Association Between Caffeine and Nicotine Use and Optimal Obesity Measures for Adolescents: A Refugee Adolescent Study

BACKGROUND: The weight impact of caffeine and nicotine use by adolescents, unlike adults, has not been conclusively determined. The prevalence of obesity among adolescents, especially in vulnerable populations such as refugee adolescents, is a crucial public health concern. The study aimed to investigate the prevalence of central obesity and its associated risk factors among refugee adolescents. METHODS: This cross-sectional study was conducted in 2022 on refugee teenagers aged 11-15 in four refugee camps in West Bank. Data was collected through surveys and anthropometric measurements to assess waist circumference, waist-to-hip ratio and body mass index. Statistical analyses evaluated the relationship between caffeine and nicotine use and central obesity measures while accounting for potential confounders. RESULTS: A total of 454 participants (51.3% boys, 48.7% girls) were included in the study. The median age was 14.49 years, with a median BMI of 21.7. The prevalence of overweight and obesity was 24% and 21.1%, respectively. 14.1% had high waist circumferences. The study found significant associations between central obesity and cigarette smoking (p = 0.03), waterpipe smoking (p = 0.008) and energy drink (p = 0.016) and coffee (p = 0.027) consumption. Adjusted multiple logistic regression revealed an association between overweight status and energy drink consumption (AOR = 3.035, p = 0.009) and the interaction between energy drink and coffee consumption (AOR = 3.924, p = 0.010). Obese status showed a significant association with waterpipe smoking (AOR = 2.975, p = 0.021). CONCLUSION: Obesity is a significant health concern among Palestinian refugee adolescents, with various factors contributing to its prevalence. Central obesity, in particular, is associated with increased health risks, emphasising the importance of identifying its determinants, including caffeine and nicotine use among adolescents.