Few studies have compared the diets of minor migrants with similar ethnic groups in the country of origin. Although Moroccans form the largest foreign population group in Spain, there is limited information on their dietary changes and the effects on nutritional status.
AIM:
To determine whether migration has caused changes in adherence to the Mediterranean diet (MD) in a sample of Moroccan adolescents living in Madrid (Spain) compared with their peers in northern Morocco (Al Hoceima).
METHODS:
A cross-sectional study was conducted among 409 Moroccan pupils, 308 living in Al Hoceima and 101 living in Madrid. Food records were compiled over three non-consecutive days by pre-trained adolescents. Energy and nutrient intakes were estimated using the DIAL software, adapted to include foods usually eaten in Morocco. Diet quality indicators studied were the Mediterranean Adequacy Index (MAI), caloric profile, cholesterol (mg/1000 kcal) and fibre density (g/1000 kcal). A binary logistic regression model was used to test the association between the MAI and the adolescents’ geographical location and socio-economic level.
RESULTS:
Moroccan adolescents living in Al Hoceima were significantly 10.5 times more likely to attain a high MAI score than their peers living in Madrid. For both sexes, migration decreased significantly the ratio of unsaturated to saturated fatty acids (1.8 vs. 2.5). For boys, migrant adolescents had significantly higher daily energy (2860.9 vs. 2139.1 kcal), protein (13.9 vs. 13.2 %) and lower fibre (11.2 vs. 14.3) intakes than autochthonous adolescents. For girls, there were no significant differences.
CONCLUSION:
Migration can be beneficial for Moroccan migrants in terms of increased daily energy intake. However, the fact that their energy intake is increasingly provided by non-Mediterranean foods could have negative consequences for their health, with increased rates of overweight and obesity. It is essential to continue to promote the Mediterranean Diet, especially among young people.
JafriA. Double fardeau de la malnutrition dans le Sud-Est de Casablanca et rôle de l’éducation nutritionnelle dans la prise en charge de la surcharge pondérale. Mémoire de Thèse, Université Hassan II, Casablanca. 2013; pp: 146.
2.
AboussalehY, SbaibiR. Etat nutritionnel de la population du Nord-Ouest du Maroc. Antropo. 2015;33:13–20.
3.
ENPSF. Enquête nationale sur la population et la santé familiale Ministère de la Santé. DPRF/DPE/SEIS Rabat, Maroc Projet PAPFAM Ligue des États Arabes Le Caire, Egypte. 2012.
4.
FAO. 352 Profil Nutritionnel de Pays. Royaume du Maroc. Organisation des Nations Unies pour l’Alimentation et l’Agriculture. 2011.
5.
PopkinB. An overview on the nutrition transition and its health implications: the Bellagio meeting. Public Health Nutr. 2002;5(1A):93–103.
6.
MéjeanC, TraissacP, Eymard-DuvernayS, DelpeuchF, MaireB. Influence of acculturation among Tunisian migrants in France and their past/present exposure to the home country on diet and physical activity. Public Health Nutr. 2008;12(6):832–41.
7.
AllaliF. Evolution des pratiques alimentaires au Maroc. Int J Med Sci. 2017; Volume 4, Special Issue, ID 145.
8.
BelahsenR. Nutrition transition and food sustainability. Proc Nutr Soc. 2014;73:385–8.
9.
BenjellounS. Nutrition transition in Morocco. Public Health Nutr. 2002;5(1A):135–40.
10.
HenriquezSaP, RuanoC, de IralaJ, Ruiz-CanelaM, Martinez-GonzalezMA, Sanchez-VillegasA. Adherence to the Mediterranean diet and quality of life in the SUN Project. Eur J Clin Nutr. 2012;66(3):360–8.
11.
Landaeta-DiazL, FernandezJM, Da Silva-GrigolettoM, Rosado-AlvarezD, GomezGardunoA, Gomez-DelgadoF, et alMediterranean diet, moderate-to-high intensity training, and health-related quality of life in adults with metabolic syndrome. Eur J Prev Cardiol. 2013;20(4):555–64.
12.
GiuglianoD, EspositoK. Mediterranean diet and cardiovascular health. Ann N Y Acad Sci. 2005;1056:253–60.
13.
NordmannAJ, Suter-ZimmermannK, BucherHC, ShaiI, TuttleKR, EstruchR, et alMeta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. Am J Med. 2011;124(9):841–51.
14.
