Double Burden of Malnutrition Among Children Under Five Years in Saudi Arabia: A Cross-Sectional Study of Prevalence and Determinants

Why It Matters

The coexistence of under‑ and over‑nutrition in the same population strains Saudi Arabia’s health system and signals gaps in early‑life feeding practices, infection management, and lifestyle guidance, demanding integrated public‑health interventions.

Key Takeaways

• Stunting affects 29.5% of children under five in Taif.
• Overweight and obesity together affect 19.3% of the same cohort.
• Low birth weight and early feeding before six months drive stunting risk.
• High dairy, fast‑food intake and screen time linked to overweight.

Pulse Analysis

The double burden of malnutrition—simultaneous prevalence of undernutrition and overnutrition—has emerged as a critical public‑health challenge in middle‑income countries. In Saudi Arabia, rapid urbanization and dietary transitions have reshaped childhood growth patterns, yet comprehensive city‑level data remain scarce. This Taif study fills that gap by applying WHO growth standards to a representative sample of 482 children, revealing that nearly one‑third are stunted while almost one‑fifth are overweight or obese. Such divergent trends within a single cohort underscore the complexity of nutrition transitions in the Gulf region.

Underlying determinants differ markedly between the two poles of malnutrition. Undernutrition was strongly associated with low birth weight, premature introduction of complementary foods, recurrent infections and insufficient protein intake—factors that reflect gaps in maternal health, early infant feeding guidance, and infection control. Conversely, overnutrition correlated with higher dairy and fast‑food consumption, excessive screen time, and repeated diarrheal episodes, pointing to lifestyle shifts and dietary excesses common in affluent urban settings. These findings highlight the need for nuanced, age‑specific interventions that address both scarcity and excess, rather than a one‑size‑fits‑all approach.

Policymakers and health providers can leverage this evidence to reinforce existing maternal‑child health services. Integrating routine growth monitoring with caregiver‑focused nutrition counseling, promoting exclusive breastfeeding for six months, and regulating antibiotic use can curb undernutrition. Simultaneously, school‑based nutrition education, limits on sugary and fast‑food marketing, and initiatives to reduce sedentary screen time can mitigate rising obesity rates. Private sector partners—food manufacturers, digital health firms, and pediatric care networks—have a market opportunity to develop culturally appropriate, protein‑rich complementary foods and tech‑enabled lifestyle programs that align with Saudi Vision 2030’s health objectives.