Assessment of the Lebanese dietary pattern as a Mediterranean dietary pattern and its association with obesity and the metabolic syndrome -

Abstract

Purpose: To compare the traditional Lebanese dietary pattern with selected Mediterranean patterns derived from the literature, to assess the effect of the Lebanese and the Mediterranean patterns on obesity as well as the Metabolic Syndrome and to examine socio-demographic and lifestyle correlates of adherence to both the Mediterranean and the Lebanese patterns among Lebanese adults. Methods: A secondary data analysis was performed on a nationally representative cross-sectional survey of Lebanese adults. This survey consisted of a general questionnaire, a Food Frequency Questionnaire, anthropometric measurements and biochemical measurements. The Lebanese Dietary score was based on results of previous factor analyses conducted on the same dataset. The other Mediterranean scores were calculated based Mediterranean indexes described in the literature namely MSDPS, MS, MD, Med-DQI, rMED and MDS. Using Pearson’s correlation, agreement by percentage and weighted Kappa, the Lebanese Dietary score was compared to the scores of the published Mediterranean indexes. Bivariate and multivariate logistic regression analyses were used to identify the association between all the indexes, obesity and the metabolic syndrome. Logistic regression analysis was used to determine the correlates of adherence to the Lebanese and Mediterranean pattern scores. Results: There was a moderate agreement between the different Mediterranean patterns and the Lebanese pattern. Out of the six Mediterranean indexes chosen in the literature, the Mediterranean index most associated with the Lebanese pattern was the MD (r=0.539). The Lebanese dietary pattern was not found to be protective against obesity or the Metabolic Syndrome. Older age and higher educational levels were associated with increased adherence to all Mediterranean Diets studied. A healthier lifestyle characterized by high levels of physical activity, no smoking, higher frequency of breakfast consumption, and lower frequency of eating out was also associated with adherence to th