{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:13:26Z","timestamp":1788992006145,"version":"build-2803163510"},"reference-count":46,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T00:00:00Z","timestamp":1566259200000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The original study conduct was funded by the World Health Organization (WHO) - Lebanon. However, no funds were available for this secondary analysis.","award":["DCR-115020-526240."],"award-info":[{"award-number":["DCR-115020-526240."]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,7,11]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine associations of behavioural risk factors, namely cigarette smoking, physical activity, dietary intakes and alcohol consumption, with blood lipids profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and participants<\/jats:title>\n                    <jats:p>Data drawn from a cross-sectional study involving participants aged 18 years and over (n=363) from the nationwide WHO STEPwise Nutrition and Non-communicable Disease Risk Factor survey in Lebanon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Demographic characteristics, behaviours and medical history were obtained from participants by questionnaire. Dietary assessment was performed using a 61-item Culture-Specific Food Frequency Questionnaire that measured food intake over the past year. Lipid levels were measured by the analysis of fasting blood samples (serum total cholesterol (TC), triglycerides (TG), very low-density lipoprotein (VLDL), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Current cigarette smoking, alcohol consumption and low physical activity were prevalent among 33.3%, 39.7% and 41.6% of the sample, respectively. The contributions of fat and saturated fat to daily energy intake were high, estimated at 36.5% and 11.4%, respectively. Abnormal levels of TC, TG, VLDL, LDL-C and HDL-C were observed for 55.4%, 31.4%, 29.2%, 47.5% and 21.8% of participants, respectively. Adjusting for potential confounders, cigarette smoking was positively associated with higher odds of TG and VLDL (OR=4.27; 95% CI 1.69 to 10.77; and 3.26; 95% CI 1.33 to 8.03, respectively) with a significant dose\u2013response relationship (p value for trend=0.010 and 0.030, respectively). Alcohol drinking and high saturated fat intake (\u226510% energy intake) were associated with higher odds of LDL-C (OR=1.68; 95% CI 1.01 to 2.82 and OR= 1.73; 95% CI 1.02 to 2.93). Physical activity did not associate significantly with any blood lipid parameter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The demonstrated positive associations between smoking, alcohol drinking and high saturated fat intake with adverse lipoprotein levels lay further evidence for clinical practitioners, public health professionals and dietitians in the development of preventive strategies among subjects with a high risk of cardiovascular diseases in Lebanon and other neighbouring countries with similar epidemiological profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-026148","type":"journal-article","created":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T06:09:43Z","timestamp":1566367783000},"page":"e026148","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Prevalence and associations of behavioural risk factors with blood lipids profile in Lebanese adults: findings from WHO STEPwise NCD cross-sectional survey"],"prefix":"10.1136","volume":"9","author":[{"given":"Magali","family":"Mansour","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Tamim","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, Clinical Research Institute, American University of Beirut, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Nasreddine","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"El Khoury","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, Tufts University, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahla","family":"Hwalla","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Chaaya","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Farhat","sequence":"additional","affiliation":[{"name":"Department of Nursing and Health Sciences, Notre Dame University, Louaize, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abla M","family":"Sibai","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,20]]},"reference":[{"key":"2025121509590585000_9.8.e026148.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.052"},{"key":"2025121509590585000_9.8.e026148.2","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1159\/000321527","article-title":"Nutrition transition and cardiovascular disease risk factors in middle East and North Africa countries: reviewing the evidence","volume":"57","author":"Mehio Sibai","year":"2011","journal-title":"Annals of Nutrition and Metabolism"},{"key":"2025121509590585000_9.8.e026148.3","unstructured":"World Health Organization . 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