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Accepted manuscript

The Cost of a Healthy Diet and Its Association with BMI in Crisis-Stricken Lebanon

Published online by Cambridge University Press:  19 February 2026

Maha Hoteit*
Affiliation:
PHENOL Research Group (Public Health Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon Institut National de Santé Publique, d’Epidémiologie Clinique, et de Toxicologie (INSPECT-LB), Beirut, Lebanon Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia P.O. Box 24005, Cyprus
Myriam Abboud
Affiliation:
College of Natural and Health Sciences, Zayed University, Dubai 19282, United Arab Emirates; myriam.abboud@zu.ac.ae
Maroun Khattar
Affiliation:
PHENOL Research Group (Public Health Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
Rana Rizk*
Affiliation:
Department of Nutrition and Food Science, Lebanese American University, Byblos P.O. Box 36, Lebanon; rana.rizk01@lau.edu.lb
*
*Corresponding authors: Rana Rizk, Email: rana.rizk01@lau.edu.lb and Maha Hoteit, Email: m.hoteit@ul.edu.lb
*Corresponding authors: Rana Rizk, Email: rana.rizk01@lau.edu.lb and Maha Hoteit, Email: m.hoteit@ul.edu.lb
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Abstract

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Objectives:

This study aimed to determine the prevalence of Lebanese adults living with underweight, overweight, or obesity, assess and compare the cost of the Mediterranean Diet (MD) with that of the current dietary consumption pattern, and explore diet cost as a determinant of living with underweight, overweight, or obesity.

Design:

Data for this nationally-representative cross-sectional study were collected through sociodemographic questionnaires, anthropometric measurements, the Arab Family Food Security Scale, and dietary assessments using a validated food frequency questionnaire and 24-hour recalls. Diet costs were calculated based on 2023 market prices using purchasing power parity. Logistic regression was used to assess associations with BMI.

Setting:

Lebanon, using data representative of the Lebanese adults’ population

Participants:

444 Lebanese residents aged 18-64 years.

Results:

Overall, 66.2% of the participants were living with underweight (4.3%), overweight (37.8%), or obesity (24.1%). On average, the cost of following MD ranged from Intl.$ 23.36 to Intl.$ 26.49/person/day, whereas, a Lebanese adult spent Intl.$ 20.46 on consumption. Only 31.1% of participants spent an amount equal to or greater than the minimum MD cost (Intl. $23.36/day). Participants who meet or exceed this threshold were 1.59 times more likely to be living with a healthy weight (aOR=1.59, p=0.043).

Conclusions:

The high prevalence of Lebanese adults living with underweight, overweight, or obesity is compounded by the unaffordability of a healthy MD. Improving the affordability of nutritious foods is crucial to promoting healthier dietary patterns and achieving better weight outcomes. Public health strategies should include economic, behavioral, and policy-level interventions to enhance diet quality and affordability in crisis-affected populations.

Information

Type
Research Paper
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society