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Population survey

Lebanon: overweight steady, obesity rising

Beirut, capital of Lebanon. Increased urbanisation, changing lifestyles, and westernised diets are being blamed for rising obesity. Photo: Flickr/ M. Khatib
Overweight levels remain steady in Lebanon, but obesity levels rise quickly over 12 years
Changing lifestyles and diets suggested as causes for trend
New study is first survey of weight trends in country

A new survey of adult and paediatric obesity trends in Lebanon has revealed that while levels of overweight have remained steady over the last 12 years, levels of obesity have risen dramatically.

The study, “Trends in overweight and obesity in Lebanon: evidence from two national cross-sectional surveys (1997 and 2009)”, by Abla-Mehio Sibai, Nahla Hwalla, et al, of the American University of Beirut, compared results from two national cross-sectional surveys carried out in 1997 and 2009. It is the first study to investigate obesity trends in the middle eastern country.

The rate of overweight rose from 20.0% to 21.2% in the 6-19 year old population and dropped from 37.0% to 36.8% in the adult population between 1997 and 2009. However, the prevalence of obesity in the same period rose from 7.3% to 10.9% in juveniles and 17.4% to 28.2% for adults.

The rise in obesity rates was partially blamed on changing lifestyles, particularly the rise of sedentary behaviour - defined as 10 or more hours of sitting time per day - in the child and adolescent population, which has increased from 19.9% in 1997 to 60.5% in 2009. Paternal education - a factor modulating obesity risk in childhood - is also cited as a potential cause; the study showed that the percentage of fathers who had completed university education had dropped from 25.7% in 1997 to 16.3% in 2009.

The authors added that the average Lebanese diet has changed significantly in recent decades, leading to a rise in average energy intake of 850 kcal per person per day between 1970 and 2005.

The obesity prevalence among Lebanese adults, of 27.4% for men and 28.8% for women, places the country above countries in western and northern Europe, but below neighbours like Saudi Arabia, which has an adult obesity rate of 43.8%, Kuwait at 39.8%, and Syria at 38.2%.

For all Lebanese adults, the increase of mean BMI over the 12-year study period was 1.36 kg/m2 in women and 1.84 kg/m2 in men, exceeding the worldwide average of 0.5 kg/m2 for women and 0.4 kg/m2 for men.

Methodology

Both the 1997 and 2009 surveys were undertaken by the author, and were based on sampling frames provided by nationally representative household-based surveys conducted by the country’s Ministry of Social Affairs, targeting a sample with an age, sex and district distribution proportionate to the Lebanese population. A total of 2,004 subjects were interviewed in 1997, and 3,636 in 2009.

Subjects were interviewed using a multicomponent questionnaire to gather information on their demographic, socioeconomic and lifestyle characteristics, and their height and weight were measured. Overweight in adults was defined as a BMI of 25.0-29.9, and obesity was defined as a BMI over 30; in children, overweight and obesity were defined based on sex and age-specific +1 and +2 BMI z-scores respectively, based on WHO standards.

Based on their results, the authors recommended population-wide community-based obesity intervention programmes, responsive to the sociocultural norms of the region.

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