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.

Sociodemographic, nutritional and health status factors associated with adherence to Mediterranean diet in an agricultural Moroccan adult's population.

Background: Numerous studies have demonstrated beneficial effects of adherence to the Mediterranean diet (MD) on many chronic diseases, including chronic kidney disease (CKD). Objective: The aim of this study was to assess the adherence of a rural population to the Mediterranean diet, to identify the sociodemographic and lifestyle determinants and to analyze the association between adherence to MD and CKD. Material and Methods: In a cross-sectional study, data on sociodemographic, lifestyle factors, clinical, biochemical parameters and diet were collected on a sample of 154 subjects. Adherence to MD was assessed according to a simplified MD score based on the daily frequency of intake of eight food groups (vegetables, legumes, fruits, cereal or potatoes, fish, red meat, dairy products and MUFA/SFA), using the sex specific sample medians as cut-offs. A value of 0 or 1 was assigned to consumption of each component according to its presumed detrimental or beneficial effect on health. Results: According to the simplified MD score, the study data show that high adherence (44.2%) to MD was characterized by intakes high in vegetables, fruits, fish, cereals, olive oil, and low in meat and moderate in dairy. Furthermore, several factors such as age, marital status, education level, and hypertension status were associated with the adherence to MD in the study population. The majority of subjects with CKD have poor adherence to the MD compared to non-CKD with a statistically insignificant difference. Conclusions: In Morocco, maintaining the traditional MD pattern play crucial role for public health. More research is needed in this area to precisely measure this association.

Food quality and nutritional status of school-going adolescents in the province of El Jadida in Morocco.

Background: Dietary diversity and variety scores represent tools for measuring the overall quality of diets. In children, they are good indicators of their nutritional status and growth. Objective: The aim of this study was to assess the consumption and eating habits as well as the lifestyle of Moroccan adolescents attending school in the city of El Jadida. Material and methods: A sample of 463 children of both sexes, aged 9 to 17, attending four schools in the city of El Jadida was studied. Eating habits and information on socioeconomic level are assessed using questionnaires and weight and height were measured on participants. Results: According to the dietary diversity score (DDS) classes, 2.4% of the children surveyed were with low DDS, 55.7% moderate and 41.9%, with high DDS. The mean DDS was 5.67 ± 1.03 in underweight children and 5.53 ± 1.5 in those with overweight (obesity included) and the food variety scores (DVS) were of 12.94±3.24 food items and 10.81±3.25 in the 2 groups respectively. In addition, data analyzes show that children from parents with a low level of education had higher averages of DDS and DVS (DDS: 5.54 ± 0.84; SVA: 10.65 ± 2.32) compared to those of parents with medium education level (DDS: 5.31±0.96; DVS: 9.72±2.62) or high level (DDS: 5.17±0.93; DVS: 9.36 ±2.42). In addition, children from parents of high economic level had a lower averages of DDS and DVS (DDS: 5.24 ± 0.88; DVS: 8.84 ± 2.10) compared to those of parents of low economic level (DDS: 5.36±1.00; DVS: 10.14±2.85). The sugary products were consumed by 56.3% of underweiht children, 75% of normal-weight children and 67% of overweight children (including obese). The estimated total energy intake (TEI) was higher than the Recommended Daily Allowances (RDA) in underweight 2933 Kcal/d and in overweight (including obese) children 3061.75 Kcal/d, while the mean daily intakes of folate, calcium, iron, potassium and zinc were lower than the (RDA). The food groups consumed by the majority of children were cereals (98.5%), fruits and vegetables (87.7%), and sweet products (69.8%) while oilseed products and fat were less consumed (9.7% and 7.8% respectively). Conclusion: The study data show that the adolescents diet were moderately diverse, little varied and poor in certain nutrients essential for their nutritional status and growth. The study draws attention to the need for parents to be aware of the benefits of improving the diet quality and weight status of adolescents.

Dietary diversity score and the incidence of chronic kidney disease in an agricultural Moroccan adults population.

