Consumption Pattern of Dietary Fat in the Egyptian Population: A Comprehensive Analysis

ith their substantial effects on populations and healthcare systems, non-commutable diseases have emerged as illnesses of public health concern. Approximately 71% of deaths worldwide occur each year. Eighty percent of, non-commutable diseases NCD mortality occurs in low-and middle-income nations, making this mostly invisible disease more problematic there. The primary goal of this work is to ascertain the consumption pattern of fat, fat subtypes, and trans-fat. Methodology : The research plan Studies using descriptive cross-section surveys Egyptian population samples are drawn from Egypt's main regions, The mother from each family will be interviewed for quantitative and qualitative data on food consumption. Findings Remark Energy consumption per capita was 2202 kcal/day on average. Protein made up 13 % of the total energy, fat made up 25%, and carbs made up 62.0%. Free sugar made up 12% of the total energy obtained from the meal that was ingested. The Egyptians' dietary energy pattern fell within the WHO's recommended range, the amount of dietary energy obtained from trans-fat content in food consumed was 0.6% of total energy, or less than 1%. Intake of fat overall was sufficient, but intake of saturated fat was nearly beyond the recommended upper limit. Hydrogenated oils, processed meat, chicken, baked goods, biscuits, fast food, chips


INTRODUCTION
Non-communicable diseases (NCDs) represent a significant public health challenge globally, surpassing infectious diseases in mortality rates, with approximately 71% of deaths attributed to NCDs annually (WHO, 2022).This burden is particularly pronounced in low-and middleincome countries, where 80% of NCD-related deaths occur, highlighting the disproportionate impact on these populations (Loyd-Sherlock, 2017).Central to discussions on NCD prevention are dietary factors, including the consumption of fats, which play a crucial role in human nutrition by providing energy and aiding in the absorption of essential vitamins (U.S.Department of Agriculture, 2022).
Recent research underscores the distinction between beneficial unsaturated fats and harmful saturated and trans fats, emphasizing the critical importance of dietary fat quality over total fat reduction (Mozaffarian et al., 2010).Understanding global and regional trends in fat consumption is essential, given the profound health implications associated with dietary shifts occurring worldwide (Kearney, 2010).Rapid urbanization, globalization of food markets, and policy changes such as trade liberalization have accelerated these dietary transitions, contributing to rising rates of obesity and chronic diseases like cardiovascular disorders and cancer (Satterthwaite, et al., 2010).Like many developing nations, Egypt is experiencing significant changes in dietary habits characterized by increased calorie-dense food consumption alongside challenges such as fluctuating food prices and limited access to diverse, nutrientrich foods (Hassan, 2005).These shifts have profound implications for public health, necessitating a comprehensive understanding of fat consumption patterns and their health implications within the Egyptian context (Ibrahim, 2002; WHO, 2005).
Globally, national dietary patterns exhibit considerable variability, with saturated fat intake ranging from 2.3% to 27% of total energy intake across different countries (Mica, 2014).Recomm- Given the scarcity of recent data on fat consumption among Egyptians, there is a critical need for updated research to establish baseline information on dietary intakes, total fat consumption, and fat subtypes among the Egyptian population.Such insights are essential for informing targeted interventions and policy measures aimed at promoting healthier dietary behaviors and reducing the burden of NCDs in Egypt and similar contexts worldwide (Hassan, 2005; Mendos, 2004).
This study aims to address these knowledge gaps by examining current fat consumption patterns in Egypt and utilizing nationally representative data to elucidate trends, disparities, and potential health implications.By doing so, this research seeks to contribute to evidence-based strategies that enhance nutritional outcomes and support public health initiatives tailored to the needs of the Egyptian population.

Aim of the work:
Studying the consumption patterns of dietary fat in the Egyptian population is crucial for understanding the nation's nutritional habits, health outcomes, and potential areas for intervention.Overall, this comprehensive analysis aims to provide insights into the current consumption pattern of dietary fat in the Egyptian population and inform strategies to improve dietary habits and promote public health."

