Demographic, socioeconomic, dietary and physical activity determinants of obesity in a large nationally representative sample of the Lebanese adult population.

Introduction: The prevalence of obesity within countries varies by gender, age, socioeconomic status, and culture. These determinants appear to predict obesity differently in different countries. The objective of this study was to estimate the impact of these determinants on obesity in a representative sample of the Lebanese adult population. Methods: A cross-sectional survey of 2697 adults aged ≥ 20 years, excluding pregnant and lactating women, was conducted in 2008. Households were selected randomly from all Governates of Lebanon based on a stratified cluster sampling. One randomly-sampled adult was interviewed in each visited household; demographic, socioeconomic and anthropometric data were measured. Dietary intake was obtained using a 24-hour recall instrument. The prevalence of obesity in 2008 was estimated. Logistic regressions analysis was carried out to assess the relationship between energy intake and obesity as well as adjusted relevant variables, excluding data from participants who reported implausible energy intakes. Results: Currently, approximately one in four Lebanese adults is obese. While men and women showed overall similar prevalence rates of obesity, gender disparities were noted across obesity classes and age groups. In males, the odds of being obese increased among those married, employed, and owning increased household assets; the opposite was the case for women. Obesity in women decreased with increasing household wealth. In women also, there was a positive association between obesity and energy intake, and a negative association between obesity and physical activity. Obese adults reported consuming a higher percentage of their energy intake from fat, and a lower intake from cereals, compared with their non-obese counterparts. Conclusion: The prevalence of obesity among Lebanese adults is on the rise, with significant demographic and socioeconomic differentials. High energy consumption and inactivity of Lebanese adults, as well as several complex socioeconomic and cultural elements, are contributing factors to the estimated high rates of obesity

Dietary, Lifestyle and Socio-Economic Correlates of Overweight, Obesity and Central Adiposity in Lebanese Children and Adolescents

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

Changes in Environmental Footprints Associated with Dietary Intake of Lebanese Adolescents between the Years 1997 and 2009

Despite global efforts to promote healthy and sustainable diets, the nutrition transition witnessed among adolescents worldwide poses serious threats to health and environmental sustainability. The present study aimed to assess the change in environmental footprints (EFPs) associated with dietary intakes of adolescents in Lebanon between 1997 and 2009. Data of Lebanese adolescents (10–19 years old) were drawn from national food consumption surveys during two time periods (1997, n = 451; 2009, n = 527). Dietary assessments were conducted using 24-h dietary recalls. EFP metrics, including water, energy and greenhouse gas emissions (GHG), were derived using review of existing life-cycle analyses. All EFPs increased significantly between 1997 and 2009; meat and sugar-sweetened beverages were the top contributors to the increase in these EFPs. The changes in EFPs between the two years remained significant even after adjustment for energy and other correlates: water (β = 267.7, CI: 123.5; 411.9); energy (β = 4.3, CI: 2.09; 6.52) and GHG (β = 0.44, CI: 0.11; 0.76). Findings show significant dietary shifts among adolescents that can threaten the environmental sustainability of Lebanese diets. Interventions across the food system are needed to promote adherence to healthy and sustainable diets among adolescents

First Physical Activity Report Card for Children and Youth in Lebanon

Evidence on physical activity (PA) indicators for children and youth at a national level is necessary to improve multilevel support for PA behaviors. Lebanon's first Physical Activity Report Card for children and youth (2018) aimed to fill this gap. : In line with the recommended methods of "Global Matrix 3.0," nationally representative data were retrieved from peer-reviewed manuscripts, national surveys, and government reports. In addition to adopting the 10 indicators of "Global Matrix 3.0," publications that discussed weight status were also retained. A grade was assigned for each indicator using a standard rubric: A = 80% to 100%, B = 60% to 79%, C = 40% to 59%, D = 20% to 39%, F = <20%, and INC = incomplete data. : Four indicators (active play, family and peers, community and environment, and physical fitness) received an "INC." Three indicators (overall PA, active transportation, and school) received a "D." Sedentary behaviors received a "C-." Weight status received a "C." Government received a "C+." Organized sport received an "F." : PA participation among Lebanese children and youth is low. Stakeholders should aim to improve low PA indicators grades. Gaps in the literature also need to be filled to inform on the status of all indicators

Results from Lebanon's 2018 Report Card on Physical Activity for Children and Youth

The prevalence of childhood obesity in Lebanon nearly doubled between 1997 and 2009.1 This shift in population health is extremely alarming, given that obesity is associated with a host of chronic diseases (eg, cardiovascular diseases, diabetes mellitus, cancer)1 representing the primary causes of death and disease burden in 2012.2 Low physical activity (PA) levels and engagement in greater sedentary activities have been used to explain such trends.1 However, little is known about PA indicators among Lebanese children and youth. This led to the development of Lebanon’s first Physical Activity Report Card for Children and Youth (Figure 1)