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Foodborne diseases continue to be a global public health problem with an estimated 600 million people falling ill annually. In return, international standards are becoming stricter which poses challenges to food trade. In light of the increasing burden of foodborne diseases, many countries in the Middle East and North Africa (MENA) region have upgraded their food laws and undertaken changes to the organizational structure of their regulatory institutions to maintain or expand international export activities, tighten control on local and imported products, and protect consumers’ health. However, until this date, the published information on the regional health burdens of foodborne diseases is very limited and it is not clear whether the recent changes will serve towards science-based and effective preventive functions and the adoption of the risk management approach. In this review, we summarize the recent food safety issues and the national food control systems of selected countries in the region although we were challenged with the scarcity of information. To this end, we examined the national food safety systems in the context of the five essential elements of the FAO/WHO Guidelines for Strengthening National Food Control Systems. These five elements—food law and regulations; food control management; inspection services; laboratory services; food monitoring; and epidemiological data, information, education, communication, and training—constitute the building blocks of a national food control system, but could also serve as tools to assess the effectiveness of the systems.

The COVID-19 pandemic is a major health crisis that has changed the life of millions globally. The purpose of this study was to assess the effect of the pandemic on mental health and quality of life among the general population in the Middle East and North Africa (MENA) region. A total of 6142 adults from eighteen countries within the MENA region completed an online questionnaire between May and June 2020. Psychological impact was assessed using the Impact of Event Scale-Revised (IES-R) and the social and family support impact was assessed with questions from the Perceived Support Scale (PSS). The IES-R mean score was 29.3 (SD = 14.8), corresponding to mild stressful impact with 30.9% reporting severe psychological impact. Most participants (45%–62%) felt horrified, apprehensive, or helpless due to COVID-19. Furthermore, over 40% reported increased stress from work and financial matters. Higher IES-R scores were found among females, participants aged 26–35 years, those with lower educational level, and participants residing in the North Africa region ( p <0.005). About 42% reported receiving increased support from family members, 40.5% were paying more attention to their mental health, and over 40% reported spending more time resting since the pandemic started. The COVID-19 pandemic was associated with mild psychological impact while it also encouraged some positive impact on family support and mental health awareness among adults in the MENA region. Clinical interventions targeted towards vulnerable groups such as females and younger adults are needed.

This essay examines the resulting environmental health conditions in Gaza since October 2023. Evidence is drawn from international agency reports and peer-reviewed literature to document destruction and public health impacts over 18 months. Key themes include water, sanitation, contamination, noise and air pollution, food insecurity, susceptible populations, health system collapse, and trauma. Palestinians are beset with a public health crisis resulting from targeted environmental destruction. Water shortages and sewage contamination increase dehydration, famine, and disease. Air pollution from explosives and waste burning exposes residents to toxins. Waste management has collapsed, heightening disease outbreaks, including polio. Agricultural land is devastated, and food security is threatened with the aid blockade. Power grid destruction has crippled essential services. The health care system’s collapse further exacerbates risks, especially for susceptible populations. In addition to mental and physical trauma, cultural and identity loss are immeasurable. The crisis in Gaza has severe and lasting consequences for health, the environment, and regional stability. An end to the bombardment, along with urgent humanitarian aid, release of all hostages, infrastructure rebuilding, and environmental remediation, are essential to mitigate long-term impacts. ( Am J Public Health. 2025;115(7):1053–1061. https://doi.org/10.2105/AJPH.2025.308140 )

Objectives Food price is a determining factor in food choice which affect diet quality accordingly. However, the association between food price and diet quality has not been thoroughly discussed among Chinese adults. This study aimed to analyze the association of daily energy-adjusted dietary costs (CNY/2000 kcal) and diet quality among Chinese adults. Methods A total of 680 Chinese adults aged above 25 years from Henan province were investigated in 2020. Three indices were adopted for evaluating diet quality: the nutrient-rich foods 9.2 (NRF 9.2) index for evaluating nutrient density, the mean adequacy ratio (MAR) for evaluating nutrient adequacy, energy density (ED) based on solid foods only for evaluating energy density. The daily energy-adjusted diet cost was calculated by dividing the estimated daily diet costs (CNY/day) by the energy intake per day (kcal/day) and multiplying the result by 2000. Results Subjects who closely adhered to the NRF9.2, MAR, and ED paid ¥8.92, ¥13.17, and ¥14.34 more for daily food consumption, respectively, than those who weakly adhered to these dietary patterns did. Furthermore, multiple linear regression analysis adjusted covariance revealed that an increase in ¥1 of the energy-adjusted diet cost per day was associated with changes of 0.494 units ( P  < 0.001), 0.003 units ( P  < 0.001), and − 0.018 units ( P  < 0.001) in the NRF9.2, MAR, and ED, respectively. Conclusion Higher energy-adjusted diet cost was associated with higher quality diets. This might be important for public health policies to develop strategies to promote healthy diets by regulating food supply and its costs.

