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.

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.

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.

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.