palestinian schoolchildren. Thus, school-based healthy lifestyle educational, health behaviors policy, and recommendation programs may have a greater e"ect on students’ academic achievement.

The COVID-19 pandemic has revealed the Eastern Mediterranean Region's food system's fragility posing severe challenges to maintaining healthy sustainable lifestyle. The aim of this cross-sectional study (N = 13,527 household's family members, mean age: 30.3 ±11.6, 80% women) is to examine the impact of the COVID-19 pandemic on food consumption patterns and household's dietary diversity in 10 Eastern Mediterranean countries. A food frequency questionnaire was used to investigate the consumption patterns along with the calculation of the Food Consumption Score (FCS), a proxy indicator of dietary diversity. Data collected on cooking attitudes, shopping and food stock explore the community mitigation measures. In the overall population, before and during the pandemic, most food groups were consumed less or equal to 4 times per week. As evident from our findings and considering that the pandemic may be better, but it's not over, small to moderate changes in food consumption patterns in relatively short time periods can become permanent and lead to substantial poor dietary diversity over time. While it is a priority to mitigate the immediate impact, one area of great concern is the long-term effects of this pandemic on dietary patterns and dietary diversity in Eastern Mediterranean households. To conclude, the COVID-19 crisis revealed the region's unpreparedness to deal with a pandemic. While the aggressive containment strategy was essential for most countries to help prevent the spread, it came at a high nutritional cost, driving poor dietary diversity.

Background: Promoting a healthy diet and lifestyle to reduce the national burden of nutrition-related problems among Palestinians requires an understanding of food consumption trends and patterns. Few studies have examined the food consumption patterns with the macro and micronutrient intakes and nutrition risk factors. The objective of this study was to study the food frequency and nutrient intake consumption patterns of Palestinian schoolchildren and their associations with the socioeconomic and risk factors. This is a national cross-sectional descriptive study conducted on Palestinian schoolchildren from the West Bank. The study examined the food consumption patterns of the macro and micronutrient intakes and nutrition risk factors among 1945 students aged 11-16 years. The data collected using the food frequency questionnaire and 24-hour recall that was administered by trained field workers. Food groups’ classification, nutrient intakes, body mass index (BMI) Z-scores, and socioeconomic di"erences were examined across the food groups’ patterns of consumption. We employed Z-score and K-Means cluster analysis to identify food consumption patterns and to examine factors associated with nutrient intakes. The food frequency results identified three food consumption clusters including the traditional, non-traditional, and mixed pattern. A total of 796 students (41%) were in traditional cluster, 458 (23.5%) in non-traditional cluster, and 691(35.5%) in mixed cluster. The nutrient intakes identified three clusters (High, Moderate, and Low consumption patterns) out of macronutrient, vitamins, and minerals categories. Most of the students located in the low consumption cluster for macronutrient, vitamins, and minerals clusters (66.9%, 67.7%, and 64 %) respectively. The traditional cluster was associated with healthy, non-obese, and physically active students and the non-traditional cluster was associated with unhealthy and obese students, but both shown significantly di"erent across the identified clusters. Imbalance in dietary intakes among schoolchildren reflects a lack of dietary diversity. High sugar, fats and oils, and beverages consumption, low consumption of grains, fruits, beans and legumes, and meat are noticed in Palestinian schoolchildren. The findings indicated the importance of considering the food groups' intake variations among Palestinian schoolchildren. As the segments relate to children’s health, nutrition diet programs should consider the high scores of non-traditional and mixed food consumption among school’s children.