Abstract

BackgroundLittle is known about sex-based dietary differences in middle-income countries, particularly those undergoing the nutrition transition. This study aims at examining sex disparities in energy and macronutrients’ intakes, food consumption patterns, and micronutrients’ adequacy in Lebanon, while adopting a life course approach.MethodsData were derived from a national cross-sectional survey conducted in Lebanon in 2008/2009. The study sample consisted of 3636 subjects: 956 children and adolescents aged 6–19.9 years; 2239 adults aged 20–59.9 years and 441 older adults aged above 60 years. At the households, trained nutritionists conducted face-to-face interviews with participants to complete a sociodemographic questionnaire and one 24-h diet recall. Food items were categorized into 25 food groups. The Nutritionist Pro software was used for the analysis of dietary intake data and the estimation of energy, macronutrients’, and micronutrients’ intakes.ResultsIn all age groups, males had significantly higher energy intakes, while females had significantly higher fiber intakes. In addition, in adolescents aged 12–19.9 years, females had higher fat intakes as compared to males (37.02 ± 0.6% vs 35.03 ± 0.61%), and in adults aged 20–59.9 years, females had significantly higher total fat (37.73 ± 0.33% vs 36.45 ± 0.38%) and saturated fat intakes (11.24 ± 0.15% vs 10.45 ± 0.18%). These differences in macronutrient intakes were not observed in younger children nor in older adults. Sex-based differences in food groups’ intakes were also observed: men and boys had significantly higher intakes of red and processed meat, bread, fast food, soft drinks, and alcohol, while girls and women had higher intakes of fruits, vegetables, milk, and sweets. In all age groups, females had lower micronutrient intakes compared to males, including calcium, iron, and zinc.ConclusionsThis study identified sex-specific priorities that ought to be tackled by context-specific interventions to promote healthier diets in Lebanon. The fact that sex-based differences in nutrient intakes and food consumption patterns were the most noticeable in the adolescent and adult years, hence women’s reproductive years call for concerted efforts to improve nutrition for women and girls as this would lay the foundation not only for their future education, productivity, and economic empowerment, but also for the health of future generations.

Highlights

  • Goal 5 of the United Nations’ Sustainable Development Goals (SDGs) aims to “achieve gender equality and empower all women and girls” around the world

  • The region is characterized by a double burden of malnutrition with strong female vs. male disparities: Women and girls in the Eastern Mediterranean Region (EMR) have a higher burden of micronutrient deficiencies while being approximately three times more prone to obesity compared to males [10,11,12]

  • Acknowledging the need for a better understanding of gender-based differences in dietary intakes, this study aims at examining sex-based disparities in energy and macronutrients’ intakes, food consumption patterns, and micronutrients’ adequacy in Lebanon, while adopting a life course approach

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Summary

Introduction

Goal 5 of the United Nations’ Sustainable Development Goals (SDGs) aims to “achieve gender equality and empower all women and girls” around the world. Women and girls continue to be twice as likely to suffer from all forms of malnutrition compared to their male counterparts, highlighting the need for a better understanding of sex disparities in food consumption and dietary intakes as a determinant of health [1]. In this manuscript, and based on the recommendations of the Institute of Medicine, the term “sex” is used as a biological classification determined by sex chromosomes, while the term gender is used when referring to behavioral, cultural, or psychological traits typically associated with one sex [2, 3]. This study aims at examining sex disparities in energy and macronutrients’ intakes, food consumption patterns, and micronutrients’ adequacy in Lebanon, while adopting a life course approach

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