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1.
Eur J Nutr ; 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31900578

RESUMO

PURPOSE: To derive dietary patterns (DPs) of Lebanese adolescents (10-18 years) and evaluate associations between identified DPs and household food insecurity (HFI). METHODS: Data on adolescents (n = 693) were drawn from a national survey conducted in 2015 on a representative sample of Lebanese households with children. In addition to a sociodemographic questionnaire, data collection included the validated Arabic-version of the Household Food Insecurity Access Scale, used to evaluate HFI. Dietary intake was assessed using a 187-item validated food frequency questionnaire. Associations between HFI scores and DPs were examined using multiple linear regressions. RESULTS: HFI was observed in 55.2% of the study sample. Two DPs were derived among adolescents: Western and Lebanese-Mediterranean (LM). The Western DP was characterized by higher consumption of sweetened beverages, fast foods, sweets, and refined grains, whereas the LM DP was characterized by higher intakes of fruits, vegetables, dairy products, and whole grains. Scores of the Western DP were negatively associated with fiber, calcium, iron, and vitamins A and D, while the LM DP scores were positively correlated with fiber, proteins, iron, calcium, and vitamins A and D (p < 0.01). LM DP scores were also negatively correlated with total fat, saturated and polyunsaturated fats, p < 0.05. After adjustment for sociodemographics, multiple linear regression showed that higher HFI scores were associated with lower adherence to LM DP among adolescents (ß = - 0.026, 95% CI - 0.046, - 0.006). CONCLUSIONS: HFI was associated with lower adherence to the Mediterranean pattern among Lebanese adolescents. Preventive strategies are needed to promote better diet quality among food-insecure youth.

2.
Front Public Health ; 7: 316, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31788465

RESUMO

This paper reviews the escalating burden of breast cancer (BC) in the Middle East (ME) and the prevalence of modifiable risk factors and underscores opportunities to promote the prevention of the disease. Similar to more developed countries, BC is the most frequent cancer among women in countries of the ME, accounting for one-third of total cancer cases and 24% of total cancer deaths. Average age at BC diagnosis appears to be a decade earlier in Middle Eastern countries compared to the Western countries, and its incidence is predicted to further increase. Although incidence rates of BC are still lower in Middle Eastern countries than Western ones, mortality rates are similar and at times even higher. It is estimated that 30% of BC cases are due to environmental and lifestyle factors, such as obesity and diet and hence can be preventable. The ME suffers from surging rates of obesity, with eight of its countries ranking among the highest worldwide in obesity prevalence among adults aged 18 and above. ME countries with the highest prevalence of obesity that are among the top 20 worldwide include United Arab Emirates (UAE), Lebanon, Egypt, Libya, Qatar, Saudi Arabia, Jordan, and Kuwait with rates ranging from 30% in UAE to 37% in Kuwait. In parallel, studies in the ME have consistently showed a shift in dietary intake whereby traditional diets, rich in fruits and vegetables, are progressively eroding and being replaced by westernized diets high in energy and fat. Accumulating evidence is reporting convincing association between consumption of such westernized diets and higher BC risk. Addressing these risk factors and studying their association with BC in terms of their nature and magnitude in Middle Eastern countries could provide the basis for intervention strategies to lower the risk and alleviate the burden of BC in these countries.

3.
BMC Pregnancy Childbirth ; 19(1): 463, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31795984

RESUMO

BACKGROUND: Nutritional status of women during pregnancy has been considered an important prognostic indicator of pregnancy outcomes. OBJECTIVES: To investigate the pattern of gestational weight gain (GWG) and gestational diabetes mellitus (GDM) and their risk factors among a cohort of Emirati and Arab women residing in the United Arab Emirates (UAE). A secondary objective was to investigate pre-pregnancy body mass index (BMI) and its socio-demographic correlates among study participants. METHODS: Data of 256 pregnant women participating in the cohort study, the Mother-Infant Study Cohort (MISC) were used in this study. Healthy pregnant mothers with no history of chronic diseases were interviewed during their third trimester in different hospitals in UAE. Data were collected using interviewer-administered multi-component questionnaires addressing maternal sociodemographic and lifestyle characteristics. Maternal weight, weight gain, and GDM were recorded from the hospital medical records. RESULTS: Among the study participants, 71.1% had inadequate GWG: 31.6% insufficient and 39.5% excessive GWG. 19.1% reported having GDM and more than half of the participants (59.4%) had a pre-pregnancy BMI ≥ 25 kg/m2. The findings of the multiple multinomial logistic regression showed that multiparous women had decreased odds of excessive gain as compared to primiparous [odds ratio (OR): 0.17; 95% CI: 0.05-0.54]. Furthermore, women with a pre-pregnancy BMI ≥ 25 kg/m2 had increased odds of excessive gain (OR: 2.23; 95%CI: 1.00-5.10) as compared to those with pre-pregnancy BMI < 25 kg/m2. Similarly, women who had a pre-pregnancy BMI ≥ 25 kg/m2 were at higher risk of having GDM (OR: 2.37; 95%CI: 1.10-5.12). As for the associations of women's characteristics with pre-pregnancy BMI, age and regular breakfast consumption level were significant predictors of higher pre-pregnancy BMI. CONCLUSIONS: This study revealed alarming prevalence rates of inadequate, mainly excessive, GWG and GDM among the MISC participants. Pre-pregnancy BMI was found a risk factor for both of these conditions (GWG and GDM). In addition, age and regular breakfast consumption were significant determinants of pre-pregnancy BMI. Healthcare providers are encouraged to counsel pregnant women to maintain normal body weight before and throughout pregnancy by advocating healthy eating and increased physical activity in order to reduce the risk of excessive weight gain and its associated complications.

