Inadequate nutrient intakes in adolescents may negatively affect their future health. The identification of inadequate micronutrient intakes by dietary study provides essential information to guide educational strategies for promoting healthy eating habits.
OBJECTIVE:
To assess the daily micronutrient intake and the prevalence of inadequacy in a sample of middle and high-school pupils in the Rif region of Morocco.
METHODS:
A cross-sectional study collected dietary information from food records over three non-consecutive days in a sample (n = 302) of Moroccan Riffian adolescents (12–18 years). The DIAL software, adapted for commonly eaten Moroccan foods, was used to estimate micronutrient intakes. The proportion of individuals with intakes below the Estimated Average Requirement (EAR) or the Adequate Intake (AI) level and the probability approach were used to estimate the prevalence of inadequacy.
RESULTS:
Regardless of gender and age group, our subjects were found to be particularly at risk of inadequate intakes of vitamins E and D, calcium and potassium. Older adolescents (14–18 years) also showed a risk of inadequate intake of folate, biotin, magnesium, iodine and zinc (among boys).
CONCLUSION:
For many nutrients, the daily diets of our Riffian adolescents do not meet the recommended intake levels. We emphasize the need for monitoring the dietary habits of adolescents and the development of nutrition education programs. Further studies which include the clinical and biological assessment of nutritional status, as well as the regular collection of quality and nationally representative micronutrient data, are recommended.
AchouriI, AboussalehY, SbaibiR, AhamiA. Anthropometry, food consumption and iron deficiency anemia, among primary school children (6-15 years) in Kenitra city (North-Western Morocco). Pan Afr Med J. 2021;38:374. Doi: 10.11604/pamj.2021.38.374.10008.
2.
El AmmariL, SaeidN, TalouizteA, GamihH, LabziziS, MendiliJE, et al. A Household-Based Survey of Iodine Nutrition in Moroccan Children Shows Iodine Sufficiency at the National Level But Risk of Deficient Intakes in Mountainous Areas. Children. 2021;8(3):240. Doi.org/10.3390/children8030240.
3.
Aparicio-UgarrizaR, Cuenca-GarcíaM, Gonzalez-GrossM, JuliánC, Bel-SerratS, MorenoL, et al. Relative validation ofthe adapted Mediterranean Diet Score for Adolescents by comparisonwith nutritional biomarkers and nutrient and food intakes: TheHealthy Lifestyle in Europe by Nutrition in Adolescence (HELENA)study. Public Health Nutr. 2019;22(13):2381–97. Doi: 10.1017/S1368980019001022.
JacobJA, NairMK. Protein and Micronutrient Supplementation in Complementing Pubertal Growth. Indian J of Pediatr. 2012;79(Suppl 1):S84–91. Doi: 10.1007/s12098-011-0430-0.
6.
BlackMM. Effects of Vitamin B12 and Folate Deficiency on Brain Development in Children. Food Nutr Bull. 2008;29(Suppl 2):S126–31. Doi: 10.1177/15648265080292S117.
7.
FrethamSJB, CarlsonES, GeorgeiffMK. The Role of Iron in Learning and Memory. Adv Nutr. 2011;2(2):112–21. Doi: 10.3945/an.110.000190.
8.
KapilU. Health Consequences of Iodine Deficiency. Sultan Qaboos Univ Med J. 2007;7(3), 267–72. PMCID: PMC3074887. PMID: 21748117.
9.
NyaradiA, LiJ, HicklingS, FosterJ, OddyWH, and others. The Role of Nutrition in Children’s Neurocognitive Development, from Pregnancy through Childhood. Front Hum Neurosci. 2013;7:97. Doi.org/10.3389/fnhum.2013.00097.
10.
SalgueiroMJ, WeillR, ZubillagaM, LysionekA, CaroR, GoldmanC, BarradoD, SarrasagueMM, RidolfiA, BoccioJ. Zinc deficiency and growth: current concepts in relationship to two important points: intellectual and sexual development. Biol Trace Elem Res. 2004;99(1-3):49–69. Doi: 10.1385/bter:99:1-3:049.
