Abla-Mehio Sibai

Folate deficiency is associated with nutritional anaemia in lebanese women of childbearing age

OBJECTIVE The objective of this study was to identify the determinants of anaemia in Lebanese women of childbearing age attending health centres in Lebanon. DESIGN Cross-sectional study carried out between May and December 2003. Anthropometric measurements as well as sociodemographic, health and dietary intake data were collected using a questionnaire. Haemoglobin (Hb), plasma ferritin, plasma folate and vitamin B12 were assessed using standard laboratory methods. SETTING Governmental health centres in Lebanon. SUBJECTS Four hundred and seventy non-pregnant Lebanese women aged 15-45 years. RESULTS Anaemia (Hb <12 g dl(-1)) and iron deficiency (ferritin <15 microg l(-1)) were prevalent in 16.0 and 27.2% of the study sample, respectively. Of the total sample, 7.7% had iron-deficiency anaemia. The percentage of women with either Hb or ferritin deficiency or both was 35.6%. Plasma folate and vitamin B12 deficiency was reported in 25.1 and 39.4%, respectively, and 12.6% of the women had both folate and vitamin B12 deficiencies. Of the anaemic group, 48.0% of the women had iron deficiency. The intake of iron was lower in iron-deficient than in non-deficient women and a positive relationship was shown between folate intake and its corresponding serum levels. Regression analysis showed that ferritin, plasma folate and family history of anaemia were significant determinants of the anaemia in the sample of women. CONCLUSIONS Anaemia not related to iron deficiency was partly explained by plasma folate deficiency. Measures to control folate and iron deficiency should be considered.

Dietary, lifestyle and socio-economic correlates of overweight, obesity and central adiposity in lebanese children and adolescents

The Eastern Mediterranean region is characterized by one of the highest burdens of paediatric obesity worldwide. This study aims at examining dietary, lifestyle, and socio-economic correlates of overweight, obesity, and abdominal adiposity amongst children and adolescents in Lebanon, a country of the Eastern Mediterranean basin. A nationally representative cross-sectional survey was conducted on 6–19-year-old subjects (n = 868). Socio-demographic, lifestyle, dietary, and anthropometric data (weight, height, waist circumference) were collected. Overweight and obesity were defined based on BMI z-scores. Elevated waist circumference (WC) and elevated waist to height ratio (WHtR) were used as indices of abdominal obesity. Of the study sample, 34.8% were overweight, 13.2% were obese, 14.0% had elevated WC, and 21.3% had elevated WHtR. Multivariate logistic regression analyses showed that male gender, maternal employment, residence in the capital Beirut, sedentarity, and higher consumption of fast food and sugar sweetened beverages were associated with increased risk of obesity, overweight, and abdominal adiposity, while regular breakfast consumption, higher intakes of milk/dairies and added fats/oils were amongst the factors associated with decreased risk. The study’s findings call for culture-specific intervention strategies for the promotion of physical activity, healthy lifestyle, and dietary practices amongst Lebanese children and adolescents.

Variations in nutritional status of elderly men and women according to place of residence.

Objective: The purpose of this study was to assess comprehensively the nutritional status of elderly individuals in institutions and to compare it with that of community based dwellers in an urban setting in Lebanon. Methods: Participants included 100 elderly men and women (aged 65 years and older) selected randomly from four institutions who were based on sex and neighborhood with 100 free-living individuals. Subjects were mentally and physically capable of responding to an interview schedule. Their nutritional status was assessed by anthropometric measurements, dietary food intake for a 3-day period, and hematological and biochemical variables. Energy and macro- and micronutrient intakes were compared with the US recommended dietary allowances (RDA) or dietary reference intakes (DRI) as appropriate. Results: Elderly living at home had significantly higher mean body mass index and waist circumference than those living in institutions. Although the total energy intake was comparable between the two groups, the elderly in the institutions consumed more fat and had lower intake of dietary fibers. Deficiencies (below 2/3rd RDA/DRI intakes) in zinc, magnesium, α-tocopherol, vitamins A and D, and pyridoxine were noted in both study groups with overall higher proportions observed among the institutionalized elderly. These were also anemic (42.5%) and had low levels of albumin (27.5%). In contrast, those living at home showed a higher prevalence of obesity and a lower calcium intake. Multivariate analysis controlling for a number of potential covariates did not change the results observed. Conclusions: The results of the present study showed a higher prevalence of obesity in those living at home and varying deficiencies by place of residence with no evidence that duration of institutionalization in itself being associated with poor nutritional status. Awareness of the risks associated with these deficiencies and excesses should address the lay and health professionals working in the community and institutions alike.

