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Background: This study aimed to analyze the probabilities of transitioning between controlled, uncontrolled, and partially controlled states of asthma patients and investigate the influence of age, smoking, dust allergy, and obesity on these probabilities., Methods: This study aimed to analyze the probabilities of transitioning between controlled, uncontrolled, and partially controlled states of asthma patients and investigate the influence of age, smoking, dust allergy, and obesity on these probabilities., Results: Results showed that controlled patients were more likely to remain in that state, with approximately 79 out of 100 patients expected to stay in optimal control in the long term. A discrete nonhomogeneous time Markov Model with the stationarity criterion was used to examine the factors affecting patient states and transitions. Patients seen during the spring and summer seasons were more likely to move into a controlled state compared with those seen in the fall and winter seasons. Patients with dust allergies and obesity significantly impacted asthma exacerbation, with overweight patients more likely to transition into a controlled state. The study estimated the transition intensities matrix under certain conditions, assuming the regularity of patients. In the long term, the probability of an asthmatic patient being in a controlled state was approximately 0.8., Conclusion: This study provided insights into the probabilities and factors influencing asthma progression in Morocco. Dust allergy and obesity were identified as significant contributors to asthma exacerbation, emphasizing the need for effective management strategies.

Background: Vitamin D is a fat-soluble vitamin found in two forms, sourced either from plants (D2) or animals (D3). Numerous epidemiological studies worldwide have highlighted its deficiency across diverse populations in various countries. When coupled with obesity, this deficiency becomes a significant global health concern. Our study aimed to evaluate the vitamin D levels among obese individuals in Southern Morocco., Methods: This is a retrospective, cross-sectional descriptive study on the vitamin D status in obese subjects. This study was conducted at the "Health Universe" Diet Center in Agadir, Morocco. The measurement method involved using a Tanita® wall-mounted metal stadiometer to determine height and a Tanita® BC 418 MA segmental body composition analyzer to determine weight. The serum level of 25-hydroxyvitamin D was determined by elec-trochemiluminescence (ECLIA) using the Elecsys® and Cobas e411®., Results: The sample of our study, consisting of 1,210 individuals, is composed of 73.5% (n = 889) females and 26.5% (n = 321) males. The mean age of the entire sample is 42.3 ± 13.1 years (ranging from 18 to 86 years). The mean BMI is 37 ± 5.69 kg/m², with a higher value in females (37.4 ± 5.85 kg/m²) compared to males (35.7 ± 5.03 kg/m²), including 42.8% moderate obesity, 34.2% severe obesity, and 23% morbid obesity. The mean serum vitamin D level in our sample is 15.7 ± 7.67 ng/mL. This level is 14.5 ± 7.42 ng/mL for females and 19.2 ± 7.31 ng/mL for males. However, only 5.3% of the subjects have an adequate serum vitamin D level, while 18% have an insufficiency, 52.5% have a moderate deficiency, and 24.2% have a severe deficiency. An inverse trend was noted for BMI, which shows a very significant inverse correlation with serum vitamin D concentration (r = -0.18 and p < 0.01)., Conclusions: Our results support the hypothesis that obesity is inversely associated with low vitamin D levels. Lifestyle improvement should be considered as the primary treatment option, aiming to enhance the dysmetabolic state associated with obesity and vitamin D deficiency.

Introduction: Our purpose was to study the body composition in a healthy female Moroccan adult group, and to help physicians to evaluate nutritional status., Materials and Methods: Five hundred and nineteen healthy women aged from 20 to 80 years were included in the study. Bone mineral density at the hip and lumbar spine and the body composition parameters were measured by dual-energy X-ray absorptiometry: fat mass (FM), fat-free mass (FFM), and percentage (%) of body fat. The FFM index (FFMI) and the FM index (FMI) were calculated. We analyzed the population by age and body mass index (BMI) defined groups., Results: The mean age of the population was 53.14 ± 13.69 years with an average BMI of 29.30 ± 5.04 kg/m2. Means of FM and FFM were 33.93 ± 9.18 kg and 36.91 ± 5 kg, respectively, with FM and FFMI of 13.65 ± 3.66 kg/m2 and 14.85 ± 1.91 kg/m2, respectively. The % FM, FFM, and their corresponding indices increased with age; a statistically significant difference was observed between the 20 and 39 age categories and the two other categories. The BMI category analysis showed that FFMI and FMI increased in obese women with a statistically significant difference between the four groups. Age and BMI were correlated significantly with the different parameters., Conclusion: This is the first Moroccan study to present body composition indexes in healthy Moroccan female adults. These reference values may be useful for the clinical evaluation of body composition and nutritional status., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

