Eating habits and lifestyle behaviors during COVID-19 lockdown: The Lebanese experience.

OBJECTIVES: This study aimed to assess dietary intake and lifestyle habits followed during the COVID-19 pandemic and subsequent lockdowns, as well as the level of adherence to the Mediterranean diet (MD), among a sample of the Lebanese population. METHODS: A cross-sectional study was conducted during the government-enforced lockdown. A validated, online, questionnaire was used to collect information about dietary and lifestyle habits. The Mediterranean diet adherence screener (MEDAS) was used to assess adherence to the MD. RESULTS: A total of 1684 participants responded to the survey. Their mean age was 23.92 ± 7.62 years, and 70.4% were females. Approximately a third of the participants reported that their dietary habits did not change and 42.3% acknowledged that their eating habits deteriorated during the lockdown. Participants smoked less and slept more during the lockdown compared to before it. Approximately 19.2% of the sample reported low adherence to the MD whereas 63.9% and 16.9% described moderate and high adherence respectively. Only age was significantly associated with higher MD adherence. CONCLUSION: Dietary intake and MD adherence were suboptimal during the COVID-19 lockdown among the sample of the Lebanese population. It is critical that the Lebanese government implements public health programs in order to promote awareness about the importance of adhering to a healthy lifestyle and making appropriate dietary and lifestyle choices.

Correction: Knowledge, attitudes and practices towards people living with HIV/AIDS in Lebanon.

[This corrects the article DOI: 10.1371/journal.pone.0249025.].

Knowledge, attitudes and practices towards people living with HIV/AIDS in Lebanon.

BACKGROUND: Up till today, studies carried in Lebanon have focused more on the prevalence of HIV and behaviors and quality of life of infected individuals, however, none of these studies discussed the degree of stigma towards these populations. Therefore, the aim of this study is to measure the rate of stigma in terms of knowledge, attitude and practice towards patients living with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) (PLWHA) and examine the factors associated with this stigma. METHODS: A cross-sectional survey, enrolling 862 participants, was carried across the five governorates in Lebanon: Beirut, Mount Lebanon, North, South and Bekaa. The survey was a self-administered questionnaire which covered information about participants' general demographics, their knowledge, attitudes, practices and awareness towards HIV/AIDS in Lebanon., attitudes towards PLWHA, practices related to HIV/AIDS and awareness regarding HIV/AIDS situation in Lebanon. RESULTS: The response rate to the survey was 78.36% (862 participants). Being Muslim (Beta = -2.56) or Druze (Beta = -2.64) compared to Christians were significantly associated with lower knowledge towards HIV/AIDS, whereas having a secondary (Beta = 2.71) and a university (Beta = 3.04) levels of education compared to illiteracy and higher age (Beta = 0.05) were significantly associated with higher knowledge. Higher knowledge (Beta = 0.66) was significantly associated with better attitude, whereas higher age (Beta = -0.14) and being Muslim compared to Christian (Beta = -3.44) were significantly associated with worse attitude. Better attitude (Beta = 0.02) was significantly associated with better practice, whereas females compared to males (Beta = -0.39), having a secondary level of education compared to illiteracy (Beta = -0.88) and being Muslim compared to Christian (Beta = -0.32) were significantly associated with worse practice. CONCLUSION: Our results stress the need for educational programs, advocacy campaigns and policies to help reduce HIV stigma. This will then help start developing interventions and strategies for a possible reduction in the stigmatization level.

Poor Awareness of Hypertension in France: The CONSTANCES Population-Based Study.

OBJECTIVES: We aimed to assess the hypertension (HTN) awareness and associated factors in France. METHODS: We conducted a cross-sectional analysis using data from the CONSTANCES population-based cohort involving 87,808 volunteer participants included between 2012 and 2018. HTN was defined as average blood pressure (BP) over 140/90 or use of BP medication, awareness as self-reported HTN. Multivariable logistic regression models were used to identify the associated factors. RESULTS: Overall, 27,160 hypertensive participants (men = 16,569) above 18 years old were analyzed. Hypertension awareness rate was 37.5%. In the multivariable regression model, awareness was predicted by female gender, age, prior cardiovascular disease (CVD), presence of diabetes mellitus (DM), presence of chronic kidney disease (CKD), level of education, and obesity or overweight. Older participants (P < 0.001), females (P < 0.001), participants with comorbidities (P < 0.001), were more likely to be aware when compared with younger participants, males and participants without comorbidities, respectively. The unawareness among participants without cardiometabolic factors (CMF, i.e., CVD, DM, CKD) was higher than participants with CMF (67% vs. 41%, respectively, P < 0.001). Moreover, some differences appeared in both genders in the association between awareness of HTN and health and lifestyle factors. CONCLUSION: Our findings show that HTN awareness is low. Particular attention should be given to young men without comorbidities as these characteristics were predictors of poor awareness. Immediate action is required to improve HTN awareness in France.

