Physical Activity Level Assessed by Accelerometer and PAQ-C in Tunisian Children.

BACKGROUND: Physical activity (PA) is an important agent in the prevention of chronic diseases such as obesity. OBJECTIVES: To provide preliminary data on PA among school children and to correlate the PA with weight status. MATERIAL AND METHODS: A total of 40 children aged between 8 and 11 years and attending Tunisian schools were recruited. The body composition was determined by using the deuterium oxide dilution technique. PA was determined by the PAQ-C (PA Questionnaire for Older Children). An objective monitoring of PA and sedentary time was achieved by using ActiGraph GT3X + accelerometers. RESULTS: PAQ-C data demonstrate that 20% of the sample had light PA levels and 80% had moderate PA levels. Times spent in sedentary (62.37%) and light (30.80%) activities were higher than that spent in moderate and vigorous (6.83%) activities. Furthermore, almost half of the sample spent more than 60 min per day in moderate-to-vigorous intensity PA (MVPA). The average MVPA was significantly higher in normal weight than overweight and obese groups (67.68 ± 20.98 vs. 49.07 ± 19.09, p = 0.007). The proportion of overweight children who spent more than 60 min per day in MVPA was significantly higher than that of normal-weight (60.9 vs. 29.4%; p = 0.049). CONCLUSION: This study indicates that half of school children comply with the health-based guidelines for PA and sedentary behavior. Our findings also suggest that obesity was associated with decrease in PA in Tunisian children.

[Multiple medication use in diabetic patients aged]. / Le polymédication chez le diabétique âgé.

BACKGROUND: Multiple medication use is especially common in those with diabetes aged due to multiple illnesses, certain chronic diseases and disabling of the growing demand for care, treatment advances, but also some over-prescription. AIMS: To assess the achievement of treatment goals in a population of older diabetics, to analyze drug consumption and to derive a practical driving prevention. METHODS: This descriptive retrospective study was interested in 600 cases of diabetic patients older than 60 years, recruited from the diabetes followed at the National Institute of Nutrition and Health Unit in Tunis Sidi Hassine involving three local clinics to during the years 2009-2010. RESULTS: The average age of the study population was 70 ± 0.5 years with extremes from 65 to 92 years. In our study, 91% of patients between 2 and 5 chronic diseases and the majority of subjects suffering from disabilities. The number of drugs prescribed in our subjects (all dosage forms combined) varies between 1 and 4,with a peak of interest to patients treated with 2-4 drugs, encountered in 91% of cases.The similarity of shapes and colors of certain drugs often confusing. CONCLUSION: Multiple medication use is common in older diabetic subjects. Hence the need for good coordination between prescribers to prevent abuse and ensure the correct therapeutic education of patients and their families.

[Effect of protein restriction on renal function and nutritional status of type 1 diabetes at the stage of renal impairment]. / Effet de la restriction protéique sur la fonction rénale et l'état nutritionnel de diabétiques type 1 au stade d'insuffisance rénale modérée.

BACKGROUND: In an effort to slow the deterioration of renal function, several authors have recommended in the diabetic stage renal disease with moderate renal impairment decreased protein intake to 0.7 or 0.3 g / kg / day associated with energy intake of at least 30 to 35 kcal / kg / day. However, in clinical practice this proved difficult to achieve without exposing patients to the risk of under nutrition. AIM: To evaluate the effects of a protein restricted diet on the development of diabetic nephropathy and the nutritional status of diabetic patients with renal impairment at the stage of moderate renal impairment compared with those of a group of diabetics with the same characteristics put under basal diabetic diet. METHODS: Prospective study of 57 diabetic patients in moderate stage renal disease of middle age (32 ± 0.6 years) followed at the National Institute of Nutrition of Tunis in 2010. Our patients were separated into two groups (group A comprising 30 patients, put on diabetic diet basal and group B comprising 27 patients used in protein-deficient diet: 0.6 to 0.7 g / kg /d). We followed the evolution of certain parameters: glomerular filtration rate (GFR), serum albumin, albuminuria, nutritional risk index (NRI) and we analyzed dietary intake at D0, D90 and D180. RESULTS: Renal function in patients in group B improved as demonstrated by the trend towards higher GFR. It increased from day 0 to day 90 and at day 180. In parallel, there was a beneficial effect on albuminuria which was reduced from 380 ± 56 mg/24h on day 0, to 322 ± 50mg/24h at day J90 and 302 ± 16 mg/24h at day 180. In group A, the opposite phenomena occurred. The patients in Group B have also reduced their overall caloric intake to less than 1800 kcal / day making sure that the balance of their diet quality could no longer be assured the result has a tendency to under nutrition noted more frequently in the latter group (NRI0 = 97.90%, NRI 90= 90.10% , NRI180=90,0%). In the literature these results were found by several studies. CONCLUSION: The protein-deficient diet (0.6 to 0.7 g/ kg /d) must be integrated into the overall care of diabetic renal insufficiency with moderate renal impairment but requires rigorous repeated dietary interviews and customized to avoid malnutrition can result.

[Vitamins A, E and leptin in obese and non-insulin-dependent diabetes]. / Statut en vitamines a, e et léptinémie chez un groupe d'obèses diabétiques non insulino-dépendant.

