Search Results (14)

Background: There is growing interest in the role of gut microbiota in the pathophysiology of inflammatory bowel diseases (IBDs), including Crohn’s disease (CD). Probiotics have been proposed as a potential adjunct therapy for these conditions by altering the intestinal environment, although studies on their effectiveness have yielded mixed results. Aim: This study aims to evaluate the short-term (2 months) effects of a dietary supplement containing Lactobacilli, Bifidobacteria, and Lactococcus bacillus on disease progression, remission, quality of life, and nutritional intake in Lebanese patients with CD. Method: A multicenter, randomized, single-blind controlled trial was conducted in 2 medical centers in Beirut from 1 April 2024 to 1 August 2024. Recruitment, prescreening, screening, enrollment, and protocol implementation were carried out at both centers. Data were collected from 21 patients with CD, who were randomly assigned to the control group (n = 10) and the intervention group (n = 11). At baseline and after two months, participants underwent clinical assessments, WHOQOL-BREF evaluation, and 24 h dietary recalls. Follow-up visits included surveys on disease progression, quality of life, adherence, and adverse events, along with repeat body composition and anthropometric measurements. Results: Probiotic supplementation over two months did not significantly alter symptoms, flares, or hospitalizations outcomes between the control and intervention groups. However, the intervention group experienced notable increases in body weight (p = 0.01), BMI (p = 0.01), body fat mass (p = 0.04), and arm muscle circumference (p = 0.01). Nutrient intake patterns differed, with the intervention group showing increased consumption of calcium, riboflavin, and folate compared to controls (p = 0.01, p = 0.04, p = 0.013, respectively). Probiotic supplementation led to significant within-group increases in dietary fiber (p = 0.01), total sugar (p = 0.02), and caffeine (p = 0.01) among the intervention participants. Adverse effects in the intervention group were mild, including nausea (18.2%) and abdominal discomfort (9.1%). QOL improved significantly in the intervention group, particularly in physical (p = 0.03), psychological (p = 0.04), and environmental domains (p = 0.003), while the control group exhibited improvements only in psychological health. Conclusions: Overall, the findings suggest that probiotics can enhance body composition, nutrient intake, and certain aspects of QOL among CD patients, despite minimal impact on disease symptoms or dietary patterns. Full article

Background: Pregnancy is a crucial period for maternal and fetal health, and in Lebanon, where cultural and economic factors influence dietary practices, there is an urgent need to evaluate the food consumption patterns and diet quality of pregnant women. Aim: To evaluate the food consumption patterns, energy intake, as well as macro- and micro-nutrient intake among a nationally representative sample of Lebanese pregnant women aged 18–49 years old. Methods: A cross-sectional study was carried out from March to October 2023, involving 500 pregnant women from all eight Lebanese governorates. Sociodemographic and medical information was gathered, food consumption was evaluated using a validated Food Frequency Questionnaire (FFQ) and three 24-h recall, and anthropometric measurements were recorded. Results: The current population did not meet the USDA healthy pattern recommendations for whole grain, seafood, dairy, nuts, seeds and soy products consumption but exceeded the guidelines for vegetables, meats, poultry, eggs, oils, and refined grains. According to Mediterranean diet guidelines, the sample fell short in recommended intakes for fruits, olives/nuts/seeds, eggs, and olive oil, while surpassing the recommended levels for potatoes, legumes, pulses, sweets, red meat, processed meat, and fish and seafood. None of the participants met the energy requirements for their trimester and age group. In terms of macronutrient intake, the requirements for protein, unsaturated fats, and fiber were not met, while intakes of fats and sugars were exceeded. Regarding micronutrients, the recommended levels were not fully achieved, with particularly low intakes of vitamin D and iodine, as well as inadequate adherence to recommendations for iron, calcium, vitamin A, vitamin E, zinc, and choline. Additionally, a third of the participants did not meet the recommended intakes for folate and vitamin B12. Conclusions: The findings reveal significant dietary inadequacies among the current population, with participants failing to meet essential recommendations for whole grains and key food groups, alongside insufficient energy intake for their trimesters and age groups. Critical micronutrient deficiencies, particularly in vitamin D, iodine, and B vitamins, highlight the urgent need for targeted nutritional interventions and public health initiatives to improve dietary practices among pregnant women in Lebanon. Full article

