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El Bilali H, Ben Hassen T. Regional Agriculture and Food Systems Amid the COVID-19 Pandemic: The Case of the Near East and North Africa Region. Foods 2024; 13:297. [PMID: 38254598 PMCID: PMC10815245 DOI: 10.3390/foods13020297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/22/2023] [Accepted: 12/31/2023] [Indexed: 01/24/2024] Open
Abstract
The COVID-19 pandemic affected agri-food systems worldwide. However, while the impacts differed from one country/region to another, the scholarly literature seems to focus on developed countries in the Global North. Consequently, this review scrutinizes the literature on the pandemic's impacts in the Near East and North Africa (NENA) region. A search on the Web of Science in March 2023 generated 334 documents, of which 151 were eligible for inclusion in the systematic review. According to the bibliometric analysis, the most active nations are Saudi Arabia, Egypt, Jordan, the United Arab Emirates, and Lebanon. In general, the coverage of studies is better in the Gulf region than in the less developed countries of North Africa and those suffering from wars (cf. Libya, Syria, and Yemen). Studies generally focus on crop production and the downstream food chain (cf. distribution and consumption). While the pandemic influenced every pillar of food security, this research concentrates on access and utilization. Meanwhile, the lion's share of the literature deals with the pandemic's socio-economic effects, especially those linked to food (in)security and health. The pandemic, which laid bare the agri-food system vulnerabilities, should be seized to foster the transition towards more resilient agri-food systems in the NENA region.
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Affiliation(s)
- Hamid El Bilali
- International Centre for Advanced Mediterranean Agronomic Studies (CIHEAM-Bari), Via Ceglie 9, 70010 Valenzano, Bari, Italy;
| | - Tarek Ben Hassen
- Program of Policy, Planning, and Development, Department of International Affairs, College of Arts and Sciences, Qatar University, Doha P.O. Box 2713, Qatar
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Hoteit M, Mohsen H, Yazbeck N, Diab S, Sarkis J, Sacre Y, Hanna-Wakim L, Bookari K. Household Food Insecurity, Anemia, Malnutrition and Unfavorable Dietary Diversity among Adolescents: Quadruple Whammies in the Era of Escalating Crises in Lebanon. Nutrients 2022; 14. [PMID: 36558449 DOI: 10.3390/nu14245290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
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.
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Abou-Rizk J, Jeremias T, Nasreddine L, Jomaa L, Hwalla N, Frank J, Scherbaum V. Infant Feeding Practices, Nutrition, and Associated Health Factors during the First Six Months of Life among Syrian Refugees in Greater Beirut, Lebanon: A Mixed Methods Study. Nutrients 2022; 14:nu14214459. [PMID: 36364722 PMCID: PMC9654662 DOI: 10.3390/nu14214459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 01/25/2023] Open
Abstract
The objective was to describe infant feeding practices, nutrition and related health aspects of infants under six months among Syrian refugees in Greater Beirut, Lebanon. A cross-sectional study was conducted among Syrian refugee mothers with infants under six months in July-October 2018 (N = 114). Additionally, eleven focus group discussions were conducted to explore supportive factors and barriers associated with early breastfeeding practices. The prevalence of pre-lacteal feeding was high (62.5%), whereas early initiation of breastfeeding was low (31%), and exclusive breastfeeding very low (24.6%). One-fifth of the infants were anemic (20.5%) and 9.6% were wasted. A significantly higher proportion of non-exclusively breastfed infants had a fever and took medicines than those who were exclusively breastfed. Supporting factors of adequate infant feeding practices comprised knowledge on maternal nutrition and exclusive breastfeeding, along with receiving support from healthcare professionals and family members. Identified barriers included preterm delivery, pre-lacteal feeding, an at-risk waist circumference and moderate to severe depression among mothers, bottle feeding, early introduction of food, maternal health reasons, breastmilk substitutes' distribution, and misinformation offered by mothers-in-law. To address sub-optimal feeding practices documented among Syrian refugees, awareness on proper breastfeeding practices, maternal nutrition, and psychosocial support should be provided to mothers and family members alike.
