Household Food Insecurity, Anemia, Malnutrition and Unfavorable Dietary Diversity among Adolescents: Quadruple Whammies in the Era of Escalating Crises in Lebanon.

Adolescence is a transitional period between childhood and adulthood. Nowadays, adolescents in Lebanon are growing during a time of unprecedented health crises and political instability. This study aimed to determine the prevalence and correlates of malnutrition, dietary diversity in adolescents' households, and adolescents' self-reported food insecurity in Lebanon. A national representative sample of 450 parent-adolescent dyads (parents: mean age ± standard deviation (SD) = 46.0 ± 7.0, mothers: 59.0%; adolescents: mean age ± SD = 15.0 ± 3.0, girls: 54.6%) were interviewed. Anthropometric and blood hemoglobin measurements were performed for adolescents. The Food Consumption Score, the Arab Family Food Security Scale and the Adolescent-Level Food-Security Scale were used. The overall prevalence of adolescent stunting, thinness, overweight, obesity and anemia was 6.7%, 4.7%, 19.3%, 12.9% and 16.7%, respectively. Almost 40.4% and 68% of adolescent's households consumed undiversified diets and were food insecure, respectively. Food insecurity (FI) affected 54.0% of adolescents. Adolescents attending schools (vs. university) were eight times more likely to be stunted (p = 0.04). Boys had a 4.3 times higher thinness risk (p = 0.005) compared to girls. Households reporting an income decline since the start of the Lebanese economic crisis were three times more likely to have a thin adolescent (p = 0.01). Parental overweight/obesity (p = 0.002) and lower education level (p = 0.04) nearly doubled the risk of adolescent overweight or obesity. At a time when escalating crises in Lebanon are shifting diets for the youngest generations, the development of adolescent-responsive nutritional policies becomes a must.

The Ukraine-Russia War Is Deepening Food Insecurity, Unhealthy Dietary Patterns and the Lack of Dietary Diversity in Lebanon: Prevalence, Correlates and Findings from a National Cross-Sectional Study.

BACKGROUND: Due to Russia and Ukraine's key roles in supplying cereals and oilseeds, the Russia-Ukraine war intensifies the current food availability and price challenges in Lebanon, which is a major wheat importer. Given these constraints, we conducted this study to assess the prevalence and correlates of food insecurity, low dietary diversity (DD), unhealthy dietary patterns, and the shifts in households' food-related habits in response to the Russia-Ukraine war among a representative sample of Lebanese household's members aged 18 years and above (N = 914). METHODS: Data were collected between June and July 2022 using self-administered questionnaires; Results: Findings showed that nearly half of the households consume an undiversified diet (46%), and 55.3% ate fewer than two meals per day. The prevalence of food insecurity among Lebanese households was 74%, with one in every four households being severely food insecure. In addition, the majority of households' members went out shopping and purchased food less than the pre-war period (68.7% and 70.3%, respectively). Furthermore, almost 68.3% of households' members highlighted price increases for cereal products, which were the least available and most stocked items. Findings obtained through binary logistic regression also showed that food insecurity was two times higher among households with low monthly income, 35% higher among females, and three times higher among married participants; Conclusions: The impact of the Russia-Ukraine conflict on food security in Lebanon requires a systems-thinking approach as well as international effort to understand the challenges and find solutions to minimize the war's negative effects.

Prevalence, correlates, and gender disparities related to eating disordered behaviors among health science students and healthcare practitioners in Lebanon: Findings of a national cross sectional study.

Background: The raised prevalence of eating disorders (ED) amongst health science students and health professionals is of mounting concern. This study aims to determine the prevalence and correlates of eating disorders risk amongst a sample of Lebanese health science students and healthcare practitioners of both genders. Methods: This cross-sectional study enrolled a convenient sample of 1,000 participants (mean age: 23 ± 5.4; females: 74.9%) from faculties of health sciences, clinics, pharmacies, and hospitals. The validated Eating Attitudes Test (EAT-26) was used to screen for eating disorders. Anthropometric data were self-reported by respondents to assess their nutritional status. Results: The risk of eating disorders was prevalent in 22.5% of participants. Females were at higher risk of ED compared to males p = 0.03. Eating disorders risk did not differ between students and practitioners (p = 0.3). The highest proportion of high-risk participants were students studying nutrition and practitioners (40.9%), outracing their counterparts in nursing (18.7%), medicine (17.8%), pharmacy (17.7%), and midwifery (4.9%) sciences (p = 0.02). Most high-risk participants had normal body weight (60.4%), and 28.9% were overweight (p = 0.001). Female gender, nutrition profession, and dieting were associated with increasing the odd of ED. Particularly, dieting increased the risk around five times. Further, each 3 participants over 10 were facing binge eating behavior. Conclusion: This study uncovers an undervalued profession-related-health-disorder in Lebanese health science students and healthcare practitioners. Specific attention should be given to EDs in professional educational programmes across healthcare disciplines.

