title: Diet, physical activity and socio-economic disparities of obesity in Lebanese adults: findings from a national study.
abstract: BACKGROUND
  The prevalence of obesity within countries varies by gender, age, lifestyle and socioeconomic factors. Identification of behavioural factors that are associated with obesity within the country's context is critical for the development of effective public health programs which aim to prevent and manage obesity. The objective of this study was to assess age and gender differentials in the prevalence of obesity in Lebanon and examine correlates of obesity with a focus on socioeconomic disparities.
  
  
  METHODS
  Following the WHO STEPwise guidelines, a national survey was conducted in Lebanon in 2008-2009. Households were selected randomly from all Governorates based on stratified cluster sampling method. One adult aged 20 years and over was randomly selected from each household for the interview. Anthropometric measurements and 24 hour recall dietary intake were obtained. The final sample included 1244 men and 1453 women. Descriptive statistics were computed for BMI, waist circumference, and percent body fat. Multivariate logistic regression analysis was carried out to assess the relationship between energy intake and obesity adjusted for relevant co-variables.
  
  
  RESULTS
  The prevalence of obesity among Lebanese adults was 26.1%. Gender differences in obesity estimates were observed across age groups and the three obesity classes, with men showing higher prevalence rates at the younger age groups (20-49 years), and women showing higher prevalence rates in older age groups (50 years and above). Obesity showed significant associations with socio-economic status in women; it decreased with higher educational attainment (OR = 0.54, 95% CI: 0.32, 0.91), greater household assets (OR = 0.26; 95% CI: 0.10, 0.72) and lower crowding index (OR = 0.62; 95% CI: 0.39, 0.98), net of the effect of other co-variates. There was a significant positive association between obesity and energy intake in both genders, and a negative association between obesity and physical activity, significantly among women.
  
  
  CONCLUSIONS
  Lifestyle and socioeconomic determinants of obesity are identified in this Lebanese population. Policy makers and service providers need to tailor public health strategies to tackle obesity accordingly.
authors.affiliation: Department of Nutrition, Faculty of Agriculture and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107-2020, Lebanon. mc31@aub.edu.lb.
authors.forename: Marie Claire
authors.initials: MC
authors.lastname: Chamieh
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK. helen.moore@durham.ac.uk.
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Moore
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK. carolyn.summerbell@durham.ac.uk.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Summerbell
authors.affiliation: Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. htamim@aub.edu.lb.
authors.forename: Hani
authors.initials: H
authors.lastname: Tamim
authors.affiliation: Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107-2020, Lebanon. am00@aub.edu.lb.
authors.forename: Abla Mehio
authors.initials: AM
authors.lastname: Sibai
authors.affiliation: Department of Nutrition, Faculty of Agriculture and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107-2020, Lebanon. nahla@aub.edu.lb.
authors.forename: Nahla
authors.initials: N
authors.lastname: Hwalla
mesh_terms: D000328:Adult; D000886:Anthropometry; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise; D005260:Female; D006306:Health Surveys; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012923:Social Class; D055815:Young Adult