*4.2. Investigation of the Country of Origin of Imported Food Products in Lebanon*

Lebanon imported its food products from France (\$107,957), Germany (\$98,250), Turkey (\$97,015), United Kingdome (\$75,571), Italy (\$70, 571), Argentina (\$69,989), Saudi Arabia (\$64, 332) and United States (\$57,785). In addition, the main importation sources of butter, oils, and fats are Denmark, Netherlands, France, Belgium, Ukraine, New Zealand, United Kingdom, and Argentina [43]. According to the nutrition labels of tested butter and margarines, the country of origin from which all the butter and margarines were imported to Lebanon were Turkey (*n* = 5), Egypt (*n* = 4), Malaysia (*n* = 3), Saudi Arabia (*n* = 1), Sri Lanka (*n* = 3), UAE (*n* = 1), Netherland (*n* = 2), Belgium (*n* = 3), France (*n* = 4), Italy (*n* = 1), Ukraine (*n* = 1), Germany (*n* = 2), and Denmark (*n* = 2). Among all these countries, 33 percent (five countries over 15) are implementing mandatory national limits and adopting monitoring mechanisms for mandatory of TFAs limits. On the other hand, in the remaining countries, the bestpractice TFAs policy passed but was not yet in effect [5]. Lebanon, long considered a middle-income country, is rapidly sinking into poverty as it faces a triple shock from the unprecedented economic crisis, the impact of COVID-19 on employment and public health, and the consequences of Beirut port explosions. Despite that, the actual relative impact of IP-TFAs exposure on heart disease mortality in Lebanon is limited, but unambiguously still considerable. The findings in our report highlight the importance of controlling the importation of food products from countries controlling IP-TFAs levels in food to avoid sinking Lebanese markets with IP-TFAs rich food products [44], both of which are often ultra-processed, unhealthy, and rich in IP-TFAs. Therefore, this population group is at higher risk of IP-TFAs-attributable CVDs.
