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Hoteit M, Mahfouz R, Sacre Y, Obeid S, Abou Nasr M, El Hajj M, Hanna-Wakim L, Fakih C. Assessment of dietary-lifestyle patterns and adherence to the USDA recommendations in Lebanese pregnant women amid the economic crisis: Findings from a national representative cross-sectional study. PLoS One 2024; 19:e0301170. [PMID: 38603738 PMCID: PMC11008882 DOI: 10.1371/journal.pone.0301170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
As Lebanon's economic crisis become uncontrollable, Lebanese pregnant women face malnutrition, with many having to skip meals and switch to resort to cheap and unhealthy alternatives altogether. The objectives of the study were to assess the dietary and lifestyle patterns of Lebanese pregnant women and to evaluate their diets compliance with the United States Department of Agriculture (USDA) pregnancy recommendations, before and during the Lebanese escalating economic crisis. A cross-sectional study was conducted between April 2021 and January 2022. A validated self-administrated questionnaire was administered during the first, second and third trimesters of pregnancy among 363 women in all Lebanese governorates. Most of the pregnant women were free of diseases. While the majority did not smoke, 14.1% smoked hookah / shisha during pregnancy. The adherence to the USDA recommendations in our sample did not significantly vary prior to and throughout the socioeconomic crisis, and it was generally low. Only the mean consumption of vegetables increased during the socioeconomic crisis (p<0.05). Regarding physical activity, while the proportion of active women slightly decreased during the socioeconomic crisis, around 55% were still active. In conclusion, higher attention should be given to the dietary habits and health of this critical population, through effective interventions that increase awareness and achieve measurable improvements.
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Affiliation(s)
- Maha Hoteit
- Food Sciences Unit, National Council For Scientific Research (CNRS-L), Beirut, Lebanon
- PHENOL Research Group (Public Health Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Rana Mahfouz
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Yonna Sacre
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Sara Obeid
- PHENOL Research Group (Public Health Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Mariane Abou Nasr
- PHENOL Research Group (Public Health Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Mohamad El Hajj
- PHENOL Research Group (Public Health Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Lara Hanna-Wakim
- Department of Agricultural and Food Engineering, School of Engineering, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Chadi Fakih
- Al Hadi Laboratory and Medical Center, Beirut, Lebanon
- Department of Obstetrics and Gynecology, Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Hoteit M, Dagher M, Tzenios N, Al Kaaki N, Rkein G, Chahine AR, Sacre Y, Hotayt S, Matar R, Hallal M, Maitar M, Hotayt B. Influence of Sugar-Sweetened Beverages Intake on Sarcopenic Obesity, Visceral Obesity, and Sarcopenia in Lebanese Patients with MASLD: A Case-Control Study. Healthcare (Basel) 2024; 12:591. [PMID: 38470703 PMCID: PMC10931226 DOI: 10.3390/healthcare12050591] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/26/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
Chronic liver diseases are a major global health concern. AIMS this study investigated the links between medical, clinical, anthropometric, and dietary factors with dysfunction-associated steatotic liver disease (MASLD) in the Lebanese population using a case-control approach to uncover factors influencing visceral obesity, sarcopenia, and sarcopenic obesity. METHODS AND MATERIALS a total of 120 participants (20-70 years old) were divided into case and control groups based on liver disease diagnosis. Patient information was gathered through a questionnaire encompassing demographics, medical history, and beverage consumption. Anthropometric and body composition data were collected in a clinical setting. RESULTS our findings indicated a clear association between the presence of MASLD and obesity, hypertension, and diabetes. The positive association with higher body mass index and all three conditions remained consistent even when data was stratified by case and control groups. A greater proportion of MASLD patients exhibited sarcopenic obesity. Furthermore, MASLD cases showed higher consumption of sugary beverages and a reduced intake of milk and water in their diets. CONCLUSIONS this study shed light on the health attributes and diets of the Lebanese population with liver diseases and suggested more research in this area and in a more ethnically diverse population.
