Is good dietary diversity a predictor of academic success?

BACKGROUND AND AIM: Interest in identifying factors influencing educational success is growing. Many studies have examined factors that may affect academic performance. It is often observed that a group of students sharing the same external variables (school environment) yet have different results, which states that individual variables have more impact on the determination of academic performance. Therefore, the present study aims to substantiate this controversy by investigating the association between dietary habits and academic performance in a population of adolescents attending school in Eastern Morocco Methods: Cross-sectional study based on a self-administered questionnaire. Items included sociodemographic variables, eating and sleeping habits, physical activity practice and the last semester grade point average of mathematics (GPAm) and first foreign language (GPAf) subjects Results: Dietary diversity score (DDS) is a significant predictor of academic performance. Weight status and sleep duration was found to be strongly associated with academic achievement. Absenteeism and smoking are negatively associated with school achievement Conclusions: Findings indicate associations between dietary diversity and academic performance of students in eastern Morocco which support creation of effective nutrition education policies to eradicate the double burden of malnutrition on the one side leanness and on the other side fighting against obesity by promoting good diet in terms of quality and quantity and encouraging physical exercise. It is also essential to review the lifestyle of adolescents by raising awareness against the scourge of smoking near schools. The results of these actions are likely to be healthier schools and improved behavioral development and academic performance of children. (www.actabiomedica.it).

Association between Physical Activity, Body Composition, and Metabolic Disorders in Middle-Aged Women of Ksar el Kebir (Morocco).

This study aimed to examine the association between physical activity (PA), body composition, and metabolic disorders in a population of Moroccan women classified by menopausal status. This cross-sectional study comprised 373 peri- and postmenopausal women aged 45-64 years old. PA levels were assessed using the short version of the International Physical Activity Questionnaire (IPAQ-SF). Body composition and metabolic disorders were assessed by measurements of anthropometric and biological parameters: weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), WC/HC ratio, percent body fat, systolic and diastolic blood pressure, fasting blood glucose, and serum lipids (total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C). Metabolic syndrome (MetS) was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Pearson correlations were used to test for associations. The mean total PA score of perimenopausal women was 1683.51 ± 805.36 MET-min/week, and of postmenopausal women was 1450.81 ± 780.67 MET-min/week. In all participants, peri- and postmenopausal women, PA was significantly and inversely associated with BMI, weight, percent body fat, HC, WC, and number of MetS components (p < 0.01), and with fasting blood glucose, TC, TG, and LDL-C (p < 0.05). The frequencies of metabolic disorders, obesity, abdominal obesity, type 2 diabetes, dyslipidemia, and MetS were significantly lower at moderate and intense levels of PA (p < 0.05), in also all participants. In middle-aged women, particularly those who are peri-menopausal, PA at moderate and intense levels is associated with more favorable body composition and less frequent metabolic disorders. However, in this particular study, PA does not appear to be associated with blood pressure and HDL-C concentrations. Future studies may be needed to further clarify these findings.

A short update on new approaches to celiac disease.

Celiac disease is an autoimmune enteropathy of the small intestine, related to gluten intolerance occurring in genetically predisposed patients. Currently, the only available treatment is a lifelong gluten-free diet. However, the total avoidance of gluten is difficult and poses a challenge to patients, nutritionists and treating physicians. For this reason, scientists have developed in recent years new therapeutic approaches complementary to dietary treatment, such as modification of gluten to make gliadin non-toxic, reduction of the inflammatory response with elafin and Lactococcus Lactis, degradation of gluten by endoproteolytic enzymes, and correction of nutritional deficiencies by adding pseudo-cereals to the diet of celiac patients. This literature review focuses on the different treatment strategies for celiac disease previously studied and summarizes the latest advances in this field.

Association between Non-Verbal Intelligence and Academic Performance of Schoolchildren from Taza, Eastern Morocco.