Adolescence is a critical period for establishing lifelong health behaviors; yet in Lebanon, limited data exist on the prevalence of risk factors among this demographic. Objective: This study aims to assess alcohol consumption, dietary habits, physical activity, mental health, and smoking behaviors among Lebanese adolescents aged 13–17 years, with a focus on gender and school-type differences. Methods: A cross-sectional analysis was conducted in Lebanon between March and July 2022 using the Global School-based Student Health Survey (GSHS) questionnaire. A representative sample of students from public and private schools participated in the survey, with key variables analyzed to identify significant patterns and disparities. Results: Our findings reveal that 6.3% of adolescents consumed alcohol, with males reporting a higher prevalence and earlier initiation (p = 0.003). Gender differences were evident in dietary habits, where males were more likely to consume sugary drinks (p = 0.04) and have consistent breakfast habits (p = 0.003). Adolescents from private schools exhibited distinct dietary behaviors, including lower milk consumption (p < 0.001) and higher fatty food intake (p = 0.008). Males were also more physically active and reported better mental health outcomes compared to females (p = 0.004). Smoking behaviors showed that males smoked more frequently, while private school students reported smoking less. No significant difference was observed in bullying experiences between genders or school types. Conclusions: The study highlights critical health behaviors among Lebanese adolescents, with significant variations by gender and school type. These findings underscore the need for targeted interventions to address the identified risk factors and promote healthier behaviors in this population. Full article

Background: The rates of obesity, undernutrition, and other non-communicable diseases are on the rise among Lebanese adults. Therefore, it is crucial to evaluate the food consumption habits of this population to understand diet quality, analyze consumption trends, and compare them to healthy diets known to reduce risks of non-communicable diseases. Aim: To evaluate the food consumption patterns, energy intake, as well as macro- and micro-nutrient intake among a nationally representative sample of Lebanese adults aged 18−64 years old. Methods: A cross-sectional study was carried out from May to September 2022 involving 444 participants from all eight Lebanese governorates. Sociodemographic and medical information was gathered through a questionnaire, food consumption was evaluated using a validated FFQ and 24 h recall, and anthropometric measurements were recorded. Results: There was a notable lack of adherence to three healthy diets (Mediterranean, EAT-Lancet, USDA) among Lebanese adults. Their dietary pattern is characterized by high energy, added sugars, sodium, and saturated fat intake while being low in healthy fats, vitamin A, D, and E. Adult women are falling short of meeting their daily calcium, vitamin D, iron, and vitamin B12 requirements, putting them at increased risk of anemia, osteoporosis, and other health issues. Grains and cereals were the most consumed food groups, and most participants were found to be overweight or obese. Conclusions: In conclusion, the results highlight the need for public health policies and interventions aimed at encouraging Lebanese adults to make healthier food choices and transition towards diets like the Mediterranean, EAT-Lancet, or USDA diet. These diets have been shown to promote overall health and wellbeing. Full article

Modifiable factors associated with cognitive decline (CD) require more attention, particularly dietary patterns. This study aimed to investigate the link between cognitive decline and associated factors, particularly dietary patterns (DPs), in community-dwelling older Lebanese of modest economic status. Our cross-sectional national study included 352 participants above 60 years old, from the medico-social centers of the ministry of social affairs all over the country. CD was screened based on literacy. Nutritional and dietary data were collected through a validated food frequency questionnaire. DPs were extracted by the K-mean cluster analysis. CD was found in 32.7% and 61.5% of literate and illiterate groups, respectively. Identified DPs included a Westernized type and Mediterranean type, with high and moderate food intakes. In the context of literacy, independent factors associated with CD were age above 80 years, living in Beirut, frailty, and adopting a Westernized (OR = 3.08, 95% CI: 1.22–7.8) and a high-intake Mediterranean DP (OR = 2.11, 95% CI: 1.05–4.22). In the context of illiteracy, the same factors were associated with CD, but not DP nor frailty, with an age cut-off at 78 years. In a Lebanese sample of older adults, factors associated with CD depend on the level of literacy, with DP only associated with CD in the context of literacy. Full article

A scarcity of research has looked into the association of maladaptive core beliefs with dysfunctional eating patterns. Moreover, no prior study has considered the potential role of difficulties in negative emotion regulation when disentangling the complex correlations between early maladaptive schemas and disturbed eating habits. Our study aimed at exploring the distinct relationships between early maladaptive schemas and disordered eating, while investigating the indirect role of emotion regulation difficulties within these associations. We collected data from 982 Lebanese young adults (18–30 years old), distributed across the five Lebanese governorates, who completed the Eating Attitudes Test (EAT-26), the Young Schema Questionnaire—Short Form 3 (YSQ-SF3), and the Difficulties in Emotion Regulation Scale—16 Item Version (DERS-16). The results showed that the disconnection and rejection schema domain, under which the early maladaptive schema of mistrust was the most predictive of disordered/inappropriate eating attitudes. All the remaining maladaptive schema domains (i.e., the impaired autonomy/performance, impaired limits, other-directedness, and overvigilance/inhibition schema domains) exerted significant indirect effects on disordered eating attitudes through difficulties in emotion regulation. Our findings gave prominence to a potential intrinsic mechanism through which maladaptive cognitive schemas are linked to disordered eating behaviors, emphasizing the role of emotion dysregulation as a cardinal actor within this model. They sustain the surmise that cognitively and emotionally vulnerable individuals exhibit stronger propensities for inappropriate dietary patterns, as a means to offset their inner weakness. This study broadens the medical community’s insights into the underpinning processes behind eating disorder psychopathology and could therefore make a step towards the adoption of innovative therapeutic approaches that promote emotion regulation skills in the context of schema therapy. Full article