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Affiliation(s)
- Maha Hoteit
- Food Science Unit, National Council for Scientific Research-Lebanon (CNRS-Lebanon), Beirut P.O. Box 11-8281, Lebanon
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 14-6573, Lebanon; (N.A.K.); (G.R.)
| | - Myriam Dagher
- Faculty of Health Sciences, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon;
| | - Nikolaos Tzenios
- Faculty of Public Health, Charisma University, London EC1V 7QE, UK;
| | - Najat Al Kaaki
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 14-6573, Lebanon; (N.A.K.); (G.R.)
| | - Ghadir Rkein
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 14-6573, Lebanon; (N.A.K.); (G.R.)
| | | | - 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
| | - Samer Hotayt
- Anesthesia Department, Saint Joseph Hospital, 75014 Paris, France;
| | - Rami Matar
- School of Medicine, St. George’s University, West Indies FZ818, Grenada;
| | - Mahmoud Hallal
- Gastroenterology Department, Faculty of Medical Science, Lebanese University, Beirut P.O. Box 14-6573, Lebanon;
- Gastroenterology and Hepatology Department, Zahraa University Medical Center (ZHUMC), Beirut P.O. Box 90-361, Lebanon
| | - Micheal Maitar
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Southern Illinois University, Springfield, IL 62901, USA;
| | - Bilal Hotayt
- Gastroenterology Department, Sahel General Hospital, Beirut P.O. Box 90-1603, Lebanon
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Bouery P, Attieh R, Sacca L, Sacre Y. Assessment of the social quality of life and the physical activity of adult celiac disease patients following a gluten-free diet in Lebanon. Nutr Health 2024; 30:103-113. [PMID: 35603827 DOI: 10.1177/02601060221095685] [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] [Indexed: 06/15/2023]
Abstract
To date, the primary and only treatment recommended for effective management of celiac disease (CD) is adherence to a strict gluten-free diet (GFD) which entails a new approach to eating that affects the social quality of life (QoL) and physical activity (PA) of patients. This cross-sectional study aimed at assessing the social QoL and PA of adult Lebanese CD patients aged between 18 and 59 years old who are following a GFD. An online CD questionnaire was administered to 136 Lebanese celiac participants on a GFD. The findings of this study show a significant association between celiac patients following a GFD and their social QoL (P-value = 0.0001). The results also showed a significant association between the same population and their PA (p-value = 0.0001). Further awareness-raising and learning activities about gluten-free products are needed to improve the adherence to a strict GFD to facilitate its availability to the Lebanese population.
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Affiliation(s)
- Priscilla Bouery
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Randa Attieh
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Lea Sacca
- Department of Health, Humanities, and Society, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Yonna Sacre
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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Roufael M, Bitar T, Sacre Y, Andres C, Hleihel W. Folate–Methionine Cycle Disruptions in ASD Patients and Possible Interventions: A Systematic Review. Genes (Basel) 2023; 14:genes14030709. [PMID: 36980981 PMCID: PMC10048251 DOI: 10.3390/genes14030709] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023] Open
Abstract
Autism Spectrum Disorder (ASD) has become a major public health concern due to its rapidly rising incidence over the past few years. Disturbances in folate or methionine metabolism have been identified in many individuals with ASD, suggesting that the folate–methionine cycle may play an essential role in the pathogenesis of autism. Thus, changes in metabolite concentrations associated with this cycle could be used as potential biomarkers and therapeutic targets for ASD. The aim of this systematic review is to elucidate the perturbations of this cycle and the possible interventions that may be proposed in this context. Several studies have shown that high levels of homocysteine and low levels of vitamins B12 and folate are associated with ASD. These changes in serum metabolites are influenced by poor diet. In fact, children with ASD tend to eat selectively, which could compromise the quality of their diet and result in nutrient deficiencies. Moreover, these disturbances may also be caused by genetic predispositions such as polymorphisms of the MTHFR gene. Few studies have demonstrated the beneficial effects of the use of nutritional supplements in treating ASD children. Therefore, larger, well-structured studies are recommended to examine the impact of vitamin B12 and folate supplementation on homocysteine levels.