11.
AnzidK, BaaliA, VimardP, Levy-DesrochesS, CherkaouiM, LópezPM. Inadequacy of vitamins and minerals among high-school pupils in Ouarzazate, Morocco. Public Health Nutr. 2014;17:1786–95. Doi.org/10.1017/S1368980013002140.
RankinD, HanekomSM, WrightHH, MacIntyreUE. Dietary assessment methodology for adolescents: a review of reproducibility and validation studies. S Afr J Clin Nutr. 2010;23(2). DOI: 10.1080/16070658.2010.11734284.
14.
OrtegaRM, López-SobalerAM, AndrésP, RequejoAM, AparicioA, MolineroLM. DIAL 1.0: Programa para evaluación de dietas y gestión de datos de alimentación. 2008.
15.
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.
16.
KhalisM, Garcia-LarsenV, CharakaH, MintSidi DeoulaM, El KinanyK, BenslimaneA, et al. Update of the Moroccan food composition tables: Towards a more reliable tool for nutrition research. J Food Compos. Anal. 2020;87:103397. Doi.org/10.1016/j.jfca.2019.103397.
17.
Institute of Medicine, Food and Nutrition Board (US). Dietary reference intakes: applications in dietary assessment. Washington (DC): National Academy Press. 2000.
18.
Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fibre, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (Macronutrients). Washington, DC: The National Academies Press. 2005.
19.
Institute of Medicine. Dietary Reference Intakes: Vitamin A,Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press. 2001.
20.
TouvierM, LioretS, VanrullenI, BocléJC, Boutron-RuaultMC, BertaJL, VolatierJL. Vitamin and mineral inadequacy in the Frenchpopulation: estimation and application for the optimization of foodfortification. Int J Vitam Nutr Res. 2006;76:343–51. Doi: 10.1024/0300-9831.76.6.343.
21.
WeinerJS, LourieJA. Practical Human Biology, Academic Press, London, 1981.
SPSS. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp. 2010.
25.
SawyerADM, van LentheF, KamphuisCBM, TerragniL, RoosG, PoelmanMP, et al. Dynamics of the complex food environment underlying dietary intake in low-income groups: a systems map of associations extracted from a systematic umbrella literature review. Int J Behav Nutr Phys Act. 2021;18:96. Doi.org/10.1186/s12966-021-01164-1.
26.
NouaytiH, BouananiNH, HammoudiJ, MekhfiH, LegssyerA, BnouhamM, ZiyyatA. Overweight and obesity in Eastern Morocco: Prevalence and associated risk factors among high school students. Rev Epidemiol Sante Publique. 2020;68(5):295–301. Doi.org/10.1016/j.respe.2020.06.007.
27.
GhouiliH, Ben KhalifaW, OuerghiN, ZouaouiM, DridiA, GmadaN, BouassidaA. Body mass index reference curves for Tunisian children. Arch Pediatr. 2018;25(8):459–63. Doi.org/10.1016/j.arcped.2018.09.005.
28.
El MokhtariO, AnzidK, HilaliA, CherkaouiM, Isabel Mora-UrdaA, LópezPM, Levy-DesrochesS. Impact of migration on dietary patterns and adherence to the Mediterranean diet among Northern Moroccan migrant adolescents in Madrid (Spain). Med J Nutrition Metab. 2020;13(2):135–48. Doi: 10.3233/MNM-190382.
29.
AfsahiK. « Pas de culture de cannabis sans les femmes. Le cas du Rif au Maroc », Déviance soc. 2015/1 (Vol. 39):73-97. DOI : 10.3917/ds.391.0073.
30.
WHO/FAO/ONU. Human Energy Requirements. Expert consultation. United Nations University, Rome. 2001.
31.