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. Full article

Non-alcoholic fatty liver disease (NAFLD) is considered the most common liver injury worldwide. NAFLD can evolve into non-alcoholic steatohepatitis (NASH) with or without fibrosis. The objectives of this study were to determine the nutritional profile and dietary patterns of NAFLD Lebanese patients and to report the type of diet-related to the presence of hepatic fibrosis. We hypothesized that the traditional pattern was related to a low risk of fibrosis. This cross-sectional study included 320 eligible Lebanese NAFLD patients. Three dietary patterns were identified: the Traditional diet, the High Fruit diet, and the Westernized diet. Multivariate analysis showed a significant relationship between high adherence to the traditional diet and absence of hepatic fibrosis with a decreased risk of 82%, p = 0.031 after adjusting for its covariables. Fruits were absent from this dietary pattern. Although our results pointed to a possible relationship between fibrosis in NAFLD patients and fruit intake, experimental studies are needed to show whether this is a causal relationship. However, the results obtained in this study may contribute to the planning of dietary interventions and recommendations and enable a better follow-up for NAFLD patients with fibrosis. Full article

Achieving sustainable, healthy diets remains a global challenge to meet the sustainable development agenda by 2030. The purpose of this study is to derive optimal dietary recommendations for children that consider nutritional, environmental, and economic parameters of sustainability, using Lebanon as a case study. Data from the latest national food consumption survey conducted among Lebanese children were used. Optimized diets were derived using Optimeal, a software that produces similar patterns to the usual diet while considering nutrition constraints (energy, and macro/micronutrient needs), environmental footprints ((EFPs): water use, energy use, and greenhouse emissions), and cost. Three optimized diets were derived that meet the nutritional needs of children aged 4–8, 9–13, and 14–18 years, while considering EFPs and cost. Compared to the usual intake, optimized diets included higher intake of vegetables, legumes and dairy, and a decrease in saturated oils, processed meats, sugar, salty snacks, sweets, and sugar-sweetened beverages. Overall, the optimized diets decreased cost by 20% and reduced water use, energy use, and GHG emissions, by 20%, 11%, and 22%, respectively. The proposed models consider various constraints and provide sustainable solutions for decision makers within a country undergoing crises. Full article

Factors associated with frailty, particularly dietary patterns, are not fully understood in Mediterranean countries. This study aimed to investigate the association of data-driven dietary patterns with frailty prevalence in older Lebanese adults. We conducted a cross-sectional national study that included 352 participants above 60 years of age. Sociodemographic and health-related data were collected. Food frequency questionnaires were used to elaborate dietary patterns via the K-mean cluster analysis method. Frailty that accounted for 15% of the sample was twice as much in women (20%) than men (10%). Identified dietary patterns included a Westernized-type dietary pattern (WDP), a high intake/Mediterranean-type dietary pattern (HI-MEDDP), and a moderate intake/Mediterranean-type dietary pattern (MOD-MEDDP). In the multivariate analysis, age, waist to height ratio, polypharmacy, age-related conditions, and WDP were independently associated with frailty. In comparison to MOD-MEDDP, and after adjusting for covariates, adopting a WDP was strongly associated with a higher frailty prevalence in men (OR = 6.63, 95% (CI) (1.82–24.21) and in women (OR = 11.54, 95% (CI) (2.02–65.85). In conclusion, MOD-MEDDP was associated with the least prevalence of frailty, and WDP had the strongest association with frailty in this sample. In the Mediterranean sample, a diet far from the traditional one appears as the key deleterious determinant of frailty. Full article

