Background: Even though the obesity epidemic continues to grow in various parts of the world, recent reports have highlighted disparities in obesity trends across countries. There is little empirical evidence on the development and growth of obesity in Lebanon and other countries of the Eastern Mediterranean Region. Acknowledging the need for effective obesity preventive measures and for accurate assessment of trends in the obesity epidemic, this study aims at examining and analyzing secular trends in the prevalence of overweight and obesity over a 12-year period in Lebanon. Methods: Based on weight and height measurements obtained from two national cross-sectional surveys conducted in 1997 and 2009 on subjects 6 years of age and older, BMI was calculated and the prevalence of obesity was determined based on BMI for adults and BMI z-scores for children and adolescents, according to WHO criteria. Age -and sex- adjusted odds ratios for overweight and obesity were determined, with the 1997 year as the referent category. Annual rates of change in obesity prevalence per sex and age group were also calculated. Results: The study samples included a total of 2004 subjects in the 1997 survey and 3636 in the 2009 survey. Compared to 1997, mean BMI values were significantly higher in 2009 among all age and sex groups, except for 6–9 year old children. Whereas the prevalence of overweight appeared stable over the study period in both 6–19 year old subjects (20.0% vs. 21.2%) and adults aged 20 years and above (37.0% vs. 36.8%), the prevalence of obesity increased significantly (7.3% vs. 10.9% in 6–19 year olds; 17.4% vs. 28.2% in adults), with the odds of obesity being 2 times higher in 2009 compared to 1997, in both age groups (OR = 1.96, 95% CI:1.29-2.97 and OR = 2.01, 95% CI: 1.67-2.43, respectively). The annual rates of change in obesity prevalence ranged between +4.1% in children and adolescents and +5.2% in adults. Conclusion: The study’s findings highlight an alarming increase in obesity prevalence in the Lebanese population, over the 12-year study period, and alert to the importance of formulating policies and nutritional strategies to curb the obesity rise in the country.

Objective: To identify and characterize dietary patterns in Lebanon and assess their association with sociodemographic factors, BMI and waist circumference (WC).Design: A cross-sectional population-based survey. In a face-to-face interview, participants completed a brief sociodemographic and semiquantitative FFQ. In addition, anthropometric measurements were obtained following standard techniques. Dietary patterns were identified by factor analysis. Multivariate linear regression was used to assess determinants of the various patterns and their association with BMI and WC.Setting: National Nutrition and Non-Communicable Disease Risk Factor Survey (2009), Lebanon.Subjects: A nationally representative sample of 2048 Lebanese adults aged 20–55 years.Results: Four dietary patterns were identified: ‘Western’, ‘Traditional Lebanese’, ‘Prudent’ and ‘Fish and alcohol’. Factor scores of the identified patterns increased with age, except for the Western pattern in which a negative association was noted. Women had higher scores for the prudent pattern. Adults with higher levels of education had significantly higher scores for the prudent pattern. The frequency of breakfast consumption was significantly associated with scores of both traditional Lebanese and prudent patterns. Multivariate-adjusted analysis revealed a positive association between scores of the Western pattern and the BMI and WC of study participants.Conclusions: The findings show the presence of four distinct dietary patterns in the Lebanese population, which were associated with age, sex, education and meal pattern. Only the Western pattern was associated with higher BMI.

The Eastern Mediterranean region is characterized by one of the highest burdens of paediatric obesity worldwide. This study aims at examining dietary, lifestyle, and socio-economic correlates of overweight, obesity, and abdominal adiposity amongst children and adolescents in Lebanon, a country of the Eastern Mediterranean basin. A nationally representative cross-sectional survey was conducted on 6–19-year-old subjects (n = 868). Socio-demographic, lifestyle, dietary, and anthropometric data (weight, height, waist circumference) were collected. Overweight and obesity were defined based on BMI z-scores. Elevated waist circumference (WC) and elevated waist to height ratio (WHtR) were used as indices of abdominal obesity. Of the study sample, 34.8% were overweight, 13.2% were obese, 14.0% had elevated WC, and 21.3% had elevated WHtR. Multivariate logistic regression analyses showed that male gender, maternal employment, residence in the capital Beirut, sedentarity, and higher consumption of fast food and sugar sweetened beverages were associated with increased risk of obesity, overweight, and abdominal adiposity, while regular breakfast consumption, higher intakes of milk/dairies and added fats/oils were amongst the factors associated with decreased risk. The study’s findings call for culture-specific intervention strategies for the promotion of physical activity, healthy lifestyle, and dietary practices amongst Lebanese children and adolescents.