4.
Nutr Cancer ; : 1-10, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31687849

RESUMO

Background: Several studies have examined the relationship between diet quality indices and colorectal cancer (CRC). However, data on the association of these indices and colorectal adenomas (CRA) as a precursor of CRC are scarce. Our objective was to investigate the association of Healthy Eating Index (HEI-2010) and Mediterranean-Style Dietary Pattern Score (MSDPS) with CRC and CRA risk.Methods: This is a hospital-based case-control study including 259 cases (129 CRC and 130 CRA patients) and 240 controls with non-neoplastic conditions. Dietary intake of subjects was examined using a valid and reliable food frequency questionnaire. The HEI-2010 and MSDPS were then calculated based on a-priori methods. Multivariate logistic regression analyses were conducted to estimate the relationship between HEI-2010 and MSDPS and the risk of CRC and CRA.Results: After adjustment for confounders, compared with the first tertiles, the highest tertiles of HEI-2010 and MSDPS were significantly associated with lower odds of CRC (OR = 0.04; 95% CI = 0.01-0.12, OR = 0.19; 95% CI = 0.09-0.38, respectively). Similarly, the highest tertiles of HEI-2010 (OR = 0.04; 95% CI = 0.08-0.32) and MSDPS (OR = 0.19; 95% CI = 0.17-0.58) were associated with reduced odds of CRA compared to the lowest tertiles.Conclusion: The findings of this study suggested that a high-quality diet assessed by HEI-2010 and MSDPS is inversely associated with the risk of CRC and CRA.

5.
Nutrients ; 11(10)2019 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-31597293

RESUMO

Human milk oligosaccharides (HMOs), phospholipids (PLs), and gangliosides (GAs) are components of human breast milk that play important roles in the development of the rapidly growing infant. The differences in these components in human milk from the United Arab Emirates (UAE) were studied in a cross-sectional trial. High-performance liquid chromatography‒mass spectrometry was used to determine HMO, PL, and GA concentrations in transitional (5-15 days) and mature (at 6 months post-partum) breast milk of mothers of the United Arab Emirates (UAE). The results showed that the average HMO (12 species), PL (7 species), and GA (2 species) concentrations quantified in the UAE mothers' transitional milk samples were (in mg/L) 8204 ± 2389, 269 ± 89, and 21.18 ± 11.46, respectively, while in mature milk, the respective concentrations were (in mg/L) 3905 ± 1466, 220 ± 85, and 20.18 ± 9.75. The individual HMO concentrations measured in this study were all significantly higher in transitional milk than in mature milk, except for 3 fucosyllactose, which was higher in mature milk. In this study, secretor and non-secretor phenotype mothers showed no significant difference in the total HMO concentration. For the PL and GA components, changes in the individual PL and GA species distribution was observed between transitional milk and mature milk. However, the changes were within the ranges found in human milk from other regions.