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Affiliation(s)
- Melissa Roufael
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
- UMR Inserm 1253 Ibrain, Université de Tours, 37032 Tours, France
- Correspondence: (M.R.); (T.B.)
| | - Tania Bitar
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
- Correspondence: (M.R.); (T.B.)
| | - Yonna Sacre
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
| | - Christian Andres
- UMR Inserm 1253 Ibrain, Université de Tours, 37032 Tours, France
| | - Walid Hleihel
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
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Rouphael M, Gerges P, Andres C, Sacre Y, Bitar T, Hleihel W. Evaluation of the Lebanese Adults' Knowledge Regarding Autism Spectrum Disorder. Int J Environ Res Public Health 2023; 20:4622. [PMID: 36901632 PMCID: PMC10001669 DOI: 10.3390/ijerph20054622] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
The daily functioning and overall well-being of people with ASD depends largely on understanding how the wider public views ASD. Indeed, an increased level of ASD knowledge in the general population may result in earlier diagnosis, earlier intervention, and better overall outcomes. The present study aimed to examine the current state of ASD knowledge, beliefs, and sources of information in a Lebanese general population sample, to identify the factors that could influence this knowledge. A total of 500 participants were involved in this cross-sectional study, which was conducted in Lebanon between May 2022 and August 2022 using the Autism Spectrum Knowledge scale, General Population version (ASKSG). Overall, the participants' understanding of autism spectrum disorder was low, with a mean score of 13.8 (6.69) out of 32, or 43.1%. The highest knowledge score was found for items related to knowledge of the symptoms and associated behaviors (52%). However, the level of knowledge regarding the etiology and prevalence, assessment and diagnosis, treatment, outcomes, and prognosis of the disease was low (29%, 39.2%, 46%, and 43.4%, respectively). Moreover, age, gender, place of residence, sources of information, and ASD case were all statistically significant predictors of ASD knowledge (p < 0.001, p < 0.001, and p = 0.012, p < 0.001, p < 0.001, respectively). The general public in Lebanon perceive a lack of awareness and insufficient knowledge regarding ASD. This results in delayed identification and intervention, leading to unsatisfactory outcomes in patients. Raising awareness about autism among parents, teachers, and healthcare professionals should be a top priority.
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Affiliation(s)
- Melissa Rouphael
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
- UMR Inserm 1253 Ibrain, Université de Tours, 37032 Tours, France
| | - Perla Gerges
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
| | - Christian Andres
- UMR Inserm 1253 Ibrain, Université de Tours, 37032 Tours, France
| | - Yonna Sacre
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
| | - Tania Bitar
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
| | - Walid Hleihel
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
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Hoteit M, Ibrahim C, Nohra J, Sacre Y, Hanna-Wakim L, Al-Jawaldeh A. Assessment of the Composition of Breastmilk Substitutes, Commercial Complementary Foods, and Commercial Snack Products Commonly Fed to Infant and Young Children in Lebanon: A Call to Action. Nutrients 2023; 15:nu15051200. [PMID: 36904200 PMCID: PMC10005724 DOI: 10.3390/nu15051200] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/08/2023] Open
Abstract
(1) Background: Nutrition for optimum growth and physical development is acquired by adequate infant feeding practices. (2) Methods: One hundred seventeen different brands of infant formulas (n = 41) and baby food products (n = 76) were selected from the Lebanese market and were analyzed for their nutritional content. (3) Results: Saturated fatty acid content was detected to be the highest in follow-up formulas (79.85 g/100 g) and milky cereals (75.38 g/100 g). Among all saturated fatty acids, palmitic acid (C16:0) accounted for the greatest proportion. Moreover, glucose and sucrose were the predominant added sugars in infant formulas, while sucrose was the main added sugar in baby food products. Our data showed that the majority of the products were non-compliant to the regulations and the manufacturers' nutrition facts labels. Our results stated also that the contribution to the daily value for the saturated fatty acids, added sugars, and protein exceeded the daily recommended intake for most infant formulas and baby food products. (4) Conclusions: This requires careful evaluation from policymakers in order to improve the infant and young children feeding practices.
