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Nutrition transition among adolescents of a south-Mediterranean country: dietary patterns, association with socio-economic factors, overweight and blood pressure. A cross-sectional study in Tunisia.
Nutr J. 2011 Apr 24; 10:38.NJ

Abstract

BACKGROUND

The increase in the burden of chronic diseases linked to the nutrition transition and associated dietary and lifestyle changes is of growing concern in south and east Mediterranean countries and adolescents are at the forefront of these changes. This study assessed dietary intake and association with socio-economic factors and health outcomes among adolescents in Tunisia.

METHODS

Cross-sectional survey (year 2005); 1019 subjects 15-19 y. from a clustered random sample. Dietary intake was assessed by a validated semi-quantitative frequency questionnaire (134 items) as was physical activity; the Diet Quality Index International measured diet quality; dietary patterns were derived by multiple correspondence analysis from intakes of 43 food groups. Body Mass Index (BMI) ≥ 85th and 95th percentile defined overweight and obesity. Waist Circumference (WC) assessed abdominal fat. High blood pressure was systolic (SBP) or diastolic blood pressure (DBP) ≥ 90th of the international reference for 15-17 y., and SBP/DBP ≥ 120/80 mm Hg for 18-19 y.

RESULTS

Energy intake levels were quite high, especially for females. The macro-nutrient structure was close to recommendations but only 38% had a satisfactory diet quality. A main traditional to modern dietary gradient, linked to urbanisation and increased economic level, featured an increasing consumption of white bread, dairy products, sugars, added fats and fruits and decreasing consumption of oils, grains, legumes and vegetables; regarding nutrients this modern diet score featured a decreasing relationship with total fat and an increase of calcium intake, but with an increase of energy, sugars and saturated fat, while vitamin C, potassium and fibre decreased. Adjusted for age, energy and physical activity, this modern pattern was associated with increased overweight in males (2nd vs. 1st tertile: Prevalence Odds-Ratio (POR) = 4.0[1.7-9.3], 3rd vs. 1st: POR = 3.3[1.3-8.7]) and a higher WC. Adjusting also for BMI and WC, among females, it was associated with decreased prevalence of high blood pressure (2nd vs. 1st tertile: POR = 0.5[0.3-0.8], 3rd vs. 1st tertile: POR = 0.4[0.2-0.8]).

CONCLUSION

The dietary intake contrasts among Tunisian adolescents, linked to socio-economic differentials are characteristic of a nutrition transition situation. The observed gradient of modernisation of dietary intake features associations with several nutrients involving a higher risk of chronic diseases but might have not only negative characteristics regarding health outcomes.

Authors+Show Affiliations

IRD (Institut de Recherche pour le Développement), UMR 204 NUTRIPASS, IRD-UM1-UM2, Montpellier, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21513570

Citation

Aounallah-Skhiri, Hajer, et al. "Nutrition Transition Among Adolescents of a south-Mediterranean Country: Dietary Patterns, Association With Socio-economic Factors, Overweight and Blood Pressure. a Cross-sectional Study in Tunisia." Nutrition Journal, vol. 10, 2011, p. 38.
Aounallah-Skhiri H, Traissac P, El Ati J, et al. Nutrition transition among adolescents of a south-Mediterranean country: dietary patterns, association with socio-economic factors, overweight and blood pressure. A cross-sectional study in Tunisia. Nutr J. 2011;10:38.
Aounallah-Skhiri, H., Traissac, P., El Ati, J., Eymard-Duvernay, S., Landais, E., Achour, N., Delpeuch, F., Ben Romdhane, H., & Maire, B. (2011). Nutrition transition among adolescents of a south-Mediterranean country: dietary patterns, association with socio-economic factors, overweight and blood pressure. A cross-sectional study in Tunisia. Nutrition Journal, 10, 38. https://doi.org/10.1186/1475-2891-10-38
Aounallah-Skhiri H, et al. Nutrition Transition Among Adolescents of a south-Mediterranean Country: Dietary Patterns, Association With Socio-economic Factors, Overweight and Blood Pressure. a Cross-sectional Study in Tunisia. Nutr J. 2011 Apr 24;10:38. PubMed PMID: 21513570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrition transition among adolescents of a south-Mediterranean country: dietary patterns, association with socio-economic factors, overweight and blood pressure. A cross-sectional study in Tunisia. AU - Aounallah-Skhiri,Hajer, AU - Traissac,Pierre, AU - El Ati,Jalila, AU - Eymard-Duvernay,Sabrina, AU - Landais,Edwige, AU - Achour,Noureddine, AU - Delpeuch,Francis, AU - Ben Romdhane,Habiba, AU - Maire,Bernard, Y1 - 2011/04/24/ PY - 2010/11/16/received PY - 2011/04/24/accepted PY - 2011/4/26/entrez PY - 2011/4/26/pubmed PY - 2011/9/16/medline SP - 38 EP - 38 JF - Nutrition journal JO - Nutr J VL - 10 N2 - BACKGROUND: The increase in the burden of chronic diseases linked to the nutrition transition and associated dietary and lifestyle changes is of growing concern in south and east Mediterranean countries and adolescents are at the forefront of these changes. This study assessed dietary intake and association with socio-economic factors and health outcomes among adolescents in Tunisia. METHODS: Cross-sectional survey (year 2005); 1019 subjects 15-19 y. from a clustered random sample. Dietary intake was assessed by a validated semi-quantitative frequency questionnaire (134 items) as was physical activity; the Diet Quality Index International measured diet quality; dietary patterns were derived by multiple correspondence analysis from intakes of 43 food groups. Body Mass Index (BMI) ≥ 85th and 95th percentile defined overweight and obesity. Waist Circumference (WC) assessed abdominal fat. High blood pressure was systolic (SBP) or diastolic blood pressure (DBP) ≥ 90th of the international reference for 15-17 y., and SBP/DBP ≥ 120/80 mm Hg for 18-19 y. RESULTS: Energy intake levels were quite high, especially for females. The macro-nutrient structure was close to recommendations but only 38% had a satisfactory diet quality. A main traditional to modern dietary gradient, linked to urbanisation and increased economic level, featured an increasing consumption of white bread, dairy products, sugars, added fats and fruits and decreasing consumption of oils, grains, legumes and vegetables; regarding nutrients this modern diet score featured a decreasing relationship with total fat and an increase of calcium intake, but with an increase of energy, sugars and saturated fat, while vitamin C, potassium and fibre decreased. Adjusted for age, energy and physical activity, this modern pattern was associated with increased overweight in males (2nd vs. 1st tertile: Prevalence Odds-Ratio (POR) = 4.0[1.7-9.3], 3rd vs. 1st: POR = 3.3[1.3-8.7]) and a higher WC. Adjusting also for BMI and WC, among females, it was associated with decreased prevalence of high blood pressure (2nd vs. 1st tertile: POR = 0.5[0.3-0.8], 3rd vs. 1st tertile: POR = 0.4[0.2-0.8]). CONCLUSION: The dietary intake contrasts among Tunisian adolescents, linked to socio-economic differentials are characteristic of a nutrition transition situation. The observed gradient of modernisation of dietary intake features associations with several nutrients involving a higher risk of chronic diseases but might have not only negative characteristics regarding health outcomes. SN - 1475-2891 UR - https://www.unboundmedicine.com/medline/citation/21513570/Nutrition_transition_among_adolescents_of_a_south_Mediterranean_country:_dietary_patterns_association_with_socio_economic_factors_overweight_and_blood_pressure__A_cross_sectional_study_in_Tunisia_ L2 - https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-38 DB - PRIME DP - Unbound Medicine ER -