Editorial: Public Health Nutrition in the Middle East

The Middle East is one region in desperate need for public health nutritionists and public health nutrition strategies to address the ever escalating burden of diet-related diseases. The Middle Eastern region has been witnessing a triple burden of disease, characterized by the simultaneous presence of undernutrition, micronutrient deficiencies, and overweight and obesity as a consequence of both emergency situations and nutrition transition that are placing different communities in the region at various nutrition-related health risks (1–6). In fact, recent sociodemographic changes resulting from the unstable political crisis in some countries have placed refugees, internally displaced individuals, and other socially and politically vulnerable populations at high risk of food and nutrition insecurity, as well as undernutrition and its comorbidities (1, 2). In parallel, populations of the region have been experiencing a rapid nutrition transition characterized by a shift away from a traditional, more seasonal, and more diverse diet, rich in whole grains, fruits, and vegetables, towards a " westernized " diet that is rich in refined carbohydrates, animal protein, total, saturated, and trans fats, sugar, and salt. In fact, data from the Food and Agriculture Organization food balance sheets and from food consumption surveys in the region have highlighted a shift towards an increasingly energy-dense diet and high intake of fat and sugar, coupled with a parallel decrease in complex carbohydrate consumption (7–13). Factors driving this transition include economic growth and increased incomes, globalization of trade and marketing, as well as rapid urbanization (5). These factors have further promoted lifestyle changes and encouraged sedentary behavior, particularly among adolescents (11–17 years) in the Eastern Mediterranean Region who showed the highest levels of insufficient physical activity (87.5%) in 2010 as compared to other regions (14). The aforementioned interrelated socioeconomic , behavioral, environmental, and dietary determinants may have contributed to a drastic increase in rates of chronic non-communicable diseases, such as obesity (5), diabetes (4), cardiovascular diseases (3), and cancer (6). While several countries of the region have obesity rates exceeding 30%, rates of undernutrition, particularly stunting, among under-five children in low-and middle-income countries remain high (15). To tackle the complex nature and multi-faceted aspect of malnutrition that is burdening the region, effective culturally sensitive nutrition programs and policies must be developed and implemented. Capacity building to draft and implement such policies is also crucial for success. This can be achieved through a solid practice and framework of public health nutrition to effectively address, …