6.
Metab Syndr Relat Disord ; 17(10): 486-493, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31566527

RESUMO

Background: Obesity is associated with increased risk for metabolic syndrome (MetS). Anthropometric cutoffs derived for Caucasians may not be applicable to identify obesity in Middle Eastern populations. This study aims to (1) determine optimal cutoff values of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) for the prediction of MetS among Lebanese adults and (2) to evaluate the ability of the derived cutoffs in predicting MetS, in comparison with published cutoffs. Methods: A cross-sectional study involving adults aged ≥20 years (n = 305) with no history of chronic diseases was conducted. Data collection included sociodemographic characteristics, anthropometric measurements, and fasting blood samples. The International Diabetes Federation criteria were used to identify MetS. Receiver operating characteristic analyses were performed to determine optimal cutoff values. The ability of the derived cutoffs in predicting MetS was examined using multiple logistic regression analyses. Results: The derived cutoff values for men and women were 26.35 and 25.74 kg/m2 for BMI, 94 and 83 cm for WC, and 0.54 and 0.53 for WHtR, respectively. The use of the derived cutoffs improved the prediction of MetS compared to reference published cutoffs. In men, abdominal adiposity indicators performed better than BMI in predicting MetS, while in women, BMI, WC, and WHtR were all strong predictors. Conclusion: The study identified, for three anthropometric indices, the optimal cutoff values that identify MetS among Lebanese adults, hence responding to the need for ethnic-and population-specific cutoffs. Of interest, the study results documented gender differences in the association between anthropometric indices and MetS.

7.
PLoS One ; 14(8): e0220942, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31419246

RESUMO

BACKGROUND: To examine the associations of dietary patterns with odds of elevated Blood Pressure (BP) among Lebanese adult males using principal component analysis (PCA), and compare the results to two other data reduction methods, including reduced rank regression (RRR) and partial least-squares (PLS) regression. METHODS: Data from the National Nutrition and Non-Communicable Disease Risk Factor Survey conducted in Lebanon between years 2008 and 2009 were used. Dietary intake data were collected by a 61-item food frequency questionnaire (FFQ). In addition, anthropometric and blood pressure measurements were obtained following standard techniques. For the purpose of this study, data of males older than 20 years with no history of chronic diseases were selected (n = 673). Elevated BP was indicated if the systolic blood pressure was > = 130mm Hg and/or the diastolic blood pressure > = 85 mm Hg. Dietary patterns were constructed using PCA, PLS and RRR and compared based on the performance to identify plausible patterns associated with elevated BP. For PLS and RR, the response variables were BMI, waist circumference and percent body fat. Multiple logistic regression was used to evaluate the associations between the dietary pattern scores of each method and risk of elevated BP. RESULTS: Three dietary patterns were identified using PCA: Western, Traditional Lebanese, and Fish and alcohol. Both the Western and the Traditional Lebanese patterns were associated with higher odds of elevated BP in the study population (OR = 1.23, CI 1.03, 1.46; OR = 1.29, CI 1.09, 1.52 respectively). The comparison among the three methods for dietary patterns derivation showed that PLS and RRR derived patterns explained greater variance in the outcome (PCA: 1.2%; PLS: 14.1%; RRR: 15.36%) and were significantly associated with elevated BP, while the PCA dietary patterns were descriptive of the study population's real dietary habits (PCA: 23.6%; PLS: 19.8%; RRR: 11.3%). CONCLUSIONS: The Western and Traditional Lebanese dietary patterns were associated with higher odds of elevated BP among Lebanese males. The findings of this study showed that, compared to PCA, the use of RRR method resulted in more significant associations with the outcome while the PCA-derived patterns were more related to the real habits in the study population.

8.
Eur J Nutr ; 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31363827

RESUMO

PURPOSE: This study tried at identifying lifestyle patterns in a sample of Lebanese adults and investigating their association with metabolically healthy overweight and obesity (MHOv/O). METHODS: This study used data from a community-based survey of Lebanese adults living in Greater Beirut (n = 305). Dietary intake was assessed using an 80-item food frequency questionnaire. MHOv/O was defined as having one or none of the following metabolic abnormalities: triglycerides ≥ 150 mg/dL; systolic blood pressure ≥ 130 mmHg; diastolic blood pressure ≥ 85 mmHg; fasting blood glucose ≥ 100 mg/dL; HDL-cholesterol < 40 mg/dL for men and < 50 mg/dL for women. 201 subjects were overweight/obese and 98 had MHOv/O. Factor analysis was implemented to derive lifestyle patterns. RESULTS: Two lifestyle patterns were identified: the unhealthy lifestyle pattern, which included foods such as fast food and soft drinks and was characterized by alcohol consumption and cigarette smoking. Eating at home loaded negatively on this pattern. The healthy lifestyle pattern was characterized by positive loadings of food groups such as milk and dairy products, fruits, vegetables and legumes. Sleep difficulties loaded negatively on this pattern, while vigorous and moderate physical activity loaded positively. Multiple logistic regression analyses showed that subjects belonging to the 3rd tertile of the healthy pattern scores had higher odds of MHOv/O as compared to those in the 1st tertile (OR 2.33, CI 1.04-4.81). CONCLUSIONS: Findings of this study provided evidence on the combined effect of lifestyle patterns in relation to cardiometabolic abnormalities and highlighted the importance of focusing on 'holistic' lifestyle pattern modifications in designing and implementing prevention interventions in overweight and obese subjects.

