Adherence to Mediterranean diet in Moroccan school-age adolescents: Sociodemographic, socioeconomic and lifestyle determinants

• Autorzy: Belaoufi H. , El-Jamal S. , Sahel K. , Aboukhalaf A. , Friki F. , Chamlal H. , Elbiyad J. , Atouife S. , El Habazi A. , Belahsen R.
• Języki publikacji: EN

Abstrakty

EN

Background. Despite its benefits, the Mediterranean diet (MD) is abandoned or not adopted by the younger generations in most Mediterranean countries. Objective. The aim here was to examine some factors determining adherence to MD in Moroccan school-age adolescents. Material and Methods. A cross-sectional survey was conducted in a school setting among 386 students (148 boys and 238 girls), aged 14 to 18 years, randomly selected and from different socioeconomic strata. A structured questionnaire was used to collect sociodemographic, socioeconomic and lifestyle data. Physical activity was assessed using the short French version of the IPAQ questionnaire. The KIDMED test was used to assess adherence to the Mediterranean diet. Weight, height and waist circumference were measured according to WHO standards. Body mass index (BMI) and waistto- height ratio (WHtR) were calculated. Statistical ANOVA test was used for to compare multiple means, Student’s t-test for independent samples, Chi2 test for categorical variables and multinomial logistic regression analysis to identify factors associated with adherence to the MD amongst adolescents sample. Results. Adherence to the MD in this population was very low, with nearly 53% having poor adherence and only 7.7% reporting optimal adherence. Multinomial regression analyses showed that poor adherence is correlated with female gender (p=0.042), low paternal education (p=0.004), limited number of meals (p=0.006), advanced age (p=0.005) and inadequate sleep duration (p=0.027). In contrast, better adherence appears to be correlated with a high number of meals per day (p<0.001) and a better socio-professional class of the father (p<0.001). Conclusion. This study revealed a low prevalence of good adherence to MD confirming a transition of the study adolescents towards a Westernized diet. Targeted nutritional intervention programs should be implemented to improve adherence to the MD among Moroccan adolescents, by promoting healthy eating habits.

• Wydawca: -
• Czasopismo: Roczniki Państwowego Zakładu Higieny
• Rocznik: 2024
• Tom: 75
• Numer: 3
• Opis fizyczny: p.261-273,ref.

Twórcy

autor

Belaoufi H.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

autor

El-Jamal S.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

autor

Sahel K.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

autor

Aboukhalaf A.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

autor

Friki F.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

autor

Chamlal H.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

autor

Elbiyad J.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

autor

Atouife S.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

autor

El Habazi A.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

autor

Belahsen R.

• Laboratory of Anthropogenetic, Biotechnologies and Health, Research Unit on Nutrition & Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco

Bibliografia

• 1. Trajkovska Petkoska A, Trajkovska‐Broach A. Mediterranean diet: a nutrient‐packed diet and a healthy lifestyle for a sustainable world. J Sci Food Agric. 2021;101(7):2627-33. doi: 10.1002/jsfa.10907.
• 2. Marques GFS, Pinto SMO, Reis ACRdS, Martins TDB, Conceição APd, Pinheiro ARV. Adherence to the Mediterranean diet in elementary school children (1st cycle). Rev Paul Pediatr. 2020;39:e2019259. doi:10.1590/1984-0462/2021/39/2019259.
• 3. Vetrani C, Piscitelli P, Muscogiuri G, Barrea L, Laudisio D, Graziadio C, et al. “Planeterranea”: An attempt to broaden the beneficial effects of the Mediterranean diet worldwide. Front Nutr. 2022;9:973757. doi: 10.3389/fnut.2022.973757.
• 4. Mattas K, Raptou E, Alayidi A, Yener G, Baourakis G. Assessing the interlinkage between biodiversity and diet through the Mediterranean diet case. Adv Nutr. 2023;14(3):570-82. doi: 10.1016/j.advnut.2023.03.011.
• 5. Truzzi ML, Puviani MB, Tripodi A, Toni S, Farinetti A, Nasi M, et al. Mediterranean Diet as a model of sustainable, resilient and healthy diet. Prog Nutr. 2020;22(2):388-94. doi: 10.23751/pn.v22i2.8632.
• 6. Belahsen R. Nutrition transition and food sustainability. Proc Nutr Soc. 2014;73(3):385-8. doi: 10.1017/S0029665114000135.
• 7. Serra-Majem L, Ortiz-Andrellucchi A. The Mediterranean diet as an example of food and nutrition sustainability: A multidisciplinary approach. Nutr Hosp. 2018;35(Spec No4):96-101. doi: 10.20960/nh.2133.
• 8. Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011;14(12A):2274-84. doi: 10.1017/S1368980011002515.
• 9. Estruch R, Ros E. The role of the Mediterranean diet on weight loss and obesity-related diseases. Rev Endocr Metab Disord. 2020;21(3):315-27. doi: 10.1007/s11154-020-09579-0.
• 10. Guasch‐Ferré M, Willett W. The Mediterranean diet and health: A comprehensive overview. J Intern Med. 2021;290(3):549-66. doi: 10.1111/joim.13333.
• 11. Serra-Majem L, Roman-Vinas B, Sanchez-Villegas A, Guasch-Ferre M, Corella D, La Vecchia C. Benefits of the Mediterranean diet: Epidemiological and molecular aspects. Mol Asp Med. 2019;67:1-55. doi: 10.1016/j.mam.2019.06.001.
• 12. Benyaich A. The effects of the mediterranean diet on chronic diseases: cardiovascular diseases, oxidative stress, dyslipidemia, diabetes mellitus, blood pressure, cancer, neurodegenerative disease and obesity. J Appl Adv Res. 2017;2(6):333-55. doi: 10.21839/jaar.2017.v2i6.122.
• 13. Serra-Majem L, Ribas L, Pérez-Rodrigo C, García-Closas R, Peña-Quintana L, Aranceta J. Determinants of nutrient intake among children and adolescents: results from the enKid Study. Ann Nutr Metab. 2002;46(Suppl. 1):31-8. doi: 10.1159/000066398.
• 14. World Health Organization. Regional Office for the Eastern Mediterranean, Houalla N, Al-Jawaldeh AE, Bagchi K, Hachem F, El Ati J, Omidvar N, et al. ( 2012) . Promoting a healthy diet for the WHO Eastern Mediterranean Region: user-friendly guide.[cited 2024 Feb 14] Available from: https://iris.who.int/handle/10665/119951.
• 15. Mitri R, Khalife S, Ziade F. Determinants of healthrelated quality of life among adolescents: The role of the Mediterranean diet. Rev Epidemiol Sante Publique. 2023;71(5):102148. doi: 10.1016/j.respe.2023.102148.
• 16. Papadaki S, Carayanni V, Notara V, Chaniotis D. Socioeconomic status, lifestyle characteristics and adherence to the Mediterranean diet among Greece adolescents. Food and Humanity. 2023;1:421-9. doi:10.1016/j.foohum.2023.06.015.
• 17. De Santi M, Callari F, Brandi G, Toscano RV, Scarlata L, Amagliani G, et al. Mediterranean diet adherence and weight status among Sicilian Middle school adolescents. Int J Food Sci Nutr. 2020;71(8):1010-8. doi:10.1080/09637486.2020.1751089.
• 18. Azzam A. Is the world converging to a ‘Western diet’? Public Health Nutr. 2021;24(2):309-17. doi: 10.1017/S136898002000350X.