WinpennyEM, GreensladeS, CorderK, van SluijsEMF. Diet Quality through Adolescence and Early Adulthood: Cross-Sectional Associations of the Dietary Approaches to Stop Hypertension Diet Index and Component Food Groups with Age. Nutrients. 2018;10:1585. Doi: 10.3390/nu10111585.
32.
Centre National de Documentation. Haut-Commissariat du Plan. Voix de la Femme Amazighe. Le Mariage des 453 Filles Mineures au Maroc: Etude diagnostic du phénomène de mariage des filles mineures entre législation, jurisprudence et pratique: cas des filles de la Province d’Azilal. 2017.
33.
Gualdi-RussoE, RinaldoN, KhyattiM, LakhouaC, ToselliS. Weight status, fatness and body image perception of North African immigrant women in Italy. Public Health Nutr. 2016;19(15):2743–51. Doi: 10.1017/S1368980016000872.
34.
WinpennyEM, van SluijsEM, WhiteM, KleppKI, WoldB, LienN. Changes in diet through adolescence and early adulthood: Longitudinal trajectories and association with key life transitions. Int J Behav Nutr Phys Act. 2018;15:86. Doi.org/10.1186/s12966-018-0719-8.
35.
HansonNI, Neumark-SztainerD, EisenbergME, StoryM, WallM. Associations between parental report of the home food environment and adolescent intakes of fruits, vegetables and dairy foods. Public Health Nutr. 2005;8:77–85. Doi: 10.1079/phn2005661.
36.
Dept. of Health and Human Services: Dept. of Agriculture., United States. Dietary Guidelines Advisory Committee. Dietary Guidelines for Americans. 7th edition. Washington, D.C.: G.P.O. 2010.
37.
PettiforJM. Nutritional rickets: deficiency of vitamin D, calcium, or both?Am J Clin Nutr. 2004;80:1725S–1729S. Doi: 10.1093/ajcn/80.6.1725S.
38.
SebbarE, SamH, SaalaouiE, ChoukriM. Dietary intake of vitamin D in the Moroccan adolescents. J Food Sci Nutr The. 2017;3(1):023–025. Doi: 10.17352/jfsnt.000011.
39.
BenjeddouK, MenchawyI, AglagoE, AzlafM, RabiB, BaddouI, et al. Vitamins A and D Fortification of Milk and Their Impact on Nutritional Status of School Children in Rural Regions of Morocco. European j nutr food saf. 2015;5(5):2013–4. Doi.org/10.9734/EJNFS/2015/21328.
40.
BenjeddouK, QandoussiL, MekkaouiB, RabiB, El HamdouchiA, RajiF, et al. Effect of multiple micronutrient fortified milk consumption on vitamin D status among school-aged children in rural region of Morocco. Appl Physiol Nutr Metab. 2019;44(5):461–7. Doi: 10.1139/apnm-2018-0368.
41.
Haut-commissariat au Plan. 2018. Présentation des résultats de l’Enquête Nationale sur la Consommation et lesDépenses desMénages, 2013/2014.
42.
Ait OuazarM, AmineM, HarifiaG, OuilkiI, YounsiR, BelkhouA, et al. Evaluation of the calcium intake in population of Marrakesh and its region: cases. Ann Endocrinol (Paris). 2010;71(1):51–5. Doi: 10.1016/j.ando.2009.11.009.
43.
FiorentinoM, LandaisE, BastardG, CarriquiryA, WieringaFT, BergerJ. Nutrient Intake Is Insufficient among Senegalese Urban School Children and Adolescents: Results from Two 24 h Recalls in State Primary Schools in Dakar. Nutrients. 2016;8:650. Doi: 10.3390/nu8100650.
44.
SouzaAM, BarufaldiLA, AbreuGA, GianniniDT, de OliveiraCL, dosSantosMM, et al. ERICA: intake of macro and micronutrients ofBrazilian adolescents. Rev Saúde Pública. 2016;50(suppl1):5s. Doi.org/10.1590/S01518-8787.2016050006698.
45.
