A traditional dietary pattern is associated with lower odds of overweight and obesity among preschool children in Lebanon: a cross-sectional study

Abstract

PurposeThe 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.MethodsA 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).ResultsTwo 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.ConclusionsThe “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.

Sex disparities in dietary intake across the lifespan: the case of Lebanon

“…Our results underline a higher intake of fruits, vegetables, and milk in females compared to men, while showing that men had a higher consumption of soft drinks, red meat, fast food, bread, and alcohol. These findings are in agreement with previous studies conducted in Lebanon showing that males were more likely to adhere to the Western dietary pattern, while females had higher adherence to the Traditional Lebanese dietary pattern, which has been described as a variant of the Mediterranean diet with fruits, vegetables, and dairy consumption being among its characteristic hallmarks [22,23,41,42]. Our findings are also in agreement with those reported from studies conducted in other parts of the world [6,9,43].…”

“…The study findings have also highlighted higher intakes of Westernized "modern" foods in males compared to females, including higher intakes of soft drinks, red and processed meat, and alcohol. Adherence to a Westernized diet has been associated with increased risk for obesity and several non-communicable diseases, thus highlighting the need for context-specific interventions aimed at promoting healthier dietary patterns in Lebanese boys and men [22,23,41,42].…”

Dietary Patterns and Childhood Obesity Risk: A Systematic Review

“…The studies were all cross-sectional studies, with the exception of one case-control study. 70 The studies were conducted in nine different countries and the majority of studies were from Asian countries (Iran, 70 China, 61,65,66,69,71 and Lebanon 64,67 ), with four from American countries (Mexico, 58 Brazil, 60,63 and Colombia 62 ), two from European countries (Norway 57,59 ), one from Australia, 19 and one from Polynesia (Samoan island of Upolu 68 ).…”

“…Mean age among the study participants ranged from 1 to 19 years. Six studies were with children aged between 1 and 6 years, 58,61,62,65,69,70 five studies with children aged between 5 and 18 years, 19,60,67,68,71 two studies with children aged between 9 and 13 years, 57,59 and three studies with adolescents in the age group between 11 and 19 years. 63,64,66 Seven studies included >1000 participants.…”

“…58,61,62,65,66,70,71 The total sample from the 16 selected studies included 44,793 children and adolescents. The total sample from Asian countries was n = 22,263, 61,[64][65][66][67][69][70][71] the American countries was n = 19,145, 58,60,62,63 the European countries was n = 1351, 57,59 Australia was n = 288, 19 and was n = 305 from the Samoan island of Upolu. 68 The most popular used methods for deriving dietary patterns are PCA, FA, and CA.…”