9.
PLoS One ; 14(7): e0219248, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31265481

RESUMO

Accumulating evidence has highlighted the role of maternal nutritional status on fetal development, birth outcomes and child health. The Mother and Infant Nutritional Assessment (MINA) cohort is a 3-year follow-up study of pregnant women and their children in Qatar and Lebanon. This study reports on the characteristics and determinants of pre-pregnancy BMI and Gestational Weight Gain (GWG) of MINA particiants, as well as birth outcomes. A total of 272 pregnant women were recruited during their first trimester from primary healthcare centers as well as private clinics in Beirut (n = 194) and Doha (n = 147). During the first visit, data collection included pre-pregnancy weight, sociodemographic and lifestyle characteristics. The weight before delivery and neonatal outcomes were extracted from the medical records. GWG was calculated as the difference between weight before delivery and pre-pregnancy weight and was classified into insufficient, adequate, and excessive, as per the IOM criteria. Overall, 42.1% of women had a pre-pregnancy BMI≥25 Kg/m2 (58% in Qatar vs 30.8% in Lebanon, p<0.001). Only 30.2% of women had adequate GWG, while 25.7% and 44.1% of women had insufficient and excessive GWG, respectively. In the cohort 68.7% of infants had a weight adequate-for-gestational age (AGA), 6.7% were SGA and 24.6% were LGA. The proportions of LGA were higher with greater GWG (p<0.05). After adjustment, Qatari women were 3 times more likely to be overweight or obese before pregnancy while a higher education level was associated with significantly lower odds of pre-pregnancy BMI≥25 Kg/m2. Pre-pregnancy BMI≥25 Kg/m2 and regular breakfast consumption were predictors of excessive GWG (OR: 3.20, CI: 1.48-6.91; OR: 2.84, CI: 1.15-7.02, respectively). The high prevalence of pre-pregnancy overweight and excessive GWG among MINA participants underscores the need for culture-specific intervention programs to promote healthy body weight in women of childbearing age, and prevent excessive weight gain during pregnancy.

10.
Nutrients ; 11(8)2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31357600

RESUMO

Amidst the ongoing societal and economic shifts in the Eastern Mediterranean region (EMR), this study aims at investigating temporal trends in food consumption and nutrient intakes among Lebanese adults, by age and sex. Data were derived from two national cross-sectional surveys conducted in Lebanon during two time periods (1997; 2008/2009). In both surveys, dietary assessment was based on 24-h recalls. The results, expressed as % energy intake (%EI), revealed a significant decrease (p < 0.001) in the consumption of bread, fruits, fresh fruit juices, milk and eggs, whereas the consumption of added fats and oils, poultry, cereals and cereal-based products, chips and salty crackers, sweetened milk and hot beverages increased over time (p < 0.001). A significant increase in dietary energy (kcal/day) and fat intake (%EI) was observed, coupled with decreases in carbohydrate intake (%EI) and dietary density of vitamin A and vitamin C (per 1000 kcal) (p < 0.001). These changes were noted in both genders and across age groups, albeit there were some disparities between groups. In conclusion, based on national nutrition surveys, this study is the first to characterize the nutrition transition in a middle-income country of the EMR, shedding light on priority areas for nutrition policies and interventions.


Assuntos
Dieta/tendências , Comportamento Alimentar , Estado Nutricional , Adulto , Fatores Etários , Estudos Transversais , Inquéritos sobre Dietas , Ingestão de Energia , Feminino , Humanos , Líbano , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Recomendações Nutricionais/tendências , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
11.
BMC Public Health ; 19(1): 637, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31126261

