Dietary adherence and overnutrition among Kuwaiti adolescents: a school-based assessment of anthropometry and dietary intake.

BACKGROUND: Adolescence is a critical period for the development of dietary behaviours that influence obesity and non-communicable disease risk later in life. In Kuwait, evidence on adolescent nutritional status integrating dietary intake with anthropometric indicators remains limited. This study aimed to assess adherence to dietary recommendations and examine the association between dietary intake and overnutrition, as measured by BMI and waist circumference (WC), among adolescents in Kuwait. METHODS: A cross-sectional study was conducted among 375 adolescents aged 13-17 years recruited from public high schools in Kuwait. Dietary intake was assessed using a 24-h dietary recall and evaluated against UK Dietary Reference Values. Anthropometric measurements included BMI and WC. Associations between dietary adherence and anthropometric outcomes were examined using multivariable logistic regression adjusted for relevant sociodemographic and behavioural covariates. RESULTS: Overall, 44.5% of participants were classified as overweight or obese based on BMI, and 34.7% had an elevated WC. Adherence to dietary recommendations was low, and almost all adolescents failed to meet recommendations for dietary fibre and fish intake. In contrast, excessive intake of free sugars (92.2%) and saturated fat (61.7%) was common. Protein intake was inversely associated with elevated WC, whereas excessive intake of total fat, carbohydrates, and red meat was positively associated with elevated WC. CONCLUSIONS: Kuwaiti adolescents exhibit a high prevalence of overnutrition alongside widespread non-adherence to dietary reference values. Dietary intake showed stronger associations with WC than with BMI, suggesting that WC may better capture diet-related differences in adiposity among adolescents. These findings underscore the need for culturally appropriate dietary reference standards and targeted public health strategies to address poor diet quality and rising metabolic risk among adolescents in Kuwait.