RichardC, CoutureP, DesrochesS, CharestA, LamarcheB. Effect of the Mediterranean diet with and without weight loss on cardiovascular risk factors in men with the metabolic syndrome. Nutr Metab Cardiovasc Dis. 2011;21(9):628–35.
15.
EstruchR, RosE, Salas-SalvadóJ, CovasMI, CorellaD, ArósF, et alPrimary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90.
16.
García-FernándezE, Rico-CabanasL, RosgaardN, EstruchR, Bach-FaigA. Mediterranean diet and cardiodiabesity: a review. Nutrients. 2014;6:3474–500.
17.
KoloverouE, EspositoK, GiuglianoD, PanagiotakosD. The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants. Metabolism. 2014;63(7):903–11.
18.
SofiF, MacchiC, AbbateR, GensiniGF, CasinA. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr. 2014;17:2769–82.
19.
EspositoK, MaiorinoMI, BellastellaG, ChiodiniP, DemosthenesP, DarioG. A journey into aMediterranean diet and type 2 diabetes: a systematic review with meta-analyses. BMJ Open. 2015.
20.
DelisleH. Finding on dietary patterns in different groups of African origin undergoing nutrition transition. Appl Physiol Nutr Metab. 2010;35(2):224–8.
21.
MonteroP, AnzidK, CherkaouiM, BaaliA, Rodríguez LópezS. Nutritional status of adolescents in the context of the Moroccan Nutritional transition: the role of parental education. J. Biosoc Sci. 2012;44:481–94.
22.
AnzidK, El HamdaniF, BaaliA, BoëtschG, LevyS, MonteroP, et alThe effect of socio-economic status and area of residence on household food variety in Morocco. Ann Hum Biol. 2009;36(6):1–23.
23.
LaassakriA, AmorH, OuirariJ, BaaliA, Roville-SausseF. Comportement alimentaire et état de santé des adolescents de la ville de Marrakech. Biom Hum Anthropol. 2010;28(3-4):105–12.
24.
MonteroP, Mora-UrdaIA, AnzidK, CherkaouiM, MarrodánMD. Diet quality of Moroccan adolescents living in Morocco and in Spain. J. Biosoc. Sci. 2016;49(2):173–86.
25.
WHO. Nutrition in adolescence: issues and challenges for the health sector: issues in adolescent health and development. ISBN 92 4 159366 0 (NLM classification: WS 115). 2005.
26.
JonesJM, BennettS, OlmstedMP, LawsonML, RodinG. Disordered eating attitudes and behaviours in teenaged girls: A school-based study. Can Med Assoc J. 2001;165:547–52.
27.
GadallaTM. Comportements malsains chez les adolescents canadiens: prévalence, tendances et corrélats –Maladies chroniques et blessures au Canada. 2012;32(3).
NeuhouserML, ThompsonB, CoronadoGD, SolomonCC. Higher fat intake and lower fruit and vegetables intakes are associated with greater acculturation among Mexicans living in Washington State. J Am Diet Assoc. 2004;104:51–7.
30.
CardosoMA, HamadaGS, de SouzaJM, TsuganeS, TokudomeS. Dietary patterns in Japanese migrants to southeastern Brazil and their descendants. J Epidemiol. 1997;7:198–204.
31.
MennenLI, JacksonM, SharmaS, MbanyaJC, CadeJ, WalkerS, et alHabitual diet in four populations of African origin: a descriptive paper on nutrient intakes in rural and urban Cameroon, Jamaica and Caribbean migrants in Britain. Public Health Nutr. 2001;4:765–72.
32.
AndersonAS, BushH, LeanM, BradbyH, WilliamsR, LeaE. Evolution of atherogenic diets in South Asian and Italian women after migration to a higher risk region. J Hum Nutr Diet. 2005;18:33–43.
33.
MisraA, GandaOP. Migration and its impact on adiposity and type 2 diabetes. Nutrition. 2007;23:696–708.
KhachaniM, MghariM. L’immigration marocaine en Espagne. Notes d’analyse et de synthèse –module démographique et économique CARIM-AS 2006/09.
36.
World Medical Association (WMA). Ethical principles formedical research involving human subjects. Helsinki: Helsinki Declaration. 2000.
37.
AnzidK, BaaliA, VimardP, Levy-DesrochesS, CherkaouiM, MonteroL. Inadequacy of vitamins and minerals among high-school pupils in Ouarzazate, Morocco. Public Health Nutr. 2014;17(8):1786–95.
38.