Interest in identifying factors influencing educational success is growing. It is often observed that a group of students share the same external variables (school environment) yet have different results, which states that individual variables have more impact on the determination of academic performance. Therefore, the present study aimed to substantiate this fact by investigating the association between non-verbal fluid intelligence and academic performance in a population of schoolchildren in Eastern Morocco. The investigation was a cross-sectional study based on a self-administered questionnaire. Items included the standard Raven's progressive matrices. Students' grades were collected from the administrative offices of the visited schools. Significant and positive correlations between the non-verbal intelligence scores and the school results were found: for the general average, the correlation was 0.574; for the school subject French, the correlation coefficient was 0.475; and for mathematics, we found a relatively low coefficient of 0.381. Non-verbal fluid intelligence significantly and positively predicted academic performance (ß = .574, p = .000). These results call for policymakers to implement the use of intelligence tests with school directors and teachers as a diagnostic tool to guide support efforts for low-achieving children and even to create pilot classes for the best-performing students.

Frequency of Metabolic Syndrome and Study of Anthropometric, Clinical and Biological Characteristics in Peri- and Postmenopausal Women in the City of Ksar El Kebir (Northern Morocco).

This study aimed to determine the frequency of metabolic syndrome and to identify its predictive factors in peri- and post-menopausal women in the city of Ksar El Kebir, in northern Morocco. A total of 373 peri- and post-menopausal women between 45 and 64 years old participated in the study. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) definition. Body mass index (BMI) was calculated to assess the degree of obesity in women; anthropometric, clinical and biological parameters were collected during interviews. The mean ages of peri- and postmenopausal women were 48.84 ± 2.4 years and 56.65 ± 4.29 years, respectively. Postmenopausal women had higher means of anthropometric and biological parameters than peri-menopausal women. We also noted a predominance of metabolic syndrome in postmenopausal women (n = 158) compared to peri-menopausal women (n = 81). Waist circumference was the predominant marker in the subjects studied, whereas triglycerides were the lower marker. In the overall population, the incidence of metabolic syndrome and its associated factors were higher in postmenopausal women than in peri-menopausal women, from which it can be concluded that post menopause may be a predictor of metabolic syndrome.

[Study of the metabolic syndrome and physical activity in a population from Marrakesh, in Morocco]. / Etude du syndrome métabolique et l'activité physique chez une population de la ville de Marrakech, au Maroc.

INTRODUCTION: the aim of this study was to correlate the metabolic syndrome with the level of the physical activity in a population from Marrakech, Morocco. METHODS: the study was conducted at Ibn Zohr Regional Hospital in Marrakech. The body mass index (BMI) was calculated to assess the degree of obesity of each subject. To determine the level of physical activity, we used the short version of the IPAQ (International Physical Activity Questionnaire); Blood parameters were measured by a Biochemistry Automaton. All statistical analyzes were performed using SPSS software. RESULTS: a total of 300 subjects participated in the study, which 57.3% were female and 42.7% were male with a sex ratio of 0.74. The average age of our population was 51.6± 13.42 years old. Seventy-nine of the participants (26.3%) had a metabolic syndrome, with a predominance of female: 60 women (34.9%) and 19 men (14.8%). There is a significant relationship between level of physical activity and the presence of metabolic syndrome (P = 0.002), between physical activity level and BMI and waist circumference (p < 0.001) and (p = 0.003) respectively. CONCLUSION: the result shows a significant association between obesity, metabolic syndrome and the level of the physical activity, which would encourage us to encourage the application of lifestyle rules, including physical activity, which remains one of the best preventive actions against this pathology.

Epidemiological profile and clinical characteristics of metabolic syndrome in Marrakesh, Morocco.

INTRODUCTION: the purpose of this study was to bring out some epidemiological and clinical characteristics of metabolic syndrome. METHODS: a total of 300 subjects willingly participated in the present study which was conducted at Ibn Zohr regional hospital in Marrakesh. We were interested in socio-demographic variables, body mass index (BMI) which assesses the degree of obesity of each subject. The blood parameters were determined by an adequate biochemistry automaton. All statistical analyses were performed using SPSS software. RESULTS: among the 300 subjects who participated in the study, 57.3% were females and 42.7% were males with a sex-ratio of 0.74. The average age was 51.6 ± 13.42 years old. Seventy nine of the participants (26.3%) had a metabolic syndrome, with a predominance of women: 60 women (34.9%) and 19 men (14.8%). Illiterates (33.8%) and married subjects (25.6%) were the most affected by the metabolic syndrome. The high waist circumference found in 97.5% was the predominant criteria in our study. Finally, the statistical analysis showed a significant association between high waist circumference, BMI and the presence of metabolic syndrome (P = 0.001>) and (P < 0.001) respectively. CONCLUSION: the metabolic syndrome is slowly but surely setting. Implementing prevention strategies and encouraging healthy lifestyles will surely minimize serious public health problems in the city.

