Abstract
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 FFQ and 24-h 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/d, 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/d). 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, behavioural and policy-level interventions to enhance diet quality and affordability in crisis-affected populations.