Assessment of the knowledge, attitudes and practices of Lebanese shoppers towards food labeling: The first steps in the Nutri-score roadmap.

Background: Food labeling is a fundamental educational tool for advocating for public awareness. It emphasizes knowledge of the nutrient content of food and thus directs the choice towards the healthiest food products. This cross-sectional survey aimed to assess the knowledge, attitudes, and practices (KAP) regarding nutrition label use in Lebanon through a valid questionnaire. Methods: Overall, 768 participants (mean age: 30.8 ±12, males: 60.2%) were recruited randomly between February and May 2020. We used word of mouth and social media to recruit our sample population. Results: Social media was the most accessed tool to attain nutrition information by responders (39.8%). More than half the participants expressed positive attitudes to check information related to sugars (66.4%), vitamins (64.9%), total fats (61.7%), proteins (59.1%), and calories (58.7%) on the food label. Expiry date, price, and brand name were the top three considerations while reading food labels. About half (46.5%) reported to "always" look at the food label. Responders reported reading labels related primarily to sugars (44.3%), calories (38.8%), and total fats (36.8%). The optimal total KAP score was 46; our findings revealed a mean KAP score of 14.46 ±7 (31.4%). When categorizing the KAP scores, 15% had high scores, and 85% scored low. Spearman's coefficients showed positive correlations between knowledge-attitude, knowledge-practice, and attitude-practice scores, with p<0.001. The regression analysis revealed that gender, age, BMI, residency area, educational level, university degree, health and diet statuses, and activity level were significant predictors of the KAP score. Being on a diet had the highest odds (OR=3.107, CI=1.904-5.072, p<0.001). Conclusion: The low awareness of food labels leads Lebanese people to choose unhealthy food options. A planned educational program is recommended to ease the interpretation of these labels.

Knowledge, Attitudes, and Practices Related to Dietary Supplementation, before and during the COVID-19 Pandemic: Findings from a Cross-Sectional Survey in the Lebanese Population.

At the start of 2020, a new coronavirus (COVID-19) invaded the world leading to the death of 3.92 million people. Sadly, to date, no remedy has been discovered for this virus. Preventive vaccines have been under investigation, but were unavailable until December 2020. Clinical deficiencies of nutrients may increase susceptibility to infections. This knowledge may have provided an incentive for some dietary supplement (DS) manufacturers to advertise their products as COVID-19 preventatives or cures without any substantiation, targeting mainly social media fans. The objective of this research was to assess the usage, knowledge and attitudes towards dietary supplementation before and during the COVID-19 pandemic among Lebanese people. A cross-sectional study was conducted based on a convenience sample (N = 2966) and information from participants aged 18 years and above was collected about periods before and during the pandemic. Our findings showed that attitudes towards DSs changed when the pandemic emerged and people believed that DSs can improve their health and strengthen their immunity. Despite the rise in DS prescription by healthcare professionals, the prevalence of DS use decreased from 73.3% before the pandemic to 69.9% during the pandemic (p < 0.001). Study results declared that the weekly or the daily estimated intake had increased during the pandemic as compared to before the pandemic, from 14% to 15.6% for antioxidants (p = 0.014), from 35.3% to 42.1% for vitamin C (p < 0.001), from 35.5% to 41% for vitamin D (p < 0.001), from 15.2% to 17.5% for vitamin E (p = 0.002), and from 18.8% to 29.3% for zinc (p < 0.001) and other vitamins and minerals (from 9% to 10.9%, p < 0.001). Binary logistic regression indicated that the use of DSs during the pandemic was 4 times higher among those infected with COVID-19, 30 times higher among those who used to take DSs before pandemic, and 1.5 times higher among those who worked in the medical sector. To conclude, there is a crucial need to increase awareness among Lebanese people regarding the use of DSs.