The impact of financial stress on student wellbeing in Lebanese higher education.

BACKGROUND: The financial crisis has indirectly affected Lebanese university students, leading to economic distress. Accordingly, this study aimed to assess the substantial negative impact of financial stress on the mental health and well-being of Lebanese college students. METHODS: A quantitative research approach was applied and took place from June 13th to July 25th, 2023, targeting 1272 university students aged 17 and above from private and public universities across Lebanon through convenience sampling. The InCharge Financial Distress/Financial Well-Being scale (IFDFW), Pittsburgh Sleep Quality Index (PSQI), Beirut Distress Scale (BDS-10), Perceived Stress Scale (PSS-10), and Well-Being Index (WHO-5) were used to assess the students' well-being. Descriptive analyses of the data was performed using SPSS software version 25. RESULTS: 1272 university students participated in this study, mostly females, with a mean age of 21.64 (± 4.43) years. Participants reported a lack of financial independence, unemployment, and no income. Positive associations were obtained between the BDS total scale as well as the PSS total and PSQI scores, while there was a significant negative relationship between IFDFW and PSQI scores. Those with a higher GPA, majoring in science/health and medicine, living in rural areas, and graduate students were linked to lower PSQI and BDS-10 scores. Financial aid and financial independence were associated with lower PSQI and BDS-10 scores. PSS-10 scores were higher among students majoring in science/health and medicine. Higher scores on the IFDFW scale correlated with lower BDS-10 and PSS-10 scores. In contrast, females had higher BDS-10 and PSS-10 scores. Scoring higher on the PSS-10 and PSQI scales, living off campus, or majoring in science/health and medicine, were associated with higher on the WHO-5 scale. CONCLUSIONS: A significant impact of financial stress on college students in Lebanon was obtained, affecting their well-being and mental health aspects. Marital status, gender, academic major, region of living, and financial independence also influences students' experiences. Tailored support and further research are needed to address these multifaceted challenges.

Vitamin D status is associated with bone mineral density and bone mineral content in preschool-aged children.

This study examined the associations between vitamin D status, bone mineral content (BMC), areal bone mineral density (aBMD), and markers of calcium homeostasis in preschool-aged children. Children (n=488; age range: 1.8-6.0 y) were randomly recruited from Montreal. The distal forearm was scanned using a peripheral dual-energy X-ray absorptiometry scanner (Lunar PIXI; GE Healthcare, Fairfield, CT). A subset (n=81) had clinical dual-energy X-ray absorptiometry (cDXA) scans (Hologic 4500A Discovery Series) of lumbar spine (LS) 1-4, whole body, and ultradistal forearm. All were assessed for plasma 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone concentrations (Liaison; Diasorin), ionized calcium (ABL80 FLEX; Radiometer Medical A/S), and dietary vitamin D and calcium intakes by survey. Age (p<0.001) and weight-for-age Z-score (p<0.001) were positively associated with BMC and aBMD in all regression models, whereas male sex contributed positively to forearm BMC and aBMD. Having a 25(OH)D concentration of >75 nmol/L positively associated with forearm and whole body BMC and aBMD (p<0.036). Sun index related to (p<0.029) cDXA forearm and LS 1-4 BMC and whole-body aBMD. Nutrient intakes did not relate to BMC or aBMD. In conclusion, higher vitamin D status is linked to higher BMC and aBMD of forearm and whole body in preschool-aged children.

Vitamin D status in Montréal preschoolers is satisfactory despite low vitamin D intake.

The 2007 to 2009 Canadian Health Measures Survey reported vitamin D status in a representative sample of Canadians (6-79 y); however, children <6 y were not assessed. Our objective was to measure vitamin D intake from food and supplements, sun exposure, and biological vitamin D status of children ages 2 through 5 y in Montréal (latitude 45°N). Preschoolers (n = 508) were recruited between June 2010 and 2011 in a random sample of licensed daycares in the regions of greater Montréal, Canada in a cross-sectional study. The total plasma 25-hydroxyvitamin D [25(OH)D] concentration was measured using a chemiluminescence assay (Liaison, Diasorin). Dietary intake was assessed during one 24-h period plus a 30-d FFQ. Socioeconomic, demographic, anthropometry, and sun exposure data were collected. Plasma 25(OH)D was ≥50 nmol/L in 88% of children, whereas 49.4% had concentrations ≥75 nmol/L during the 1-y study. Almost 95% of preschoolers had vitamin D intakes less than the Estimated Average Requirement (EAR), and 4.8% of preschoolers ≤3.9 y and 25.9% of preschoolers ≥4 y had calcium intakes less than the EAR. Plasma 25(OH)D was different across age, income, sun index, milk intake, and dietary and supplemental vitamin D intake tertiles. Despite vitamin D intakes less than the EAR, the vitamin D status of Montréal preschoolers attending daycare is mostly satisfactory even in winter, suggesting that the EAR value is too high in the context of typical exogenous intakes of vitamin D in North America.