The hypothesis:
Cultural Dietary Practices: Traditional Egyptian cuisine often includes deep-fried dishes and sweets made with rich, saturated fats like ghee and palm oil.These cultural preferences may contribute to a high consumption of saturated fats.

METHODOLOGY:
The study design descriptive cross-section survey study

Subjects and Setting:
The study focused on the Egyptian population, with samples drawn from key geographic regions including Urban, Lower Egypt, Upper Egypt, and Border areas.The primary unit of analysis was the mother, typically the head of the household.The investigation centered on gathering dietary histories and quantitative and qualitative data from individuals aged 18 to 50 years.
A multi-stage sampling methodology was employed for this study.Initially, Egypt was stratified into four main geographic regions: Urban, Alex; Lower Egypt (including Sharkia, Bheira, and Kalubia), Upper Egypt (comprising Souhag and Quina), and Border areas (specifically Matrouh).Provinces were then randomly selected from each region.The subsequent stage involved cluster sampling of households within designated

Exclusion criteria:
Household members with specific chronic diseases (chronic renal diseases, chronic liver diseases.,Diabetes) as people with specific chronic diseases has different dietary recommendations than healthy people that cannot generalized to others.

Dietary assessments: Qualitative dietary assessment:
Food frequency for all the foods commonly used in Egypt.The questionnaire will include several intakes from each food item daily, weekly, monthly, and per year and the mean intake of each item per once was calculated.Special emphasis on food sources of different fat sources (saturated (red meat, butter, chicken, full cream milk) detailed intake of unsaturated fat Monounsaturated fat (olive oil, olive walnut, fatty fish) polyunsaturated fat (tuna, nuts, vegetable oils (sesame transfat industry (processed sources (processed meat, bakeries, processed chicken, chips.Processed cheese, plant cheese.hydrogenated oils.bakeries.creamer.Mayonnaise).

Statistical Analysis:
The SPSS version 20 program will be used to analyze the data.Data will be expressed in numbers and percentages, and the parentage of co-morbidity, and the mortality rate can be measured, for qualitative nonparametric variables the median percentiles will be used while in quantitative parametric data, the mean ± standard deviation (SD) will be used.The Chi-square test also will be used for qualitative variables to determine the p-values and confidence interval (CI), T-test, ANOVA, and the Pearson correlation test will also be used.Significant statistical correlations between different variables will be detected by using the Chisquare test.The statistical significance correlation is reached if the P-value is less than 0.05.

Ethical considerations:
The approval of the research ethics committee of the Ministry of Health and Population and (IN000116)

RESULTS:
A concentrated population in urban centers relative to other places is indicated by Table 1 population concentration of the country in rural and urban areas.
The prevalence of BMI categories among participating moms in various demographic areas of Egypt is presented in Table 3.It highlights important issues around obesity and overweight in both urban and rural areas, with consequences for public health initiatives and policies targeted at improving the health and well-being of mothers.Underweight moms are found in both urban and rural regions, with slightly higher percentages in rural areas (40).The majority of mothers (329) who are normal-weight reside in both urban and rural areas, indicating a wellbalanced distribution of this group across demographic categories.The prevalence of overweight mothers is high in Egypt's rural and urban areas, suggesting that this is a national problem.Mothers are significantly more likely to be obese in rural than in metropolitan areas, with the prevalence being higher in the latter.With 2153 moms taking part, there is a sizable sample size in both urban and rural locations, giving a thorough picture of the distribution of BMI among mothers in Egypt.
The standard error of the mean, which shows the accuracy of the estimations, and typical values are included in this descriptive overview of nutrient consumption per capita in homes.By showing the range of consumption levels across various percentiles of the population examined in Table 4, these percentiles shed light on the distribution of nutrient intake.Additionally, data demonstrates that the average daily consumption of energy and macronutrients in households was (2202.8+21.9)kcal, the average daily intake of COH was 341.1+3.9 g, and the mean daily intake of protein was 72.0 g + 0.847 g.A mean daily amount of 61.2 + 0.97 g of fat and 7.7 ± 0.14 g of fiber were consumed.
Table 5: These data offer a thorough understanding of the amount of fat and its subtypes consumed per person in homes, including information on average values and variations across intake percentiles.Each person consumes 61.2 ±0.97g of total fat on average each day.The consumption distribution over percentiles reveals that it is 34.56 g at the 25th percentile, 51.04 g at the median (50th percentile), and up to 78.03 g at the 75th percentile.Daily intake of SFA is 20.02 ± 0.32 g on average.SFA consumption ranged from 9.88 g (25th percentile) to 26.12 g (75th percentile) at various percentiles.The range of MUFA intake is from 18.0±9.93g (25th percentile) to 23.83 g (75th percentile) per day.The average daily consumption of PUFA is 21.6 ±0.51 grams.From 9.64 grams (the 25th percentile) to 26.86 grams (the 75th percentile), consumption ranges.The daily intake of UNSFA ranges from 20.07 grams (25th percentile) to 48.88 grams (75th percentile), with an average of 39.0±0.78 g.The recommended daily consumption of trans fat is 1.6 grams, with a standard error of 0.02 grams.The 25th percentile of consumption is 0.16 grams, and the 75th percentile is 1.11 grams.

