Nutritional and health status among nursing home residents in Lebanon: comparison across gender in a national cross sectional study.

BACKGROUND: This study described the differences between elderly men and women living in Lebanese long-term care nursing homes on socio-economic, health and nutritional status. METHODS: This study used a cross-sectional design. Field researchers obtained data from 221 residents; 148 (67%) women and 73 (33%) men, living in 36 nursing homes. Data on health conditions; nutritional, psychological, and functional status; socio-demographic characteristics, as well as social relations were collected. The analysis used both chi-square and t-test tests. RESULTS: The majority of elderly had low socio-economic and poor health status. In comparison to men, women were significantly less educated, had lower occupational status, had no partner, relied financially on their children and relatives, and enjoyed better social relations and health behaviours. Furthermore, the prevalence of both; malnutrition, and at risk of malnutrition, were at 3.2% and 27.6% respectively. There was no statistically significant difference between women and men on Mini Nutritional Assessment, Activities of Daily Living, Geriatric Depression Scale, Body Mass Index, and chronic diseases. While women reported "good" health status compared to men, they continued to have higher prevalence of diseases and chronic pain. CONCLUSIONS: This study explored the socio-demographic, health, and nutritional status of elderly residing in Lebanese nursing homes and compared these characteristics across gender. The results indicated the need of health support and institutional interventions for elderly women residents.

The compliance of nutrition claims on pita bread in Lebanon and risk on public health: a cross-sectional study.

BACKGROUND: Mislabeling is a type of fraud, that can lead to major health concerns, especially when used on staple foods like bread. This study aimed to assess the compliance of nutrition claims on pre-packaged Pita bread in Mount Lebanon with national (LIBNOR; NL 661:2017) and international (CODEX; CAC/GL -2-1985) standards. METHODS: A cross-sectional study was conducted and Lebanese bread samples (n = 75) were collected from all the registered bakeries in Mount Lebanon directorate (n = 25). The claim compliance assessment was based on values of the nutrition facts panel and standard nutrient analyses, following official methods. RESULTS: Of all assessed breads, 84% carried nutrition claims, and 25.3% carried health claims. Among nutrition claims, 70.7% had non-addition claims, 56.0% had nutrient content claims, and 1.3% had comparative claims. The results showed a high prevalence of nutrition claims with majority non-compliant. Based on the nutrition facts panel, only 32.4% of the sugar related claims, 45.5% of the fiber claims, and 54.4% of salt claims were eligible to make those statements. Based on the chemical nutrient analyses, only 47.0% of sugar claims, 16.1% of fiber claims, and 37.5% of salt claims were compliant. All the claims related to protein (n = 7) were compliant. CONCLUSIONS: These results suggest the urgent need to develop clear guidelines for the effective implementation of the current standard; in order to prevent mislead consumers from making poor decisions at the point-of-sale, which might affect their overall health and efforts towards proper nutrition.

Developing criteria for elderly nursing homes: the case of Lebanon.

PURPOSE: The purpose of this study is to establish a set of measurable criteria for elderly nursing homes (ENHs) in Lebanon. Donabedian's model known by structure/process/outcome was used as the driving conceptual framework for the study. DESIGN/METHODOLOGY/APPROACH: The study reports on a panel discussion where administrators, caregivers and specialists, separately established and exchanged key information on best practice approach. The work was carried out in the summer of 2008, using the consensus panel method. A group of expert opinions (Dalkey) made up of elderly home administrators and caregivers, policy makers, and academics discussed specific key issues related to elderly health and quality of life. FINDINGS: A total of 40 criteria were retained along seven main dimensions: types of elderly homes; funding; health services; boarding services; activities; structures; and elderly rights. RESEARCH LIMITATIONS/IMPLICATIONS: A major limitation in this study is that elderly were not part of the consensus making process. Thus, including elderly in the process would have substantiated and added validity to the established criteria. PRACTICAL IMPLICATIONS: The criteria developed in this study can be turned into key performance standards for elderly homes in Lebanon, other Mediterranean and Arab countries. These criteria would greatly benefit elderly homes if validated and used as guidelines for quality care. ORIGINALITY/VALUE: The study is original in the sense that it seeks to establish measures for criteria, a blueprint, and benchmarks for ENH standards.

Quality of life and wellbeing of the elderly in Lebanese nursing homes.

PURPOSE: The purpose of this paper is to assess quality of life in relation to wellbeing among Lebanese nursing home elderly residents. The study attempts to understand the impact of structures, processes and skills on elderly health status. DESIGN/METHODOLOGY/APPROACH: In this paper, 220 normally functioning elderly respondents from 33 nursing homes were studied. A quasi-experimental approach measured psychological and health-related factors using the Geriatric Depression Scale, Activity of Daily Living, EuroQol EQ-5D and the Mini-Nutritional Assessment (MNA) instruments. FINDINGS: A relatively high level of mild depression among elderly residents and a lack of mobility were found. Generally, normally functioning elderly residents were well nourished and had moderate daily activity levels. ORIGINALITY/VALUE: The study is original in the sense that it assesses elderly residents' psychological and physical health status in relation to institutional structures, processes, and skills.

Validity and reliability of the Arabic version of activities of daily living (ADL).

BACKGROUND: The Activity of Daily Living (ADL) is an instrument that screens elderly respondents for physical functioning and assesses whether they are dependent or independent in their daily activities. This study demonstrates a translation procedure and obtains the reliability and validity of a translated, Arabic ADL. METHODS: The ADL was translated to Arabic through a forward translation method followed by a committee-consensual approach. The ADL and the Arabic Mini-Mental State Examination (AMMSE) were administered to an opportunistic sample of 354 Lebanese elderly living in nursing homes who did not have dementia. RESULTS: Reliability split half measures, sensitivity, and negative predictive values were high across all dimensions of the ADL with the exception of feeding. There were non-significant differences on the scored ADL between the three age groups: young age, middle age and older old. In addition, a non-significant difference was found on the scored ADL between the high and low AMMSE scores. CONCLUSION: Overall, the translated ADL was consistent and valid measure for assessing daily activities in elderly nursing home residents. As it is quick and easy to use, the ADL in Arabic could help caregivers and doctors to prescribe appropriate physical exercise for elderly Arabic speaking patients.

The Fluoride Debate: The Pros and Cons of Fluoridation.

Fluoride is one of the most abundant elements found in nature. Water is the major dietary source of fluoride. The only known association with low fluoride intake is the risk of dental caries. Initially, fluoride was considered beneficial when given systemically during tooth development, but later research has shown the importance and the advantages of its topical effects in the prevention or treatment of dental caries and tooth decay. Water fluoridation was once heralded as one of the best public health achievements in the twentieth century. Since this practice is not feasible or cost effective in many regions, especially rural areas, researchers and policy makers have explored other methods of introducing fluoride to the general population such as adding fluoride to milk and table salt. Lately, major concerns about excessive fluoride intake and related toxicity were raised worldwide, leading several countries to ban fluoridation. Health-care professionals and the public need guidance regarding the debate around fluoridation. This paper reviews the different aspects of fluoridation, their effectiveness in dental caries prevention and their risks. It was performed in the PubMed and the Google Scholar databases in January 2018 without limitation as to the publication period.