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Affiliation(s)
- Maha Hoteit
- Food Sciences Unit, National Council For Scientific Research (CNRS), Beirut P.O. Box 11-8281, 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
| | - Carla Ibrahim
- 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
- Doctoral School of Sciences and Technology (DSST), Lebanese University, Hadath 1533, Lebanon
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, Lebanon
| | - Joanna Nohra
- 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
- Doctoral School of Sciences and Technology (DSST), Lebanese University, Hadath 1533, Lebanon
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, 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
| | - Ayoub Al-Jawaldeh
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt
- Correspondence:
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Nasr L, Sacre Y, Attieh R, Mannan H. Association between the Timing of Pre-Workout Macronutrient Intake and Rated Appetite among Resistance-Trained Adults in Jbeil, Lebanon. Int J Environ Res Public Health 2023; 20:2399. [PMID: 36767765 PMCID: PMC9915277 DOI: 10.3390/ijerph20032399] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/21/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Macronutrients play an important role in appetite regulation. In addition, adequate nutrient and energy intake, which may be altered by exercise-induced appetite fluctuations, is required to ensure important training outcomes. However, findings regarding appetite responses to macronutrient consumption before training and to different resistance training intensities remain inconclusive. This study investigated the association of three types of macronutrient intake before different intensities of resistance training with appetite. A purposive cross-sectional design was used to collect data from 280 resistance-trained individuals (mean age 26.4 ± 5.8 years) representing five gyms located in Jbeil, Lebanon, and who completed an online questionnaire. Data collected included socio-demographics, nutritional strategies followed by each respondent, training characteristics, and appetite rating before, during and after exercise using a validated visual analogue scale (VAS). A short-term suppression of appetite was reported during resistance-training, with no significant difference in exercise intensities (p > 0.05). In addition, low-fiber carbohydrate and protein food/beverage content consumed 30-60 min before training had an advantage in appetite suppression. In summary, these findings suggest that resistance training combined with pre-workout consumption of a whole meal was associated with appetite suppression, at least during the short period of exercise. From the perspective of appetite control and energy balance, the critical factor is the quantity and quality of macronutrient food sources, in addition to the timing surrounding training of nutrients ingested.
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Affiliation(s)
- Lea Nasr
- Faculty of Arts and Sciences, Department of Human Nutrition and Food Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
| | - Yonna Sacre
- Faculty of Arts and Sciences, Department of Human Nutrition and Food Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
| | - Randa Attieh
- Faculty of Arts and Sciences, Department of Human Nutrition and Food Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
| | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
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Hoteit M, Mohsen H, Hanna-Wakim L, Sacre Y. Parent's food literacy and adolescents nutrition literacy influence household's food security and adolescent's malnutrition and anemia: Findings from a national representative cross sectional study. Front Nutr 2022; 9:1053552. [PMID: 36643976 PMCID: PMC9837989 DOI: 10.3389/fnut.2022.1053552] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 12/06/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction Food and nutrition literacy are widely fundamental to improve the food security and reduce the double burden of malnutrition and iron deficiency in low- and middle-income countries. Objectives This study aimed (1) to assess the nutrition literacy (NL) of Lebanese adolescents and their parents' food literacy (FL), (2) to investigate the impacts of adolescents' NL and parental FL on (a) the household food security, (b) the adolescents' self-reported food security, and (c) the adolescents' nutrition status with a focus on malnutrition and anemia. Methods 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 Arab Family Food Security Scale and the Adolescent-Level Food Security Scale were used. Results Around 45.0% of the adolescents were nutritionally illiterate, and nearly half (47.8%) of parents had poor FL. Around 68.2 and 54.0% of the households and adolescents were food insecure, respectively. Moreover, 6.7, 4.7, 32.2, and 16.7% of the adolescents were stunted, thin, overweight/obese, and anemic, respectively. Poor parental FL increased the risk of household food insecurity (FI) by 2.7 times, p < 0.001. Adolescents' nutrition illiteracy increased their FI risk by 60.0% (p = 0.02). The number of offspring, household income, crowding status, and participants' residence also influenced the percentage of FI and malnutrition prevalence among households and adolescents. Conclusion Improvements in FL and NL are promising to mitigate FI malnutrition in Lebanon.