Validation of the Arabic version of the short Geriatric Depression Scale (GDS-15)

BACKGROUND This study aimed to examine the validity and reliability of an Arabic version of the 15-item Geriatric Depression Scale (GDS-15). METHODS 121 community-dwelling older adults and primary care patients aged 60 and above participated in this study. Older adults with dementia, those with thyroid dysfunction, and hearing or speech impairments were excluded. Test-retest reliability was examined by re-administering the translated GDS-15 to a subset of 38 participants at least seven days after the initial interview. RESULTS The Arabic GDS-15 had good psychometric properties, but the best properties were reported for the 7/8 cutoff. Cronbachs alpha as a measure of internal consistency reliability was high (0.88) and kappa ranged from 0.57 to 0.75. The performance of the GDS-15 was equally good for both community-dwelling older adults and those in primary care settings, and for both forms of the GDS (examiner administered vs. self-administered). CONCLUSION The Arabic GDS is a useful measure to assess depression among community-dwelling older adults and primary care patients who do not have dementia. Because of the use of formal Arabic, GDS-15 can be widely used with all Arabic-speaking people.

Trends in nutritional intakes and nutrition-related cardiovascular disease risk factors in Lebanon: the need for immediate action.

AIM To examine the burden of cardiovascular disease (CVD) risk factors and their association with dietary variables in the Lebanese population while reviewing secular trends in the populations nutritional intakes and nutrition-related CVD risk factors. METHODS Data on CVD risk factors and food consumption patterns in Lebanon were collected from scholarly papers, including individual studies and systematic review articles. Electronic databases were searched using combinations of key terms. RESULTS The prevalence of obesity in Lebanon followed an alarming increasing trend over time, paralleled by an escalation in the prevalence of hypertension, diabetes and hyperlipidemia. Food consumption surveys illustrate an increasing trend in energy intake and the proportion of energy derived from fat and animal products, with a concomitant decrease in carbohydrates and cereals intakes. CONCLUSION The shift towards an atherogenic diet coupled with the alarming increase in nutrition-related cardiovascular risk factors suggest that the Lebanese population is at an increased risk for CVDs. This should alert to the importance of formulating multicomponent intervention strategies at both the individual and population levels to halt the progression of nutrition-related diseases in the country, while highlighting the need for immediate public health efforts to promote the adoption of healthy dietary habits.

Dietary Patterns in Cardiovascular Diseases Prevention and Management : Review of the Evidence and Recommendations for Primary Care Physicians in Lebanon

The objective of this paper is to discuss the advantages of using the dietary pattern approach in evaluating the role of diet in cardiovascular diseases (CVD) prevention and management and to report on the association between major dietary patterns and CVD risk factors among Lebanese adults. The significance of this type of research to primary care physicians is also highlighted. The dietary pattern approach overcomes the inconsistent findings of single nutrient analysis in evaluating diet-disease associations, takes into consideration the synergistic effects of nutrients, and provides culture specific recommendations. Using data from the national Nutrition and Non-Communicable Disease Risk Factor Survey, we appraised the association of dietary patterns with CVD risk factors among Lebanese adults. Two major dietary patterns were identified: Western pattern, characterized by high intake of fast food sandwiches, desserts, and carbonated beverages and the traditional Lebanese pattern, characterized by high intakes of fruits and vegetables, olives and olive oil, and traditional dishes. Only the Western pattern was associated with increased risk of obesity (abdominal obesity), hyperglycemia and the metabolic syndrome. These findings demonstrated the valuable results that can be obtained using the dietary patterns approach in evaluating the association between diet and CVD risk factors and provided evidence that this approach can be used as a tool to push for desirable dietary changes in the country.