Growth outcomes and nutrient adequacy in children with disabilities in the West Bank: Associations with disability severity and socioeconomic factors

Background: Children with disabilities are at increased risk of nutritional inadequacy, yet data from resource-constrained settings are limited. This study examined the association between disability severity, etiology, socioeconomic and demographic factors, and nutritional status among children with disabilities in the West Bank, Palestine. Methods: A cross-sectional study was conducted among 118 children with disabilities aged 6 to 18 years. Disability severity was assessed using the Disability Rating Scale. Anthropometric status was evaluated using World Health Organization (WHO) Z-scores, and dietary intake was assessed using two 24-h recalls and a semi-quantitative Food Frequency Questionnaire. Nutrient adequacy and the Mean Adequacy Ratio were calculated relative to dietary reference standards. Results: Micronutrient inadequacy was widespread, with vitamin A and vitamin D intake below recommended levels in all participants and calcium inadequacy exceeding 95%. Inadequate micronutrient intake was more common among adolescents (57.1%) and low-income households (46.2%). Stunting was more frequent among younger children (51.2%) and those in institutional care (34.1% vs. 14.3%). Disability severity was significantly associated with BMI-for-age (F = 14.455, p < 0.001) and height-for-age (F = 5.149, p = 0.025). Energy (χ2 = 12.851, p = 0.025), carbohydrate (χ2 = 16.700, p = 0.005), and magnesium intake (χ2 = 37.563, p < 0.001) varied across severity levels. Conclusion: Children with disabilities in the West Bank face substantial micronutrient inadequacy, with nutritional risk associated with functional severity and socioeconomic context. Integration of routine nutritional screening within disability services is warranted to address critical nutrient gaps and support growth and functional outcomes.