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- Dietary Patterns and their Association with Obesity and Sociodemographic Factors in a National Sample of Lebanese Adults.
- Abstract OBJECTIVE
- Public Schools Adolescents Obesity and Growth Curves in Lebanon.
- Abstract BACKGROUND
- Abstract PURPOSE
- Effect of Pretransplantation Body Mass Index on Allograft Function and Patient Survival after Renal Transplantation.
CONCLUSION: It is concluded from these results that obesity in the
absence of smoking, diabetes mellitus, hyperlipidaemia, renal or liver
disease causes lipid peroxidation and decreased activities of cytoprotective
enzymes, and should therefore receive the same attention as obesity with
Interna onal Nutri on, May/June 2011;46(3):138-145
Obesity, Metabolic Syndrome, and the Mediterranean
Diet in a Sample of Lebanese University Students
Yahia, Najat PhD, RD, LD, CWM; Hayek, George MD; Shahin, Sandra BS
Metabolic syndrome is a condition characterized by the clustering of central
obesity, hyperglycemia, hypertension, and dyslipidemia. Each abnormality
promotes atherosclerosis independently, but when clustered together,
these metabolic disorders are increasingly atherogenic and enhance the risk
of cardiovascular morbidity and mortality. The prevalence of metabolic
syndrome is on the rise, especially in young people, and its onset may be
early in life. Therefore, universities are unique settings for early monitoring
and intervention of metabolic risk factors. A pilot study was conducted
among 100 Lebanese university students (62 male students and 38 female
students) aged 18 to 27 years studying at Notre Dame University, Lebanon,
to assess the prevalence of obesity and metabolic syndrome and to
examine students' eating habits in relation to the consumption of the
Mediterranean diet. Parameters measured were weight, height, waist
circumference, percentage body fat, blood pressure, and fasting blood
glucose level. Metabolic syndrome was evaluated based on the third report
of the National Cholesterol Education Program Adult Treatment Panel.
Measurements of blood lipid levels, including triglyceride, total cholesterol,
high-density lipoprotein, and low-density lipoprotein, were made for half of
the students. Dietary intake was assessed by using a food frequency
ques onnaire tailored to Lebanese food. Study results indicated that 49%
of male students were overweight and 7% were obese compared with 21%
overweight and 3% obese female students. Only 4% of students, all men,
had the full metabolic syndrome components. However, many students had
1 or more elements of it. Overall, a total of 56% of the students exhibited 1
or more components of metabolic syndrome: 22% of students had 1
component, 30% had 2 components of the syndrome and 4% had 3
components of metabolic syndrome. In comparison to the traditional
Mediterranean Diet Pyramid, those students who had metabolic syndrome
had higher consumption of red meat and sweets and a lower consumption
This considerable prevalence of obesity and metabolic syndrome among
students is of concern and may warrant early screening for these disorders.
Students' eating habits showed deviation from the traditional
Mediterranean Diet Pyramid, so promotional campaigns focusing on the
traditional Mediterranean diet may be helpful and necessary
Public Health Nutr. 2011 May 4:1-9. [Epub ahead of print]
Dietary Patterns and their Association with Obesity and
Sociodemographic Factors in a National Sample of
Naja F, Nasreddine L, Itani L, Chamieh MC, Adra N, Sibai AM, Hwalla N.
1Department of Nutri on and Food Sciences, Faculty of Agricultural and
Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh,
Beirut 1107-2020, Lebanon.
assess their association with sociodemographic factors, BMI and waist
interview, participants completed a brief sociodemographic and
semiquantitative FFQ. In addition, anthropometric measurements were
obtained following standard techniques. Dietary patterns were identified by
factor analysis. Multivariate linear regression was used to assess
determinants of the various patterns and their association with BMI and
Survey (2009), Lebanon.
SUBJECTS: A na onally representa ve sample of 2048 Lebanese adults
aged 20-55 years.