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Affiliation(s)
- Joana Abou-Rizk
- Institute of Nutritional Sciences, Faculty of Natural Sciences, University of Hohenheim, 70599 Stuttgart, Germany
- Correspondence: or
| | - Theresa Jeremias
- Institute of Nutritional Sciences, Faculty of Natural Sciences, University of Hohenheim, 70599 Stuttgart, Germany
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon
| | - Lamis Jomaa
- Department of Human Sciences, College of Health and Sciences, North Carolina Central University, Durham, NC 27707, USA or
- Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon
| | - Jan Frank
- Institute of Nutritional Sciences, Faculty of Natural Sciences, University of Hohenheim, 70599 Stuttgart, Germany
| | - Veronika Scherbaum
- Institute of Nutritional Sciences, Faculty of Natural Sciences, University of Hohenheim, 70599 Stuttgart, Germany
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Ibrahim C, Bookari K, Sacre Y, Hanna-Wakim L, Hoteit M. Breastfeeding Practices, Infant Formula Use, Complementary Feeding and Childhood Malnutrition: An Updated Overview of the Eastern Mediterranean Landscape. Nutrients 2022; 14:4201. [PMID: 36235853 DOI: 10.3390/nu14194201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND With increasing global rates of overweight, obesity and non-communicable diseases (NCDs) along with undernutrition and micronutrient deficiencies, the Eastern Mediterranean Region (EMR) is no exception. This review focuses on specific nutrition parameters among under five years children, namely ever breastfed, exclusive breastfeeding, mixed milk feeding, continued breastfeeding, bottle feeding, introduction of solid, semi-solid, or soft foods and malnutrition. METHODOLOGY PubMed, Google Scholar, United Nations International Children's Emergency Fund (UNICEF) databases, World Health Organization (WHO) databases, the World Bank databases and the Global Nutrition Report databases were explored between 10 January and 6 June 2022, to review the nutrition situation among under five years children in the EMR. RESULTS The regional average prevalence of ever breastfed, exclusive breastfeeding, mixed milk feeding, continued breastfeeding, bottle feeding, introduction of solid, semi-solid, or soft foods was estimated at 84.3%, 30.9%, 42.9%, 41.5%, 32.1% and 69.3%, respectively. Iran, Iraq, Libya and Palestine have seen a decline over time in the prevalence of exclusive breastfeeding. Lebanon, Egypt, Kuwait and Saudi Arabia reported early introduction of infant formula. Moreover, Lebanon, Pakistan, Saudi Arabia and United Arab Emirates were seen to introduce food early to the child, at between 4-6 months of age. The estimated weighted regional averages for stunting, wasting and underweight were 20.3%, 8.9% and 13.1%, respectively. Of concern is the increasing prevalence of stunting in Libya. As for overweight and obesity, the average prevalence was reported to be 8.9% and 3%, respectively. Lebanon, Libya, Kuwait and Palestine showed an increased trend throughout this time. CONCLUSIONS In this review, the suboptimal infant and young child feeding patterns and the twofold incidence of malnutrition in the EMR are highlighted and we urge the prioritizing of measures to improve children's nutrition.
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Mohsen H, Ibrahim C, Bookari K, Saadeh D, Al-Jawaldeh A, Sacre Y, Hanna-Wakim L, Al-Jaafari M, Atwi M, AlAsmar S, Najem J, Hoteit M. Prevalence of Essential Nutrient Supplement Use and Assessment of the Knowledge and Attitudes of Lebanese Mothers towards Dietary Supplement Practices in Maternal, Infancy and Preschool Ages: Findings of a National Representative Cross-Sectional Study. Foods 2022; 11:foods11193005. [PMID: 36230080 PMCID: PMC9561973 DOI: 10.3390/foods11193005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 12/02/2022] Open
Abstract
Mothers are understandably concerned about protecting the well-being of their offspring in every way possible, including providing oral dietary supplements (DSs). Up to now, there has been limited data on maternal knowledge and attitudes toward concomitant maternal–child DSs practices in Lebanon. This study evaluated the maternal knowledge and attitudes toward DSs and documented the DS-related practices in mothers and their under-5 children with their correlates. This cross-sectional study involved a representative stratified cluster random sample of 511 mother–child dyads (mothers: mean age ± SD = 30.25 ± 4.98 years; children: mean age ± SD = 18.7 ± 15.5 months, girls: 55.0%). A self-administered questionnaire was used to meet study aims. Most mothers lack awareness and hold unfavorable attitudes regarding DS use. Among all mothers, 47% were DS users, with the majority using vitamin D (82%). Almost 64% of mothers provide DSs for their children, with a predominant use of multivitamin drops (61.0%). “To keep the child healthy” was the reported reason by 60.0% of mothers to provide DSs for their children. Physicians were the primary information source about DSs for most mothers (64.0%). The usage of DSs among mothers was influenced by their pregnancy status, child’s age, number of children per household, and their awareness and attitudes towards DSs. DS usage among children was correlated with maternal DS use and their mothers’ attitudes towards DSs. DS usage among Lebanese mother–child dyads is common. Mothers should be the focus of education sessions regarding DS use.
