Knowledge, Attitudes, and Practices of Consumers on Food Allergy and Food Allergen Labeling: A Case of Lebanon.

The epidemiology of food allergies is increasing worldwide. International labeling standards were developed to enhance consumers' awareness of allergen-free foods. The main objective of the present study is to assess the characteristics of allergen labeling and consumers' knowledge, attitudes, and purchasing habits of food products with allergens in Lebanon. We evaluated the allergen labeling of 1000 food products form Lebanese supermarkets. A random sample of 541 consumers was recruited through an online survey (November 2020-February 2021). Descriptives and regression analysis were conducted. Results showed that wheat represents the largest group of food allergens on food labels, followed by milk and soybean. Furthermore, 42.9% of supermarket food products had a precautionary allergen labeling with "may contain traces of allergens". The majority of food products complied with local regulations for locally manufactured and imported products. One-quarter of survey respondents had a food allergy or were caregivers of food-allergic individuals. Regression analyses showed that "previous experience of a severe reaction" was negatively associated with food allergy-related knowledge and attitude scores respectively (ß = -1.394, 95% CI: (-1.827, -1.034) and ß = -1.432, 95% CI: (-2.798, -0.067)). The findings of this study provide practical insights on food allergy labeling issues for stakeholders and policymakers in the food supply chain.

Knowledge, Attitudes and Practices of the Lebanese Community toward Food Adulteration.

Food adulteration is the purposeful act of decreasing the quality of food goods offered for sale, whether by adding or replacing inferior substances or by the removal of some valuable ingredient. A limited number of studies have explored the knowledge, attitudes and practices (KAPs) concerning food adulteration in Lebanon. The objectives of the present study were to determine the knowledge, attitudes and practices of identifying adulteration in the process of food purchase by Lebanese adult consumers, and to identify factors associated with food adulteration. An online survey (n = 499) was administered among Lebanese adults aged 18 years and above. Results showed that the majority had a low food adulteration knowledge score (73.1%). During shopping, fewer than half of the participants checked the ingredients (42%) and nutrition facts label (33.9%). Regression analyses showed that six predictors were significantly associated with participants' knowledge scores including gender, age, marital status, education (undergraduate and master degree) and employment status (student). The results of this study show that knowledge and practices of identifying adulteration in the process of food purchase by consumers are lacking among most respondents. Increasing knowledge, awareness and motivation to identify food adulteration products during food shopping will empower consumers to improve buying practices, especially for the public with a lower level of education.

Impact of a Pilot School-Based Nutrition Intervention on Dietary Knowledge, Attitudes, Behavior and Nutritional Status of Syrian Refugee Children in the Bekaa, Lebanon.

This study evaluated the impact of a 6-month school nutrition intervention on changes in dietary knowledge, attitude, behavior (KAB) and nutritional status of Syrian refugee children. A quasi-experimental design was followed; Syrian refuge children in grades 4 to 6 were recruited from three informal primary schools (two intervention and one control) located in the rural Bekaa region of Lebanon. The intervention consisted of two main components: classroom-based education sessions and provision of locally-prepared healthy snacks. Data on household socio-demographic characteristics, KAB, anthropometric measures and dietary intake of children were collected by trained field workers at baseline and post-intervention. Of the 296 school children enrolled, 203 (68.6%) completed post-intervention measures. Significant increases in dietary knowledge (ß = 1.22, 95% CI: 0.54, 1.89), attitude (ß = 0.69, 95% CI: 0.08, 1.30), and body mass index-for-age-z-scores (ß = 0.25, 95% CI = 0.10, 0.41) were observed among intervention vs. control groups, adjusting for covariates (p < 0.05). Compared to the control, the intervention group had, on average, significantly larger increases in daily intakes of total energy, dietary fiber, protein, saturated fat, and several key micronutrients, p < 0.05. Findings suggest a positive impact of this school-based nutrition intervention on dietary knowledge, attitude, and nutritional status of Syrian refugee children. Further studies are needed to test the feasibility and long-term impact of scaling-up such interventions.