[Nutrition transition, prevalence of double burden of malnutrition and cardiovascular risk factors in the adult population living in the island of Anjouan, Comoros]. / Transition nutritionnelle, prévalence de la double charge de la malnutrition et facteurs de risque cardiovasculaires chez les adultes de l'île comorienne d'Anjouan.

INTRODUCTION: Overweight and obesity has been increasing at an alarming rate, in particular in the developing countries. The purpose of this study was to determine the prevalence of underweight and overweight and to assess the relationship between body mass index and cardiovascular risk factors in adults living in the island of Anjouan. METHODS: We conducted a cross-sectional study involving a sample of 902 individuals aged 25 to 64 years using the empirical survey based on "quota sampling". Nutritional status was determined by calculating the body mass index, the abdominal circumference and waist-to-hip ratio (WHR). Blood pressure, abdominal circumference and hip circumference were measured during the interview while capillary fasting blood glucose was measured the next day. RESULTS: The results show an average age of 39.5 ± 11.67 years. The overall prevalence of underweight, overweight and obesity was 4.1%, 28.6% and 22.2% respectively. The risk factors associated with overweight/obesity were: advanced age (p= 0.004), gender (p=0.000), weight (p=0.000), diabetes (p= 0.006), hypertension (p= 0.01), abdominal obesity (p= 0.000), hip circumference (p=0.000), WHR (p=0.000), time of inactivity/day (p=0.001) and smoking (p< 0.05), in contrast to physical inactivity (p= 0.10). CONCLUSION: These results confirm the presence of a double burden of nutrition. Hence the urgency to implement preventive measures for noncommunicable diseases.

Profile of diabetes and cardiovascular risk factors in adults Anjouan Island (Comoros).

INTRODUCTION: The aim of this study was to estimate the prevalence of Diabetes Mellitus (DM) and Impaired Fasting Glucose (IFG) in the peri-urban adult population living in the island of Anjouan, Comoros and to investigate the factors associated with diabetes mellitus. METHODS: The survey was a cross-sectional study, in which a sample of 902 individuals (540 women and 362 men) aged 25 to 64 was selected using empirical sampling "quotas" or "reasoned choice" survey method. Hypertension and obesity abdominal measurements of these subjects were collected during face-to-face interviews and following day fasting blood glucose was measured in capillary blood. RESULTS: Participation rate was 83.5%. The mean age of subjects was 39.5 ± 11.63 years. The sex ratio was 0.67. Overall crude diabetes and IFG prevalence were 8.5% and 8.1%, respectively. The risk factors for diabetes type 2 onset were a family history of diabetes (P = 0.006), older age (P = 0.000), glycemic control (P = 0.010), excess waist circumference (P = 0.03) and hypertension (p = 0.000), were significantly positively associated with DM, contrary to sex (P = 0.142). CONCLUSION: These high figures confirm that diabetes and factors associated do not spare Anjouan population. Awareness, primary prevention, are to set up for a better control of non-communicable diseases.

Morphological and Nutritional Properties of Moroccan Capparis spinosa Seeds.

Capparis spinosa is one of the few shrub species which has so many qualities with many uses. In this case, the present work aimed to study both some morphological characteristics and biochemical components (proteins, lipids, and carotenoids) of fresh C. spinosa seeds with three different sizes, collected from two Moroccan regions. In this study, C. spinosa seeds present a total of proteins ranging from 23.32 to 28.5% on a dry weight basis. Additionally, the total lipids varied between 2.8 and 3.4%. C. spinosa seeds contained a high level of carotenoids. Besides, the analytical values have been variously affected by both size and location. Further, the preliminary morphological and anatomical characterization of leaves, stems, and morphological properties such as length, width, thickness, geometric mean diameter, sphericity, surface area, and mass of 100 seeds have been determined. Consequently, this present study confirms the importance of Moroccan C. spinosa seeds, which represent a significant nutritional value. Also, its good morphological quality is a significant indicator of commercial criteria.