RESULTS: Four dietary patterns were identified: 'Western', 'Traditional
Lebanese', 'Prudent' and 'Fish and alcohol'. Factor scores of the identified
patterns increased with age, except for the Western pattern in which a
negative association was noted. Women had higher scores for the prudent
pattern. Adults with higher levels of education had significantly higher
scores for the prudent pattern. The frequency of breakfast consumption
was significantly associated with scores of both traditional Lebanese and
prudent patterns. Multivariate-adjusted analysis revealed a positive
association between scores of the Western pattern and the BMI and WC of
patterns in the Lebanese population, which were associated with age, sex,
education and meal pattern. Only the Western pattern was associated with
J Med Liban. 2011 Apr-Jun;59(2):80-8.
Public Schools Adolescents' Obesity and Growth Curves in
Chacar HR, Salameh P.
Department of Clinical Paediatrics, Faculty of Medicine, University of
OBJECTIVE: Our objective was to draw growth curves and assess obesity
prevalence in adolescents of public schools, and to explore selected food
consumption frequency and physical activity.
schools. From the list of schools provided by the Ministry of Education, a
random sample of 20 schools was chosen, distributed in all Lebanese
regions. Participants were 2547 adolescents, aged between 11 to 18 years.
Anthropometric measures of height and weight were taken, growth curves
were drawn. Obesity and at risk of obesity prevalences were also
calculated. Selected food intake frequency, physical activity and sedentary
behavior were also analyzed.
RESULTS: Growth curves were drawn for boys and girls. Overall, 6.6% of
adolescents were obese, while 20.5% were at risk of obesity. There were
significant differences in obesity prevalence estimates between age groups
in girls : increased age was associated with higher obesity (3.8% in those <
or =13 years of age versus 10.6%in those > 17 y ; p = 0.02) ; this trend was
not found in boys (6.5% in those < or = 13 y and 7.2% in those > 17 y; p =
0.78). As expected, a significant increase in the risk of being overweight was
found with increased frequency of eating fried potatoes, chocolate and
eating out. In contrast, eating fruits and having physical activity were
associated with a lower risk of being overweight.
CONCLUSION: In Lebanese public schools, we found high rates of obesity
and associated behaviors. Preventing obesity should focus on promoting
healthy lifestyles for adolescents of low socioeconomic status.
Eastern Mediterranean Health Journal, March, 2011;17(3)
Pattern of Obesity and Associated Diabetes in Lebanese
Adolescents: A Pilot Study.
and B. Barbour
Faculty of Public Health, Lebanese University, Beirut, Lebanon
(Correspondence to: P. Salameh:firstname.lastname@example.org).
Obesity-associated diabetes in adolescents is increasing throughout the
world. In this study, body mass index and capillary blood glucose were
measured in a randomly selected sample of adolescents from 3 Lebanese
private schools. Obesity was evaluated according to International Obesity
Task Force cut-oﬀs. Out of 300 students, 18.7% were at risk of obesity and
3.0% were obese. Random glycaemia level was ≥ 140 mg/dL in 10.3% of
students. In those fas ng, 10.5% had glucose intolerance and 3.5% had
diabetes. Glucose levels were significantly higher in overweight versus
normal weight individuals: 86 (SD 13) versus 96 (SD 16) mg/dL. Among the
normal weight group 8.6% had abnormal glycaemia while among those who
were overweight 37.0% had abnormal glycaemia. Lebanese school students
have high rates of overweight and of obesity-associated diabetes and
Int J Obes (Lond). 2011 Feb;35(2):251-8. Epub 2010 Jul 6.
A Mediterranean Diet Pattern with Low Consumption of
Liquid Sweets and Refined Cereals is Negatively
Associated with Adiposity in Adults from Rural Lebanon.
Issa C, Darmon N, Salameh P, Maillot M, Batal M, Lairon D.
INRA, UMR 1260, Nutriments Lipidiques et Préven on des Maladies
Métaboliques, Marseille, France.
BACKGROUND: The beneficial impact of the traditional Mediterranean diet
pattern on adiposity is still under debate, and this has never been assessed
in a developing Mediterranean country.
traditional Mediterranean diet and adiposity indexes, that is, body mass
index (BMI) and waist circumference (WC), in a sample from rural Lebanon.