Forearm bone mineral density varies as a function of adiposity in inuit women 40-90 years of age during the vitamin D-synthesizing period.

Aging Inuit women are at increased risk for low vitamin D status due to habitation at higher latitudes, darker skin, and ongoing nutrition transition. Lower serum 25-hydroxyvitamin D (25[OH]D) concentration and higher risk of fracture have been separately reported in Inuit women, with particular relevance to postmenopausal women. We evaluated vitamin D status, forearm bone mineral density (fBMD), and nutrition in Inuit women ≥40 years. Women (n = 568) were randomly selected to participate in the 2007-2008 International Polar Year Inuit Health Survey from 36 Arctic communities. fBMD was measured using peripheral dual-energy X-ray absorptiometry. Dietary intakes were derived from 24 h recall and food-frequency questionnaires. Fasting serum 25(OH)D, parathyroid hormone, and osteocalcin (OC) were measured using a LIAISON(®) automated analyzer. The weighted prevalence of women having 25(OH)D concentration below 37.5, 50, and 75 nmol/L was 7.2 %, 17.6 %, and 48.6 %, respectively, with older women having better status. The dietary density of most nutrients increased with age, as did traditional food intake. fBMD was low in 3 (1.4 %) premenopausal (Z score < -2) and 107 (29.6 %) postmenopausal (T score < -1.5) women. Regression revealed that either weight, body mass index, or percent body fat significantly predicted fBMD in premenopausal women, in addition to age and OC in postmenopausal women. Women ≥50 years have higher vitamin D status and more nutrient-dense diets than women 40-49 years. While measures of adiposity predicted fBMD in all women, additional predictors after menopause included age and bone turnover.

Vitamin D status of Inuit preschoolers reflects season and vitamin D intake.

Rickets ascribed to hypovitaminosis D remains a public health concern among Aboriginal children in Canada and the United States. Our primary objective in this study was to investigate the prevalence and risk factors (gender, age, vitamin D intake, and socioeconomic status) for low vitamin D status of Inuit preschoolers living in 16 Arctic communities (51(o)N-70(o)N) and participating in the 2007-2008 Nunavut Child Inuit Health Survey. Children were selected randomly in summer (n = 282) and a follow-up was performed in winter for a subsample (n = 52). Dietary intake was assessed through the administration of a 24-h dietary recall and a FFQ. Anthropometric measurements (height, weight) were assessed. Plasma 25-hydroxy vitamin D was measured using a chemiluminescent assay (Liaison, Diasorin). Prevalence of vitamin D insufficiency (<75 nmol/L) among preschoolers was 78.6% and 96.8% in summer and winter, respectively. Median vitamin D concentrations and interquartile ranges in summer and winter were 48.3 (32.8-71.3) and 37.7 (21.4-52.0) nmol/L, respectively. The prevalence of vitamin D deficiency < 25 and < 37.5 nmol/L was 13.6 and 36.5%, respectively. Children who met or exceeded the adequate intake, those who consumed 2 or more milk servings (1 serving = 250 mL), and those who lived in households without crowding (47.7%) had a better vitamin D status than those who did not. The predictors of vitamin D status were dietary intake and age. Given low traditional food consumption and low consumption of milk, interventions promoting vitamin D supplementation may be required.

Anthropometric, metabolic, psychosocial and dietary factors associated with dropout in overweight and obese postmenopausal women engaged in a 6-month weight loss programme: a MONET study.

