Adherence to the Mediterranean diet in two Moroccan populations living at different distances from the Mediterranean Sea.

Background: There is growing strong scientific evidence over the past few decades that the Mediterranean diet (MD) has protective effects on cardiometabolic health. Objective: This study aimed to assess MD adherence and its association with sociodemographic and lifestyle factors among women living in two Moroccan provinces, El Jadida and Tetouan, located at different distances from the Mediterranean Sea. Material and methods: It is a cross-sectional study involved 355 subjects of which 55.8% reside in the province of El Jadida, and data on socio-demographic characteristics, lifestyle, cardiovascular risks, medical history and of food frequency consumption were collected. Compliance with the MD was assessed with a simplified MD adherence score based on the weekly frequency of consumption of eight food groups. Results: The overall mean Simplified Mediterranean Diet Score was 4.37 ± 1.47 with inadequate compliance in 55.2% of the sample. No significant association was found between adherence to MD and geographic, socio-demographic, lifestyle or the major cardiovascular risk factors. However, the participants do not comply with half of the recommendations based on the Mediterranean diet pyramid. The lowest level of compliance was observed for olive oil, followed by sweets, eggs, potatoes, fruits, red meat, vegetables, legumes, olives, nuts and seeds. The increased contribution of sugars, dairy products and meat to the overall food intake is significant in the category with high adherence to MD. Conclusion: The study data indicate that Mediterranean Diet is far from being a global pattern in this Moroccan population. The study draws attention to the need for a promoting intervention to maintain this pattern as the original diet in the region.

Dietary behavior of pregnant women in the province of El Jadida and impact of low birth weight on the anthropometric status of newborns. Case-control study.

Background: Low birth weight (LBW) is a major health problem responsible for neonatal mortality and morbidity such as diabetes, obesity and cardiovascular disease in adulthood. Objective: This case-control study aims to compare data on the intake of energy, macro and micronutrient in two groups of pregnant women, who gave birth to low birth weight (LBW) babies named cases and those who gave birth to babies of normal weight (NW) called controls. Material and methods: The collection of information was done using an established questionnaire for 400 pregnant women, allowing the collection of data on socio-demographic and obstetrical factors. Nutritional intake was obtained by recording food consumption using the 24-hour recall method. Anthropometric measurements of parturient and fundal height (FH) were measured before delivery. Results: The mean FH of the cases was 25.69±0.13 and that of the controls was 31.83±0.06. The gestational age of the cases was on average 31.65±0.21 week of amenorrhea (WA) against 38.04±0.08 WA for the controls. 37% of LBW newborns had an Apgar score < 7 (p< 0.001) and 71% were hospitalized in neonatal intensive care (p<0.001). Micronutrient deficiency was raised and concerned calcium 34.02% vs 60.65%, folates 48.32% vs 68.01% and iron 50.85% vs 66% in cases and controls respectively. Newborns from NW had a weight of 3395.5±15.99 against 1957.25±30.72 for those from LBW. Conclusion: This study shows that the nutritional intake did not cover all the nutrient needs of the pregnant women studied and that newborns with LBW are associated with an altered anthropometric status. Improving the living conditions of mothers, good monitoring of pregnancy, and good nutritional education can significantly improve the nutritional status with the same food intake and should be integrated into the nutritional intervention strategies.

Meal intake in an adult Moroccan population: determinants and implications for weight status.

Background: In recent decades, the Moroccan population has changed its dietary practices, particularly those related to meal-taking. It is about irregular meal schedules, reduced frequency and shorter time of meal taking times, as well as a decrease in family meal-taking. All these factors are likely to influence its nutritional status. Objective: The aim is to study meal-taking practices, their determinants and their implications on weight status. In this study, meal-taking practices are defined by the regularity of the schedule, the frequency and the duration of the meals as well as the family commensality. Material and Methods: This work data are part of a study conducted among 507 households in the region of Rabat-SaléKenitra in Morocco, with a validated conceptual and methodological framework. The questionnaire was completed with one member of each household and the body mass index (BMI) was determined by an impedance meter. Results: The main results indicate that the majority of the surveyed population was aged 35 years (59%), female (52%), urban (70%), with a BMI ≥25 kg/m2 (51%), took usually three meals a day (89%), spent less than 90 minutes a day in meals and snacks (60%), had irregular meal schedule (69%), and usually eat at least two meals or snacks a day with family (49%). The univariate analysis showed that urban area was a factor favoring variations of meal times, the male sex was a factor favoring three meals a day, the level of higher education was a factor penalizing the daily duration of meals, and that marital status "married" was a factor favoring family commensality. In addition, variable meal times were revealed as a factor contributing to overweight/obesity, and meal times ≥90 min were revealed as a protective factor of overweight/obesity. Conclusion: The study identified factors associated with meal times, frequency and duration. The results obtained will serve as a basis for the development of educational actions for a change in behavior conducive to health.