Background: Healthy diet plays an important role in the management of chronic kidney disease (CKD) and in the prevention of related comorbidities. Dietary diversity score (DDS) is well recognized as an indicator for assessing diet quality and food security. However, its association with CKD has not been investigated. Objective: The aim of this study was to estimate the prevalence of CKD and to evaluate its association with DDS among a Moroccan adults from Sidi Bennour province. Materials and methods: A cross sectional study was conducted among 210 individuals. General information among others was collected. Weight, height and waist circumference were measured and body mass index (BMI) was calculated. Blood samples were collected and the serum creatinine was determined. Subsequent glomerular filtration rate (eGFR) was estimated by the modification of diet in renal disease (MDRD) formula and the chronic kidney disease was defined by an eGFR<60 ml/min/1.73m². Dietary intake was assessed using a 24-hours dietary recall, and DDS was computed according to the FAO guidelines. Results: The participants mean age was 54.18±13.45 years, with a sex ratio of 0.38 and 4.4% as the prevalence of chronic kidney disease. The dietary diversity score was lower than 3 (lowest DDS) in 14.4% of the subjects, between 4 and 5 (medium DDS) in 72.5% and higher than 6 (high DDS) in 13.1% of the subjects. Subjects with higher DDS consistently have a higher level of eGFR compared to those with lower DDS while the DDS was not associated with the incidence of CKD in the present study. Conclusion: Even if no statistically significant association was found between CKD and dietary diversity, there is a relationship of higher eGFR levels among the study participants with higher dietary diversity.

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.

Weight status and its determinants among Moroccan adolescents in the province of El Jadida.

Background: Despite the efforts of health systems, the prevalence of malnutrition reflected by weight status still poses challenges for many countries around the world. In fact, with the decrease in undernutrition, excess weight and obesity are gradually increasing in parallel with that of chronic diseases. Among school-going adolescents, however, weight status is less studied, particularly in developing countries. Objective: The objective of this research is to examine the situation and the determinants of the weight status of adolescents in the province of El Jadida in Morocco. Material and methods: The study was carried out on a sample of 463 students from the province of El Jadida of which 58.1% are boys and 41.9% girls, ages 9 and 17. Nutritional status was assessed by anthropometric measurements including height, weight and waist and hip circumference. Body mass index (BMI) was calculated to determine underweight, overweight and general obesity and waist circumference and the waist circumference to hip circumference ratio were used to determine abdominal obesity. Results: The results indicate that only 59.6% of students had normal weight status, 40.4% had abnormal BMI values corresponding to thinness in 18.8% and overweight (overweight and obesity) in 21.6%. A significant difference in the prevalence of abnormal weight status by sex and level of physical activity was found. The results of the present study reveal an abnormal weight status in a large proportion of adolescents linked in addition to the peculiarities of the puberty phase to the sedentary lifestyle in the study population. Conclusions: The results obtained revealed the coexistence of over-nutrition and undernutrition which require a prevention policy based on regular monitoring of weight status as well as on nutritional education and the promotion of physical activity for children and parents.

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.

Study of the association of the nutritional profile of pregnant women with the birth weight of newborns in Morocco.