Connaissance sur la vitamine D : état des lieux de la prévalence de l'hypovitaminose D chez la population marocaine

De par le monde, la vitamine D (VTD) suscite un important gain d'intérêt auprès de la communauté scientifique en raison, d'une part, de ses effets sur l'organisme, et d'autre part, au caractère de sa déficience observé chez la population. L'objectif de cet article est de présenter un état d'art sur les généralités relatives à la VTD et de mettre en exergue la prévalence de l'hypovitaminose D, à partir de certaines études non exhaustives, chez la population marocaine. A ce titre, la VTD peut être considérée comme une pro-hormone qui exerce des effets ubiquitaire sur l'organisme et dont les répercussions de sa déficience affectent aussi bien la santé osseuse et extra osseuse de l'individu. Par ailleurs, la prévalence de la déficience de la VTD chez la population marocaine est très présente, ainsi, ce taux est entre 78.1 % et 98.4% chez la population féminine, de 85. 2% chez la population masculine et fluctue entre 70.1 % et de 90% chez la population marocaine consultante en médecine ambulatoire. Tenant compte, de la prévalence d'hypovitaminose D chez l'adulte marocain et de ses effets sur l'organisme, une action de sensibilisation quant à l'importance de la VTD pour l'organisme s'inscrit dans une démarche de santé publique marocaine

Socio-economic and behavioural determinants of fruit and vegetable intake in Moroccan women.

OBJECTIVE: To estimate daily fruit and vegetable intakes and to investigate socio-economic and behavioural differences in fruit and vegetable consumption among urban Moroccan women. DESIGN: A cross-sectional survey. Fruit and vegetable intake was measured with a single 24 h recall. SETTINGS: A representative population-based survey conducted in the area of Rabat-Salé. SUBJECTS: Women (n 894) of child-bearing age (20-49 years). RESULTS: Mean fruit and vegetable intake was 331 g/d (155 g/d for fruit and 176 g/d for vegetables). Only one-third (32.1 %) of women consumed ≥ 400 g/d and half the sample (50.6 %) were considered as low consumers, i.e. <280 g/d. Women of higher economic status ate significantly more fruit (P<0.05) and more fruit and vegetables combined (P<0.05). Women ate significantly less vegetables if they ate out of home more often or skipped at least one main meal (breakfast, lunch or dinner) or ate more processed foods (P<0.05, P<0.01 and P<0.001, respectively). Fruit and vegetable diversity was not associated with any of the factors investigated. CONCLUSIONS: In this population, fruit and vegetable intakes are driven by different determinants. Indeed, while vegetable consumption was related only to behavioural determinants, fruit consumption was influenced only by economic status. Therefore, programmes promoting fruit and vegetable intake would be more effective if they account for these specific determinants in their design.

A double burden of overall or central adiposity and anemia or iron deficiency is prevalent but with little socioeconomic patterning among Moroccan and Tunisian urban women.

In North Africa, overnutrition has dramatically increased with the nutrition transition while micronutrient deficiencies persist, resulting in clustering of opposite types of malnutrition that can present a unique difficulty for public health interventions. We assessed the magnitude of the double burden of malnutrition among urban Moroccan and Tunisian women, as defined by the coexistence of overall or central adiposity and anemia or iron deficiency (ID), and explored the sociodemographic patterning of individual double burden. In cross-sectional surveys representative of the region around the capital city, we randomly selected 811 and 1689 nonpregnant women aged 20-49 y in Morocco and Tunisia, respectively. Four double burdens were analyzed: overweight (body mass index ≥25 kg/m(2)) or increased risk abdominal obesity (waist circumference ≥80 cm) and anemia (blood hemoglobin <120 g/L) or ID (C-reactive protein-corrected serum ferritin <15 µg/L). Adjusted associations with 9 sociodemographic factors were estimated by logistic regression. The prevalence of overweight and ID was 67.0% and 45.2% in Morocco, respectively, and 69.5% and 27.0% in Tunisia, respectively, illustrating the population-level double burden. The coexistence of overall or central adiposity with ID was found in 29.8% and 30.1% of women in Morocco, respectively, and in 18.2% and 18.3% of women in Tunisia, respectively, quite evenly distributed across age, economic, or education groups. Generally, the rare, associated sociodemographic factors varied across the 4 subject-level double burdens and the 2 countries and differed from those usually associated with adiposity, anemia, or ID. Any double burden combining adiposity and anemia or ID should therefore be taken into consideration in all women. This trial was registered at clinicaltrials.gov as NCT01844349.