The Gaza Strip, spanning approximately 365 square kilometers, has been a focal point of geopolitical tensions and humanitarian crises. The military escalation on October 7th exacerbated existing vulnerabilities, notably food security and hunger, with an estimated 85750 deaths due to Israeli attacks, representing about 8% of the 2.34 million population. This research aims to provide policymakers and humanitarian organizations with actionable insights, such as identifying the most vulnerable populations, quantifying the impact of specific restrictions, and informing the development and implementation of targeted interventions that improve long-term food security and alleviate human suffering in Gaza. A cross-sectional study was conducted from May to July 2024, assessing food insecurity and hunger among Palestinian households across the five governorates of Gaza. The study applied a quantitative research approach, utilized the Household Food Security Survey Module (HFSSM), Household Food Insecurity Access Scale (HFIAS), and Household Hunger Scale (HHS) to measure food insecurity, famine, and hunger. Self-reported anthropometric data and socioeconomic status were also collected. Data were analyzed using SPSS version 29, employing correlation tests, chi-square analysis, and logistic regression. A survey of 1209 households across the Gaza Strip revealed a catastrophic humanitarian crisis. More than 54% of households experienced complete house destruction. Food insecurity reached unprecedented levels, with about 98% of households experiencing severe food insecurity, according to the HFIAS, while 100% experienced different levels of food insecurity as per the HFSSM. A staggering 95% of households experienced other sorts of hunger. The war was associated with significant (p < 0.001) weight loss among individuals, with the average weight dropping from 74.8 ± 15.9 kg before the war to 64.8 ± 15.2 kg, concomitant with significant (p < 0.001) reduction in BMI from 26.4 ± 5.4 to 22.8 ± 5.2 kg/m2. Factors such as displacement, age, socioeconomic status, and educational level significantly exacerbated hunger severity. The study reveals a severe food insecurity and hunger crisis in the Gaza Strip, exacerbated by the ongoing damaging attacks by Israeli forces. These findings underscore the urgent need for immediate and sustained humanitarian assistance to address the critical food security and nutritional needs of the Gazan population.

Foodborne pathogens are known as significant public health hazards worldwide, particularly in the Middle East region. Antimicrobial resistance (AMR) among foodborne pathogens becomes one of the top challenges for the environment, public health, and food safety sectors. However, less is known about antimicrobial-resistant foodborne pathogens in the Middle East region. Possibly because of the lack of surveillance, documentation, and reporting. This review focuses on the current status of antimicrobial resistance profiling among foodborne pathogens in the Middle East. Therefore, PubMed and other relevant databases were searched following PRISMA guidelines. Subject heading and texts were searched for “antimicrobial resistances,” “foodborne,” and “Middle East” to identify observational studies on AMR foodborne pathogens published during the last 10 years (2011 to 2020). Article retrieval and screening were done using a structured search string and strict inclusion/exclusion criteria. Median and interquartile ranges of percent resistance were calculated for each antibiotic-bacterium combination. A total of 249 articles were included in the final analysis from ten countries, where only five countries had more than 85% of the included articles. The most commonly reported pathogens were Escherichia coli , Salmonella spp. Staphylococcus aureus , and Listeria spp. An apparent rise in drug resistance among foodborne pathogens was recorded particularly against amoxicillin-clavulanic acid, ampicillin, nalidixic acid, streptomycin, and tetracycline that are commonly prescribed in most countries in the Middle East. Besides, there is a lack of standardization and quality control for microbiological identification and susceptibility testing methods in many of the Middle East countries.