The objective of the present study was to examine anthropometric, metabolic, psychosocial and dietary factors associated with dropout in a 6-month weight loss intervention aimed at reducing body weight by 10 %. The study sample included 137 sedentary, overweight and obese postmenopausal women, participating in a weight loss intervention that consisted of either energy restriction (ER) or ER with resistance training (ER+RT). Anthropometric (BMI, percent lean body mass, percent fat mass, visceral adipose tissue and waist circumference), metabolic (total energy expenditure, RMR, insulin sensitivity and fasting plasma levels of leptin and ghrelin), psychosocial (body esteem, self-esteem, stress, dietary restraint, disinhibition, hunger, quality of life, self-efficacy, perceived benefits for controlling weight and perceived risk) and dietary (3-d food record) variables were measured. Thirty subjects out of 137 dropped out of the weight loss programme (22 %), with no significant differences in dropout rates between those in the ER and the ER+RT groups. Overall, amount of weight loss was significantly lower in dropouts than in completers ( - 1.7 (sd 3.5) v. - 5.6 (sd 4.3) kg, P < 0.05); weekly weight loss during the first 4 weeks was also significantly lower. Dropouts consumed fewer fruit servings than completers (1.7 (sd 1.1) v. 2.7 (sd 1.53), P < 0.05) and had higher insulin sensitivity levels (12.6 (sd 3.8) v. 11.1 (sd 2.8) mg glucose/min per kg fat-free mass, P < 0.05). The present results suggest that the rate of weight loss during the first weeks of an intervention plays an important role in the completion of the programme. Thus, participants with low rates of initial weight loss should be monitored intensely to undertake corrective measures to increase the likelihood of completion.

Higher body mass, older age and higher monounsaturated fatty acids intake reflect better quantitative ultrasound parameters in Inuit preschoolers.

OBJECTIVES: Investigate the effects of selected factors associated with quantitative ultrasound parameters among Inuit preschoolers living in Arctic communities (56° 32'-72° 40'N). MATERIALS AND METHODS: Children were selected randomly in summer and early fall (n=296). Dietary intake was assessed through the administration of a 24-h dietary recall (24-h recall) and a food frequency questionnaire (FFQ). Anthropometry was measured using standardized procedures. Plasma 25-hydroxy vitamin D (25(OH)D) and parathyroid hormone (PTH) were measured using a chemiluminescent assay (Liaison, Diasorin). Quantitative ultrasound parameters were measured using Sahara Sonometer, (Hologic Inc.). RESULTS: Children divided by speed of sound (SoS) and broadband ultrasound attenuation (BUA) quartiles were not different for age (years), sex (M/F), calcium (mg/d) and vitamin D intake (µg/d) and plasma 25(OH)D concentration (nmol/L). However, children in the highest BUA and SoS quartile had higher body mass index (BMI) compared to those in quartile 1. Using multivariate linear regression, higher BMI, older age and monounsaturated fatty acids (MUFA) intake were predictors of BUA while only BMI was a predictor of SoS. CONCLUSIONS: Further investigation assessing intakes of traditional foods (TF) and nutrients affecting bone parameters along with assessment of vitamin D status of Inuit children across seasons is required.

Older age and lower adiposity predict better 25-hydroxy vitamin D concentration in Inuit adults: International Polar Year Inuit Health Survey, 2007-2008.

UNLABELLED: Our aim was to determine the prevalence and correlates of serum 25-hydroxy vitamin D (25(OH)D) concentration in Inuit adults. Low 25(OH)D concentration (< 50 nmol/L) was common; the strongest positive predictors were older age and healthy waist circumference. Nutritional health promotion and interventions along with longitudinal nutritional assessments are needed. PURPOSE: While 25(OH)D concentration of Canadian Inuit has not been examined on a large scale, Nutrition Canada Survey (1973) suggested that Inuit have low intakes of vitamin D. Our main purpose was to determine the prevalence and correlates of 25(OH)D concentration in a recent Inuit Health Survey. METHODS: Inuit adults (≥ 18 years) participated in the 2007-2008 International Polar Year Inuit Health Survey conducted in the months of August to October. Households were selected randomly in 36 communities. Dietary intake was assessed using a 24-h recall and a food frequency questionnaire. Anthropometric measurements, household living conditions, supplement use, and health status were assessed. In fasting samples, serum 25(OH)D and parathyroid hormone were measured using chemiluminesent assays (Diasorin, Liaison). RESULTS: Of the 2,595 participants, serum 25(OH)D was available on 2,207, of whom 67.4% and 42.2% had concentrations below 75 and 50 nmol/L, respectively. Further, 27.2% had values <37.5 nmol/L. Older adults (≥ 51 years) consumed higher quantities of traditional food and consequently had higher vitamin D intake than younger adults (18-30 and 31-50 years) (p < 0.05). The strongest positive predictors of 25(OH)D (≥ 50 or 75 nmol/L) among Inuit adults were older age and healthy waist circumference. CONCLUSIONS: This is the first population assessment of dietary vitamin D and 25(OH)D concentration in Inuit adults. The high prevalence of suboptimal 25(OH)D concentration noted in the late summer and early fall raises concerns of greater prevalence and more severe inadequacies in the winter.