Table (6)
Descriptive of the mean of the per capita consumption of macronutrients in different demographic areas of Egypt.There was a statistical difference in the energy intake in 4 demographic areas The highest energy intake was in upper Egypt-and the lowest energy intake was in urban areas.There is a significant difference in protein intake of the 4 demographic areas.The highest protein intake was in upper Egypt and the lowest protein intake was in urban areas There is a statistical difference in the fat intake in 4 demographic areas the highest fat intake was in upper Egypt and the lowest fat intake was in urban areas.There was a significant difference regarding Fiber intake among the main demographic areas in Egypt the higher fiber intake was reported in lower Egypt and the lowest fiber intake was reported in urban areas.

Table (7)
There was a significant difference regarding Saturated fat intake among the main demographic areas in Egypt.The higher Saturated fat intake was reported in (upper Egypt and the lowest Fat intake was reported in Urban areas.There was a significant difference in Unsaturated fat intake the highest intake was reported in upper Egypt and the lowest Fat intake was reported in urban areas.There was a significant difference regarding mono Unsaturated fat intake among the main demographic areas in Egypt the higher Mon unsaturated fat intake was reported in frontier Egypt and the lowest Fat intake was reported in upper areas.

Table (8)
The median intake of cereals consumption per capita was (357.14),Tubers (90.26 g/day, Legumes (43.24 g/day), sugar gram55, all meat products (69.5.5 g /day) milk (142.3 ml /day vegetables (142.80 g/day fruits (94.07g /day) (beverage (80.9 ml /day) and nuts (.5 gm /day Dietary pattern of the studied households as obtained by food frequency method showed cereals, (bread, rice), tubers, legumes, and fruits are the food items that consumed by more than 50% of the total samples.

Figure (1, 2)
Results revealed that the dietary energy pattern of Egyptians was within the range of the 3 main 3 parameters compared to the recommendation, set by WHO (year).Although the fat/energy ratio and carbohydrates energy ratio were closer to the upper limits of the recommendations the protein /energy ratio for the Egyptian diet was close to the lower limit of the WHO recommendations the energy derived from free Sugar was >10% as WHO recommendation The contribution of free sugar to the total energy derived from food consumed was 12%.
Table (9) The mean intake of saturated (20gm) per capita per day Dietary energy derived from saturated fat was 8.1 % which is < 10% which was near the upper limit of saturated fat consumption and may exceed that of the recent recommendation by the American heart association of decrease the upper limit of saturated fat intake < 6% of the total energy.The mean intake from polyunsaturated fat was 21.6 gm.T h e dietary energy derived f r o m polyunsaturated f a t t y acids, was 8.8% which was within the recommended intake of 6-10% of the total dietary energy intake, However, the average daily mono-unsaturated fatty 18.0 gm which represents 7.3% of the total energy intake while the recommended is from 6-10% as within the recommendation.The dietary energy derived from trans was 0.65% of the total energy which is<1% as stated by WHO recommendation.
Figure (3) shows the average daily per capita total fat and fatty acid content of the different food items consumed by the study sample figure (3) results of the survey revealed that the daily average per capita total fat of the food consumed was 61.2 gm./day/per capita, while the average daily per capita saturated fat from food was 20.0 gm./day/per capita which represented 32.7% of the fatty acid content of consumed food However, the average daily per capita monounsaturated fatty acid content of consumed food was 18.0 gm./day/per capita with a percent of 29.2% of the total fat content of consumed food.The polyunsaturated fatty acids content of consumed food by the studied sample was 21.0 gm./per capita /day with a percent of 35.3% of the total fat content of the consumed food.the average daily per capita trans-fat content of fat consumed was nearly 1.6g / day / per capita representing 2.6%% of the total energy intake.