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Affiliation(s)
- Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut, Lebanon,Faculty of Public Health, PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Lebanese University, Beirut, Lebanon,Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon,University Medical Center, Lebanese University, Beirut, Lebanon,*Correspondence: Maha Hoteit,
| | - Hala Mohsen
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Lara Hanna-Wakim
- Department of Agricultural and Food Engineering, School of Engineering, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Yonna Sacre
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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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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Mohsen H, Sacre Y, Hanna-Wakim L, Hoteit M. Nutrition and Food Literacy in the MENA Region: A Review to Inform Nutrition Research and Policy Makers. Int J Environ Res Public Health 2022; 19:10190. [PMID: 36011837 PMCID: PMC9408592 DOI: 10.3390/ijerph191610190] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Improving food and nutrition literacy is fundamental to tackling the Middle East and North Africa (MENA) region's enormous challenges, including malnutrition and food insecurity. To direct initiatives, it is crucial to assess the region's food and nutrition literacy. Thus, we aimed to review studies on food/nutrition literacy status in the MENA countries and illuminate the region's research gaps in these areas, in terms of assessment, policy, and program implementation. METHODS PubMed and Google Scholar databases were searched between 18 December and 8 May 2022, to identify relevant articles published up to 2022 in the MENA region. RESULTS Twelve studies were included in this review. Lebanon, Palestine, and Iran are the only three MENA countries where nutrition and/or food literacy were assessed. People in these countries mostly had inadequate food and/or nutrition literacy levels, especially in the skills rather than the cognitive domain. Food and/or nutrition literacy showed associations with food habits, food-label use, food-consumption patterns, school performance, food security, dietary diversity, and nutrient adequacy. The MENA countries developed no policies or programs to address food and nutrition literacy. CONCLUSION This review is a wake-up call for researchers and policymakers to develop a robust approach to combat food and nutrition literacy concerns in the MENA region.
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Affiliation(s)
- Hala Mohsen
- Doctoral School of Sciences and Technology (DSST), Lebanese University, Hadath 1103, Lebanon
- Faculty of Public Health, Section 1, Lebanese University, P.O. Box 6573, Beirut 1105, Lebanon
- PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, P.O. Box 6573, Beirut 1105, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, P.O. Box 6573, Beirut 1105, Lebanon
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), P.O. Box 446, Jounieh 1200, Lebanon
| | - Yonna Sacre
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), P.O. Box 446, Jounieh 1200, Lebanon
| | - Lara Hanna-Wakim
- Department of Agricultural and Food Engineering, School of Engineering, Holy Spirit University of Kaslik (USEK), P.O. Box 446, Jounieh 1200, Lebanon
| | - Maha Hoteit
- Faculty of Public Health, Section 1, Lebanese University, P.O. Box 6573, Beirut 1105, Lebanon
- PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, P.O. Box 6573, Beirut 1105, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, P.O. Box 6573, Beirut 1105, Lebanon
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Daher M, Fahd C, Nour AA, Sacre Y. Trends and amounts of consumption of low-calorie sweeteners: A cross-sectional study. Clin Nutr ESPEN 2022; 48:427-433. [PMID: 35331524 DOI: 10.1016/j.clnesp.2022.01.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS White sugar has been blamed to cause health consequences including diabetes and obesity. With the increased need to decrease sugar intake, attention was shifted towards sugar alternatives also known as low-calorie sweeteners. Low-calorie sweeteners are ubiquitous within food products, but their consumption among Lebanese adults isn't well elucidated. Our study aims to investigate the trends and amounts of low-calorie sweeteners' consumption in addition to their main sources among a sample of Lebanese adults. METHODS A cross-sectional study was conducted over 384 adult Lebanese individuals from both genders residing in Beirut and Mount-Lebanon from February to August 2020. After excluding eight individuals, 376 completed the survey. To assess the trends, frequency and quantity of low-calorie sweeteners' consumption, a questionnaire was filled by trained and licensed dietitians in addition to a previously validated food frequency questionnaire adapted to the most widely known products in the Lebanese market. Food products were divided into categories, amount of sweeteners in each item was obtained from the label, and analysis was performed according to