• 19. Depboylu GY, Kaner G. Younger age, higher father education level, and healthy lifestyle behaviors are associated with higher adherence to the Mediterranean diet in school-aged children. Nutrition. 2023;114:112166.doi: 10.1016/j.nut.2023.112166.
• 20. Seral-Cortes M, Sabroso-Lasa S, Bailo-Aysa A, Gonzalez-Gross M, Molnár D, Censi L, et al. Mediterranean diet, screen-time-based sedentary behavior and their interaction effect on adiposity in European adolescents: the HELENA study. Nutrients. 2021;13(2):474. doi: 10.3390/nu13020474.
• 21. Oliveira IdRd, Maciel NMS, Costa BTd, Soares ADN, Gomes JMG. Association between abdominal obesity, screen time and sleep in adolescents. J Pediat. 2023;99:45-52. doi: 10.1016/j.jped.2022.02.007.
• 22. Oukheda M, Bouaouda K, Mohtadi K, Lebrazi H, Derouiche A, Kettani A, et al. Association between nutritional status, body composition, and fitness level of adolescents in physical education in Casablanca, Morocco. Front Nutr. 2023;10:1268369. doi: 10.3389/fnut.2023.1268369.
• 23. El Rhazi K, Nejjari C, Zidouh A, Bakkali R, Berraho M, Gateau PB. Prevalence of obesity and associated sociodemographic and lifestyle factors in Morocco. Public Health Nutr. 2011;14(1):160-7. doi: 10.1017/S1368980010001825.
• 24. WHO Anthro (version 3.2.2, January 2011) and macros. Geneva, Switzerland. [cited 2024 Mai 14] Available from: http://www.who.int/childgrowth/software.
• 25. World Health Organization – Regional Office for the Eastern Mediterranean. Résultats de l’Enquête Nationale sur la Population et la Santé Familiale (ENPSF); 2018. [cited 2024 Mai 20] Available from: https://www.sante.gov.ma/Documents/2020/03/Rapport%20ENPSF%202018%202i%C3%A8me%20%C3%A9dition.pdf.
• 26. Brancato L, Miéville M. L’influence du milieu socioéconomique sur le comportement alimentaire des adolescents européens âgés de 12 à 18 ans; 2018. [cited 2024 Mai 17] Available from: https://folia.unifr.ch/global/documents/315384.
• 27. Felső R, Lohner S, Hollódy K, Erhardt É, Molnár D. Relationship between sleep duration and childhood obesity: systematic review including the potential underlying mechanisms. Nutr Metab Cardiovasc Dis. 2017;27(9):751-61. doi: 10.1016/j.numecd.2017.07.008.
• 28. Perks SM, Roemmich JN, Sandow-Pajewski M, Clark PA, Thomas E, Weltman A, et al. Alterations in growth and body composition during puberty. IV. Energy intake estimated by the youth-adolescent food-frequency questionnaire: validation by the doubly labeled water method. Am J Clin Nutr. 2000;72(6):1455-60. doi:10.1093/ajcn/72.6.1455.
• 29. Khalidi H, Mohtadi K, Msaad R, Benalioua N, Lebrazi H, Kettani A, et al. The association between nutritional knowledge and eating habits among a representative adult population in Casablanca City, Morocco. Nutr Clin Metab. 2022;36(3):182-9. doi: 10.1016/j.nupar.2022.04.002.
• 30. OnsnN-SrcEsnnrH R, Plrssnnr C, Bnrcsnno M. Relations entre la stature et quelques facteurs mésologiques chez des enfants demeurant en Belgique. Bull Soc Roy Belge Anthrop Préhist. 1982;93:87-95.
• 31. Rei M, Severo M, Rodrigues S. Reproducibility and validity of the Mediterranean Diet Quality Index (KIDMED Index) in a sample of Portuguese adolescents. Br J Nutr. 2021;126(11):1737-1748. doi:10.1017/S0007114521000532.
• 32. Štefan L, Prosoli R, Juranko D, Čule M, Milinović I, Novak D, et al. The reliability of the Mediterranean diet quality index (KIDMED) questionnaire. Nutrients. 2017;9(4):419. doi: 10.3390/nu9040419.
• 33. Carrillo HA, Ramírez-Vélez R. Adherence to the Mediterranean diet in a sample of Colombian schoolchildren: An evaluation of the psychometric properties of the KIDMED questionnaire. Nutr Hosp. 2020;37(1):73-79. doi: 10.20960/nh.02760.