RESUMO

BACKGROUND: The scarcity of evidence-based research on non-communicable diseases (NCDs) among Syrian refugees has hampered efforts to address the high burden of these diseases in host countries. The objective of this study is to examine published research on NCDs among Syrian refugees in order to inform future research, practice, programs, and policy. . METHODS: Using the scoping review framework proposed by Arksey et al., 17 different databases were searched to identify studies reporting on NCDs among Syrian refugees. The number of relevant documents found was 34, with the earliest going back to 2013-2 years after the beginning of the Syrian conflict. RESULTS: The majority of these documents were descriptive in nature and only two studies addressed the effectiveness of interventions in the management of NCDs. No studies investigated the prevention of these diseases. Furthermore, only 7 studies addressed the host community and only one research article, conducted in Lebanon, included subjects from the host community. The increasing number of documents over the past 5 years illustrates a growing interest in studying NCDs among Syrian refugees. Examination of the papers showed high prevalence of NCDs among Syrian refugees as well as unmet healthcare needs. CONCLUSION: The findings of this review highlighted the dire need for further research on the burden of NCDs among Syrian refugees. Future studies should diversify research design to include interventions, address the host community in addition to the refugees, tackle prevention as well as treatment of NCDs, and explore strategies to enhance the resilience of the host country's health system while ensuring quality of care for NCDs. The increasing momentum for research found in this review presents an opportunity to fill current knowledge gaps, which could result in preventing, controlling and ultimately reducing the burden of NCDs among Syrian refugees and their host communities.


Assuntos
Efeitos Psicossociais da Doença , Doenças não Transmissíveis/epidemiologia , Refugiados/estatística & dados numéricos , Humanos , Prevalência , Síria/epidemiologia
12.
BMJ Open ; 9(3): e025074, 2019 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-30852542

RESUMO

INTRODUCTION: Pharmacists are uniquely positioned to provide patients with evidence-based information in order to ensure effective and safe use of Complementary and alternative medicine (CAM) products. OBJECTIVE: Assess beliefs, practices and knowledge related to CAM products among community pharmacists in Lebanon. DESIGN, METHODS AND SETTING: Using stratified random sampling, a nationally representative survey was conducted among community pharmacists in Lebanon. Through face-to-face interviews, pharmacists completed a multicomponent questionnaire consisting of four sections: (1) sociodemographic characteristics; (2) beliefs related to regulation of CAM products, role of media in promoting their safe use, availability of resources and continuing education; (3) practices including selling CAM products, providing advice for patients and reporting adverse effects and (4) knowledge about specific CAM products, their uses, side effects and interactions. RESULTS: A total of 341 pharmacists agreed to participate (response rate: 86%). Only pharmacists with complete data were included in this study (n=310). Pharmacists agreed that CAM products are effective (63.8%) and that they should be exclusively sold in pharmacies (80.3%), but disagreed that commercially marketed CAM products are well regulated (63.5%) and that media plays a positive role in educating users about these products (55.8%). As for practices, 64.5% of pharmacists were always or often advising patients on safe use; however, 74.2% of participants rarely or never reported adverse effects. Regarding knowledge, although the majority of pharmacists were aware of the uses of CAM products, fewer knew about their side effects and their interactions with drugs. After adjustment for covariates, receiving education/training on CAM products during university was the sole predictor of higher knowledge score (ß=0.68, 95% CI 0.29 to 1.07). CONCLUSIONS: This study revealed positive beliefs of pharmacists in Lebanon towards CAM products and indicated important gaps in their practice and knowledge. Deliberate efforts to enhance the education of pharmacists are warranted to ensure the safe integration and use of CAM products in Lebanon.

13.
Public Health Nutr ; 22(2): 202-211, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30511613

RESUMO

OBJECTIVE: Food insecurity (FI) is a major public health problem in Lebanon, a small middle-income country with the highest refugee per capita concentration worldwide and prolonged political and economic challenges. The present study aimed to measure the prevalence and sociodemographic correlates of household FI and to explore the association of household FI with anthropometric measures of children and their mothers. DESIGN: Cross-sectional survey (2014-2015). SETTING: Lebanon.ParticipantsNationally representative sample of Lebanese households with 4-18-year-old-children and their mothers (n 1204). RESULTS: FI prevalence (95 % CI), measured using the Arabic-translated, validated Household Food Insecurity Access Scale, was found to be 49·3 (44·0, 54·6) % in the study sample. Mild, moderate and severe FI were found in 7·0 (5·5, 9·2) %, 23·3 (20·1, 26·8) % and 18·9 (14·9, 23·5) % of households, respectively. Multiple regression analysis showed that low maternal and paternal education, unemployment and crowding were significant correlates of household FI (P<0·05). No significant associations were observed between FI and anthropometric measures of children and their mothers, after adjusting for other socio-economic correlates. Food-insecure households reported various mechanisms to cope with food shortage, such as reducing the number of meals/d (49·6 %), borrowing food (54·4 %), spending savings (34·5 %) and withdrawing children from schools (8·0 %). CONCLUSIONS: FI exists among a remarkable proportion of Lebanese households with children. Correlates of household FI should be considered when designing social welfare policies and public health programmes to promote more sustainable, resilient and healthier livelihoods among vulnerable individuals.

