A school-based study in Jazan City found stunting in 12.3% of the adolescents it assessed, while 4.3% were classified as thin. The findings point to a larger height-for-age problem than a low-BMI problem in this group, but the cross-sectional design cannot show what caused either condition.
Stunting means being shorter than expected for age, based on a WHO height-for-age growth score; thinness is defined through a body-mass-index-for-age score. Of 324 participants, 40 met the stunting definition, including six with severe stunting, while 14 met the thinness definition. The reported 95% confidence intervals ran from 9.0% to 16.0% for stunting, 0.6% to 3.4% for severe stunting, and 2.2% to 6.5% for thinness.
Age was linked to higher odds
Age was associated with higher odds of stunting. The reported odds ratio, a statistical measure of association, was 1.56 before adjustment and 1.61 after the model accounted for other variables. The adjusted estimate had a 95% confidence interval of 1.12 to 2.30. The relationship remained in the adjusted analysis, but it does not show that age itself causes stunting.
Household income showed a less straightforward pattern. Compared with households earning more than 10,000 SAR per month, those earning below 5,000 SAR had lower adjusted odds of stunting, as did those in the 5,000 to 10,000 SAR group. The adjusted odds ratios were 0.28, with a 95% confidence interval of 0.13 to 0.60, and 0.25, with a 95% confidence interval of 0.08 to 0.77, respectively. The cross-sectional data cannot explain this inverse association or show that lower income protects against stunting.
Thinness showed no clear demographic pattern
Sex differences were mixed. Males had a lower mean height-for-age score than females, negative 0.83 compared with negative 0.52, and the difference was statistically significant. Yet the study found no statistically significant sex difference in stunting, severe stunting, mean BMI-for-age or thinness: stunting was 13.4% in males and 9.4% in females, while thinness was 4.6% and 3.5%, respectively.
Thinness affected 14 adolescents, or 4.3%, and no examined sociodemographic factor was significantly associated with it. Maternal education and maternal employment produced borderline estimates, but both confidence intervals included the no-association value. The reported odds ratios were 0.18 for maternal education and 0.35 for maternal employment.
The setting matters
Researchers collected data between January and May 2023 from adolescents attending governmental intermediate schools in Jazan City. Multistage cluster sampling randomly selected two schools per educational sector and three classes per participating school, followed by systematic random sampling of students. The final analysis included 324 participants with complete questionnaire and anthropometric data.
Height and weight were measured using WHO-standardized procedures and recorded in 0.5-centimetre and 0.1-kilogram increments. The measurements were converted into height-for-age and BMI-for-age scores using WHO AnthroPlus 1.0.4 and the WHO 2007 reference for ages 5 to 19. Prevalence was reported with 95% confidence intervals, and the researchers used logistic regression after checking whether predictors overlapped too closely; variables with univariable P values below 0.20 entered the adjusted models, while two-sided P values below 0.05 were treated as statistically significant.
This was a cross-sectional snapshot from governmental intermediate schools in Jazan City, so it cannot establish whether the observed age or income associations were causal. It also does not by itself show that the same pattern would hold in private schools, rural areas or other Saudi settings.
Paper data and sources
Original title: Stunting and thinness among adolescents residing in Jazan City, Saudi Arabia: a school-based cross-sectional study using WHO AnthroPlus.
Authors: Eltyeb EE, Al-Makramani AA
Journal/Repository: Annals of Saudi medicine
Status: Peer-reviewed
First online: 2026-10-01
DOI: 10.5144/0256-4947.2026.349
Original paper · Full text