Cut-point values for classifying active children and validity and reliability of physical activity questionnaire for children in Morocco.

BACKGROUND: The Physical Activity Questionnaire for Children (PAQ-C) is widely used to assess physical activity in populations; however, there is a lack of information about the psychometric properties (validity and reliability) and about the PAQ-C score meaning in populations from low-middle income countries. AIMS: The aim of this study is to evaluate the reliability and validity of PAQ-C and to determine the cut-point values of PAQ-C using accelerometry as a reference in a group of Moroccan children. METHODS: In a sample of 171 children and adolescents aged 8 to 14 years, physical activity was assessed with the GT3X + accelerometer and the PAQ-C. PAQ-C was administered for a second time (retest) after 1 week for a subsample (n = 73). Reliability was analyzed by intraclass correlation coefficient (ICC). The PAQ-C was compared against count per minute CPM and moderate to vigorous intensity PA (MVPA) obtained by accelerometry. Receiver operating curve analyses were performed to assess the performance of PAQ-C in identifying MVPA as measured by accelerometry (reference method). RESULTS: Test-retest reliability was poor with an ICC = (0.48 [0.27; 0.63] for the whole sample, while for the ≥11 year group, the intra-class correlation coefficient was moderate (0.71 [0.42; 0.86]. PAQ-C scores were significantly related to accelerometry-derived metrics of physical activity, CPM (R = 0.29, P < 0.001) and MVPA (R = 0.26, P < 0.001). For the age group ≥11 years, the associations between PAQ-C Scores and CPM and MVPA were stronger, respectively, R = 0.37 (P < 0.001), R = 0.38 (P < 0.0001). We identified that a PAQ-C Score cut-point of 2.33 (95%CI [0.43-0.68]) discriminated adequately between those who met physical activity guidelines and those that did not in the overall sample. CONCLUSIONS: The PAQ-C is valid and useful to assess population level physical activity in those ≥11 years in Morocco and so might be helpful in population surveillance of physical activity in Moroccan adolescents.

Objectively Measured Physical Activity and Sedentary Time among Children and Adolescents in Morocco: A Cross-Sectional Study.

BACKGROUND: Regular physical activity in childhood and adolescent plays an important role in reducing the risk of cardiovascular health diseases, diabetes, and obesity in adulthood. However, little is known about physical activity levels (PA) and sedentary time among children and adolescents in Morocco. OBJECTIVE: To examine gender, type of day, and age grade differences in objectively measured sedentary time, physical activity levels, and physical activity guideline attainment among children and adolescents in Morocco. METHOD: 172 children/adolescents (mean age = 10.92 ± 1.55 years, 49.4% are boys) were recruited for this study and wore a tri-axial accelerometer (GT3X+) for 7 consecutive days. Time spent in sedentary, PA levels, and daily steps were measured and compared according to gender, age grade, and the type of day (weekdays/weekends). RESULTS: In weekdays children/adolescents spent more time in sedentary than weekends (p < 0.001). Boys were eight times more likely to meet the recommendation for at least 60 min of moderate to vigorous physical activity per day than girls (OR: 8.569; 95% [CI]: 4.23-17.32), p < 0.001. CONCLUSION: These findings highlight the need for effective and sustainable strategies and programs aiming to promote physical activity and to reduce sedentary behavior among children and adolescents in Morocco.

Development and validation of bioelectrical impedance analysis equations for prediction total body water and fat-free mass using D2O technique in Moroccan children aged between 8 and 11 years old.

BACKGROUND/OBJECTIVES: Estimating body composition using bioelectric impedance analysis (BIA) requires specific prediction equations. The purpose of our study was to examine the validity of published BIA equations for assessing total body water (TBW) and fat-free mass (FFM) using deuterium oxide dilution (D2O) as a reference method and to develop new FFM and TBW BIA equations if needed for Moroccan pre-pubertal children. SUBJECTS/METHODS: Data were collected from 247 schoolchildren aged 8-11 years old. Children were sorted by gender and age group and assigned in development and validation groups. D2O dilution was used as reference method for estimating TBW and FFM. Bland and Altman test, effect size, pure error, and proportional bias were used to assess the reliability of previous published equations. Cross-validation was performed by Bland and Altman test and BIA new equations were developed by linear regression. RESULTS: Previously published equations were tested and showed significant bias values indicating that if used they would provide biased values of TBW and FFM. The new prediction equations developed were: [Formula: see text] (l) = 0.269 + 0.292 Ht2/R (cm2/Ω) + 0.221 weight (kg) + 0.824 sex (boys = 1, girls = 0) + 0.291 age (years) (R2 = 0.91, RMSE = 1.54 kg); [Formula: see text] (kg) = -0.450 + 0.380 Ht2/R (cm2/Ω) + 0.291 weight (kg) + 1.294 sex (boys = 1, girls = 0) + 0.446 age (years) (R2 = 0.91, RMSE = 1.97 kg). These equations provide better values of proportional bias, agreement, and pure error than the other tested equations. CONCLUSIONS: The new BIA prediction equations seem to be the most accurate for Moroccan pre-pubertal children.

Efficacy of Multiple Micronutrients Fortified Milk Consumption on Iron Nutritional Status in Moroccan Schoolchildren.

Iron deficiency constitutes a major public health problem in Morocco, mainly among women and children. The aim of our paper is to assess the efficacy of consumption of multiple micronutrients (MMN) fortified milk on iron status of Moroccan schoolchildren living in rural region. Children (N = 195), aged 7 to 9 y, were recruited from schools and divided into two groups: the nonfortified group (NFG) received daily a nonfortified Ultra-High-Temperature (UHT) milk and the fortified group received (FG) daily UHT milk fortified with multiple micronutrients including iron sulfate. Blood samples were collected at baseline (T0) and after 9 months (T9). Hemoglobin (Hb) was measured in situ by Hemocue device; ferritin and C Reactive Protein were assessed in serum using ELISA and nephelometry techniques, respectively. Results were considered significant when the p value was <0.05. At T9 FG showed a reduction of iron deficiency from 50.9% to 37.2% (p = 0.037). Despite the low prevalence of iron deficiency anemia (1.9%); more than 50% of children in our sample suffered from iron deficiency at baseline. The consumption of fortified milk reduced the prevalence of iron deficiency by 27% in schoolchildren living in high altitude rural region of Morocco. Clinical Trial Registration. Our study is registered in the Pan African Clinical Trial Registry with the identification number PACTR201410000896410.