Factors influencing cooking method, frequency, and duration of meal preparation in Moroccan households.

Background: The construction of the consumer's identity is dependent on how they prepare their meals. Objective: Study the cooking methods, frequency, and duration of meal preparation in Moroccan households as well as the associated factors. Materials and methods: This work is a part of a study with a validated conceptual and methodological framework that was conducted in 507 households in the region of Rabat-Salé-Kenitra in Morocco. The characteristics of the population and data on the cooking methods, frequency, and duration of meal preparation were collected by a survey. Associations between variables were studied by univariate logistic regression with a significance level of p<0.05. Results: The majority of the population was aged between 35 and 65 years (76%) and lived in urban areas (70%). The univariate analysis showed that the urban area was a factor that hindered stewing (p=0.009), while the work status (p=0.04) and the marital status "Married" (p=0.04) were favorable factors; the household size (p=0.02) is a factor favoring steaming method; urban area (p=0.04), work status (p 0.03), nuclear family type (p<0.001), and household size (p=0.02) are factors hindering the use of oven cooking; urban area (p=0.02) and higher education level (p=0.04) are factors favoring the use of fried food, age category [20-34] years (p=0.04), higher education level (p=0.01) and work status (p=0.01) were factors that favored the use of grilling; nuclear family type, (p=0.04) and household size (p=0.03) were factors that hindered the preparation of breakfast; urban area (p=0.03) and Arab ethnicity (p=0.04) are factors hindering snack preparation; urban area (p<0.001) is a factor favoring dinner preparation; household size (p=0.01) and use of stewing at least four times a week (p=0.002) are factors hindering meal preparation time, while use of baking (p=0.01) is a favoring factor. Conclusion: The study results point towards the implementation of a nutritional education strategy based on combining habits, preferences, and good cooking practices.

Food purchasing habits at traditional and modern markets and consumption of natural and processed foods in Moroccan households.

Background: The locations of food purchase have an impact on the quality of food consumed. Objective: To examine food purchasing habits at traditional and modern markets, their associated factors, and their effects on consuming natural and processed foods. Material and methods: This work used a validated conceptual and methodological framework of a study conducted among 507 households in the Rabat-Salé-Kenitra region in Morocco. Data on sociodemographic and economic characteristics and the frequency of food purchasing were collected from household representatives through a population survey. The food frequency questionnaire was used to collect frequency of consumption of 20 foods, including 10 natural and 10 processed. The associations between the variables were studied by the Chi-square test with a level of significance of p <0.05. Results: Among the households 70% were urban, 62% have nuclear families, 51.5% a size of 5 to 12 members, 41% middle standard of living, 87% frequented markets and souks (MS), and 19% frequented large and medium-sized stores (LMS) at least once a week. The households have in majority a frequency of natural foods consumption ≥ 3 times/week, including fresh vegetables (91%), olive oil (85%), and fresh fruit (84%); and processed foods, such as refined flours (68%), industrial cheese (65%) and industrial yoghurt (52%). MS and LMS frequentation were associated with environment (p<0.001), family type (p=0.01 and p=0.002, respectively), household size (p=0.04 and p=0.002 respectively) and standard of living (p<0.001). Foods whose consumption was associated with both MS and LMS frequentation included fresh vegetables (p<0.001) as natural foods and baked goods as processed foods (respectively, p=0.01 and p=0.04). Conclusion: The results of this study argue for implementing a nutrition education strategy based on the choice of food purchase locations as well as the consumption of natural or processed foods as part of a sustainable Mediterranean diet.

Assessment of diet quality in children and adolescents with type 1 diabetes.

