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.

Development and validation of anthropometric predictive equations that estimate the total body water and fat-free mass in Tunisian adults.

OBJECTIVE: To develop and validate equations that estimate total body water (TBW) and fat-free mass (FFM) in adults using anthropometric measurements. METHODS: A cross-sectional study was conducted among 178 adults (77 men and 101 women; aged 18-59 years). Participants were distributed by sex and age groups, and then randomly assigned to equal two groups; the development (n = 89) and the validation (n = 89). The anthropometric measurements included height and weight. The deuterium dilution technique (DDT) estimated TBW and FFM. Linear regression models were used with the TBW and FFM as the dependent variable, and height and weight as the independent variables. Cross-validation was performed by Bland and Altman plot, and the new anthropometric equations were developed. RESULTS: In the validation sample, the developed equations had high R2 of 94.4 for both TBW and FFM in all age groups, and low standard errors (RMSE: 1.80 kg for TBW and 2.44 kg for FFM). The pure error was 2.03 for the TBW equation and 2.71 for the FFM equation. The Bland-Altman plot illustrated the good level of concordance between the TBW and FFM predicted by the new equations as determined by DDT. The following developed equations showed a better agreement with the DDT: [Formula: see text]; [Formula: see text]. CONCLUSION: In this study, we developed and validated prediction equations for the estimation of TBW and FFM from DDT in healthy adult Tunisian population. The newly anthropometric prediction equations seem to be the most accurate for Tunisian adult.

Loss of Sour Taste Is the Striking Feature among Four Basic Taste Qualities in Tunisian COVID-19 Patients.

BACKGROUND: Taste disorders (TDs) have been reported to be very common in patients suffering from coronavirus disease 2019 (COVID-19), which is caused by the SARS-CoV-2 virus. In most of the hitherto conducted studies, a gustatory assessment was performed on the basis of surveys or self-reports by patients. The aim of our study was to undertake an objective assessment of four basic taste qualities by conducting tasting sessions that allowed detection thresholds in COVID-19 Tunisian patients and to study their associations with inflammation. METHODS: This analytical cross-sectional study was conducted on 89 patients aged between 21 to 70 years who had been diagnosed with COVID-19. We used Burghart taste strips to assess taste perception of the four taste qualities, i.e., sour, bitter, sweet, and salty. Serum levels of interleukin-1ß (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) were measured. RESULTS: Taste disorders were reported by 40.4% of the patients, while objective assessments revealed that 63.8% of participants were suffering from hypogeusia and/or ageusia. Sour taste was the most altered (70.8%) gustatory quality. Patients with severe COVID-19 had significantly lower sour and bitter taste scores when compared to patients with minor/moderate forms. There was no significant association between serum inflammatory markers and taste disorders. However, the relationship between bitter and sweet taste qualities and IL-1ß levels was significant (p = 0.018 and p = 0.041). CONCLUSIONS: Our results demonstrate the interest in the objective assessment of taste dysfunctions in COVID-19 patients.

External validation of a prediction model for estimating fat mass in children and adolescents in 19 countries: individual participant data meta-analysis.

OBJECTIVE: To evaluate the performance of a UK based prediction model for estimating fat-free mass (and indirectly fat mass) in children and adolescents in non-UK settings. DESIGN: Individual participant data meta-analysis. SETTING: 19 countries. PARTICIPANTS: 5693 children and adolescents (49.7% boys) aged 4 to 15 years with complete data on the predictors included in the UK based model (weight, height, age, sex, and ethnicity) and on the independently assessed outcome measure (fat-free mass determined by deuterium dilution assessment). MAIN OUTCOME MEASURES: The outcome of the UK based prediction model was natural log transformed fat-free mass (lnFFM). Predictive performance statistics of R2, calibration slope, calibration-in-the-large, and root mean square error were assessed in each of the 19 countries and then pooled through random effects meta-analysis. Calibration plots were also derived for each country, including flexible calibration curves. RESULTS: The model showed good predictive ability in non-UK populations of children and adolescents, providing R2 values of >75% in all countries and >90% in 11 of the 19 countries, and with good calibration (ie, agreement) of observed and predicted values. Root mean square error values (on fat-free mass scale) were <4 kg in 17 of the 19 settings. Pooled values (95% confidence intervals) of R2, calibration slope, and calibration-in-the-large were 88.7% (85.9% to 91.4%), 0.98 (0.97 to 1.00), and 0.01 (-0.02 to 0.04), respectively. Heterogeneity was evident in the R2 and calibration-in-the-large values across settings, but not in the calibration slope. Model performance did not vary markedly between boys and girls, age, ethnicity, and national income groups. To further improve the accuracy of the predictions, the model equation was recalibrated for the intercept in each setting so that country specific equations are available for future use. CONCLUSION: The UK based prediction model, which is based on readily available measures, provides predictions of childhood fat-free mass, and hence fat mass, in a range of non-UK settings that explain a large proportion of the variability in observed fat-free mass, and exhibit good calibration performance, especially after recalibration of the intercept for each population. The model demonstrates good generalisability in both low-middle income and high income populations of healthy children and adolescents aged 4-15 years.