The prevalence of orthorexia nervosa (ON) appears to be increasing, and more research into its cross-cultural aspects is required to provide culturally appropriate psychological treatment. Until now, there has been relatively little research published about ON across cultures. Therefore, the objectives of the present study were to determine: (1) the prevalence of ON in Polish and Lebanese adults and (2) the association between ON and sociodemographic variables and Body Mass Index (BMI) in two culturally different samples. One thousand two hundred and sixty-two adults participated in the present study (N_Poland = 743 adults; N_Lebanon = 519 adults). The Düsseldorf Orthorexia Scale and the Eating Habits Questionnaire were used in the present study. Information about age, sex, anthropometry, and marital status was obtained from all participants as well. The Polish sample had an ON prevalence rate of 2.6%, while the Lebanese sample had an ON prevalence rate of 8.4%. No significant correlation was found between ON and age in both samples. A statistically significant difference was found between marital status and country on ON, with the highest mean score seen among Lebanese singles. In Lebanon, having a low of BMI ≤ 25 kg/m² compared to a high BMI was significantly associated with lower ON tendencies, while this association was not significant among Polish participants. This study was the second to focus on the prevalence of ON in Western and non-Western countries and its association with sociodemographic characteristics and BMI ranges. Knowledge about ON and its correlates in diverse populations may inform the design of culturally tailored behavior change interventions and the development of culturally appropriate tools in various groups to improve their dietary patterns. Full article

Nonalcoholic fatty liver disease (NAFLD) is considered the most common liver disease in the world. Dietary habits have a significant impact on the biological and physical profile of patients and increase the risk of NAFLD. The overall pattern of diet intake is more associated with health outcomes than nutrients. The aim of this study was to evaluate the nutritional profile and the dietary patterns of Lebanese NAFLD patients and compare it with controls. During this study; 112 NAFLD Lebanese adult patients (55 men and 57 women); and 110 controls (44 men and 66 women) were recruited. Dietary intake was evaluated by two 24-h recalls and a semi-quantitative 90-item food frequency questionnaire. Dietary patterns were determined by factor analysis. Results from the study demonstrated that 40% of cases belonged to the high fruit group as compared to 30% following a high meat; fast food dietary pattern. Both groups increased the odds of NAFLD by four-fold (p < 0.05). The traditional diet decreases the odds by 33% after adjustment with the covariables. The high fruit diet group was, as with the high meat, fast food dietary pattern, the main potential risk factor for NAFLD in Lebanese patients. Full article

This study evaluates total water intake (TWI) from plain water, beverages and foods among Lebanese children and compares TWI to dietary reference intakes (DRIs). In a national cross-sectional survey, data on demographic, socioeconomic, anthropometric, and physical activity characteristics were obtained from 4 to 13-year-old children (n = 752). Food and beverage consumption patterns were assessed using a validated food-frequency questionnaire. TWI was estimated at 1651 mL/day, with beverages contributing 72% of the TWI compared to 28% from foods. Beverages with the highest contribution to TWI included plain water, fruit juice and soda. A significantly higher proportion of 9–13-year-old children failed to meet the DRIs compared to 4–8 years old (92%–98% vs. 74%). Gender differentials were observed with a significantly higher proportion of boys meeting the DRIs compared to girls. The water to energy ratio ranged between 0.84 and 0.87, which fell short of meeting the desirable recommendations. In addition, children from higher socioeconomic status had higher intakes of water from milk and bottled water, coupled with lower water intakes from sodas. The study findings show an alarming high proportion of Lebanese children failing to meet TWI recommendations, and call for culture-specific interventions to instill healthy fluid consumption patterns early in life. Full article

This study aimed to examine the proportion and socio-demographic correlates of Metabolically Healthy Overweight and Obesity (MHOv/O) among Lebanese adults and to investigate the independent effect of previously identified dietary patterns on odds of MHOv/O. Data were drawn from the National Nutrition and Non-Communicable Disease Risk Factor Survey (Lebanon 2008–2009). Out of the 337 adult participants who had complete socio-demographic, lifestyle, dietary as well as anthropometric and biochemical data, 196 had a BMI ≥ 25 kg/m² and their data were included in this study. MHOv/O was identified using the Adult Treatment Panel criteria. Dietary patterns previously derived in this study population were: Fast Food/Dessert, Traditional-Lebanese and High-Protein. The proportion of MHOv/O in the study sample was 37.2%. Females, higher education and high level of physical activity were positively associated with odds of MHOv/O. Subjects with higher adherence to the Traditional-Lebanese pattern had higher odds of MHOv/O (OR: 1.83, 95% CI: 1.09–3.91). No significant associations were observed between the Fast Food/Dessert and the high-protein patterns with MHOv/O. Follow-up studies are needed to confirm those findings and understand the mechanisms by which the Traditional-Lebanese pattern may exert a protective effect in this subgroup of overweight and obese adults. Full article