SavyM, Martin-PrevelY, TraissacP, Emyard-DuvernayS, DelpeuchF. Dietary diversity scores and nutritional status of women change during the seasonal food shortage in rural Burkina Faso. J Nutr. 2006;136:2625–32.
39.
OrtegaRM, López-SobalerAM, AndrésP, RequejoAM, AparicioA, MolineroLM. DIAL 1.0: Programa para evaluación de dietas y gestión de datos de alimentación. 2008.
40.
El MoumniK, MaimouniE, DufournyG. Aliments et préparations typiques de la population marocaine. Outil pour estimer la consommation alimentaire. Brussels: Centre d’Information et de Recherche sur les Intolérances et l’Hygiène Alimentaires; 2008.
41.
FidanzaF, AlbertiA, LantiM, MenottiA. Mediterranean adequacy index: correlation with 25-year mortality from coronary heart disease in the Seven Countries Study. Nutr Metab Cardiovasc Dis. 2004;14:254–8.
42.
AlbertiA, FruttiniD, FidanzaF. The Mediterranean Adequacy Index: Further confirming results of validity. Nutrition, Metabolism & Cardiovascular Diseases. 2009;19:61e66.
43.
Da SilvaR, Bach-FaigA, Raido QuintanaB, BucklandG, Vaz de AlmeidaM, Serra-MajemL. World wide variation of adherence to the Mediterranean diet, in 1961–1965 and 2000–2003. Public Health Nutr. 2009;12(9A):1676–84.
44.
WeinerJS, LourieJA. Practical Human Biology, Academic Press, London, 1981.
SPSS. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp; 2010.
48.
Instituto Nacional de estadistica. The Population and Housing Census. 2011.
49.
ArangoJ, CebollaH, PinyolG, StanekM. Urso G, Schuster A, editors. Migration, employment and labour market integration policies in the European Union (2011). Brussels: International Organization for Migration; 2013;283-91.
50.
GonzálezEC. Circularity in a Restrictive Framework: Mobility between Morocco and Spain. Circular Migration Between Europe and its Neighbourhood: choice or necessity Oxford: Oxford University Press; 2013.
51.
IbáñezZ, AcebilloM, LeónM. Voluntary, involuntary and programmed circular migration in spain: the case of moroccan workers in the berry-producing region of huelva (Spain). Institut de Govern i Polítiques Públiques; 2015.
52.
LiuC, EsteveA, TreviñoR. The living arrangements of Moroccans in Spain: Generation and time. Demographic Research. 2019;40:1063–96.
53.
TyrrellRL, GreenhalghF, HodgsonS, WillsWJ, MathersJC, AdamsonAJ,et al. Food environments of young people: linking individual behaviour to environmental context. J Public Health (Oxf). 1. 2017;39(1):95–104.
54.
El KabbaouiM, ChdaA, BousfihaA, AarabL, BencheikhR, TaziA. Prevalence of and risk factors for overweight and obesity among adolescents in Morocco. East Mediterr Health J. 2018;24(6):512–21.
55.
SandovalJRG, CaracuelJC, CoccaA, CoccaM, GurrolaOC. Relation Between Body Mass Index and Body Image in Spanish and Mexican Adolescents. Behave Med. 2018;44(4):80–288.
56.
Mekhancha-DahelCC, MekhanchaDE, BahchachiN, BenatallahL, NezzalL. Overweight, obesity: signs of nutritional transition in children and adolescents in Khroub, Algeria. Rev Epidemiol Sante Publique. 2005;53:569–73.
57.
Aounallah-SkhiriH, RomdhaneHB, TraissacP, Eymard-DuvernayS, DelpeuchF, AchourN,et al. Nutritional status of Tunisian adolescents: associated gender, environmental and socio-economic factors. Public Health Nutr. 2008;11(12):1306–17.
58.
CasaliME, BorsariL, MarchesiI, BorellaP, BargelliniA. Lifestyle and food habits changes after migration: a focus on immigrant women in Modena (Italy). Ann Ig. 2015;27:1.
59.
RguibiMA, BelahsenR. Overweight and obesity among urban Sahraoui women of South Morocco. Ethnicity & disease. 2004;14(4):542–7.
60.
MorenoLA, PigeotI, AhrensW, editors. Epidemiology of Obesity in Children and Adolescents: Prevalence and Etiology. Springer Science & Business Media, 2011 - 500 pages.
