Biodemographic Characteristics of Children with Down Syndrome, Their Siblings, and Their Parents in Moroccan Population.

OBJECTIVE: In this study, we present the results of biodemographic characteristics of households and associated factors with Down syndrome (DS) birth in Morocco. METHODS: We conducted a retrospective survey between 2014 and 2017 addressed to 277 families with 925 siblings and at least one child with DS (279 with DS). The data are collected using a standardized questionnaire in Marrakech-Safi region. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). χ2 and student t tests were used for testing statistical significance. Differences were considered significant when the p value <0.05. RESULTS: The binary logistic regression analysis between DS and non-DS children in their biodemographic characteristics studied (sex, breastfeeding, duration of exclusive breastfeeding, birth weight, maternal age at birth, paternal age at birth, oral contraceptive use, duration of oral contraceptive use before pregnancy, child age, and rank of birth) showed that only maternal age and paternal age at birth, duration of exclusive breastfeeding, birth weight, and child age were associated with DS birth (odds ratio [OR] = 1.08; 95% Cl: 1.04-1.13, OR = 1.04; 95% Cl: 1.00-1.08, OR = 0.95; 95% Cl: 0.92-0.98, OR = 0.31; 95% Cl: 0.22-0.44, and OR = 0.90; 95% CI: 0.87-0.93, respectively). In the other hand, the comparison between some of socio- and biodemographic characteristics of households studied with data from National Population Survey and Family Health (2018) showed a higher level of education in women and men in our sample in comparison with the general population. Similar results were shown in proportion of men and women in paid employment, the proportion of smoking and alcohol consumption among men, and the rate of oral contraceptive use before pregnancy among women. CONCLUSION: Highlighting the biodemographic characteristics of people with DS will help families to take good care of this group.

Parents' perceptions of morbidities and some functional abilities in people with down syndrome in Morocco.

Objective: This study aimed to assess parental perceptions of morbidity and certain functional abilities in people with Down syndrome (DS) and their variability according to age and sex in Morocco. Material and Methods: A retrospective and analytical survey was conducted between May 2014 and November 2017, and addressed to the parents of 279 individuals with DS, including 161 boys (57.7%) aged 1-40 years. The sample was subdivised to tree age groups, children under 10 years old, adolescents aged 10-18 years and adults aged ≥ 18 years. Information about the identity of parents, age and sex of people with DS, their morbidity during the two years preceding the survey, and some functional abilities was collected. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) test was used for testing statistical significance. Differences were considered significant when the p-value < 0.05. The multivariate analysis were used to identify the causes of morbidies independently associated with age and sex of child. Associations were measured in Odds ratio (OR) with 95% confidence intervals (95% Cl). Results: The most common factors of morbidity registered in the study sample with DS, included respiratory infections, visual disturbances, oral pathologies, and cardiac problems (75.4%, 72.1%, 59.3%, and 44.9%, respectively). The hearing deficit, cardiac problems, respiratory infections, and oral pathologies showed statistically significant differences among the three age groups. According to the participants parents' perceptions, half of them (50%) were able to walk at 30 months, talk at 72 months, sit at 16 months, crawl at 16 months and eat alone at 48 months old. Conclusion: People with DS at different ages present a set of potentially treatable diseases that require multidisciplinary medical monitoring. They also need early paramedical care to improve their functional abilities.

Assessment of phenolic and flavonoid contents, antioxidant and antimicrobial activities of Moroccan propolis.

Background: Despite the extensive literature focused on propolis extract, few data exists on the bioactive compounds and biological activities in the Moroccan propolis and its economic value is low. Objective: In this research, the aim was to evaluate the total content of phenols and flavonoids as well as the antioxidant, antibacterial and antifungal activities of Moroccan propolis. Material and Methods: The polyphenol and flavonoid content of the Moroccan propolis from three geographic regions, was quantified in the ethanolic extract by colorimetric methods using folin-ciocalteu and aluminum chloride. The antioxidant activity was evaluated by the DPPH test and expressed as IC50. Disk diffusion and broth microdilution methods were used to examine in vitro antimicrobial activity against known human microorganism pathogens. Results: The obtained data revealed that Moroccan propolis samples presented significant variations in total polyphenols and flavonoids. All samples showed significant antioxidant activity with IC50 values ranging from 4.23±0.5 to 154±0.21 µg/ mL. A strong correlation between total phenolic activity, flavonoids and antioxidant activity was found. The in vitro study of antibacterial activity showed that the propolis samples exhibited a range of growth inhibitory actions against all bacterial strains tested with the highest activity against gram-positive bacteria. Only propolis from the Sidi Bennour region demonstrated an antifungal activity. Conclusion: The study data show that Moroccan propolis extracts have a promising content of antioxidant and antimicrobial compounds that could be exploited to prevent certain diseases linked to oxidative stress and pathogenic infections.

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.

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.

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 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.

Bio-demographic characteristics of households and risk factors for Down Syndrome in Morocco.