Impact of nutrients and Mediterranean diet on the occurrence of gestational diabetes.

Background: The Mediterranean diet (MedDiet) is a dietary pattern effective in terms of prevention of many diseases such as gestational diabetes mellitus (GDM). Recently, many studies have paid attention to nutritional factors during pregnancy as a modifiable contributor to GDM risk.Objective: to investigate associations of nutrients intakes and MedDiet pattern of eating with risk of GDM.Subjects/Methods: This study conducted on N = 120; Pregnant women with GDM (n = 60) and without controls (n = 60). The dietary habits were assessed by a dietary history method and a validated food frequency questionnaire. We calculated a MedDiet score which measures the degree of adherence to a Med Diet.Result: A low Med Diet score was found in pregnant women with and without gestational diabetes in 46.7% and 38.8% of cases, respectively, with no significant difference. Our data showed that the higher the adherence score to the MedDiet, the lower the fasting blood glucose level and the plasma glucose 2 h post load. These findings concerned the two groups studied (P < 10-3). We also noted that controls had a significantly higher intake of legumes, vegetables and fish. Monounsaturated fatty acids and saturated fatty acids consumption was significantly higher in the control group (2.3 ± 0.8 vs 1.7 ± 0.7, P < 10-3). GDM subjects consumed significantly more dairy products and cereals (P < 10-3). After adjustment for confounders, no nutrient was associated with the risk of developing gestational diabetes except vitamin D intake (OR 0.29 [0.15-0.54], P < 10-3) which had a protective effect.Conclusion: Our study underlines the importance of adequate vitamin D intake during pregnancy and suggests that the MedDiet may reduce the incidence of gestational diabetes.

Relevance of body mass index and bioelectrical impedance analysis vs. deuterium dilution technique to assess excess of fat among young adults.

Our study aimed to assess the nutritional status by using body composition among young Tunisian adults through three measurement methods: body mass index (BMI), bioelectrical impedance analysis (BIA) and deuterium oxide dilution technique (2H2O) and to determine the accuracy of BMI and BIA in order to evaluate the overweight and obesity among young adults in Tunisia. Our study involved 144 young adults. Anthropometric parameters were measured. The fat mass percentage (%FM) was determined by 2H2O and BIA techniques. The analysis of deuterium enrichment was performed using a Fourier transform infrared spectrophotometer (FTIR). According to BMI, 26.4% of subjects were overweight and 5.5% were obese. The mean of %FM estimated by BIA was significantly higher than that determined by 2H2O (29.7 ± 7.7 vs. 26.3 ± 10.6, p < .0001). Consequently, the prevalence of overweight and obesity assessed by BIA was significantly higher than by 2H2O (51.4% vs. 34%, p < .0001). Using BMI, the prevalence of overweight and obesity was similar to that estimated by 2H2O (31.9% vs. 34%, p = 0.544). Compared to 2H2O, BIA overestimates the prevalence of overweight and obesity in young adults. On the other hand, the BMI showed an interesting correlation with the %FM determined by 2H2O.

Impacts of nutritional education before Ramadan fasting on dietary intake, weight and body composition in diabetic patients.

BACKGROUND: The fasting period of Ramadan requires special attention for diabetic patients in particular. AIM: To determine the impacts of a nutritional education program before Ramadan fasting (RF) on dietary intake, anthropometry and body composition. METHODS: This was an interventional and comparative study including 54 type 2 diabetic patients, recruited at the National Institute of Nutrition. The patients were divided into two groups: an educated group who received a nutritional education session before Ramadan (n=26), and an uneducated group who did not receive any education (n=28). Food survey, anthropometry and body composition measurements were conducted before and after the month of Ramadan. RESULTS: During RF, a significantly decrease in carbohydrate intake was observed in both educated and uneducated patients (∆=-4.1 vs. ∆=-6.25). Lipid intake was increased significantly during RF for all patients. This increase was lower in patients receiving education compared to the other group (3.4±7.43 vs. 5.25±5.7). During RF, a significant increase in protein, saturated and monounsaturated fatty acids intake was shown in the uneducated group compared to educated group (respectively, ∆=1.19±2.30 vs. ∆ =1.06±7.10, ∆=3.40±7.43 vs. ∆=5.25±5.70 and ∆=2.23±5.60 vs. ∆=2.31±5.10). The weight loss was similar between the two groups of educated (-1.05 kg) and uneducated (-0.58 kg) patients. There was no significant change in body composition during Ramadan in both groups of diabetics. CONCLUSIONS: Nutritional education programs positively impact diabetic patients who prefer RF or insist to fast during Ramadan. These programs must be provided to diabetics before Ramadan.

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.