Introduction : Unhealthy dietary habits are a major risk factor for chronic diseases, particularly if adopted during early adulthood. In a study conducted on a large sample of university students from both public and private universities in Lebanon, we observed differences in obesity prevalence between males and females. Given this difference, the objective of this analysis was to define the different dietary patterns among university students, focusing on correlation with gender and body mass index (BMI). Methods : A cross-sectional study was carried out on 3384 students, using a proportionate cluster sample of Lebanese students from both public and private universities. Results : Three dietary patterns were identified among university youth namely, vegetarian/low calorie diet (mainly plant food while avoiding ‘western’ food, composite dishes, and bread); mixed diet (high consumption of plant food, followed by composite dishes, bread, and a low consumption of western type food), and finally the westernized diet (high consumption of white bread and western food, and a strong avoidance of plant food and composite dishes). We observed significant differences between males and females in terms of their reported food intake and dietary patterns. Females were particularly more prone to adopt the vegetarian/low calorie diet than males (ORa=1.69; p<0.001), while males were more likely to adopt a westernized diet (ORa=1.51; p<0.001), seemingly in private universities (p=0.053). Students with high income and obese students (BMI ≥ 30 kg/m2) were more likely to consume vegetarian/low calorie diets (P<0.05). Conclusion: Male university students, despite having a higher BMI, reported a higher consumption of food according to a westernized dietary pattern as compared to female university students in Lebanon, while the latter reported a higher adoption of a vegetarian diet. Health promotion programs are needed among university youth in Lebanon to address their dietary intakes.

Consumption of sugar-sweetened beverages (SSBs) among children has been associated with adverse health outcomes. Numerous behavioral interventions aimed at reducing the intake of SSBs among children have been reported, yet evidence of their effectiveness is lacking. This systematic review explored the effectiveness of educational and behavioral interventions to reduce SSB intake and to influence health outcomes among children aged 4 to 16 years. Seven databases were searched for randomized controlled trials published prior to September 2016. Studies identified were screened for eligibility. Trials were included in the review if they met the PICOS (Population, Intervention, Comparison, Outcome, and Study design) criteria for inclusion of studies. Data were extracted by 2 reviewers following Cochrane guidelines and using Review Manager software. Of the 16 trials included, 12 were school based and 4 were community or home based. Only 3 trials provided data that could be pooled into a meta-analysis for evaluating change in SSB intake. Subgroup analyses showed a trend toward a significant reduction in SSB intake in participants in school-based interventions compared with control groups. Change in body mass index z scores was not statistically significant between groups. The quality of evidence from included trials was considered moderate, and the effectiveness of educational and behavioral interventions in reducing SSB intake was modest. PROSPERO registration number CRD42014004432.

Mixed evidence exists with respect to the association between household food insecurity (HFIS) and obesity in low-to-middle income countries (LMICs), particularly among women. This study aimed to measure socioeconomic correlates of HFIS and explores its association with dietary intake and odds of obesity among mothers in Lebanon, a middle-income country undergoing nutrition transition. A cross-sectional study was conducted among a representative sample of households (n = 378) in Beirut, Lebanon. Surveys were completed with mothers of children <18 years. HFIS was measured using a locally-validated, Arabic-translated Household Food Insecurity Access Scale (HFIAS). Dietary intake was assessed using the multiple pass 24-h recall method. Associations between HFIS (food vs food insecure) and socio-demographic characteristics were reported using crude and adjusted odds ratios. The odds of consuming <2/3rd Dietary Reference Intakes (DRIs) for nutrients among mothers from food secure and food insecure households were explored. In addition, logistic regression analyses were conducted to explore the association of HFIS with obesity (BMI ≥ 30 kg/m2) and at-risk waist circumference (WC ≥ 80 cm) among mothers. HFIS was found among 50% of study sample and was inversely associated with household income and mother’s educational level, even after adjusting for other socioeconomic variables (p < 0.01). Mothers in food insecure households reported consuming significantly less dairy products, fruits, and nuts yet more breads and sweets; and they had higher odds of consuming <2/3rd the DRI’s for key micronutrients (potassium, folate, and vitamin C) compared to secure ones. Adjusting for socioeconomic correlates, food insecure mothers had 1.73 odds of obesity (95% CI: 1.02–2.92) compared to food secure mothers. High HFIS prevalence was reported among urban Lebanese households. Mothers from food insecure households had a high risk of dietary inadequacy and obesity. Adequate evidence-based public health strategies are needed to reduce the vulnerability of mothers to food insecurity in LMIC settings and alleviate their risk of a high burden of nutrient insecurity and obesity.

This study evaluated the impact of a 6-month school nutrition intervention on changes in dietary knowledge, attitude, behavior (KAB) and nutritional status of Syrian refugee children. A quasi-experimental design was followed; Syrian refuge children in grades 4 to 6 were recruited from three informal primary schools (two intervention and one control) located in the rural Bekaa region of Lebanon. The intervention consisted of two main components: classroom-based education sessions and provision of locally-prepared healthy snacks. Data on household socio-demographic characteristics, KAB, anthropometric measures and dietary intake of children were collected by trained field workers at baseline and post-intervention. Of the 296 school children enrolled, 203 (68.6%) completed post-intervention measures. Significant increases in dietary knowledge (β = 1.22, 95% CI: 0.54, 1.89), attitude (β = 0.69, 95% CI: 0.08, 1.30), and body mass index-for-age-z-scores (β = 0.25, 95% CI = 0.10, 0.41) were observed among intervention vs. control groups, adjusting for covariates (p < 0.05). Compared to the control, the intervention group had, on average, significantly larger increases in daily intakes of total energy, dietary fiber, protein, saturated fat, and several key micronutrients, p < 0.05. Findings suggest a positive impact of this school-based nutrition intervention on dietary knowledge, attitude, and nutritional status of Syrian refugee children. Further studies are needed to test the feasibility and long-term impact of scaling-up such interventions.

The coronavirus (COVID-19) pandemic has had serious repercussions on the global economy, work force, and food systems. In Lebanon, the pandemic overlapped with an economic crisis, which threatened to exacerbate food insecurity (FI). The present study aims to evaluate the trends and projections of FI in Lebanon due to overlapping health and economic crises. Data from Gallup World Poll (GWP) 2015–2017 surveys conducted in Lebanon on nationally representative adults (n = 3000) were used to assess FI trends and explore its sociodemographic correlates. Predictive models were performed to forecast trends in FI (2018–2022), using GWP data along with income reduction scenarios to estimate the impact of the pandemic and economic crises. Pre crises, trend analyses showed that FI could reach 27% considering wave year and income. Post crises, FI was estimated to reach on average 36% to 39%, considering 50–70% income reduction scenarios among Lebanese population. FI projections are expected to be higher among females compared to males and among older adults compared to younger ones (p < 0.05). These alarming findings call for emergency food security policies and evidence-based programs to mitigate the burden of multiple crises on the FI of Lebanese households and promote resilience for future shocks.