BACKGROUND: At the obese ones, there is an imbalance between the free defenses antioxydants and radicals from where the installation of an oxydative stress, responsible for the development of non-insulin-dependent diabetes. AIM: Our objectives was to evaluate the levels of vitamins A, E and of leptin, to search the link witch could exist between vitamins and leptin. METHODOLOGY: We proportioned the rates in vitamins A, E and in leptine at 30 obese subjects diabetic of type 2 including 12 men and 18 women of average age (50.93 +/- 6.13) years not carrying pathologies other than the diabetes and obesity compared to 30 witnesses who theirs are paired according to the age and the sex.. RESULTS: Our results chows that levels of antioxidants did not differ between the two groups but we find a non significant decrease in vitamin E/(TC +TG) ratio (1.86 +/- 0.38 vs. 2.11 +/- 0.74 ; p = 0.08) and significant increase of vitamin A level in women obese with non-insulin-diabetes mellitus compared with control group of women (0.69 +/- 0.16 vs. 0.55 +/- 0.15 ; p = 0.01). Moreover a negative and significative correlation between vitamin E and leptin (r = 0.452 ; p = 0.01), and a negative and no significative correlation between vitamin A and leptin (2 = - 0.221; p > 0.05) were observed. CONCLUSION: The rate of vitamin A, is different for each sex with share. The vitamin E could have a negative control on the secretion of the leptin.

Development and validation of impedance-based equations for the prediction of total body water and fat-free mass in children aged 8-11 years.

BACKGROUND/OBJECTIVES: Accuracy of impedance analysis depends on population-specific prediction equations. The aim of this study was to propose new prediction equations to estimate body composition using impedance analysis for healthy Tunisian children and validate them using the deuterium oxide dilution (D2O) technique. SUBJECTS/METHODS: Body composition was estimated by the Tanita impedance analyzer. The validity of this system was investigated in 134 school children aged between 8 and 11 years. The validity of other published equations was also tested in our sample. Total body water (TBW) and Fat-Free Mass (FFM) were determined using the D2O technique. Participants were divided equally into development (n = 67) and validation groups (n = 67) to develop prediction equation using linear regression models. RESULTS: The comparison between body composition obtained by Tanita system and by D2O technique illustrated a significant difference (p < 0.01). Compared to D2O technique, Tanita impedance analysis underestimates fat mass and overestimates FFM and TBW. The prediction equations for TBW and FFM were developed with sex, age, weight and resistance index as possible predictor variables. The selected equations presented the highest adjusted coefficient of determination (R2), the lowest standard error of the estimate (SEE) value and the lowest p-values. The pure error was 1.263 for the TBW equation and 1.646 for the FFM. The Bland Altman plot illustrated the good level of concordance between the TBW and FFM predicted by the new equations and measured by isotope dilution. CONCLUSIONS: Our study provides valid prediction equations for estimation of TBW, FFM from impedance analysis measures for Tunisian children. These equations are applicable to children aged between 8 and 11 years.

[Obesity and life style in a population of male school children aged 6 to 10 years in Ariana (Tunisia)]. / Obesite et mode de vie dans une population d'ecoliers de la region de l'Ariana (Tunisie) ages de 6 à 10 ans.

The increase of the prevalence of the obesity in childhood puts in reason some factors of the environment and the way of life of the child that encourage the hold of weight at these topics of as much more that if they are exposed genetically. A prospective survey has been done close to 3148 school boy aged of 6 to 10 years and who were schooled in the gouvernorat of Ariana showed that the prevalence of the obesity is around 3.7%. A survey case/witness has been achieved in a second time on the way of life of the group of the obese matched to a group of children no obese. An intended questionnaire to parents of children of these 2 groups permitted to collect some informations concerning the weight and the present size of parents, habits of life of their children. The weight to the birth has been searched for in the school medical file or from the notebook of health of the child. The obesity of parents is one factor of risk of the child obesity. The short length of sleep (< 8 hours), the erosion between meals especially in the evening after the dinner, the daily consumption of sugary foods and sparkling drinks is the important risk factors exposing to the infantile obesity this group of age. These behaviours can be corrected by a strategy of prevention and nutritional education.

Dietary fiber in the diets of urban Tunisian women: association of fiber intake with BMI, waist circumference and blood chemistry: preliminary study.

BACKGROUND: The change of the way of life and the food practices in Tunisia due inter alia to the improvement of the socioeconomic conditions induced low fuel consumption of food with significant nutritional interest such as those rich in food fibres which have positive effects on the reduction and the prevention of some complications of the metabolic diseases such as the obesity whose prevalence among Tunisian women is increasingly high. OBJECTIVE: We assessed the association between the mean daily fiber intake and anthropometric parameters, the serum lipid profile and the serum glucose concentration among urban Tunisian women. METHODS: We conducted a 7-day food weighing method among 260 women of which 60 are obese (BMI > 30 kg/m(2)). The weighing method was done by trained and experienced workers in the National Institute of Nutrition of Tunisia. All the results were treated with the (Bilnut) software (1991 version) to which a list of 235 special Tunisian foods was added. We calculated their mean daily fiber intake and we prospectively evaluated the correlations between it and the BMI, the waist circumference, total plasma cholesterol, HDL-cholesterol, triglyceridemia and glycaemia. RESULTS: Obese women are found to consume less fiber than non-obese women (21.73 ± 3.25 g/day vs 26.25 ± 2.7 g/day; P<0.0001). Very high and significant correlations were observed between dietary fiber intake and the parameters investigated: BMI (r=-0.709, P<0.0001), waist circumference (r=-0.790; P<0.0001), total plasma cholesterol (r=-0.488; P<0.0001), triglyceridemia (r=-0.741; P<0.0001) and glycaemia (r=-0.557, P<0.0001). However, we find a positive but a non significant correlation with the HDL-cholesterol and the mean daily fiber intake (r=0.309; P=0.02). CONCLUSIONS: This study provides additional support to the inverse association between fiber consumption and weight gain, the serum lipid profiles, the glycaemia and the waist circumference. Our findings emphasizes the relevance of increased the intakes of fiber from varied sources that may help avoid weight gain among obese adults.