Background In a context of nutrition transition and major shifts in lifestyle and diet, the Middle East and North Africa features a marked gender excess adiposity gap detrimental to women. In this setting, where gender issues are especially acute, we investigated gender differences in dietary intake with a focus on diet quality, and how the differences varied with the area of residence and socio-demographic characteristics. Methods The study was conducted in 2009–2010 in the Greater Tunis region (Tunisia), as a case study of an advanced nutrition transition context in the region. A cross-sectional survey used a random, stratified, clustered sample of households: 1689 women and 930 men aged 20–49 years were analyzed. Dietary intake was assessed using a 3-day food record. Nutrient content was derived from a specific Tunisian food composition database. We analysed the Diet Quality Index-International (DQI-I) and sub-scores (variety, adequacy, moderation and balance). A score of DQI-I > 60 defined good diet quality. Inequality measures were women vs. men differences in means for interval variables and odds-ratios (OR) for DQI-I > 60. Their variation with socio-demographic characteristics was estimated using models featuring gender x covariate interactions. Results Mean energy intake/day was 2300 ± 15 kcal for women vs. 2859 ± 32 kcal for men. By 1000 g/kcal/d women consumed more fruits and sweets but less red meat and soft drinks than men. Women had a higher mean moderation sub-score than men (+ 1.8[1.4, 2.2], P  < 0.0001) but lower variety (− 2.0[− 2.3, − 1.6], P < 0.0001) and adequacy (− 1.8[− 2.0, − 1.5], P < 0.0001). Thus, the overall mean DQI-I was lower among women than men (58.6 ± 0.3 vs. 60.4 ± 0.3, − 1.8[− 2.6, − 1.0], P  < 0.0001) as was the proportion of DQI-I > 60 (45.2% vs. 55.7%, OR = 0.7[0.5, 0.8], P  < 0.0001). Adjusted gender differences in DQI-I decreased with age but were higher in larger households and extreme categories of education (no-schooling and university) vs. the middle categories. Conclusion In this nutrition transition context with only average diet quality, it was somewhat lower for women. Socioeconomic patterning of gender contrasts was mild. Beyond, that women had lower adequacy and variety scores but better moderation is a possible pathway for gender specific prevention messages.

Dietary arsenic (As) contamination is a major public health issue. In the Middle East, the food supply relies primarily on the import of food commodities. Among different age groups the main source of As exposure is grains and grain-based food products, particularly rice and rice-based dietary products. Rice and rice products are a rich source of core macronutrients and act as a chief energy source across the world. The rate of rice consumption ranges from 250 to 650 g per day per person in South East Asian countries. The source of carbohydrates through rice is one of the leading causes of human As exposure. The Gulf population consumes primarily rice and ready-to-eat cereals as a large proportion of their meals. Exposure to arsenic leads to an increased risk of non-communicable diseases such as dysbiosis, obesity, metabolic syndrome, diabetes, chronic kidney disease, chronic heart disease, cancer, and maternal and fetal complications. The impact of arsenic-containing food items and their exposure on health outcomes are different among different age groups. In the Middle East countries, neurological deficit disorder (NDD) and autism spectrum disorder (ASD) cases are alarming issues. Arsenic exposure might be a causative factor that should be assessed by screening the population and regulatory bodies rechecking the limits of As among all age groups. Our goals for this review are to outline the source and distribution of arsenic in various foods and water and summarize the health complications linked with arsenic toxicity along with identified modifiers that add heterogeneity in biological responses and suggest improvements for multi-disciplinary interventions to minimize the global influence of arsenic. The development and validation of diverse analytical techniques to evaluate the toxic levels of different As contaminants in our food products is the need of the hour. Furthermore, standard parameters and guidelines for As-containing foods should be developed and implemented.

The pathways through which the COVID-19 pandemic has impacted population mental health are potentially gendered. Little research has explored these pathways in low- and middle-income country contexts, such as in the Middle East and North Africa (MENA) region, where socioeconomic roles are highly gendered. To address this gap, we examine the relationships between pandemic-related socioeconomic changes and subjective wellbeing in the MENA region. Our core hypothesis is that the COVID-19 pandemic affected men and women’s subjective wellbeing differently in part because these effects were mediated by gendered socioeconomic roles. We exploit multiple waves of longitudinal, nationally-representative phone survey data across Egypt, Jordan, Morocco, Sudan, and Tunisia. The data were collected between November 2020 and August 2021 and include 32,296 observations of 20,256 unique individuals. Mental health is measured through the WHO-5 subjective wellbeing scale. Our key independent variables capture pandemic-related employment loss, income loss, experience of limitations on food access, enrollment of children in alternative schooling modalities, and receipt of formal and informal transfers. We find significantly worse subjective wellbeing for women in Egypt and Morocco during the pandemic, but not the three other countries. There were negative associations between employment and income loss during the pandemic and subjective wellbeing, but not gender-differentiated ones. In contrast, high levels of limitations on food access were associated with worse mental health for men than women. Receipt of transfers generally did not have any association with subjective wellbeing. Further research is needed into how social assistance programs implemented in response to pandemics may be designed so as to address the negative mental health consequences of such events.