Unhealthy behaviors and risk of uncontrolled hypertension among treated individuals-The CONSTANCES population-based study.

From an epidemiological standpoint, quantifying the individual and the combined effect of lifestyle factors on uncontrolled blood pressure (BP) deserves further evaluation. We aimed to examine the individual and combined associations between unhealthy behaviors and uncontrolled hypertension among treated hypertensive adults. Cross-sectional analysis was conducted using data from CONSTANCES, an ongoing French population-based cohort study. Uncontrolled BP was defined as mean systolic BP ≥140 mmHg and/or mean diastolic BP ≥90 mmHg. Unhealthy behaviors were considered as heavy alcohol consumption, low or medium adherence to dietary recommendations, sedentary physical activity level, and overweight. A total of 10,710 hypertensive treated volunteer participants were included and 56.1% had uncontrolled hypertension; of them, 2.0%, 24.5%, 54.0% and 19.5% exhibited 0, 1, 2 or ≥3 unhealthy behaviors respectively. In men, there was an increased odds of uncontrolled hypertension with heavy alcohol drinking compared to light-or-never (adjusted odds ratio 1.34, 95% CI 1.10-1.63), with low as well as with medium adherence to dietary recommendations compared to high (p < 0.05 for both), and with overweight or obesity compared to a normal body mass index (p ≤ 0.001 for both). In addition, men reporting a combination of ≥3 unhealthy behaviors compared to none, had an increased odds of hypertension of 1.67 (95% CI 1.09-2.53). Unhealthy behaviors described as, heavy alcohol consumption, non-adherence to dietary recommendations and overweight are associated with uncontrolled hypertension, at the individual and combined level, and particularly in men. Improvement of modifiable lifestyle factors could offer considerable benefits in the management of hypertension.

Unhealthy behavior and risk of hypertension: the CONSTANCES population-based cohort.

OBJECTIVES: We aimed to evaluate the individual and combined association between unhealthy behavior and hypertension (HTN). METHODS: We conducted cross-sectional analysis using data from the population-based cohort study CONSTANCES. Blood pressure measurements were taken based on standardized operational procedures. Dietary adherence was done following the dietary approach to stop HTN diet. We considered heavy alcohol drinking, sedentary-level physical activity, low/medium dietary adherence and overweight/obesity as unhealthy behaviors. Participants' characteristics were compared according to the number of unhealthy behaviors and the association between HTN and unhealthy behaviors was estimated using logistic regression. RESULTS: A total of 86 448 volunteer participants were included and the prevalence of HTN was of 31.1%. Of those with HTN, 8.2, 33.0, 44.3 and 14.5% exhibited 0, 1, 2 or at least 3 unhealthy behaviors, respectively. In both sexes, the prevalence of HTN increased with low/medium dietary adherence compared with high (P < 0.01), in overweight/obese compared with normal BMI (P < 0.001), with heavy alcohol consumption compared with moderate or never (P < 0.05) and with sedentary physical activity level compared to high in women only (P = 0.049). Combination of several unhealthy behaviors was associated with increased odds of HTN (P trend <0.001); men reporting 2 or at least 3 unhealthy behaviors had an adjusted odds ratio of HTN of 1.77 and 2.29, respectively, while women had an adjusted odds ratio of 1.71 and 2.14, respectively. CONCLUSION: Individual and combined unhealthy lifestyle factors were strongly associated with HTN in this large population-based study.

Prevalence and risk factors of hypertension: A nationwide cross-sectional study in Lebanon.

There is limited epidemiologic data on hypertension (HTN) in Lebanon. This study aimed to determine the prevalence and associated risk factors of HTN in the adult Lebanese population and evaluate the association between dietary and psychological factors on systolic blood pressure (SBP). Cross-sectional analyses were conducted using a multistage cluster sample across Lebanon. A total of 2014 participants were included. The prevalence and control rates of HTN were 31.2% and 28.7%, respectively. In women, educational level and physical activity were negatively associated with HTN (P < .05 for both) and adherence to the Lebanese Mediterranean diet was associated with a lower SBP. Other factors were associated with HTN in men. There was no relationship with SBP and psychological distress. Of the modifiable risk factors, body mass index persisted as the only contributory factor in both sexes (P < .01). Accordingly, prevention of HTN at the population level should focus mainly on overweight prevention.