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Nutrients ; 13(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34371969


The prevalence of diet-related non-communicable diseases is on the rise in the countries of the Eastern Mediterranean, including Lebanon. This study aimed to provide data on fatty acid profiles and ratios of Lebanese composite dishes, Arabic sweets, and market foods. Methods: Thirty types of traditional dishes, collected from five different Lebanese governorates, thirty-seven types of Arabic sweets and forty-six market food products were considered for analysis. Food samples were chemically analyzed for total, unsaturated and saturated fatty acids. The range of total fatty acids in composite dishes, Arabic sweets, and market food products was between 1.2-11.7 g/100 g, 5.3-25.8 g/100 g, and 0.5-100 g/100 g, respectively. Additionally, the range of saturated fatty acids in composite dishes, Arabic sweets, and market food products was between 0.5-4.9 g/100 g, 2.5-23.6 g/100 g and 0.1-56.4 g/100 g, respectively. Furthermore, about 75% of these foods were poor in unsaturated fatty acids. Regarding saturated fatty acid, the polyunsaturated to monounsaturated (P.M.S) ratio was lower than the recommended ratio of 1:1:1 in 96% of samples. To conclude, there is a need to prioritize fat content in foods and consider processing modifications in the food production system with the aim of achieving a higher P:M:S ratio intake among the population.

Dieta/tendências , Ácidos Graxos/análise , Análise de Alimentos , Qualidade dos Alimentos , Cultura , Dieta Saudável , Gorduras na Dieta/análise , Ácidos Graxos Monoinsaturados/análise , Ácidos Graxos Insaturados/análise , Rotulagem de Alimentos , Humanos , Jordânia , Kuweit , Líbano , Oriente Médio , Arábia Saudita , Urbanização
F1000Res ; 10: 12, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33708377


Background: The important role of Mediterranean diet was elucidated in various clinical and epidemiological studies underlying its impact on reducing the burden of non-communicable diseases in Mediterranean and non-Mediterranean populations. Objective: The aim of this study was to convert the recipes of the Lebanese traditional dishes into meal planning exchange lists whose items are expressed in grams and adjusted to Lebanese household measures (cups and spoons) that could be used by healthcare professionals. Methodology: Thirty traditional Lebanese dishes were collected in which the carbohydrate, fat and protein were analyzed using Association of Official Analytical Chemists procedures then followed by a calculation of exchange lists of foods per serving using Wheeler method. Results:  The variations in macronutrients and fiber content were found among the Lebanese dishes. Carbohydrate was lowest (1.1g/100g) and protein was highest (29.7g/100g) in Shawarma Dajaj whereas fat content ranged between 0.5 and 22.4 g/100 g in the dishes. For each dish and according to each serving size, carbohydrate, milk (whole milk, reduced fat or skim), fat and protein (lean meat, medium fat meat and high fat meat) exchanges were calculated. Conclusion: This study provides healthcare professionals, dietitians and consumers the chance to proficiently plan traditional-type dishes, ensuring prominent dietetic and medical nutritional therapy practices and patient's self-control.

Fibras na Dieta , Nutrientes , Doces , Humanos
JMIR Res Protoc ; 10(1): e21585, 2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33507158


BACKGROUND: The lack of availability of evidence-based services for people exposed to adversity globally has led to the development of psychological interventions with features that will likely make them more scalable. The evidence for the efficacy of e-mental health from high-income countries is compelling, and the use of these interventions could be a way to increase the coverage of evidence-based psychological interventions in low- and middle-income countries. Step-by-Step is a brief (5-session) intervention proposed by the World Health Organization as an innovative approach to reducing the suffering and disability associated with depression. OBJECTIVE: This study aims to evaluate the effectiveness and cost-effectiveness of a locally adapted version of Step-by-Step with Syrian nationals (trial 1) and Lebanese nationals and other populations residing in Lebanon (trial 2). METHODS: This Step-by-Step trial involves 2 parallel, two-armed, randomized controlled trials comparing the e-intervention Step-by-Step to enhanced care as usual in participants with depressive symptoms and impaired functioning. The randomized controlled trials are designed and powered to detect effectiveness in 2 populations: Syrians in Lebanon (n=568) and other people residing in Lebanon (n=568; Lebanese nationals and other populations resident in Lebanon). The primary outcomes are depressive symptomatology (measured with the Patient Health Questionnaire-9) and functioning (measured with the World Health Organization Disability Assessment Scale 2.0). Secondary outcomes include anxiety symptoms, posttraumatic stress disorder symptoms, personalized measures of psychosocial problems, subjective well-being, and economic effectiveness. Participants are mainly recruited through online advertising. Additional outreach methods will be used if required, for example through dissemination of information through partner agencies and organizations. They can access the intervention on a computer, tablet, and mobile phone through a hybrid app. Step-by-Step has 5 sessions, and users are guided by trained nonspecialist "e-helpers" providing phone-based or message-based support for around 15 minutes a week. RESULTS: The trials were funded in 2018. The study protocol was last verified June 20, 2019 (WHO ERC.0002797) and registered with (NCT03720769). The trials started recruitment as of December 9, 2019, and all data collection was completed in December 2020. CONCLUSIONS: The Step-by-Step trials will provide evidence about the effectiveness of an e-mental health intervention in Lebanon. If the intervention proves to be effective, this will inform future scale-up of this and similar interventions in Lebanon and in other settings across the world. TRIAL REGISTRATION: NCT03720769; INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/21585.