Figure (4):
shows that the majority of dietary fat was in the form of Visible fat (vegetable oil, butter, and ghee,) accounting for about 63.7% of total dietary fat, and the rest (36.3%) was hidden fat or invisible fat (in meat products, milk, cheese, bakery products, and chips).

Table (12) and Figure (6)
The consumption pattern of the fat groups(oils) The most common oils used for cocking are the blended (mixture oils which are the main items in the subsidy oils in the ration card (18.0+5.8)g. per day followed by the plant margarine in different brands in different brands (14.0+0.9)plant oils and animal fat butter (2.3 and 2.26 g /day

DISCUSSION:
Fat is one of three primary nutrients that the body needs, along with protein and carbs.It helps the body absorb key fat-soluble vitamins from diet and produces energy (Mozaffarian et al., 2010).The difference between "good," healthpromoting fats and "bad," harmful fats is now recognized to have a bigger influence on health than it did in the past few years (WHO 2022).The goal should be to choose more healthy unsaturated fats and limit unhealthy trans and saturated fats, as opposed to cutting back on total fat intake to follow a low-fat diet (U.S. National

Library of Medicine. 2202).
Based on present data, the average daily energy consumption was 2204 kcal.Fat accounted for 25% of the average daily energy intake, protein for 13%, and carbohydrates for 62%.The survey's findings demonstrated that as long as the amounts of all three fat subtypes saturated, unsaturated, and trans were within the WHO recommendation, the average daily per capita intake pattern for total fat and fatty acid subtypes was consistent with the WHO's 2017 recommendation (WHO, 2018).A similar conclusion was drawn from an Indian study carried out in 2016: the average daily intake of trans fat per person was roughly 1. 6 grams or 0.65% of total calories (Mani 2016).The average consumption of saturated fatty acid (SFA) and fat was low.Similar to what happened in the US ten years ago, countries like Egypt and others are today witnessing a significant increase in the prevalence of obesity despite a decline in fat consumption of fat and saturated fat (Micha, 2010).As a result of their proactive approach to the issue, the US Dietary Guideline Advisory Committee removed the upper limit for fat intake in their most recent dietary reference intake (Lele 2022) The World Health Organization suggests that the ideal edible oil has a proportionate ratio of SFA:MUFA: PUFA of 1:1.5:1 (WHO, 2010).Based on several decades of research.Regrettably, not all naturally occurring vegetable oils possess this perfect balance; some are more PUFA-rich than others.One method that can enhance one's health is the most effective way to ensure that the "perfect" oil contains the appropriate concentration of MUFA and PUFA blending oils.(Mani., 2016).Studies on the effects of consuming a combination of oils on positive synergy in humans have demonstrated statistically significant reductions in plasma lipid fats in Eastern countries and inflammation, which in turn reduce the risk of coronary heart disease.Thankfully, due to their wellestablished benefits, blended oils have been recommended by the National Institute of Nutrition (NIN) for a healthy diet (Egyptian Food Composition Tables , 2006).This recommendation made sense given that the majority of oil used in Egyptian cooking is blended oils, the mix that is subsidized on ration ).The Dietary Guidelines for Americans 2020-2025 state that (DGA), individuals should limit their daily calorie intake from saturated fat to no more than 10%.
According to a US study on fatty acid consumption, total fat makes up 37% of an average person's calories, saturated fat makes up 14.5%, and monounsaturated fat makes up 12% (Micha, 2014).The Mediterranean Diet is one nutrientdense eating plan.Higher levels of adherence to the Med Diet pattern are linked to a reduced death rate, according to epidemiological research, when this eating pattern is also adopted to protect against glycemic management and lower cardiovascular risk, which in turn promotes better control of diabetes (Capurso, 2017).Increased People are less strictly adhering to the Med Diet as a result of being forced to move to less-priced but typically