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Affiliation(s)
- Hala Mohsen
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
| | - Carla Ibrahim
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
- Doctoral School of Sciences and Technology (DSST), Lebanese University, Hadath P.O. Box 6573, Lebanon
- PHENOL Research Group (Public HEalth Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut P.O. Box 6573, Lebanon
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, Lebanon
| | - Khlood Bookari
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia
- National Nutrition Committee, Saudi Food and Drug Authority, Riyadh 11451, Saudi Arabia
| | - Danielle Saadeh
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
- INSPECT-LB (Institut National de Santé Publique d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut P.O. Box 1103, Lebanon
| | - Ayoub Al-Jawaldeh
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt
| | - Yonna Sacre
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, Lebanon
| | - Lara Hanna-Wakim
- Department of Agricultural and Food Engineering, School of Engineering, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, Lebanon
| | - Marwa Al-Jaafari
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
- Doctoral School of Sciences and Technology (DSST), Lebanese University, Hadath P.O. Box 6573, Lebanon
| | - Marwa Atwi
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
| | - Sabine AlAsmar
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
| | - Jessica Najem
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
| | - Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
- PHENOL Research Group (Public HEalth Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut P.O. Box 6573, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut P.O. Box 6573, Lebanon
- University Medical Center, Lebanese University, Beirut P.O. Box 6573, Lebanon
- Correspondence:
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Ibrahim C, Kammouni Z, Barake M, Kassir M, Al-Jawaldeh A, Matta J, Sacre Y, Hanna-Wakim L, Haddad J, Hoteit M. Pediatric Health Risk Assessment for Exposure to Aluminum from Infant Formulas and Children under the Age of Five's Food Products among Arab Infants: Experience from Lebanon. Foods 2022; 11:foods11162503. [PMID: 36010503 PMCID: PMC9407326 DOI: 10.3390/foods11162503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 12/02/2022] Open
Abstract
Chronic dietary aluminum (Al) exposure can have various negative effects on health. The aim of our study is to (1) assess the contamination level of Al in infant formulas (n = 41) and baby food products (n = 76) available in the Lebanese market, and to (2) evaluate the margin of exposure of Al through the consumption of these foods among children under the age of five in Lebanon. Flame atomic absorption spectrometry (FAAS) was used to evaluate all of the samples. Al levels in all tested children’s food items were below the limit of detection. The highest Al level was detected in cornflakes (0.361 ± 0.049 mg/kg) and pureed foods (0.362 ± 0.079 mg/kg). Among infants aged 0−23 months, the average Al exposure due to the daily intake of infant formulas and baby foods was 0.01 and 0.0104 mg/kg BW/day for males and females, respectively. Babies aged 8−10 and 3−5 months had the highest and lowest levels of Al exposure, respectively. Additionally, the toxicological contribution of Al exposure determined for several age groups to a provisional tolerated weekly intake (PTWI) set by JECFA was <6% and <7% for males and females, respectively. The total Al exposure through the consumption of infant formulas and complementary foods among all ages in both males and females was below the values of weekly tolerable intakes (2 mg/kg/BW/W) set by JECFA. However, the values of hazard quotient (HQ) exceeded 1 in both male and female Lebanese infants. As a result, the risk of infants being exposed to Al in baby foods needs to be continuously considered.
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Affiliation(s)
- Carla Ibrahim
- Doctoral School of Sciences and Technology (DSST), Lebanese University, Hadath 6573, Lebanon
- Faculty of Public Health, Section 1, Lebanese University, Beirut 6573, Lebanon
- PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut 6573, Lebanon
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, Lebanon
| | - Zeinab Kammouni
- Faculty of Public Health, Section 1, Lebanese University, Beirut 6573, Lebanon
| | - Maryam Barake
- Faculty of Public Health, Section 1, Lebanese University, Beirut 6573, Lebanon
| | - Mounir Kassir
- Platform for Research and Analysis in Environmental Sciences, Doctoral School of Science and Technology (DSST), Lebanese University, Beirut 6573, Lebanon
| | - Ayoub Al-Jawaldeh
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt
| | - Joseph Matta
- Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, P.O. Box 11-5076, Riad Solh, Beirut 1107 2180, Lebanon
- Industrial Research Institute, Lebanese University Campus, Hadath 6573, Lebanon
| | - Yonna Sacre
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, Lebanon
| | - Lara Hanna-Wakim
- Department of Agricultural and Food Engineering, School of Engineering, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, Lebanon
| | - Joyce Haddad
- Directorate of Preventive Healthcare, Ministry of Public Health, Beirut 6573, Lebanon
| | - Maha Hoteit
- Faculty of Public Health, Section 1, Lebanese University, Beirut 6573, Lebanon
- PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut 6573, Lebanon
- Correspondence:
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