14.
Eur J Nutr ; 58(1): 91-102, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29127474

RESUMO

PURPOSE: The high burden of preschool overweight in the Middle East and North Africa highlights the need for rigorous investigations of its determinants. This study aims at identifying dietary patterns amongst preschoolers in Lebanon and assessing their association with overweight and obesity. METHODS: A national cross-sectional survey was conducted amongst 2-5-year-old children (n = 525). Socio-demographic, dietary, lifestyle and anthropometric variables were collected. Dietary patterns were derived by factor analysis. Overweight/obesity was defined based on the World Health Organization 2006 criteria (BMI-for-age z-score > + 2). RESULTS: Two patterns, "Fast Food and Sweets" and "Traditional Lebanese", were identified. The "Fast Food and Sweets" pattern was characterized by higher consumption of sweetened beverages, fast foods, salty snacks and sweets. The "Traditional Lebanese" was driven by higher intakes of cereals, dairy products, fruits and vegetables. Children belonging to the 3rd tertile of the Traditional pattern scores had significantly lower odds of overweight/obesity compared to the 1st tertile (OR 0.33; 95% CI 0.11, 0.97). Higher maternal education and higher frequency of eating with family predicted adherence to the traditional pattern, while the presence of a household helper was a negative determinant. Adherence to the Fast Food and Sweets pattern was positively associated with the child's age, and negatively associated with female gender and maternal education. CONCLUSIONS: The "Traditional Lebanese" pattern was associated with decreased risk of preschool overweight. Policies aiming at re-anchoring this traditional dietary pattern in contemporary lifestyles may be developed as potential preventive strategies against overweight in this age group.


Assuntos
Dieta/métodos , Inquéritos Nutricionais/estatística & dados numéricos , Obesidade Pediátrica/epidemiologia , Pré-Escolar , Estudos Transversais , Dieta/estatística & dados numéricos , Comportamento Alimentar , Feminino , Humanos , Líbano/epidemiologia , Masculino , Inquéritos Nutricionais/métodos , Obesidade Pediátrica/prevenção & controle , Fatores Socioeconômicos
15.
BMC Med Res Methodol ; 18(1): 155, 2018 11 29.
Artigo em Inglês | MEDLINE | ID: mdl-30497391

RESUMO

BACKGROUND: Declining participation rates are impeding health research. Little is known about factors influencing the decision to participate in low- and middle-income countries (LMIC). Therefore, this paper reports on the various individual factors and their with contextual factors in influencing participation in research among pregnant women and the recommendations to enhance their recruitment in Lebanon. METHODS: This study used a qualitative research design drawing on focus groups and in-depth interviews. The Theoretical Domain Framework guided data collection and analysis. The three participant groups included: Group 1-Pregnant women (n = 25) attending public pre-natal events and antenatal clinics in Beirut; Group 2-Pregnant women (n = 6) already enrolled in the ongoing Mother and Infant Nutritional Assessment birth cohort study; Group 3-Key informants (n = 13) including health care workers involved in recruiting pregnant women. Conversations were audio recorded, transcribed, translated into English, and thematically analyzed. RESULTS: Three main factors influencing participation were revealed, with each factor encompassing several sub-themes: (1) personal factors (altruism, self-confidence, personal interest in the topic, previous understanding of the nature and purpose of research, education level, and previous research experience), (2) contextual factors (societal factors, family and friends), and (3) study characteristics (burden of the study, ethical considerations, incentives, and research interpersonal skills and physician endorsement to participate). The results suggested a dynamic interaction among the identified factors, forming two intersecting axes, with a four-quadrant configuration. The y- and x-axes represented personal factors and contextual factors, respectively. Individuals positioned on the lower-left quadrant were the least likely to participate; those on the upper-right quadrant were the most likely to participate; while those on the upper-left and lower-right quadrants were indecisive. Study characteristics seemed to affect the decision of pregnant women to participate situated in any of the four quadrants. Specific recommendations to improve participation were also identified. CONCLUSIONS: Our findings suggested an interaction of personal factors, contextual factors, and study characteristics affecting subjects' participation. This interaction integrates factors into a novel dynamic framework that could be used in future studies. The recommendations identified may help improve participation of pregnant women in health research hence enhancing the quality and generalizability of research findings in LMIC.