continental rural areas of Lebanon for a cross-sectional study. The
questionnaire included socio-demographic, anthropometric and dietary
sections. The daily consumption frequencies of selected food groups,
categorized as positive or negative components, were calculated based on a
food frequency questionnaire. Adherence to the Mediterranean diet was
assessed using six a priori scores; including the widely used Mediterranean
diet score (MDS). Associations between diet scores and BMI and WC were
tradi onal Mediterranean diet. A total of 17.0% of men and 33.7% women
were obese. The MDS was negatively associated (P<0.05) with WC, but not
BMI, in men and women. The constructed composite Mediterranean score
combining positive components of the diet (whole cereals, vegetables,
legumes and fruit, olive oil and fish) and negative components adapted to
this sample (refined cereals and pastries, and liquid sweets) was
consistently and negatively associated with both BMI and WC for men and
women in mul variate models. A 2-point increase in that score was
associated with a decrease in BMI of 0.51 and 0.78 kg m(-2) and a decrease
in WC of 2.77 and 4.76 cm in men and women, respec vely.
negatively associated with obesity and visceral adiposity in a rural
population of a developing Mediterranean country.
J Adolesc Health. 2010 Dec;47(6):591-5. Epub 2010 Jun 23.
Bone Mineral Content and Density in Obese, Overweight,
and Normal-Weighted Sedentary Adolescent Girls.
El Hage R, Moussa E, Jacob C.
Faculty of Art and Social Sciences, Division of Physical Education, University
of Balamand, El-Koura, Lebanon. email@example.com
PURPOSE: The aim of this study was to compare the whole body (WB)
bone mineral content (BMC) and bone mineral density (BMD) in obese,
overweight, and normal-weighted adolescent sedentary girls.
weighted adolescent (aged, 12-20) sedentary (prac cing less than 2 hours
of physical activity/week) girls. The three groups (obese, overweight, and
normal) were matched for age and maturation index (years since
menarche). BMC, bone mineral area (BMA), BMD, and body composition
were assessed by dual-energy X-ray asborptiometry. Bone mineral apparent
density (BMAD) was calculated for the WB.
weighted girls (p < .05 and p < .001, respec vely). Overweight girls had
higher BMC values than normal-weighted girls (p < .05). BMD values were
not different among the three groups. However, obese and overweight girls
had lower BMAD and higher BMC/height values in comparison with normal-
weighted girls (p < .05). Finally, after adjustment for lean mass, BMC, BMA,
BMD, and BMAD were not different among the three groups.
with higher BMC, BMC/height, and lower BMAD of the WB. This study
suggests that BMD, BMC, BMA, and BMAD of the WB are not significantly
different among the three groups (obese, overweight, and normal) after
adjustment for lean mass. Therefore, our results suggest that the skeleton
of the overweight and the obese girls adapts to the increased lean mass.
Ann Nutr Metab. 2010;57(2):135-42. Epub 2010 Nov 9.
Metabolic Syndrome and Insulin Resistance in Obese
Prepubertal Children in Lebanon: A Primary Health
Nasreddine L, Ouaijan K, Mansour M, Adra N, Sinno D, Hwalla N.
Department of Nutrition and Food Science, Faculty of Agriculture and Food
Sciences, American University of Beirut, Riad El Solh, Beirut, Lebanon.
BACKGROUND: Ethnic-based associations between obesity and the
metabolic syndrome (MS) have been suggested. The prevalence of MS in
obese children was found to range between 13.9 and 48.8%, depending on
the country of origin. This study was conducted to investigate the
relationship between obesity and various components of MS in prepubertal
children in Lebanon.
METHODS: Eighty-seven obese children (Tanner stage 1), 25 overweight
and 28 normal-weight controls were recruited from private and public
schools. Anthropometric, biochemical and blood pressure measurements
RESULTS: According to the modified Adult Treatment Panel III definition,
the MS was iden ﬁed in 26.4 and 4% of obese and overweight children,
respectively, with a higher prevalence among girls than boys. The most
common abnormalities among subjects with MS were elevated waist
circumference (WC) (100.0%), high triglyceride (91.7%) and low high-
density lipoprotein cholesterol (66.7%) levels. Insulin resistance was
iden ﬁed in 70% of obese children and 75% of those having the MS. Body
mass index, WC and homeostasis model assessment of insulin resistance
were significant determinants of the MS in this age group.
underscoring the importance of early screening of obesity and its
associated metabolic abnormalities and of developing successful
multicomponent interventions addressing pediatric obesity and MS.