Assessment of iron deficiency in the context of the obesity epidemic: importance of correcting serum ferritin concentrations for inflammation.

BACKGROUND: The correction of serum ferritin (SF) concentrations for inflammation because of infectious or parasitic diseases was recently proposed, especially in developing countries, but in many countries, adiposity has become the main cause of inflammation. OBJECTIVE: We assessed, overall and by adiposity status, the bias in the estimation of iron deficiency (ID) on the basis of uncorrected SF. DESIGN: A cross-sectional survey in 2010 in Rabat-Salé, Morocco, used a random sample of 811 women aged 20-49 y. Adiposity was assessed by body mass index (BMI) (in kg/m²) (normal: BMI <25; overweight: BMI ≥25 to <30; obese: BMI ≥30), waist circumference, and body fat. Inflammation was indicated by a C-reactive protein (CRP) concentration >2 mg/L. ID was indicated by an SF concentration <15 µg/L. The correction factor of SF for inflammation was derived from our sample. Differential effects of SF correction on ID status on the basis of adiposity were assessed by models that included adiposity × correction interactions and accounted for the within-subject correlation. RESULTS: The prevalence of overweight was 33.0% and of obesity was 34.0%. Inflammation (42.3%) was strongly linked with adiposity (20.1%, 37.6%, and 68.4% in normal, overweight, and obese subjects, respectively; P < 0.0001). SF increased from a CRP concentration >2 mg/L. The correction factor of SF was 0.65. The prevalence of ID (37.2% compared with 45.2%; difference -8.0%, P < 0.0001) was underestimated by not correcting SF, and the difference increased with adiposity (-2.9%, -8.5%, and -12.4% in normal, overweight, and obese subjects, respectively; P-interaction < 0.0001). Analogous results were observed for other adiposity measures. CONCLUSION: In developing countries where ID remains prevalent but rates of obesity are already high, corrected SF should be used when assessing ID status, even if infectious or parasitic diseases are no longer widespread. This trial was registered at clinicaltrials.gov as NCT01844349.

Developing national obesity policy in middle-income countries: a case study from North Africa.

BACKGROUND: The prevalence of overweight and obesity is a rapidly growing threat to public health in both Morocco and Tunisia, where it is reaching similar proportions to high-income countries. Despite this, a national strategy for obesity does not exist in either country. The aim of this study was to explore the views of key stakeholders towards a range of policies to prevent obesity, and thus guide policy makers in their decision making on a national level. METHODS: Using Multicriteria Mapping, data were gathered from 82 stakeholders (from 33 categories in Morocco and 36 in Tunisia) who appraised 12 obesity policy options by reference to criteria of their own choosing. RESULTS: The feasibility of policies in practical or political terms and their cost were perceived as more important than how effective they would be in reducing obesity. There was most consensus and preference for options targeting individuals through health education, compared with options that aimed at changing the environment, i.e. modifying food supply and demand (providing healthier menus/changing food composition/food sold in schools); controlling information (advertising controls/mandatory labelling) or improving access to physical activity. In Tunisia, there was almost universal consensus that at least some environmental-level options are required, but in Morocco, participants highlighted the need to raise awareness within the population and policy makers that obesity is a public health problem, accompanied by improving literacy before such measures would be accepted. CONCLUSION: Whilst there is broad interest in a range of policy options, those measures targeting behaviour change through education were most valued. The different socioeconomic, political and cultural contexts of countries need to be accounted for when prioritizing obesity policy. Obesity was not recognized as a major public health priority; therefore, convincing policy makers about the need to prioritize action to prevent obesity, particularly in Morocco, will be a crucial first step.