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.

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.

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.

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.

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.