Assuntos
Participação do Paciente , Seleção de Pacientes , Gestantes/educação , Pesquisa Qualitativa , Adulto , Feminino , Grupos Focais/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Humanos , Líbano , Motivação , Gravidez , Gestantes/psicologia , Sujeitos da Pesquisa/educação , Sujeitos da Pesquisa/psicologia , Sujeitos da Pesquisa/estatística & dados numéricos , Classe Social , Adulto Jovem
16.
Nutrients ; 10(10)2018 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-30257485

RESUMO

There have been increases in the incidence of obesity in Lebanon over the past few decades. Fatty acid intake and metabolism have been postulated to influence obesity, but few epidemiological studies have been conducted. The aim of this study was to investigate the correlation between serum fatty acid levels and indicators of obesity in a cross-sectional study nested within a cohort of 501 Lebanese adults residing in Greater Beirut. A total of 395 available serum samples (129 men, 266 women) were profiled for phospholipid fatty acid composition. Spearman correlation coefficients adjusted for relevant confounders and corrected for multiple testing were calculated between serum fatty acids, desaturation indices, and indicators of adiposity (body mass index (BMI) and waist). BMI was significantly positively correlated with saturated fatty acids in men (r = 0.40, p < 0.0001, q < 0.0001) and women (r = 0.33, p < 0.0001, q < 0.0001). BMI was significantly positively correlated with monounsaturated fatty acid palmitoleic acid in women (r = 0.15, p = 0.01, q = 0.03). This study suggests that high blood levels of some saturated fatty acids and the monounsaturated fatty acid palmitoleic acid, likely derived from both dietary intakes of saturated fatty acids and endogenous lipogenesis, may have been associated with adiposity in the Lebanese population. The causality of these associations needs to be explored in experimental settings.


Assuntos
Adiposidade/fisiologia , Gorduras na Dieta/sangue , Ácidos Graxos Monoinsaturados/sangue , Obesidade/sangue , Fosfolipídeos/sangue , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Incidência , Líbano/epidemiologia , Lipogênese/fisiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Circunferência da Cintura
17.
Nutr J ; 17(1): 85, 2018 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-30208898

RESUMO

BACKGROUND: Following the release of the Sustainable Development Goals, dietary patterns and guidelines are being revised for their effect on the environment in addition to their health implications. The objective of this study was to evaluate and compare the Environmental Footprints (EFPs) of food consumption patterns among Lebanese adults. METHODS: For this study, data for adults aged > 18 years (n = 337) were drawn from a previous national survey conducted in Lebanon (2008-2009), where dietary intake was assessed using a 61-item Food Frequency Questionnaire. Dietary patterns previously derived in the study sample included: Western, Lebanese-Mediterranean and High-Protein. In this study, food consumption and dietary patterns were examined for their EFPs including water use, energy use, and greenhouse gas (GHG) emissions, using review of life cycle analyses. RESULTS: In the study population, the EFPs of food consumption were: water use: 2571.62 ± 1259.45 L/day; energy use: 37.34 ± 19.98 MJ/day and GHGs: 4.06 ± 1.93 kg CO2 eq / day. Among the three dietary patterns prevalent in the study population, the Lebanese-Mediterranean diet had the lowest water use and GHG per 1000 Kcal (Water (L/Kg): 443.61 ± 197.15, 243.35 ± 112.0, 264.72 ± 161.67; GHG (KG CO2 eq/day) 0.58 ± 0.32, 0.38 ± 0.24, 0.57 ± 0.37, for the Western, Lebanese-Mediterranean and High- Protein, respectively). The scores of the High-Protein dietary pattern were associated with higher odds of the three EFPs, whereas the Lebanese-Mediterranean dietary pattern was associated with lower odds of energy use. Furthermore, scores of the Western pattern were associated with higher water use. CONCLUSIONS: The findings of this study showed that, among Lebanese adults, the Western and High-Protein dietary patterns had high EFPs, whereas the Lebanese-Mediterranean dietary pattern had lower water use and GHG emissions. Coupled to our earlier findings of the Lebanese-Mediterranean pattern's beneficial effects on health, the findings of this study lend evidence for the notion that what is healthy for people may also be healthy for ecosystems and highlight the need for nutrition recommendations to take into consideration the nexus of water, food, energy, in addition to health.