higher-calorie products (Karam, 2022).The results of the survey show that dietary sources of monounsaturated fat, which are the richest sources, like olive oils and tuna fish, are consumed at lower levels.Furthermore, there was little compliance with the other Med Diet components Combination oils, or the oils in the subsidiary oils on the ration card, were the most popular source of polyunsaturated fats.Plant oils from vegetables and sunflower seeds accounted for the second most prevalent source of polyunsaturated fat in Egyptian cuisine, with hydrogenated oils also referred to by other names coming in third.Less than 10% of total calories were obtained from polyunsaturated fat, which is in line with the worldwide statistics on fat consumption from Iran.Food consumption patterns in Egypt showed that cereals, bread, rice, sugar, tubers, meat, legumes, vegetables, and fruits were the most frequently consumed foods.There was the average daily consumption of fruits, vegetables, dairy, and seafood.The present results concurred with those of current results agreed with Lebanon's findings for the number of fruits and vegetables reported.The country profile of Iran corroborated our results (Renata 2022).A study conducted in Iran found that people were eating less meat and more grains.Meat and poultry items were admitted at a mean of 91.7 g per day, with chicken coming in second at 36.1 g per day.It was shown that very little fish was consumed (19.7 g per day).Milk was the least popular dairy product, consumed in days (Mohammadi 2021).Worldwide, the prevalence of overweight and according to epidemiological research, obesity significantly increases the.) obesity is rising (WHO 2018) risk of developing metabolic syndrome-related cardiovascular diseases, type 2 diabetes mellitus (T2DM), chronic kidney disease, many cancers, and infertility in women (Stevens 2020).According to our data, the majority is overweight (>33%), while the minority is underweight (%0.03).Over half of the sample, or 34.9%, were obese.The typical distribution of weight is 12% in cities and 53% in rural areas.T h e same result of 32.5 and 39.4% (38.29) for overweight and obese people, respectively, was discovered in Ghana according to the percentages 32.5 and 39.4% (Ofori 2016; Bakuri 2021) for being overweight or obese, respectively.Kuwaitis' increasing rates of obesity and overweight, together with their rising consumption of calories and macronutrients and declining intakes of fiber and micronutrients, are prime examples of the country's nutritional shift (Zaghloul.,2013).

CONCLUSION:
The average daily consumption of energy per person was 2202 kcal, proteins were 72.0 g/day, and fat was 61.2 g/day.
Protein made up 13% of the total energy, fat made up 25%, and carbs made up 62.0%.Free sugar made up 10% of the total energy obtained from the meal that was ingested.The Egyptians' dietary energy pattern fell within the WHO's recommended range.The amount of dietary energy obtained from the trans-fat content of the food ingested was 0.6% of the total energy, which is less than 1% as recommended by the WHO.The overall amount of fat consumed was sufficient, but the amount of saturated fat consumed was nearly twice as much as recommended that is, more than the recent recommendation of the American Heart Association.

RECOMMENDATION
❖ Dietary diversification for the different target populations is recommended for a healthy diet ❖ Measures of regulations of labeling for beverages and processed food for their content of fats ❖ More concern to be given to Figure (4):shows that the majority of dietary fat was in the form of Visible fat (vegetable oil, butter, and ghee,) accounting for about 63.7% of total dietary fat, and the rest (36.3%) was hidden fat or invisible fat (in meat products, milk, cheese, bakery products, and chips).Table (11) and Figure 5 show Saturated (20.0g) dietary fat is furnished by both visible and invisible fat but more invisible fat unsaturated (39.6) gm to visible fat 30.2 gm and 9.2 gm of invisible fat.An unsaturated fatty acid dominates the fat pattern of dietary visible fat, most of it supplied 76.3% while representing 23.7% of invisible fat the reverse is observed for saturated fat which represents 55% of invisible fat and 45% of visible fat sources.