61.
littletonHL, ollendickT. Negative Body Image and Disordered Eating Behavior in Children and Adolescents: What Places Youth at Risk and How Can These Problems be Prevented?Clin Child Fam Psychol Rev. 2003;6:51–66.
TarasH. Nutrition and Student Performance at School. J Sch Health. 2005;75:199–213.
64.
AlsufianiHM, KumosaniTA, FordD, MathersJC. Dietary patterns nutrient intakes and nutritional and physical activity status of Saudi older adults: a narrative review. J Aging Res Clin Practice. 2015;4(1):2–11.
65.
WelchAA, LundE, AmianoP, DorronsoroM, BrustadM, KumleM,et al. Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutr. 2002;5(6B):1273–85.
66.
RahmanL, NiggCR, RosnerLS, IversenCS, ChungHV, LaiM,et al. Fish Intake by Adolescents Is Related to Nutrient Intake but Not Lifestyle Factors. Asia-Pac J Public Health. 2013;27(2):NP1627–NP1638.
67.
Serra-MajemL, RibasL, NgoJ, OrtegaRM, GarcíaA, Pérez-RodrigoC,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.
68.
DoninAS, NightingaleCM, OwenCG, RudnickaAR, McNamaraMC, PrynneCJ,et alEthnic differences in blood lipids and dietary intake between UK children of black African, black Caribbean, South Asian, and white European origin: the Child Heart and Health Study in England (CHASE). Am J Clin Nutr. 2010;92(4):776–83.
69.
DekkerLH, SnijderMB, BeukersMH, de VriesJHM, BrantsHAM, de BoerEJ,et al. A prospective cohort study of dietary patterns of non-western migrants in the Netherlands in relation to risk factors for cardiovascular diseases: HELIUS-Dietary Patterns. BMC Public Health. 2011;11:441.
70.
DarmonN, KhlatM. An overview of the health status of migrants in France, in relation to their dietary practices. Public Health Nutr. 2001;4:163–72.
71.
HCP. Enquête nationale sur la consommation et les dépenses des ménages. 2000/2001.
72.
GilbertPA, KhokharS. Changing dietary habits of ethnic groups in Europe and implications for health. Nutr Rev. 2008;66(4):203–15.
73.
CoonKA, TuckerKL. Television and children’s consumption patterns. A review of the literature. Minerva Pediatr. 2002;54(5):423–36.
74.
Aounallah-SkhiriH, TraissacP, El AtiJ, Eymard-DuvernayS, LandaisE, AchourN,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;24(10):38.
75.
NajaF, HwallaN, Itani, KaramS, SibaiAM, NasreddineL. A Western dietary pattern is associated with overweight and obesity in a national sample of Lebanese adolescents (13–19 years): a cross-sectional study. Br. J Nutr. 2015;1909-19.
76.
BonaccioM, Di CastelnuovoA, PounisG, CostanzoS, PersichilloM, CerlettiC,et al. High adherence to the Mediterranean diet is associated with cardiovascular protection in higher but not in lower socioeconomic groups: prospective findings from the Moli-sani study. Int J Epidemiol. 2017;1478-87.
77.
SchmidhuberJ, TraillWB. The changing structure of diets in the EU-15 in relation to healthy eating guidelines. Public Health Nutr. 2006;9:584–95.
78.
MonteroP, MarrodánMD, CarmenateM, MoraAI, Rodríguez-LópezS, AnzidK,et al. status of Moroccan adolescents living in Madrid. Public Health Nutr. 2010;13(9A):103.
79.
PapadakiA, ScottJA. The impact on eating habits of temporary translocation from a Mediterranean to a Northern European environment. Eur J Clin Nutr. 2002;56:455–61.
80.
PanY, DixonZ, HumburgS, HuffmanF. Asian students change their eating patterns after living in the United States. J Am Diet Assoc. 1999;99:54–7.
81.
SharmaS, CadeJ, RisteL, CruickshankK. Nutrient intake trends among African-Caribbeans in Britain: a migrant population and its second generation. Public Health Nutr. 1999;2:469–76.
82.
D’InnocenzoS, BiagiC, LanariM. Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet. Nutrients. 2019;11(6):1306.
83.
Neumark-SztainerD, WallM, LarsonNI, EisenbergME. , Loth K. Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study. J Am Diet Assoc. 2011;111(7):1004–11.
84.
RathiN, RiddellL, WorsleyA. Food consumption patterns of adolescents aged 14–16 years in Kolkata, India. Nutr J. 2017;16(1):50.