Background: Micronutrient malnutrition is a serious public health problem in most developing countries, including Morocco, due to poor and therefore lower quality diets that lack dietary diversity. Objective: The present study aimed to assess dietary diversity and variety and their relationship with micronutrient adequacy in children and adolescents with type 1 diabetes (T1D). Materials and methods: A cross-sectional study was carried among 240 children and adolescents with T1D. Weight and height were measured and BMI was calculated. Dietary intake data were obtained from two 24-h recalls. A Dietary diversity (DDS) and dietary variety scores (DVS) and mean adequacy ratio (MAR) and nutritional adequacy ratios (NARs) were calculated and compared according to sociodemographic/anthropometric categories. Results: 52.1% of the patients were female. The mean age of the patients was 8.49 ± 4.1 years. The mean BMI was 19.44 ± 5.24 kg/m2; the mean DDS was 4.62±1.20 and the mean MAR was 0.66 ± 0.11. Older children living in rural areas have a low DDS/DVS. Parental education and income level are associated with DDS/DVS. General and central obesity were significantly elevated in children with high DDS. In addition, a high intake of vegetables, eggs, fiber and micronutrients (Magnesium, Calcium, Potassium, Zinc, Phosphorus and Vit B1) is associated with a high DDS; however, high DVS is associated with high consumption of dairy products, carbohydrates and low intake of protein and fat. There are also positive correlations between DDS/DVS and NARs for various nutrients. Conclusion: The quality of the respondents' diets are moderately diversified. DDS or DVS can be used as indicators of micronutrient adequacy in Moroccan T1D children. Nutritional education needs to be strengthened to improve dietary diversity in children, especially in rural areas.

Assessment of nutritional status, dietary intake and adherence to dietary recommendations in type 1 diabetic children and adolescents.

Background: Currently, T1D is one of the most common chronic diseases in children and adolescents. The International Diabetes Federation (IDF) estimates that more than 1.1 million children and adolescents are living with (T1D). A few studies have evaluated the relationship between dietary intake and glycemic control (GC) in people with T1D, and in particular, children and adolescents. Objective: The aim of this study was to evaluate the relationship between anthropometric characteristics, lipid profile, inflammation, dietary intake and GC in comparison with international guidelines. Materials and methods: The study included a sample of 240 children, aged 15 years old or less with T1D. A structured questionnaire was used to collect information on the socio-demographic status, disease characteristics, and diet of the participants. Weight, height, and WC were measured and WHtR and BMI were calculated. Biochemical measurements were determined. Dietary intake was assessed using three 24-hour recalls. Results: Saturated fat intake was five times higher than recommended. Only 8.3% of participants reached the recommended level of fiber. Overweight, obesity, TC, TG, HDL and CRP were significantly higher in children with poor GC to those with good GC. In addition, participants with poor GC had significantly low intakes of calories, carbohydrates, fiber, MUFAs, and PUFAs and high intakes of fat and SFAs. The use of Bivariate correlation analyses showed that calorie, protein, fat and fiber intake were positively correlated with weight, height, WC, and GO, whereas carbohydrate intake was negatively associated with these parameters. On the contrary, CO showed a negative correlation with calorie, protein, fat and fiber intake and a positive correlation with carbohydrate intake. Conclusions: The results revealed that the dietary quality was poor and adherence to dietary recommendations was low with insufficient fiber intake and excess SFA. These results suggest that GC can be improved by a healthy, balanced diet by increasing fiber intake and limiting SFA intake. Liczba pobran: 2.

Validation of conceptual and methodological framework for the study of dietary practices and nutritional status of an adult population.

Background: The use of validated and reliable methods and instruments is necessary to study dietary practices and nutritional status due to their direct impacts on population health. Objective: The aim is the validity and reliability of the conceptual and methodological framework of research on factors associated with dietary practices and nutritional status (FADPNS), carried out on adult population of the Rabat-Salé-Kenitra region in Morocco. Material and methods: First, we developed a conceptual and methodological framework for research on FADPNS, which aimed to study dietary practices, nutritional status, and the factors associated with them in an adult Moroccan population. Then, we studied the validity and reliability of this framework in three phases. Phase 1 focused on the validation of the content of the conceptual and methodological framework, Phase 2 focused on the study by an expert committee of the internal consistency validity (ICV) of the questionnaires used in this research , and Phase 3 consisted of the study of the reliability of the items questionnaires by the test of Cronbach Alpha. Results: Thus, the validated content of the conceptual framework of research on FADPNS includes socio-demographic, socio-economic, and socio-cultural characteristics; health status; physical activity, places of food purchase; food preparation, taking of meals, family commensality; social representations of good dietary practices; food consumption; and nutritional status. The questionnaires used in this research received an ICV score of 85%. The reliability test of the questionnaires showed a Cronbach Alpha value ≥ 0.5, which turned out to vary from "moderate" to "excellent". Conclusion: This work enabled the validation of the conceptual framework and the methodology of the study of the factors associated with dietary practices and nutritional status in the RSK region.

Risk factors for low birth weight in El Jadida province, Morocco. Case-control study.

