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.

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.

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.

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.

Socio-economic characteristics, health status and access to health care in an elderly Moroccan community: study of the gender factor.

Background: In Western societies, gender differences in health and health behavior are extensively documented, but less is known about gender health disparities in Morocco. Aging is not yet a research topic or a source of concern. However, the country will face significant demographic aging in the future. Objective: The purpose of this study was to investigate gender differences in indicators associated with socioeconomic status, health status, and access to health care among the elderly population of the El Jadida region in Morocco. Material and methods: It is a cross-sectional study on a random sample of 537 persons, aged 60 and older (136 women and 401 men) from the El Jadida region. Results: When compared to their male counterparts, older Moroccan women face a number of disadvantages, including lower levels of education and literacy, lower levels of employment, rising rates of widowhood and living alone, and a lower likelihood of receiving formal pension benefits. In terms of health status, half of older women do not have medical coverage, almost all feel more tired, and, in discomfort, half suffer from total and central obesity, with more visual, oral, and memory health problems. Older Moroccan men, on the other hand, have greater hypertension, smoke and consume more tobacco and alcohol, and are more anxious, depressed, and insomniac. Overall, for both sexes, the perception of self-rated health status was deemed poor, with three health problems reported per person. Many other demographic, psychosocial, and economic indicators were not significantly related to gender. Conclusions: In Morocco, older people face a variety of problems that have a negative impact on their perception of aging. Furthermore, there are gender differences in socioeconomic status, prevalence, symptoms, and correlates of chronic diseases, health service use, and lifestyle. Longitudinal studies and immediate implementation of medical policy for this population are needed.

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.

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.

Prevalence of gestational diabetes and associated risk factors in the population of Safi Province in Morocco.

INTRODUCTION: the association of diabetes with pregnancy is a frequent gestational situation that constitutes a real public health problem with prevalence and risk factors varying according to the population type. The present study aims to determine the prevalence of gestational diabetes (GD) and associated risk factors (socio-demographic characteristics, medical and obstetric history) in pregnant women from the Moroccan province of Safi. METHODS: this cross-sectional, descriptive and analytical study was conducted during the period from October 2018 to February 2019, on 208 pregnant women, attending the antenatal consultation services of four health centers equally distributed between urban and rural areas of Safi Province in Morocco. The data on blood glucose levels and the risk factors for gestational diabetes generally described in the literature were collected. The statistical Chi-square test and the logistic regression were used to check the association between gestational diabetes and the risk factors. RESULTS: the mean age of the pregnant women sample was 28.9 ± 6.8 years and the prevalence of GD was 24.5%. Using multivariate logistic regression, the most significantly associated risk factors were the diabetic inheritance of a primary relative (OR=2.616 [95% CI: 1.281-5.341]; p=0.008) and the high education level (OR=2.301 [95% CI: 1.123-4.716] p=0.023). CONCLUSION: the results show that gestational diabetes is a frequent pathology among the study population. The data revealed also that the diabetes inheritance (primary relative) and the high level of education are the main risk factors of this pathology in the surveyed pregnant women in the study province.

Anthropometry of women of childbearing age in Morocco: body composition and prevalence of overweight and obesity.

OBJECTIVE: To determine the prevalence of obesity and body fat distribution of Moroccan women of childbearing age, using a panel of anthropometric measurements. DESIGN AND SETTING: A cross-sectional survey conducted in 1995 in an agricultural community, El Jadida province of Morocco. Weight, height, waist and hip circumferences and triceps, biceps, subscapular and supra-iliac skinfold thicknesses were measured. Body mass index (BMI), waist/hip ratio (WHR), sum of all and sum of trunk skinfold thicknesses were determined. SUBJECTS: In total, 1269 women aged 15-49 years from urban and rural areas were surveyed. RESULTS: The means of all anthropometric measurements including body fat were higher in urban than in rural women and increased with age. Trunk fat contributed 50% of total fat. Globally, 4.7% of women were underweight (BMI<18.5 kg m(-2)), 35.2% were overweight or obese (BMI> or =25 kg m(-2)), 10.1% were obese (BMI> or =30 kg m(-2)) and 16.8% had central obesity (WHR>0.85). The prevalence of overweight and obesity was higher in the urban than in the rural area. Underweight prevalence decreased with age, whereas that of overweight and obesity increased. All anthropometric parameters adjusted for age increased with the increase of BMI and WHR. CONCLUSIONS: Although undernutrition is still prevalent, there is an alarming prevalence of overweight and obesity in Moroccan women of childbearing age. The results indicate a shift in this country from the problem of dietary deficiency to the problem of dietary excess, and alert one to the necessity of establishing an intervention to prevent obesity-related diseases. It is necessary to address which of the anthropometric variables studied here is the best predictor of obesity-related diseases in this population.