the type of sweetener they are made of. Frequencies were converted into numbers of servings per day and multiplied by the standard portion size. Daily individual consumption of each sweetener apart was obtained by multiplying the amount of sweetener in each item consumed by total daily consumption. The amount in mg/kg was obtained by dividing total consumption of each sweetener apart by the mean weight of our population. The Statistical Package for Social Sciences (SPSS) was used for data entry and analysis. RESULTS Results showed that 94.4% were consuming an artificially-sweetened item at least once in the last six months. While weight loss and healthy lifestyle constituted the main reasons for past and current consumption respectively, safety and unpleasant taste affected consumption trends. Pills and powders' consumption was significantly associated with gender (p = 0.032) and dieting (p = 0.000) but not with age (p = 0.831), educational level (p = 0.294), living district (p = 0.421) or income (p = 0.828) where women and dieters used significantly more pills and powders than their counterparts. "Food and beverages" consumption was independent of all factors except age (p = 0.001); it peaked at 26-40 and declined thereafter. Consumption of low-calorie sweeteners came mainly from beverages and was as follows while remaining within the acceptable daily intake limits: aspartame: 98.9 mg/d (1.38 mg/kg/d); sucralose: 22.19 mg/d (0.31 mg/kg/d); acesulfame-K: 39.12 mg/d (0.55 mg/kg/d); stevia 3.28 mg/d (0.05 mg/kg/d). Food and beverages were consumed more than pills and powders due to unintentional consumption. CONCLUSION Despite that safety and unpleasant taste affected consumption of low-calorie sweetened products, intake of such products was found to be highly prevalent in the studied population. While remaining within the acceptable daily intake limits, consumption of food and beverages exceeded that of pills and powders due to unintentional consumption making awareness a necessity to help consumers make an informed decision. Moreover, a nation-level study is needed to generalize the results.
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Affiliation(s)
- Mira Daher
- Faculty of Arts and Sciences, Department of Nutrition and Food Sciences, Holy Spirit University of Kaslik, P.O Box 446, Jounieh, Lebanon.
| | - Carla Fahd
- Faculty of Arts and Sciences, Department of Nutrition and Food Sciences, Holy Spirit University of Kaslik, P.O Box 446, Jounieh, Lebanon
| | - Afif Abdel Nour
- School of Engineering, Holy Spirit University of Kaslik, P.O Box 446, Jounieh, Lebanon
| | - Yonna Sacre
- Faculty of Arts and Sciences, Department of Nutrition and Food Sciences, Holy Spirit University of Kaslik, P.O Box 446, Jounieh, Lebanon
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Tayba Z, Sacre Y, Attieh R, Mannan H. Caffeine improves work durability and physical performance in anaerobic exercises among active adults in Tripoli Lebanon. BMC Sports Sci Med Rehabil 2021; 13:104. [PMID: 34474683 PMCID: PMC8414861 DOI: 10.1186/s13102-021-00334-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/22/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND People worldwide have a high intake of caffeine. Active adults are among the group of people who have always been interested in caffeine as an ergogenic aid. This study aims at examining the association between caffeine consumption and perceived performance (aerobic and anaerobic exercises) among active people attending different gyms in Tripoli, Lebanon. METHODS A cross-sectional study was conducted on 206 participants attending seven gyms in Tripoli. Participants were recruited using simple random sampling for a face-to-face individual interview. Data were collected using a semi-structured questionnaire. Data have been coded, entered, and analyzed using SPSS software. RESULTS The prevalence rate of active people practicing both aerobic and anaerobic exercises is 63.6%. More than half of our sample (54.8%) has been working out for a duration of more than 6 months and 84.6% of respondents spend at least 30 min during their workouts. Caffeine consumption was popular in our sample with 92.2% indicating that they use caffeinated products. The findings of this study showed an association between anaerobic exercise and caffeine, perceived as physical performance enhancer and work durability enhancer. Yet no association was found between aerobic exercise and caffeine consumption. CONCLUSIONS Perhaps, future research could focus on the safe doses of caffeine that could be given for anaerobic exercises to have an ergogenic effect. This could help us to build scientific guidelines for caffeine's association with sports performance.
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Affiliation(s)
- Zeina Tayba
- Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Yonna Sacre
- Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Randa Attieh
- Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Haider Mannan
- Western Sydney University, Campbelltown, NSW 2560 Australia
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