• 34. Serra-Majem L, Ribas L, Ngo J, Ortega RM, García A, Pérez-Rodrigo C, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutr. 2004;7(7):931-5. doi:10.1079/PHN2004556.
• 35. El-Jamal S, Sahel K, Elfane H, Barakat I, Elhendaoui H, Essaih S, et al. Profile of type 1 diabetic children and adolescents in the province of El-Jadida. Zhong Hua Yi Shi Za Zhi. 2023;53(4):1013-22. Available from: https://www.researchgate.net/profile/Sanaa-El-Jamal/publication/374031222_Profile_of_type_1_diabetic_children_and_adolescents_in_the_province_of_El-Jadida/links/650abd8f61f18040c20e452f/Profileof-type-1-diabetic-children-and-adolescents-in-theprovince-of-El-Jadida.pdf.
• 36. McCarthy HD, Ashwell M. A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message–‘keep your waist circumference to less than half your height’. Int J Obes. 2006;30(6):988-92. doi:10.1038/sj.ijo.0803226.
• 37. WHO Anthro (version 1.0.4, January 2011) and macros. [cited 2024 June 14] Available from: http:// www.who.int/childgrowth/software/en/.
• 38. IPAQ Research Committee. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ) – short and long forms.2005. [cited 2024 June 15] Available from: http://www.ipaq.ki.se/scoring.pdf.
• 39. Committee on Public Education. Children, adolescents, and television. Pediatrics. 2001;107(2):423-6. doi: 10.1542/peds.107.2.423.
• 40. Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016;12(6):785-6. doi: 10.5664/jcsm.5866.
• 41. Obeid CA, Gubbels JS, Jaalouk D, Kremers SP, Oenema A. Adherence to the Mediterranean diet among adults in Mediterranean countries: A systematic literature review. Eur J Nutr. 2022;61(7):3327-44. doi: 10.1007/s00394-022-02885-0.
• 42. Mziwira M, Elfane H, El-Jamal S, Barakat I, Sahel K, Kalili A, et al. Adherence to the Mediterranean diet in two Moroccan populations living at different distances from the Mediterranean Sea. Rocz Panstw Zakl Hig. 2024;75(1):45-58. doi: 10.32394/rpzh.2024.0296.
• 43. Azekour K, Outaleb Z, Eddouks M, Khallouki F, El Bouhali B. Adherence to the Mediterranean diet of school-age children in Moroccan oases, Draa-Tafilalet Region. East Mediterr Health J. 2020;26(9):1070-77.doi: 10.26719/emhj.20.023.
• 44. Morelli C, Avolio E, Galluccio A, Caparello G, Manes E, Ferraro S, et al. Impact of vigorous-intensity physical activity on body composition parameters, lipid profile markers, and irisin levels in adolescents: a crosssectional study. Nutrients. 2020;12(3):742. doi: 10.3390/nu12030742.
• 45. Sahel K, Aboukhalaf A, Eljamal S, Elfane H, Ayachi M, Belahsen R. Weight status and its determinants among Moroccan adolescents in the province of El Jadida. Rocz Panstw Zakl Hig. 2022;73(1):27-37. doi: 10.32394/rpzh.2022.0193.
• 46. Bibiloni MM, Gallardo-Alfaro L, Gómez SF, Wärnberg J, Osés-Recalde M, González-Gross M, et al. 45071 Determinants of Adherence to the Mediterranean Diet in Spanish Children and Adolescents: The PASOS Study.Nutrients. 2022;14(4):738. doi: 10.3390/nu14040738.
• 47. Facendola R, Ottomano Palmisano G, De Boni A, Acciani C, Roma R. Determinants of the adherence to Mediterranean diet: application of the k-means cluster analysis profiling children in the Metropolitan City of Bari. Front Sustain Food Syst. 2024;7:1329090. doi: 10.3389/fsufs.2023.1329090.
• 48. Arcila-Agudelo AM, Ferrer-Svoboda C, Torres-Fernàndez T, Farran-Codina A. Determinants of adherence to healthy eating patterns in a population of children and adolescents: Evidence on the mediterranean diet in the city of Mataró (Catalonia, Spain). Nutrients. 2019;11(4):854. doi: 10.3390/nu11040854.
• 49. Del Mar Bibiloni M, Pons A, Tur JA. Compliance with the Mediterranean Diet Quality Index (KIDMED) among Balearic Islands’ adolescents and its association with socioeconomic, anthropometric and lifestyle factors. Ann Nutr Metab. 2016;68(1):42-50. doi: 10.1159/000442302.

Identyfikatory

DOI

10.32394/rpzh/194469