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.

Micronutrient deficiencies and inadequacies constitute a global health issue, particularly among countries in the Middle East. The objective of this review is to identify micronutrient deficits in the Middle East and to consider current and new approaches to address this problem. Based on the availability of more recent data, this review is primarily focused on countries that are in advanced nutrition transition. Prominent deficits in folate, iron, and vitamin D are noted among children/adolescents, women of childbearing age, pregnant women, and the elderly. Reports indicate that food fortification in the region is sporadic and ineffective, and the use of dietary supplements is low. Nutrition monitoring in the region is limited, and gaps in relevant information present challenges for implementing new policies and approaches to address the problem. Government‐sponsored initiatives are necessary to assess current dietary intakes/patterns, support nutrition education, and to reduce food insecurity, especially among vulnerable population groups. Public–private partnerships should be considered in targeting micronutrient fortification programs and supplementation recommendations as approaches to help alleviate the burden of micronutrient deficiencies and inadequacies in the Middle East.

Objectives: To investigate, measure and assess the food consumption pattern of the adult population living in Beirut, Lebanon, and to identify inadequate or excessive intake of food groups particularly linked to non-communicable diseases.Design: A cross-sectional food consumption survey was conducted in 2001. Dietary habits were assessed by means of a quantitative food-frequency questionnaire.Setting: Dietary survey of the urban population (Beirut).Subjects: Random sample of 444 adult subjects (aged 25–54 years) in Beirut.Results: The mean consumption of food by the study population was estimated to be 3030 g day⁻¹, providing an energy intake of 2523.57 kcal day⁻¹. Fat contributed 38.9% to the average daily energy intake, protein 13.4% and carbohydrates 47.2%. Mean consumption of fruits and vegetables was approximately 367 g day⁻¹and 45.3% of subjects consumed less than the recommended 400 g daily. Cereals contributed 324.5 g day⁻¹, providing 35.0% of daily energy intake, with bread being the most highly consumed (146.2 g day⁻¹) in this food group. The mean intake of meat and poultry products was 91.7 g day⁻¹and provided 8.8% of daily energy intake, with consumption of butchery products especially beef being the highest (47.6 g day⁻¹) followed by poultry (36.1 g day⁻¹). A low consumption of fish was noted (19.7 g day⁻¹), with 73.6% of subjects consuming less than the recommended 2 servings of fish per week. Dairy products contributed 243.1 g day⁻¹or 10.9% of daily energy intake, and milk was the least consumed dairy product (56.8% of consumers). The intake of added fats and oils, excluding those in cooked recipes, was 20.4 g day⁻¹; olive oil was not used in cooking but was added solely at the table and its mean intake was 5 g day⁻¹. The consumption of butter was low (0.86 g day⁻¹) and vegetable oil was the type of fat mostly used in cooking. The average intake of alcoholic beverages was low (33.6 g day⁻¹), accounting for 0.7% of total energy intake. Women had significantly higher intakes of milk, dairy products, vegetables and coffee than men (P< 0.05). The percentage of women who reported the use of low-fat items was significantly higher than that of men. Younger people (25–34 years) ate significantly more meat, sugar, alcoholic beverages and soft drinks, and consumed significantly less cooked vegetables and legumes, than older ones (P< 0.05).Conclusions: The rather high contribution of fat to daily energy intake, the low intake of fish and the relatively high percentage of people consuming less than the recommended amount of fruits and vegetables observed in this study suggest that the adult Lebanese population is at increased risk of cardiovascular diseases, obesity and other non-communicable diseases, which provides the basis for recommending increased intakes of fish, particularly fatty fish, and fruits and vegetables.

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.

This review argues that nutrition is an integral component of food security, and should be embedded within all four of its dimensions – availability, access, utilization, and stability. The review highlights current food insecurity in the Middle East and North Africa (MENA) region, as exacerbated by the triple burden of malnutrition, where undernutrition, micronutrient deficiencies, and overweight/obesity coexist. Previous efforts to address food security in MENA have focused on food availability, overlooking the other three dimensions and leaving nutrition considerations aside. Meanwhile, the literature has recognized the need to highlight nutrition as fundamental, and opted for the term ‘food and nutrition security’. To achieve food and nutrition security in MENA, a nutrition lens must be applied across all four dimensions – from assessment, to policy and programming, to capacity building. For example, MENA countries can adopt policies and programs including well-structured food subsidies, dietary guidelines, public awareness, and education campaigns to increase availability and accessibility of nutritious and safe foods, and stimulate consumer demand for those. To accomplish this, MENA needs to build stakeholders' capacity and equip them to address the challenges that are hindering the achievement of food and nutrition security now and into the future.