Background: The most studied risk factors for Down Syndrom (DS) were: region of residence, exposure to chemicals, parents' education level, cigarette and alcohol use by father or mother or both, and oral contraceptive (OC) use. Objective: The aim of this study was to compare certain variables considered as risk factors on DS such as parental age at birth, OC use, child's sex, and rank of birth between children with DS and their siblings without DS as well as to determine the socio-bio-demographic characteristics of the families studied compared with the general Moroccan population. Material and Methods: We conducted a cross-sectional analysis of 277 families with 925 siblings and at least one child with DS (279 with DS) between 2014 and 2017. The data are collected using a standardized questionnaire in MarrakechSafi region. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) and Student t tests were used for testing statistical significance. Differences were considered significant when the p-value <0.05. Results: The binary logistic regression analysis between DS and non-DS children in their bio-demographic characteristics studied (sex, maternal age at birth, paternal age at birth, oral contraceptive (OC) use, length of oral contraceptive use before pregnancy and rank of birth) showed that only maternal age and paternal age at birth and OC use were associated with DS birth (OR= 1.16; 95% CL: 1.11-1.21, OR= 1.05; 95%CL: 1.01-1.09 and OR= 0.01; 95%CL: 0.00-0.003, respectively). In the other hand, the comparison between socio and bio-demographic characteristics of households studied with data from National Population Survey and Family health (2018) showed a higher level of education in women and men in our sample. Similar results were shown in rate of men and women in paid employment, the rate of smoking and alcohol consumption among men and the rate of OC use before pregnancy among women. Conclusion: These results will help to sensitize the Moroccan population about risk factors for DS.

Nutritional composition and bioactive compounds of a local variety of Vitis vinifera L. cultivated in Morocco.

Background: The vine is considered one of the most important and popular fruits in the world thanks to its high nutritional value and high fiber content. Objective: This study aim was to evaluate the nutritional composition in a local variety 'Doukkali' grape (Vitis vinifera L.) in the perspective of their suitability for pharmaceutical and agri-food use. Material and methods: The proximate composition and minerals were determined using AOAC methods, the total sugar by HPLC method. The total phenolic compounds using the Folin-Ciocalteu reagent, the total flavonoids using aluminum chloride colorimetric method and tannins by the method of vanillin. Results: The analysis of the raisin of this variety revealed a high carbohydrate content of 61% with high levels of glucose (31.6%), fructose (30.4%), dietary fiber (13.92%) and minerals including potassium (445.50 mg/100 g DM), calcium (193.26 mg/100 g DM), sulfur (171.63 mg/100 g DM), sodium (137.50 mg/100 g DM), phosphorus (99.79 mg/100 g DM), magnesium (54.74 mg/100 g DM) and iron (2.39mg/ g DM). Analysis of bioactive compounds showed significant content of polyphenols varying from 43 to 309.1 mg GAE/g DM, flavonoids from 1.0 to 23.8 mg CEQ/g DM and tannins from 2.5 to 50.45 mg TAE/g DM. Conclusions: The study shows that the local variety of Doukkali grape has an important nutritional potential that can contribute to the nutritional needs and the fight against malnutrition as well as to the dietary diversity of the local population.

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.

Models to predict non-alcoholic fatty liver disease linked to obesity in Morocco.

Background: The prevalence, risk factors and screening for the problem of non-alcoholic fatty liver disease linked to obesity are not well known in Morocco. The diagnosis of this disease by biopsy is invasive and the assessment of its severity by ultrasound shows variability in observation. Objective: The aim of this retrospective study is to estimate the prevalence of NAFLD linked to obesity, to determine the risk factors associated with it and to develop a non-invasive procedure as a method of diagnosing this disease in Morocco. Material and Methods: It's a retrospective study. The collection of anthropometric, clinical, biochemical, and radiological data over a period from 2014 to 2018 were captured from registers of patients at the Med VI University Hospital in Marrakech. Data were analyzed using SPSS version 26 software. Descriptive statistics were presented using frequencies and means +/- standard deviation to describe categorical and numeric data respectively. Pearson's chi-square test was used to test the association between categories of two independent samples. Multinomial logistic regression is used to find disease risk factors and models to predict non-alcoholic fatty liver disease (NAFLD) linked to obesity in Morocco. Results: Gender, increased age, body mass index, alanine aminotransferase, triglycerides, C-reactive protein, alkaline phosphatase, gamma-glutamyl transferase were significantly correlated with NAFLD and its evolvement. Conclusion: The prevalence of NAFLD linked to obesity is an alarming problem in Morocco. It was 83.5%. Age, gender, body mass index, alanine aminotransferase, triglycerides, C-reactive protein, alkaline phosphatase and gamma-glutamyl transferase are risk factors for NAFLD and its severity. It were used to develop two algorithms that can be used, as a more objective and non-invasive screening method for NAFLD.

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.

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.

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.

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.

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.

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.

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.

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.