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Polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) are unintentionally produced, toxic environmental chemicals that persist for long years and bioaccumulate along the food chain, contaminating humans through diet. A particularly critical population subgroup is pregnant women given the adverse health effects on fetuses and newborns. Several anthropogenic sources of exposure to PCDD/Fs exist in Lebanon. Therefore, the aim of the present cross-sectional study is to measure the levels of PCDD/Fs in a sample of pregnant women in Lebanon and to explore potential associated factors. In this study, we measured serum concentrations of seven dioxins and ten furans, among 423 pregnant women recruited at delivery, using gas chromatography MS/MS. Among 269 participants, maternal sociodemographic information was collected including vicinity to landfills, incineration, pesticide use, industrial activity, and smoking. Anthropometric data were registered regarding pre-pregnancy body mass index (BMI), pre-pregnancy weight loss from restrictive diet, and gestational weight gain. Intake of major food groups generally related to PCDD/Fs was reported (fish, red meat, poultry, and dairy). Bivariate and multivariate analyses were performed to identify associations. PCDD/Fs were detected in 0 to 56.1% of the sample. Geometric mean concentrations were 75.5 (2.35) pg/g lipid and 2.25 (1.39) TEQ

Summary Background & aims This study aimed to evaluate the domain-specific physical activity (PA) levels and sitting time of a sample of university students and examine the association of PA with percent body fat. Methods Two hundred and twenty-one students were included in the analysis. We administered the long form of the International Physical Activity Questionnaire (IPAQ) twice within one-month interval. Total PA as well as occupational, transportation-, housework-, and leisure-related PA were assessed, in addition to sitting time. Dietary intake was derived from six non-consecutive 24-hour dietary recalls. Percent body fat (dependent variable) was analyzed using a bioelectrical impedance analyzer (BIA). Multivariate logistic regression, adjusted for potential confounders, examined the associations of domain-specific PA and sitting time with percent body fat. Results Men had higher levels of total and leisure PA than women. All participants had prolonged sitting time, with 48% having a sitting time of more than 10.15 hours/day. In multivariate analysis, moderate leisure PA, compared to vigorous PA was associated with a lower percent body fat. This association remained statistically significant even after adjustment for energy intake and sitting time. Housework-related PA was associated with a higher percent body fat. Conclusion Moderate leisure PA was highly associated with percent body fat even after adjustment for confounding variables. Adequate interventions targeting this kind of leisure should be promoted among universities students.

Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) remain a global concern in both developed and developing countries. Given that diet constitutes the major route of exposure to these pollutants, the objective of the current study is to investigate PCBs and OCPs serum levels in relation to dietary quality indices in a sample of Lebanese adults. Sociodemographic, nutritional, and anthropometric data were obtained from 302 participants in face-to-face interviews. Nutritional intakes from a previously validated quantitative 164-item food frequency questionnaire were used to calculate six a priori dietary indices: Healthy Eating Index (HEI-2015), alternate Healthy Eating Index (aHEI), Diet Quality Index-International (DQI-I), Mediterranean Diet Quality Index (Med-DQI), Med-DQIf, Mediterranean Diet Scale (MDS), and Mediterranean Diet Score (MedDietScore). Serum levels of six indicator PCBs (PCBs 28, 52, 101, 138, 153, 180) and four OCPs (HCB, β-HCH, DDT, and DDE) were investigated in relation to diet quality indices. Individuals with a higher adherence to the HEI-2015 and to the Mediterranean diet assessed by the Med-DQI/Med-DQIf displayed increased levels of OCPs (HCB, βHCH, DDT, and DDE). An inverted U-shaped association was observed between DQI-I and PCBs serum levels (PCBs 138, 153, 180, and ƩPCBs). This is the first study in the Middle East and North Africa region to investigate the association between POPs serum levels and a substantial number of a priori dietary indices. The impact of different food combinations and nutrient interactions on pollutants body burden and toxicity remains to be established in future studies.

In this study, the six indicator non-dioxin-like polychlorinated biphenyls NDL-PCBs (PCB28, PCB52, PCB101, PCB138, PCB153, PCB180), as well as four organochlorine pesticides (OCPs), hexachlorobenzene (HCB), β-hexachlorocyclohexane (β-HCH), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichlorethylene (DDE) were measured in 98 maternal and 49 cord sera samples of a group of Lebanese women who gave birth in three hospitals in Greater Beirut, between March and July 2018. Results showed that the levels of these persistent organic pollutants (POPs) in maternal serum were below critical limits as well as those in other countries (Tunisia, France, Portugal, Spain, Poland, Greenland, Canada, Brazil, and China). The ratios of cord serum concentrations to maternal serum concentrations of analyzed POPs were higher than 1. PCB maternal serum concentrations were found to be linked to illegal incineration (OR = 5.78; p = 0.004) as well as eggs (OR = 4.68; p = 0.027) and fruits and vegetables consumption (OR = 3.92; p = 0.016). OCP concentrations were linked to red meat and cold cuts intake (OR = 3.67–4.59; p = 0.001–0.004). While PCB levels were not correlated to newborns anthropometric measurements, OCP levels in cord serum were found to be positively linked to the birth length of newborns (p = 0.014–0.027).