Assuntos
Dieta , Ingestão de Alimentos , Meio Ambiente , Adulto , Conservação de Recursos Energéticos , Conservação dos Recursos Naturais , Conservação dos Recursos Hídricos , Estudos Transversais , Inquéritos sobre Dietas , Dieta Mediterrânea , Dieta Ocidental , Proteínas na Dieta/administração & dosagem , Feminino , Humanos , Líbano , Masculino , Política Nutricional , Inquéritos e Questionários , Desenvolvimento Sustentável
18.
Front Psychiatry ; 9: 400, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30210375

RESUMO

Background: The relation between dietary inflammation and risk of depression has not been widely explored. We examined the association between the inflammatory effect of the diet and the odds of depression among Iranian female adolescents. Methods: Using a stratified cluster sampling technique, 300 female adolescents aged 15-18 years were recruited from schools in Tehran between years 2014-2015. Depression was assessed using the Depression, Anxiety and Stress Scale (DASS)- a 21-point scale. The dietary inflammatory index (DII®) was used to evaluate the inflammatory potential of the diet. Dietary intake was assessed using a validated food frequency questionnaire. In addition to descriptive statistics, multivariable linear and logistic regression were used to calculate confounder-adjusted beta estimates and odds ratios. Results: In total, 88 females (30%) had at least a moderate level of depressive symptoms (DASS > 6). Females with the most pro-inflammatory diet had higher DASS depression score (ß = 1.67; 95% CI = 0.03, 3.31) and were at 3.96 (95% CI = 1.12, 13.97) times higher odds of having at least moderate depressive symptoms, compared to females with the least anti-inflammatory diets. Conclusion: These data suggest that Iranian adolescent females eating a pro-inflammatory diet, as indicated by higher DII scores, had greater odds of having at least moderate depressive symptoms.

19.
Nutr Res ; 57: 12-27, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30122192

RESUMO

The Eastern Mediterranean Region (EMR) is undergoing social and economic changes that may impact the nutritional status of children living in its countries. The objective of this review is to evaluate the nutritional status and dietary intakes of children (0-12 years) in selected EMR countries, namely, Jordan, Lebanon, Kingdom of Saudi Arabia (KSA), and the United Arab Emirates. MedLine, PubMed, Scopus, and Google Scholar were searched for relevant articles published between 1990 and 2016; international organizations and governmental websites were also searched. Stunting in the region was estimated at 7.3% to 9.3%, wasting at 1.1% to 11.8%, and underweight at 1.6% to 5.3%. In contrast, overweight and obesity affected 19% to 21% of school-aged children from Lebanon and KSA. Available biochemical data showed that pediatric anemia, vitamin A, and vitamin D deficiencies remain a challenge in the region. Dietary intake studies have identified inadequate intakes of iron, calcium, zinc, folic acid, vitamin A, and vitamin D, concurrently with high intakes of fat, saturated fat, and sugar. This review provides valuable insight into the nutrition situation of children in 2 major areas of the EMR, the Levant and the Gulf, and identified several gaps and challenges in existing nutritional assessment studies. Key issues include the triple burden of malnutrition in this age group (underweight, nutrient inadequacies, and overweight/obesity), while calling for integrated action to improve the nutritional status of children in countries of the region. Opportunities for future research include nationwide nutritional and dietary surveys in countries where the largest data gaps remain such as the United Arab Emirates and KSA.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Deficiências Nutricionais/epidemiologia , Dieta , Transtornos do Crescimento/epidemiologia , Estado Nutricional , Obesidade/epidemiologia , Magreza/epidemiologia , Anemia/epidemiologia , Criança , Feminino , Humanos , Lactente , Masculino , Região do Mediterrâneo/epidemiologia , Oriente Médio/epidemiologia , Síndrome de Emaciação/epidemiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-30147730

RESUMO

The main objective of this study was to identify predictors of Complementary and Alternative Medicine (CAM) use in Lebanon. Data for this study were drawn from a national survey conducted among Lebanese adults (n=1500). A modified version of the Social Behavioral Model (SBM) was used to understand CAM use in the study population. In this version, predisposing factors included sociodemographic characteristics (age, gender, education, and employment) and Push and Pull factors. Additionally, enabling resources included income, and medical need encompassed presence of chronic disease and perceived health status. Simple and multiple logistic regressions were used to examine the predictors of CAM use in the study population. Results of the multiple logistic regression showed that younger and older adults were less likely to use CAM as compared to middle-aged respondents. The Push factor "dissatisfaction with conventional medicine" was associated with higher odds of CAM use. For three of the six Pull factors, compared to participants who strongly disagreed, those who had a tendency of taking care of one's health were more likely to use CAM. Income and presence of chronic disease were also associated with higher odds of CAM use. The findings of this study affirmed the utility of the SBM in explaining the use of CAM and proposed a new version of this model, whereby the Push and Pull factors are integrated within the predisposing factors of this model.

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