Background: Low birth weight (LBW) is considered to be one of the most important indicators of a newborn's chances of survival, and a major risk of medium- and long-term morbidity. Objective: To identify risk factors associated with low birth weight newborns among pregnant women during childbirth in Moroccan hospital environment with a view to proposing avenues of intervention for its prevention. Material and methods: Data concerning the weight of newborns at birth, nutritional education, pregnancy monitoring and other risk factors, etc. were collected from 312 pregnant women who gave birth in the maternity ward of El-Jadida Provincial Hospital in Morocco. Results: The study identified 156 cases of newborns with LBW and 156 controls of normal-weight newborns. After adjustment for the variables included in the analysis, the determined factors associated with LBW are nutritional education [OR: 6.22 (2.60-14.87), P<0.001], illiterate women [OR: 8.74 (1.65-46.08), P=0.011], insufficient pregnancy monitoring [OR: 5.69 (2.74-11.83),P<0.001], pregnant women with a normal weight [OR: 3.84 (1.73-8.52), P=0.001], lack of psychological support [OR: 3.23 (1.72-6.08), P<0.001] and tiring domestic activity [OR: 2.13 (1.14-3.99), P=0.017]. Conclusion: Promotion of nutrition for pregnant women, proper implementation of maternal health programs and improvement of their social condition are the modifiable factors that should help reduce LBW risk.

Corrigendum to "Food Expenditure and Food Consumption before and during Ramadan in Moroccan Households".

[This corrects the article DOI: 10.1155/2020/8849832.].

Nutritional status of sub-Saharans residing in the city of El Jadida - Morocco: weight in relation to socio-economic status.

BACKGROUND: Onset of overweight and obesity has been previously reported as a result of population migration to western countries. OBJECTIVE: To determine the nutritional status, weight status and their association with socioeconomic status in sub-Saharan settled in El Jadida city in a Mediterranean country Morocco. MATERIALS AND METHODS: A descriptive study was carried out in 2018 on 256 sub-Saharans migrants living in the city of El Jadida in Morocco. Information on socio-economic and socio-demographic characteristics as well as anthropometric measurements was collected. The body mass index (BMI) and abdominal obesity by measuring waist circumference (WC) and waist circumference to hip ratio (WHR) and the distribution of body fat by calculating the sum of skin folds are determined. RESULTS: Analysis results indicate that height, waist circumference, hip circumference, sum of trunk skinfolds, total sum of skinfolds, and BMI increase with age. The prevalence of underweight decreases with age, overweight was 38.7% in the youngest age group (18-25 years) and reached higher values after 35 years (44.10%). In addition, the prevalence of general obesity (based on BMI) increased with age and abdominal obesity (based on WHR and WC) was more marked in sub-Saharan people aged 26 to 35 years. These results also reveal the coexistence of underweight, overweight and obesity in all age groups. The analysis revealed a significant association between several variables and obesity. Significant associations were found between age and BMI (P=0.04), between level of education (university) and WHR (p=0.02), between sex and WHR, and between sex and WC (p=0.049). The study revealed also that the majority of the study sample gained weight after their settling in the host country. CONCLUSIONS: The study data show that obesity including overweight and abdominal obesity were prevalent among sub-Saharan migrants residing in the city of El Jadida. This prevalence is associated with socio-demographic and socioeconomic factors.

Food Expenditure and Food Consumption before and during Ramadan in Moroccan Households.

Fasting in the month of Ramadan is a religious, cultural, and social ritual for Muslims. The benefits it is supposed to provide to people who practice it are often impaired by unhealthy lifestyles including diet. The present research aimed to study risky eating behaviors and the variation in food expenditure of the Moroccan population during Ramadan. This study was conducted in 2018 in 340 households in urban and rural localities in the Rabat-Salé-Kenitra region of Morocco. Information on eating habits was collected by a nutritional survey using the method of dietary history; household food expenditure and sociodemographic characteristics were collected by a questionnaire. The average age of the population is 40 ± 14 years; the majority (40%) has a middle standard of living, and the average food expenditure increased by 50% during Ramadan. The food survey showed a significant increase in energy intake (p < 0.001), carbohydrate intake (p < 0.001), sucrose intake (p=0.02), sodium intake (p < 0.001), and calcium intake (p < 0.001) and a significant decrease in protein intake (p < 0.001) and lipid intake (p < 0.001), with no significant change in saturated fatty acid intake (p=0.86) during Ramadan. These results show that some dietary behaviors adopted during Ramadan could promote the development or worsening of overweight and chronic diseases. These data reveal the importance of nutritional education adapted to this sacred month.