METHODS: A cross-sectional, mixed methods study that in April 2024 collected quantitative and qualitative data to assess food insecurity and malnutrition among residents of the Northern part of the Gaza Strip during the first seven months of the war. Quantitative data assessed weight loss among participants as a marker of starvation. Qualitative interviews evaluated food availability, food variability, and changing eating habits. Demographics were represented as counts and percentages. Weight was reported as mean ± SD. The Spearman Correlation Coefficient evaluated potential correlations of weight loss with sex, place of residence, and age. Statistical significance was set at a p-value less than 0.05.

RESULTS: 497 participants were recruited, including 330 males (66.4%) and 167 females (33.6%). The age range was (13-83 years). The mean baseline weight was 84.94 kg ± 20.06, with a weight range (35-180 kg). In April 2024, the mean weight had dropped to 66.22 kg ± 14.34, representing an average decline of 18.72 kg (new weight range 28-142 kg). Age was associated with a weak positive correlation with weight loss (r = .204, p = .000). Qualitative interviews with 95 breadwinners or homemakers revealed a high prevalence of hunger and severe shortages in food quantity, quality, and variability. Physical and financial barriers significantly impacted food sourcing. Also, due to food shortages, most participants reported high consumption of edible wild plants and unconventional types of flour such as corn flour or grounded animal feed.