BACKGROUND: Low birth weight (LBW) is an important predictor of neonatal morbidity and mortality. It reflects the nutritional status of the mother and the quality of health care services during pregnancy. OBJECTIVE: The objective of this study is to determine the factors associated with low birth weight of children born to Moroccan pregnant women in the province of El Jadida. MATERIAL AND METHODS: This cross-sectional case-control study was carried out in the maternity ward of El Jadida provincial hospital on 344 parturient women, half of whom had given birth to children with an LBW and the other half of children with normal weight (NW) at birth. Information on maternal gestational and socioeconomic characteristics as well as eating habits was collected using a questionnaire and anthropometric measurements were taken on the newborns. RESULTS: The study identified 172 parturient who gave birth to newborns with LBW and 172 parturient who gave birth to newborns of NW. The proportions of LBW are greater in first-time mothers (50.6%) and professionally inactive (86.6%). The mean weight of LBW newborns is 2013.95 ± 372.95g compared to 3380 ± 217.59g for NW newborns. The determined factors associated with LBW are the low socio-economic level (OR = 3.18; 95% CI: 1.09-9.23), insufficient monitoring of prenatal consultation (OR = 2.91; 95% CI: 1, 71-4.95), origin from rural areas (OR = 0.52; 95% CI: 0.30-0.91) and lack of nutritional education (OR = 0.17; 95% CI: 0, 09-0.34). The daily calcium intake in mothers of newborns with LBW is 33.82% of the recommended daily allowance (RDA), the daily iron requirement coverage was 50%, folates 66, 16% and zinc 87.72% of the RDA. CONCLUSIONS: Well-targeted and coordinated education and awareness-raising actions on early pregnancy and feeding pregnant women could have a positive impact on improving the birth rate of children with a weight deficit.

Association of Metabolic Syndrome and Chronic Kidney Disease in Moroccan Adult Population.

Background: Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that may promote the development of chronic kidney disease (CKD). The aim of this research was to determine the prevalence of MetS and its components and, to study their association with CKD among Moroccan adult population living in an agricultural province. Materials and Methods: The study involved 210 adult participants of 18 and over years, of both sexes, sampled from urban and rural areas of Sidi Bennour province in Morocco. Systolic and diastolic blood pressure, weight, height, and waist circumference were measured and body mass index (BMI) was calculated. Blood total cholesterol, triglycerides, glucose, and serum creatinine were determined. Subsequent glomerular filtration rate (GFR) was estimated by the modification of diet in renal disease formula and the CKD was defined by an estimated GFR (eGFR) <60 mL/min/1.73 m2. The diagnosis of MetS was based on the National Cholesterol Education Program/Adult Treatment Panel (NCEP ATP III) report. Results: The mean age of the participants was 54.18 ± 13.45 years, the prevalence of MetS and CKD were 38% and 4.4%, respectively. Abdominal obesity was the strongest risk factor of MetS among the studied population (71%), followed by increased fasting plasma glucose (40.5%), high blood pressure (35.2%), hypercholesterolemia (31.0%), and hypertriglyceridemia (23.8%). The prevalence of these comorbid factors increased with age (P = 0.000), BMI (P = 0.000), and decreased with education level (P = 0.012). The presence of MetS was significantly associated with decreased eGFR (P = 0.022), hence the prevalence of CKD was markedly greater in subjects with MetS than those without. Conclusions: Our finding indicates that MetS is a serious public health problem in the study population and that its individual components are involved in decreasing the eGFR and the progression of renal dysfunction. The study results support the need of the development of a strategy to control and prevent worsening of the MetS individual components and development of CKD.

Undiagnosed chronic kidney disease and its associated risk factors in an agricultural Moroccan adult's population.

INTRODUCTION: Chronic kidney disease is among the major non-communicable diseases with increasing prevalence. This study aimed to estimate the prevalence of chronic kidney disease and its associated risk factors among Moroccan population sample from Sidi Bennour province. METHODS: An observational, descriptive and analytical study was conducted in an agricultural community of Morocco. A sample of 182 subjects aged 18 or older, randomly selected from the province health care centers. The information on the participants was collected using a structured questionnaire, blood samples were collected and the serum creatinine was determined. Subsequent glomerular filtration rate (eGFR) was estimated by the modification of diet in renal disease formula and the chronic kidney disease was defined by an eGFR<60 mL/min/1.73 m2. RESULTS: The participants mean age was 53.58±12.06 years, with a sex ratio of 0.30 and the prevalence of chronic kidney disease was 4.4%. The risk factors associated with chronic kidney disease were age, hypertension, and nephrotoxic treatment, that are significantly correlated with renal impairment (P=0.006 for age, P=0.008 for hypertension and P=0.001 for nephrotoxic medication used respectively). CONCLUSIONS: The study data show that chronic kidney disease should be of important consideration in any strategy to address non-communicable diseases and associated risk factors.