Adolescent malnutrition is a major public health problem, yet sex-specific determinants such as lifestyle behaviors remain understudied. This study examined gender differences in dietary habits, lifestyle behaviors, and nutritional status among private high school students in Addis Ababa, Ethiopia. A cross-sectional study was conducted among 283 adolescents aged 14–19 years, randomly sampled from three private schools between October 2022 and June 2023. Data on socio-demographics, diet, and lifestyle were collected using a structured questionnaire. Anthropometric measurements classified nutritional status as stunted (height-for-age Z + 2 SD), or well-nourished. Z-scores were computed using WHO AnthroPlus. Chi-square tests compared sex differences, and logistic regression identified predictors of nutritional status. Based on BMI-for-age, 50.5% of adolescents were well-nourished (− 2 SD to + 1 SD), 11.5% were underweight ( + 2 SD). Nearly 60% had poor dietary diversity, one-third skipped meals, and 49.5% had unhealthy weight. Boys were more physically active (≤ 1 h/day: 45.4% vs. 54.6%, p = 0.001) but more likely to skip meals (p = 0.04) and frequently consumed cakes and biscuits (p = 0.02). Girls reported higher fast-food intake (≥ 4 times/week) and longer screen time (> 2 h/day), though not significant. Among boys, younger age (14–16 years) increased odds of being well-nourished compared with older boys (AOR = 2.26, 95% CI: 1.12–4.60, p = 0.025). Among girls, frequent fast-food intake (AOR = 0.32, 95% CI: 0.10–1.00, p = 0.05) and screen time (AOR = 0.43, 95% CI: 0.20–0.94, p = 0.035) predicted suboptimal nutrition. Negative body image (AOR = 1.83, 95% CI: 1.13–2.98, p = 0.01) and screen time > 2 h/day (AOR = 0.60, 95% CI: 0.37–0.98, p = 0.04) were predictors for both sexes. Adolescent nutrition is shaped by shared and gender-specific factors. Body image and screen time influence both sexes, while younger age benefits boys and fast-food intake harms girls. Gender-responsive, school- and family-based interventions are needed.
Mekonen et al. (2025) studied this question.