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.

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.

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.

(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.

Assessment of Feeding Behaviors and Parents' Frustrations of Children with Autism Spectrum Disorder in Lebanon: A Case-Control Study.

Children with autism spectrum disorder (ASD) exhibit restrictive and repetitive behaviors that affect their eating habits. The purpose of this study is to identify the behavioral feeding problems and eating habits among ASD children compared to typically developed (TD) children age/gender-matched controls, along with their parents'/caregivers' strategies for dealing with them. It included 43 ASD children and 43 TD children aged two to eleven years. The analysis was performed based on two valid questionnaires: the Behavior Pediatrics Feeding Assessment Scale (BPFA) and "My Child Eating Habits" (MCEH). The BPFA and MCEH scores conceded three manifestations that fall into food selectivity and problematic mealtime behavior in both groups of children. Compared to TD children, children with ASD exhibited higher BPFA scores, which indicated food-related behavioral and skill-based problems (p = 0.004). Children with ASD were less likely to consume fruits, vegetables, and milk than TD children, which may lead to nutritional deficiencies (p = 0.003, p = 0.003, and p = 0.010, respectively). Parents of ASD children were concerned about their behavioral problems and expressed their intention of an early intervention. These findings highlight the importance of nutritional clinical routines that incorporate the evaluation of the nutritional status and feeding behaviors of ASD children.

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.

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.

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.

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.

Assessment of the social quality of life and the physical activity of adult celiac disease patients following a gluten-free diet in Lebanon.

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.