Pediatr Int. 2010 Aug;52(4):573-8. doi: 10.1111/j.1442-200X.2009.03021.x.
Activity, Inactivity and Quality Of Life among Lebanese
Fazah A, Jacob C, Moussa E, El-Hage R, Youssef H, Delamarche P.
Laboratory of Physiology and Biomechanics of Motor Performance, Division
of Physical Education, University of Balamand, Tripoli, Lebanon.
overweight and obesity prevalence rates for Lebanese adolescents, and to
examine differences in physical activity, screen time (sum of time spent in
front of TV, computer, and videogames), and health-related quality of life
(HRQOL) for the first time among normal, overweight, and obese
METHODS: One thousand Lebanese adolescents (14-18 years old) from
nine schools participated in the study. Height, weight, physical activity,
screen time, and HRQOL variables were assessed using validated self-report
RESULTS: A total of 7.8% of boys and 1.75% of girls were obese, and 22.5%
of boys and 12.47% of girls were overweight. Normal-weight boys reported
higher physical activity scores at health clubs than obese boys. Normal-
weight girls reported higher leisure time and total physical activity scores
than obese girls. In the normal-weight group, boys reported higher total
screen time than girls. Normal-weight boys reported higher physical
functioning scores than their obese peers. Normal-weight girls reported
higher physical functioning and average HRQOL scores than obese girls.
Normal-weight and overweight boys reported higher average HRQOL scores
CONCLUSION: The present study is the first to provide data on physical
activity, screen time, and HRQOL among Lebanese adolescents. Despite the
need for further research, all those concerned with the pediatric population
are urged to develop and implement effective strategies to increase
physical activity and improve HRQOL among adolescents based on the
J Med Liban. 2010 Apr-Jun;58(2):97-100.
Body Mass Index and Body Fat in Lebanese Female
Fazah A, Jacob C, El-Hage R, Delamarche P, Moussa E.
Laboratory of Physiology and Biomechanics of Motor Performance, Division
of Physical Education, University of Balamand, Tripoli, Lebanon.
body mass index (BMI) and body fat (BF) among Lebanese female
study. BMI was calculated as weight/height. Adiposity was measured by
dual energy X-ray absorptiometry (DEXA).
Correla on coeﬃcient of fat mass (BF) with BMI is 0.93. The two linear
regression formulas are: %BF = 6.89 + (1.1 *BMI) and BF = - 0.425 + (129
CONCLUSION: Correlations of BMI with DEXA measurements were higher
with BF than %BF. For a given BMI, Lebanese girls have a higher than
expected %BF. Based on the current findings, there may be a need to
develop new cutoff points. From a public health perspective, this may
considerably increase the prevalence of obesity among Lebanese female
Transplant Proc. 2010 Apr;42(3):785-8.
Effect of Pretransplantation Body Mass Index on Allograft
Function and Patient Survival after Renal Transplantation.
Abou-Jaoude MM, Nawfal N, Najm R, Honeidi M, Shaheen J, Almawi WY.
Department of Surgery, Sacre'-Coeur Hospital, Baabda-Hazmieh, Lebanon.
We evaluated the effects of pretransplantation recipient body mass index
(BMI) on allograft survival and on kidney function. Kidney transplant
recipients were grouped according to their pretransplantation BMIs: Group
I (BMI<18.5 kg/m2; n=10); Group II (BMI 18.5-24.9 kg/m2; n=62); Group III
(BMI 25.0-29.9 kg/m2; n=47); and Group IV (BMI>30.0 kg/m2; n=16).
Excellent 1-year patient and graft survival rates were observed in all groups.
Increased BMI was associated with increased hypertension and longer
hospital stays. The incidence of acute rejection episodes, slow graft
function, and delayed graft function, as well as the need for antithymocyte
globulin Fresenius (ATG-F) rescue therapy were comparable between the 4
pa ent groups. The 1-year glomerular filtration rate was markedly different
between the 4 pa ent groups. The 1-year posttransplantation glucose level
was higher among obese patients compared with the other groups. A
mul variate regression analysis conﬁrmed the associa on of a higher 1-
year GFR with obesity (BMI>30.0 kg/m2). Overweight and obese recipients
showed excellent long-term patient and graft survival rates. Accordingly,
denying patients renal transplantation because of obesity may not be
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