Background The food frequency questionnaire (FFQ) is the most frequently used method to assess dietary intake in epidemiological studies evaluating diet-disease association. The objective of this study was to validate a FFQ for use among Lebanese adults by evaluating various facets of validity and reproducibility. Methods The quantitative 164-items FFQ was validated against the average of six 24-h dietary recalls (DRs) in a sample of 238 Lebanese adults. Reproducibility of the FFQ was assessed by administering it twice within 1 month’ time interval. Results Positive statistically significant Pearson correlations were observed in most macro and micronutrients between the FFQ and the six 24-h DRs, ranging from 0.16 to 0.65, with two thirds of the correlation coefficients exceeding 0.3. Energy, gender, and age-adjusted statistically significant Pearson correlation coefficients ranged from 0.14 to 0.64, with two thirds of the coefficients exceeding 0.2. Intakes from the FFQ were mostly higher than those of the 24-h DRs. Mean percent difference between nutrient intakes from both dietary methods decreased remarkably after using energy-adjusted mean intakes. Values were acceptable to good for all macronutrients and several micronutrients. Cross-classification analysis revealed that around 64.3 to 83.9% of participants were classified into the same and adjacent quartile whereas grossly misclassified proportions ranged from 3.7 to 12.2%. Weighted kappa values ranged from 0.02 to 0.36 with most of them exceeding 0.2. In indirect validity analysis, key nutrient mean intakes estimated from the six 24-h DRs were significantly positively associated with tertiles of food groups derived from the FFQ. Bland Altman plots showed that the majority of data points fell within the limits of agreement (LOA) for all nutrients. As for reproducibility analysis, ICC values were all statistically significant ranging from 0.645 to 0.959 and Bland Altman plots confirmed these results. Conclusions Based on various aspects of validity and reproducibility, and an extensive range of statistical tests, the present FFQ developed for a Lebanese community is an acceptable tool for dietary assessment and is useful for evaluating diet-disease associations in future studies.

Background The International Physical Actvity Questionnaire (IPAQ) is a validated tool for physical activity assessment used in many countries however no Arabic version of the long-form of this questionnaire exists to this date. Hence, the aim of this study was to cross-culturally adapt and validate an Arabic version of the long International Physical Activity Questionnaire (AIPAQ) equivalent to the French version (F-IPAQ) in a Lebanese population. Methods The guidelines for cross-cultural adaptation provided by the World Health Organization and the International Physical Activity Questionnaire committee were followed. One hundred fifty-nine students and staff members from Saint Joseph University of Beirut were randomly recruited to participate in the study. Items of the A-IPAQ were compared to those from the F-IPAQ for concurrent validity using Spearman’s correlation coefficient. Content validity of the questionnaire was assessed using factor analysis for the A-IPAQ’s items. The physical activity indicators derived from the A-IPAQ were compared with the body mass index (BMI) of the participants for construct validity. The instrument was also evaluated for internal consistency reliability using Cronbach’s alpha and Intraclass Correlation Coefficient (ICC). Finally, thirty-one participants were asked to complete the A-IPAQ on two occasions three weeks apart to examine its test–retest reliability. Bland-Altman analyses were performed to evaluate the extent of agreement between the two versions of the questionnaire and its repeated administrations. Results A high correlation was observed between answers of the F-IPAQ and those of the A-IPAQ, with Spearman’s correlation coefficients ranging from 0.91 to 1.00 (p