F1000Res ; 9: 1254, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33299557


Background: The expanding burden of diet-related non-communicable diseases in the Eastern Mediterranean Countries requires urgent public health vigilance and actions. This study aimed at establishing a database analysis of total sugar, salt and iron content in Lebanese foods, focusing on traditional dishes. Methods: The collection of food samples was done using stratified sampling techniques. These samples were classified into five strata, taking into account variation by geographical area (Mount Lebanon, Bekaa, Beirut, Tripoli, and Saida). The number of samples per governorate was estimated to be 30 according to the variability in the dishes' composition. Food samples were chemically analyzed for total sugar, salt, and iron. Results: Among all the governorates, all the tested traditional Lebanese dishes contained little total sugar. More than 60% of the samples tested were rich in sodium. The sodium content ranges were 120-720 mg/100 g in Mount Lebanon, 240-960 mg/100 g in Bekaa, 80-520 mg/100g in Beirut, 252-1952 mg/100g in Tripoli and 40-680 mg/100 g in Saida. The highest mean amount of sodium was observed in the dishes Fatayer Sabanikh and Malfouf Mehche (≥ 600 mg/100 g). Furthermore, more than 80% of the samples had poor amounts of iron in all governorates. Conclusion: This study emphasizes the need for multi-cultural education and awareness on food sources of salt and iron, and the health effects regarding high intake of salt and low intake of iron. This study is a stepping stone for further research exploring total sugar, salt and iron content of traditional dishes, as well as potential intake by individuals in the Lebanese population.

Dieta , Ferro , Humanos , Líbano , Valor Nutritivo , Açúcares
Front Psychiatry ; 10: 986, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32116815


Background: E-mental health is an established mode of delivering treatment for common mental disorders in many high income countries. However, evidence of its effectiveness in lower income countries is lacking. This mixed methods study presents lessons learned and preliminary data on the feasibility of a minimally guided e-mental health intervention in Lebanon. The aim was to pilot test Step-by-Step, a WHO guided e-mental health intervention, and research methods prior to future, controlled testing. Methods: Participants were recruited using social media and advertisements in primary care clinics. Participants completed baseline and post-intervention questionnaires on depression symptoms (primary outcome, PHQ-8), anxiety symptoms, well-being, disability and self-perceived problem severity, and a client satisfaction questionnaire. In addition, seven completers, four drop-outs, 11 study staff, and four clinic managers were interviewed with responses thematically analyzed. Website analytics were used to understand participant behavior when using the website. Results: A total of 129 participants signed up via the Step-by-Step website. Seventy-four participants started session 1 after completing pre-test questionnaires and 26 completed both baseline and post-intervention data. Among those who completed post-assessments, depression symptoms improved (PHQ-8 scores (t=5.62, p < 0.001 two-tailed, df = 25). Wilcoxon signed ranks tests showed a significant difference between baseline and post-Step-by-Step scores on all secondary outcome measures. Client satisfaction data was positive. Interview responses suggested that the intervention could be made more appropriate for younger, single people, more motivating, and easier to use. Those who utilized the support element of the intervention were happy with their relationship with the non-specialist support person (e-helper), though some participants would have preferred specialist support. E-helpers would have liked more training on complex cases. Website analytics showed that many users dropped out before intervention start, and that some re-entered screening data having been excluded from the study. Conclusion: Step-by-Step skills and techniques, model of service integration, and its non-specialist support element are acceptable. Though the sample was small and non-controlled and drop-out was high, results suggest that it may be effective in reducing depression and anxiety symptoms and increasing well-being. Lessons learned will inform content revision, the development of an app version of Step-by-Step, and the research methodology of upcoming effectiveness studies.