Figure 1 )
Figure 1): Average daily per capita macronutrient intake from total calories of food consumed by the household.

Figure ( 2 )
Figure (2) Comparison between the actual intake of macromolecules RDA from the total energy intake

Figure
Figure (3): Average daily percentage of the dietary fat subtypes from the total fat intake population (g/capita/day).

Figure ( 4
Figure (4): Fat and fatty acid pattern by source of fat (g/capita/day).

Figure ( 5 )
Figure (5): Fat and fatty acid pattern by the source of fat (g/capita/day)

Figure ( 6 )
Figure (6) Comments oils in consumption pattern of fat groups

Figure 8 :
Figure 8: food items consumption of visible fat in grams

Figure
Figure (10) sources of saturated fat consumption by Egypt

. Department of Agriculture, 2022; Mozaffarian et al., 2010).
Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 97

Consumption Pattern of Dietary Fat in the Egyptian Population: A comprehensive analysis
Salwa M Saleh; Gihan A Fouad; Mohamed A Afify; Hoda M El Gezery; Dooa H El Sabakhawy Asmaa T Zaher, Radwa E Komsan; Nahal A Abd El Rahman; Asmaa S Abd El Wahed; Amer H Abd Alal Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 98

Consumption Pattern of Dietary Fat in the Egyptian Population: A comprehensive analysis
Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 104

Consumption Pattern of Dietary Fat in the Egyptian Population: A comprehensive analysis
Salwa M Saleh; Gihan A Fouad; Mohamed A Afify; Hoda M El Gezery; Dooa H El Sabakhawy Asmaa T Zaher, Radwa E Komsan; Nahal A Abd El Rahman; Asmaa S Abd El Wahed; Amer H Abd Alal Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 106

Mozaffarian D; Micha R and Wallace S (2010):
Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 117

Table ( 1
) Descriptive of the Household numbers in demographic areas of Egypt

Table (3) Distribution of participating mothers according to MBI in demographic areas of Egypt BMI/ Site Total
Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 120

Table ( 8) Mean, median, standard deviation, and quartiles of food groups consumption in households (per capita) in Egypt by food frequency questionnaire
Zaher, Radwa E Komsan; Nahal A Abd El Rahman; Asmaa S Abd El Wahed; Amer H Abd Alal Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 121

between the actual intake and RDA of the main macromolecules actual intake RDA Consumption Pattern of Dietary Fat in the Egyptian Population: A comprehensive analysis
Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 122

Pattern of Dietary Fat in the Egyptian Population: A comprehensive analysis
Salwa M Saleh; Gihan A Fouad; Mohamed A Afify; Hoda M El Gezery; Dooa H El Sabakhawy Asmaa T Zaher, Radwa E Komsan; Nahal A Abd El Rahman; Asmaa S Abd El Wahed; Amer H Abd Alal Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 124

Consumption Pattern of Dietary Fat in the Egyptian Population: A comprehensive analysis
Salwa M Saleh; Gihan A Fouad; Mohamed A Afify; Hoda M El Gezery; Dooa H El Sabakhawy Asmaa T Zaher, Radwa E Komsan; Nahal A Abd El Rahman; Asmaa S Abd El Wahed; Amer H Abd Alal Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 125

Consumption Pattern of Dietary Fat in the Egyptian Population: A comprehensive analysis
Salwa M Saleh; Gihan A Fouad; Mohamed A Afify; Hoda M El Gezery; Dooa H El Sabakhawy Asmaa T Zaher, Radwa E Komsan; Nahal A Abd El Rahman; Asmaa S Abd El Wahed; Amer H Abd Alal Bulletin of the National Nutrition Institute of the Arab Republic of Egypt June 2024(63) 126