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Dietary patterns and odds of Type 2 diabetes in Beirut, Lebanon: a case–control study

Farah Naja13, Nahla Hwalla13, Leila Itani1, Maya Salem1, Sami T Azar2, Maya Nabhani Zeidan1 and Lara Nasreddine13*

Author Affiliations

1 Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, P. O. Box 11–0236, Riad El-Solh, Beirut, 1107-2020, Lebanon

2 Department of Internal Medicine, American University of Beirut, P.O.Box 11–0236, Riad El-Solh, Beirut, 1107-2020, Lebanon

3 Members of the Public Health and Nutrition (PHAN) Research Group at the American University of Beirut, P.O.Box 11–0236, Riad El-Solh, Beirut, 1107-2020, Lebanon

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Nutrition & Metabolism 2012, 9:111  doi:10.1186/1743-7075-9-111

Published: 27 December 2012



In Lebanon, Type 2 diabetes (T2D) has a major public health impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities. Diet is an important environmental factor in the development and prevention of T2D. Dietary patterns may exert greater effects on health than individual foods, nutrients, or food groups. The objective of this study is to examine the association between dietary patterns and the odds of T2D among Lebanese adults.


Fifty-eight recently diagnosed cases of T2D and 116 population-based age, sex, and place of residence matched control participants were interviewed. Data collection included a standard socio-demographic and lifestyle questionnaire. Dietary intake was evaluated by a semi-quantitative 97-item food frequency questionnaire. Anthropometric measurements including weight, height, waist circumference, and percent body fat were also obtained. Dietary patterns were identified by factor analysis. Multivariate logistic regression analysis was used to evaluate the associations of extracted patterns with T2D. Pearson correlations between these patterns and obesity markers, energy, and nutrient intakes were also examined.


Four dietary patterns were identified: Refined Grains & Desserts, Traditional Lebanese, Fast Food and Meat & Alcohol. While scores of the “Refined Grains & Desserts” had the highest correlations with energy (r = 0.74) and carbohydrates (r = 0.22), those of the “Fast Food” had the highest correlation with fat intake (r = 0.34). After adjustment for socio-demographic and lifestyle characteristics, scores of the Refined Grains & Desserts and Fast Food patterns were associated with higher odds of T2D (OR: 3.85, CI: 1.13-11.23 and OR: 2.80, CI: 1.14-5.59; respectively) and scores of the Traditional Lebanese pattern were inversely associated with the odds of T2D (OR: 0.46, CI: 0.22-0.97).


The findings of this study demonstrate direct associations of the Refined Grains & Desserts and Fast Food patterns with T2D and an inverse association between the Traditional Lebanese pattern and the disease among Lebanese adults. These results may guide the development of nutrition interventions for the prevention and management of T2D among Lebanese adults.

Dietary patterns; Lebanon; Type 2 diabetes