López-SobalerAM, AparicioA, González-RodríguezLG, Cuadrado-SotoE, RubioJ, MarcosV, et al. Adequacy of Usual Vitaminand Mineral Intake in Spanish Children and Adolescents: ENALIAStudy. Nutrients. 2017;9:131. Doi: 10.3390/nu9020131.
46.
BouzianiA, SaeidN, BenkiraneH, QandoussiL, TabozY, El HamdouchiA, et al. Dietary Calcium Intake in Sample of School Age Children in City of Rabat, Morocco. J Nutr Metab. 2018)2:1–7. Doi: 10.1155/2018/8084623.
47.
BouzianiA, SaeidN, IdrissiM, El MzibriM, BendjeddouK, El BerriH, et al. Calcium Status In Moroccan Children And Adolescents Assessed By 24-hour Urinary Excretion. Nor Afr J Food Nutr Res. 2019;03;(05):172–9. Doi.org/10.5281/zenodo.3350884.
48.
SaeidN, RamiA, MounachS, HamraniA, El HamdouchiA, MouzouniFZ, et al. Assessment of iodine intake and deficiency in school-age children in Morocco. Nutr Food Sci. 2018;48(6):873–85(13). Doi: 10.1108/NFS-03-2018-0069.
49.
ZahidiM, TaoufikT. Assessment of iodine concentration in dietary salt at household level in Morocco. BMC Public Health. 2016;16:418–23. Doi: 10.1186/s12889-016-3108-8.
50.
KemnicTR, ColemanM. Vitamin E Deficiency. Treasure Island (FL): StatPearls Publishing. 2020.
51.
JaniR, SalianN, UdipiS, GhugreP, LohiaN, HaasJ, BoyE. Folate status and intake of tribal Indian adolescents aged 10 to 17 years. Food Nutr Bull. 2015;36:1. Doi: 10.1177/156482651503600102.
52.
VitoloR, CanalQ, CampagnoloD, GamaM. Factors associated with risk of low folate intake among adolescents. J Pediatr (Rio J). 2006;82:121–6. Doi: 10.2223/JPED.1449.
53.
Martínez SteeleE, PopkinBM, SwinburnBet al. The share ofultra-processed foods and the overall nutritional quality of dietsin the US: evidence from a nationally representative cross-sectionalstudy. Popul Health Metr. 2017;15:6. Doi.org/10.1186/s12963-017-0119-3.
54.
KawadeR. Zinc status and its association with the health of adolescents: a review of studies in India. Glob Health Action. 2012;5:7353. Doi: 10.3402/gha.v5i0.7353.
55.
HarikaR, FaberM, SamuelF, MulugetaA, KimiyweJ, EilanderA. Are Low Intakes and Deficiencies in Iron, Vitamin A, Zinc, and Iodine of Public Health Concern in Ethiopian, Kenyan, Nigerian, and South African Children and Adolescents?Food Nutr Bull. 2017;38(3):405–27. Doi: 10.1177/0379572117715818.
FAO. 352 Profil Nutritionnel de Pays. Royaume du Maroc. Organisation des Nations Unies pour l’Alimentation et l’Agriculture. 2011.
58.
Haut-Commissariat au Plan (2009) Enquête nationale sur la consommation et les dépenses des ménages 2000–2001. Rapport de synthèse (National Survey of Household Consumption and Expenditure. Summary Report.
59.
TakruriHRH, DamehAFM. Study of the Nutritional Value of Black Cumin Seeds (Nigella sativa L). J. Sci. Food Agric. 1998;76(3):404–10. Doi: 10.1002/(sici)1097-0010(199803)76:3<404::aid-jsfa964>3.0.co;2-l.
60.
BarakatAA, MaslatAO, AL-KofahiMM. Element Analysis and Biological Studies on Ten Oriental Spices Using XRF and Ames Test. J Trace Elem Med Biol. 2003;17(2):85–90. Doi: 10.1016/s0946-672x(03)80003-2.
