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Dietary intakes, sources, and determinants of free sugars amongst Lebanese children and adolescents: findings from two national surveys

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Abstract

Purpose

To determine the intake levels, dietary sources, and determinants of free sugars (FS) consumption amongst Lebanese children and adolescents.

Methods

This study is based on data collected by two national cross-sectional surveys conducted on representative samples of Lebanese children: survey 1 (under-five years (U5) children) (n = 899) and survey 2 (5–18 years-old children) (n = 1133). Multi-component questionnaires were used for data collection. Dietary intakes were assessed using one 24 h dietary recall. Median daily intakes of FS, and percent contribution of various food groups to FS intake were compared between sex and age groups. Logistic regressions were conducted to explore the determinants of high FS intake (> 10% energy intake/d), as per the WHO recommendations.

Results

Median contribution of FS to daily energy intake was 8.5% in U5 children and 11.9% amongst those aged 5–18 years old. The top contributors to FS in both surveys were sugar-sweetened beverages and biscuits and chocolates. The proportion of children and adolescents exceeding WHO upper limits for FS was estimated at 43 and 62% in survey 1 and survey 2, respectively. Regression models showed females, higher household monthly incomes and higher parental educational levels were associated with significantly lower odds of exceeding the WHO upper limit for FS.

Conclusion

The study showed that a high proportion of Lebanese children and adolescents exceeded the WHO upper limit for FS intake, while also documenting a socioeconomic gradient in FS intake. Findings call for devising food system-based interventions to help reduce FS intake in this nutritionally vulnerable age group.

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Abbreviations

24-h:

24-H recalls

AOR:

Adjusted odds ratio

CI:

Confidence interval

EI:

Energy intake

ELNAHL:

Early Life Nutrition and Health

EMR:

Eastern Mediterranean Region

FS:

Free sugars

L-FANUS:

Lebanese Food and Nutrition Security Survey

OR:

Odds ratio

SE:

Standard error

SSBs:

Sugar sweetened beverages

U5:

Underfive

WHO:

World Health Organization

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Funding

This study was funded by the World Health Organization, Eastern Mediterranean Regional Office Special Grant for Research in Priority Areas of Public Health, 2016 – 2017. Original surveys used in the study were funded by the Lebanese National Council for Scientific Research (LNCSR) and the University Research Board at the American University of Beirut.

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Authors and Affiliations

  1. Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon

    Lamis Jomaa, Samer Hamamji, Samer Kharroubi, Marwa Diab-El-Harakeh, Fatima Al Zahraa Chokor & Lara Nasreddine

Authors
  1. Lamis Jomaa
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  2. Samer Hamamji
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  3. Samer Kharroubi
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  4. Marwa Diab-El-Harakeh
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  5. Fatima Al Zahraa Chokor
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  6. Lara Nasreddine
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Contributions

LN conceptualized the research question, drafted the manuscript, and contributed to the interpretation of the data. LJ critically reviewed the manuscript and contributed to the interpretation of the data. LN is the principal investigator on survey 1. LJ is the principal investigator on survey 2. MDH and FC conducted data analysis. SK assisted and supervised the statistical analyses. SH contributed to data analysis, in partial fulfillment of the requirements for MSc in Nutrition at the Department of Nutrition and Food Sciences at the American University of Beirut. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lara Nasreddine.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The study has been approved by the Institutional Review Board at the American University of Beirut and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Jomaa, L., Hamamji, S., Kharroubi, S. et al. Dietary intakes, sources, and determinants of free sugars amongst Lebanese children and adolescents: findings from two national surveys. Eur J Nutr 60, 2655–2669 (2021). https://doi.org/10.1007/s00394-020-02444-5

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  • DOI: https://doi.org/10.1007/s00394-020-02444-5

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