Clinical trial NCT01844349: Nutritional Transition in the Maghreb and Prevention of Obesity and Non-communicable Diseases
Official title: Understanding the Nutritional Transition in the Maghreb to Contribute to the Prevention of Obesity and Non-communicable Diseases
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Iron Deficiency,
Anaemia,
Overweight,
Metabolic Syndrome
Keywords: North Africa
Urban women
Double burden of malnutrition
Iron depletion
Overweight/obesity
Metabolic syndrome
Abdominal obesity
Excess body fat
Lead sponsor: Institute of Research for Development, France
Sponsor class: OTHER_GOV
First posted: 2013-05-01
Enrollment: 8218
Sex: ALL
Minimum age (years): 6
Maximum age (years): 49
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: Residents of the region of the capital city

Brief summary: Problematic and state of the art Obesity and its associated non communicable diseases (NCDs) are rising rapidly in middle income countries, such as those in the Maghreb (North Africa). This progression is related to the context of a nutrition transition (changing food and physical activity environment) and profound changes in technological advances and in society. These societies and their health systems are insufficiently prepared for this evolution, which has enormous health and socioeconomic consequences. In the context of limited resources, the priority has been given on an international level to prevention. But several problems arise: - these countries are still confronted by undernutrition in terms of micronutrient deficiencies, which coexist with obesity and NCDs, including at a family level and also individual level. Known as the 'double burden', this coexistence is relatively new and has been rarely documented until recently. Educational measures could be ineffective in a society where cultural norms do not recognise obesity and where changes in lifestyle are possibly not seen as acceptable. As well as information about citizen's knowledge of risk factors, data on their perceptions and attitudes are indispensable. Policies that involve changing the 'obesogenic' environment that individuals occupy is a priority.

Objectives of the project Overall aim: to contribute to the development of preventive strategies for obesity and chronic NCDs in the context of a nutrition transition.

Specific objectives: characterise the nature and size of the double burden (obesity/undernutrition) in regions, families and individuals; estimate the prevalence of biological and behavioural risk factors; characterise the psycho-sociocultural determinants of behaviour.


Eligibility criteria: Inclusion Criteria:

* To live in the region of the capital city
* To give free informed consent

Exclusion Criteria:

* Pregnancy

Primary outcomes:
measure: Body mass index in kg/m²
timeFrame: baseline
Secondary outcomes:
measure: Serum ferritin in µg/L
timeFrame: baseline
Other outcomes:
measure: Blood pressure in mm Hg
timeFrame: baseline
Locations:
city: Kenitra
country: Morocco
facility: Faculty of Sciences, Ibn Tofaïl University
state: Rabat-Salé
city: Tunis
country: Tunisia
facility: National Institute of Nutrition and Food Technology (INNTA)
state: Great Tunis
Study officials:
affiliation: Institute of Research for Development
name: Agnes Gartner, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Ben Cherifa F, El Ati J, Doggui R, El Ati-Hellal M, Traissac P. Prevalence of High HDL Cholesterol and Its Associated Factors Among Tunisian Women of Childbearing Age: A Cross-Sectional Study. Int J Environ Res Public Health. 2021 May 20;18(10):5461. doi: 10.3390/ijerph18105461.
citation: Sassi S, Abassi MM, Traissac P, Ben Gharbia H, Gartner A, Delpeuch F, El Ati J. Intra-household double burden of malnutrition in a North African nutrition transition context: magnitude and associated factors of child anaemia with mother excess adiposity. Public Health Nutr. 2019 Jan;22(1):44-54. doi: 10.1017/S1368980018002495. Epub 2018 Oct 9.
citation: Traissac P, El Ati J, Gartner A, Ben Gharbia H, Delpeuch F. Gender inequalities in excess adiposity and anaemia combine in a large double burden of malnutrition gap detrimental to women in an urban area in North Africa. Public Health Nutr. 2016 Jun;19(8):1428-37. doi: 10.1017/S1368980016000689. Epub 2016 Apr 6.
citation: Gartner A, El Ati J, Traissac P, Bour A, Berger J, Landais E, El Hsaini H, Ben Rayana C, Delpeuch F. 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. J Nutr. 2014 Jan;144(1):87-97. doi: 10.3945/jn.113.178285. Epub 2013 Nov 6.
citation: Gartner A, Berger J, Bour A, El Ati J, Traissac P, Landais E, El Kabbaj S, Delpeuch F. Assessment of iron deficiency in the context of the obesity epidemic: importance of correcting serum ferritin concentrations for inflammation. Am J Clin Nutr. 2013 Sep;98(3):821-6. doi: 10.3945/ajcn.112.054551. Epub 2013 Jul 24.