Helicobacter pylori Infection and Its Association with Mediterranean Diet Adherence in Lebanese Children and Adolescents: A Cross-sectional Study

Abstract
Background: Lebanon, a middle-income country in the Eastern Mediterranean, has been experiencing a socioeconomic and humanitarian crisis since at least 2019, which has severely impacted the population’s well-being. As a result, the country has faced unprecedented deprivation of basic survival needs including food, clean water, hygiene, and healthcare. Objectives: This cross-sectional study aimed to evaluate the association between adherence to the Mediterranean diet (MD) and Helicobacter pylori (H. pylori) infection among children and adolescents during the economic crisis. A total of 198 children and adolescents, visiting the pediatric gastroenterology departments of two hospitals in a suburban area of Northern Lebanon, were enrolled in this study. Methods: Data collection involved a structured questionnaire that included anthropometric measurements, sociodemographic and behavioral characteristics, and adherence to the MD. H. pylori infection was determined using the H. pylori CHECK stool antigen test. Multiple binary logistic regression was conducted to identify the association between H. pylori infection and patient characteristics, including adherence to the MD. Results: Helicobacter pylori was detected in 12.1% of the tested children and adolescents. Factors associated with H. pylori infection included washing fruits and vegetables before consumption, use of olive oil, and consumption of dairy products. Additionally, multiple binary logistic regression analysis indicated that children and adolescents who consumed olive oil or dairy products were more likely to have H. pylori infection. Conclusions: The consumption of olive oil and dairy products was associated with H. pylori infection. Further studies are required to confirm the effect of diet on H. pylori infection, with a detailed assessment of macronutrient and micronutrient intake.
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