The prevalence of obesity within countries varies by gender, age, lifestyle and socioeconomic factors. Identification of behavioural factors that are associated with obesity within the country’s context is critical for the development of effective public health programs which aim to prevent and manage obesity. The objective of this study was to assess age and gender differentials in the prevalence of obesity in Lebanon and examine correlates of obesity with a focus on socioeconomic disparities. Following the WHO STEPwise guidelines, a national survey was conducted in Lebanon in 2008–2009. Households were selected randomly from all Governorates based on stratified cluster sampling method. One adult aged 20 years and over was randomly selected from each household for the interview. Anthropometric measurements and 24 hour recall dietary intake were obtained. The final sample included 1244 men and 1453 women. Descriptive statistics were computed for BMI, waist circumference, and percent body fat. Multivariate logistic regression analysis was carried out to assess the relationship between energy intake and obesity adjusted for relevant co-variables. The prevalence of obesity among Lebanese adults was 26.1%. Gender differences in obesity estimates were observed across age groups and the three obesity classes, with men showing higher prevalence rates at the younger age groups (20–49 years), and women showing higher prevalence rates in older age groups (50 years and above). Obesity showed significant associations with socio-economic status in women; it decreased with higher educational attainment (OR = 0.54, 95% CI: 0.32, 0.91), greater household assets (OR = 0.26; 95% CI: 0.10, 0.72) and lower crowding index (OR = 0.62; 95% CI: 0.39, 0.98), net of the effect of other co-variates. There was a significant positive association between obesity and energy intake in both genders, and a negative association between obesity and physical activity, significantly among women. Lifestyle and socioeconomic determinants of obesity are identified in this Lebanese population. Policy makers and service providers need to tailor public health strategies to tackle obesity accordingly.

Proper nutrition is critical for healthy aging and maintaining functional independence. Limited research has been done on the assessment of dietary patterns of older adults and their association with diet quality indices. This study was conducted to identify, characterize, and evaluate the dietary patterns and diet quality of older adults in Lebanon, a middle-income country undergoing nutrition transition. A cross-sectional population-based study was conducted on a nationally representative sample of community-dwelling older adults aged >50 years (n = 525). Socio-demographic, anthropometric, and lifestyle variables were collected through interviews, and dietary intake was assessed using a semi-quantitative food frequency questionnaire (FFQ). Five commonly used diet quality indices (DQIs) were calculated, including the Alternative Healthy Eating Index (AHEI), the alternate Mediterranean diet score (aMed), the Dietary Approach to Stop Hypertension (DASH) style diet score, and the Lebanese Mediterranean Diet index. Dietary patterns (DPs) were derived using exploratory factor analysis. Associations of identified DPs with energy, energy-adjusted nutrients, and DQIs were evaluated by Pearson’s correlations. Multiple linear regression analyses were used to examine correlates of DPs. Three DPs were derived: Lebanese, Western, and High Protein/Alcohol patterns. The Lebanese pattern had highest correlations with fiber, folate, vitamin C, and all five DQIs. The Western was positively associated with energy and sodium and was inversely correlated with fiber, most vitamins, and a number of DQIs, namely AHEI, aMED, and DASH-style diet score. Highest correlations with intakes of proteins and fat were observed for the High Protein/Alcohol pattern. The Lebanese pattern was associated with female gender, education, nonsmoking and physical activity, whereas the Western pattern was associated with adverse health behaviors, including smoking, skipping breakfast, and physical inactivity. Of the three identified patterns, the Lebanese DP was associated with better diet quality and healthier lifestyle behaviors while the Western pattern implicated a lower quality diet. Public health programs promoting prudent diets, including the Mediterranean and Lebanese DPs, are needed to improve the diet quality of middle-aged and older adults in an attempt to improve their functionality and quality of life.

Many Mediterranean countries, including Lebanon, are experiencing a shift in food consumption away from the traditional Mediterranean diet (MD), concomitant with the escalating burden of non-communicable diseases and dwindling environmental resources. Objective: to examine the adherence to the MD and its association with environmental footprints (EFPs), including water use, energy use, and greenhouse gas (GHG) emissions, among Lebanese adults. Data of Lebanese adults were drawn from the national food consumption survey (n = 2610). Assessment of dietary intake was conducted using a food-frequency questionnaire. Adherence to the MD was examined using four published MD scores. Metrics for the EFPs were calculated using a review of existing life cycle assessments (LCAs). For all MD scores, less than 13% of participants were in the highest tertile. After adjustments for covariates, two of the MD scores were associated with lower water use. For GHG, significant inverse associations were observed with all MD scores. Energy use was not associated with MD scores. Overall, low adherence to the MD among Lebanese adults was observed, together with an inverse association between adherence to the MD and water use and GHG emissions. These findings support and enforce ongoing efforts that aim to increase adherence to the MD in order to address health issues, as well as tackle environmental sustainability.