Organochlorine pesticides (OCPs) were banned by the Stockholm Convention many years ago; however, they are still detected in the environment due to their high persistence, their current illegal use, and their import from countries where they have not been banned. We evaluated the serum concentrations of selected OCPs (hexachlorobenzene (HCB), β-hexachlorocyclohexanes (β-HCH), p,p'-dichlorodiphenyltrichloroethane (DDT) and its metabolite p,p'-dichlorodiphenyldichloroethylene (DDE) in a sample of Lebanese adults using gas chromatography coupled to an ion trap mass spectrometer detector. The mean concentrations of HCB, β-HCH, DDT, and DDE were 7.1, 8.6, 2.1, and 18.9 ng/g of lipids, respectively, and the major contributor among the four OCPs was DDE. The OCP levels in the present study were in general lower than the values observed in several countries worldwide and their concentrations at the 95th percentile were lower than the biomonitoring equivalents (BEs) excluding any appreciable health risk. We observed an inverse association between HCB concentrations and body mass index (BMI) as well as HCB, β-HCH, and DDE levels, and smoking habits. Milk consumption however was positively associated with an increased serum level of β-HCH. This study, which was the first to investigate OCP serum levels in a Lebanese population, provides a baseline to which future measurements can be compared.

Exposure to persistent organic pollutants (POPs) in the general population is 90% from food intake. Dietary patterns provide a global estimation of exposure to POPs, taking into account multiple food sources of environmental contaminants.To evaluate the association of dietary, socio-demographic, anthropometric, and lifestyle-related variables with clusters of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs), in a sample of students and employees of Saint Joseph University of Beirut.A total of 302 participants were randomly recruited. Questionnaires covering dietary, socio-demographic, and lifestyle-related characteristics were administered. Anthropometric measurements were obtained. Serum concentrations of six indicator PCBs (PCB 28, 52, 101, 138, 153 and 180) and four OCPs, hexachlorobenzene (HCB), β-hexachlorocyclohexanes (β-HCH), p,p'-dichlorodiphenyltrichloroethane (DDT) and its metabolite p,p'-dichlorodiphenyldichloroethylene (DDE) were measured, and cluster analysis was applied. We evaluated the association of dietary intake with PCBs/OCPs exposure using two different approaches: food consumption categories and dietary patterns retrieved from principal component analysis (PCA).Three clusters of PCBs/OCPs were obtained: middle-level, high-level, and low-level. Practicing physical activity was associated with a three times higher risk of having high-level PCBs/OCPs, after adjustment for confounding variables (ORa = 2.97; CI = 1.23-7.19; p 0.05). The highest tertile of fish and shellfish consumption increased by three-folds the odds of having high-level PCBs/OCPs (ORa = 3.41; CI = 1.07-10.84; p 0.05). PCA revealed six dietary patterns. A "cereals, fats and oils, and eggs" dietary pattern was associated with 50% increase in the risk of having high-level PCBs/OCPs (ORa = 1.48; CI = 1.03-2.13; p 0.05).The present results offer a valuable contribution to the understanding of the factors increasing exposure to POPs, namely fish consumption and the "cereals, fats and oils, and eggs" dietary pattern. We also demonstrated that physical activity was positively associated with a higher risk of exposure to PCBs and OCPs, knowing that data on this matter are scarce.

The country of Lebanon banned organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in 1982 and 1997, respectively, and adopted the Stockholm Convention on persistent organic pollutants (POPs) in 2003. Compliance with the Stockholm Convention began immediately, and research related to POPs in Lebanon had already been completed. A National Implementation Plan for POPs was formulated and updated several times, and includes a national inventory of PCBs that were mainly detected in insulating oils and equipment in power stations. High levels of PCBs have also been detected in sediments from the Port of Tripoli, the second major sea port in Lebanon. High levels of OCPs, which are illegally smuggled into Lebanon and improperly handled and used by farmers, have been detected in underground and surface waters for many years. There have also been human biomonitoring studies of PCBs and OCPs; for example, in 1999, measurable amounts of DDE were found in breast milk, and a 2018 study reported measurable amounts of PCBs and OCPs in human serum. While these levels were well below concentrations observed in other countries, they were slightly higher than the levels observed by the National Health and Nutrition Examination Survey (NHANES). This review provides an overview of the available PCB and OCP data from Lebanon between 1999 and 2017. In total, 12 studies of PCBs and OCPs in environmental samples, human serum samples, and human milk samples are included in this review, and the results of these studies are compared in terms of geography and chronology.

Polychlorinated biphenyls (PCBs) are persistent organic pollutants that are still routinely detected 30 years after their restriction in many countries. PCBs have been associated with several non-communicable diseases. They are best measured via human biomonitoring (HBM). The concentrations of six indicator PCBs (PCBs 28, 52, 101, 138, 153, and 180) were measured in the serum samples of 316 Lebanese students and employees from Saint Joseph University of Beirut, Lebanon, using gas chromatography coupled to an iron trap mass spectrometer detector. PCBs were detected in 56.3 to 59.2% of the serum samples. The sum of PCB (∑PCBs) levels ranged from