Background: Weight load is a cosmopolitan health problem. In Morocco, women are the most affected by the phenomenon since obesity has risen from 26.8% to 29.0%., Objective: To determine the prevalence of weight load and associated factors among female students in higher education., Methods: Data were collected by a questionnaire. Anthropometric measurements were made using a scale and a wall-mounted scale. Data were analysed by the statistical software SPSS version 13.0. Quantitative variables were described in mean ± standard deviation. Factors associated with obesity were determined by binary logistic regression., Results: About two-thirds of the students had a normal weight, 21% were overweight and 3% were obese. In addition, 58% of students were physically inactive and 77% ate cake and fast food. In addition, 63% of students were dissatisfied with their weight. A significant relationship is found between level of primary education, type of establishment, cake and fast food consumption and weight load., Conclusion: The results revealed that 24% of participants were weight load and had behavioral risk factors such as a sedentary lifestyle and an unbalanced diet, which requires the promotion of a healthy lifestyle among these students as well as psychological support for those dissatisfied with their body image., (© 2021 Boukrim M et al.)

Background: Obesity constitutes a major risk factor for the development of diabetes, and has been linked with poor glycaemic control among type 2 diabetic patients., Aims: This study examines the prevalence of overweight/obesity and associated factors in type 2 diabetic patients in the Beni-Mellal Khenifra region in Morocco., Methods: A questionnaire-based cross-sectional study was conducted in 2017 among 975 diabetes patients attending primary health centres. Demographic and clinical data were collected through face-to-face interviews. Anthropometric measurements, including body weight, height and waist circumference, were taken using standardized techniques and calibrated equipment., Results: The prevalence of overweight was 40.4%, the general obesity was 28.8% and the abdominal obesity was 73.7%. Using multivariate analysis, we noted that the general obesity was associated with female sex (AOR= 3,004, 95% CI: 1.761-5.104, P<0.001), increased age (AOR=2.192, 95% CI: 1.116-4.307, P<0.023) and good glycaemic control (AOR=1.594, 95% CI: 1.056-2.407, P=0.027), whereas abdominal obesity was associated wih female sex (AOR=2.654, 95% CI: 1.507-4.671, P<0.001) and insulin treatment (AOR=2.927, 95% CI: 1.031-8.757, P=0.048)., Conclusion: Overweight, general obesity and abdominal obesity were high among participants, especially among women. Taken together, these findings urge the implementation of a roadmap for this diabetic subpopulation to have a new lifestyle., (© 2021 Chetoui A et al.)

Objective: To evaluate whether the lifestyle intervention MetSLIM targeting individuals of low socio-economic status of Turkish, Moroccan and Dutch origin was successful in improving waist circumference and other cardiometabolic risk factors, lifestyle behaviour and quality of life., Design: A quasi-experimental intervention study (Netherlands Trial Register NTR3721). The intervention group participated in a 12-month combined dietary and physical activity programme. Examinations were performed at baseline and after 12 months. Participants underwent anthropometric measurements and blood withdrawal, and completed questionnaires on dietary intake, physical activity and quality of life., Setting: Socio-economically deprived neighbourhoods in two Dutch cities, involving non-blinded ethnicity-matched and gender-matched research assistants, dietitians and sports instructors., Subjects: Mainly Turkish (49 %) and Dutch (36 %) subjects, aged 30-70 years, with a waist-to-height ratio of >0·5 (intervention, n 117; control, n 103). Dropout was 31 %., Results: At 12 months, the intervention group showed greater improvements than the control group in waist circumference (β=-3·3 cm, 95 % CI -4·7, -1·8, P<0·001) and other obesity measures. Additionally, greater reductions were observed for total cholesterol (β=-0·33 mmol/l, 95 % CI -0·56, -0·10, P=0·005) and LDL cholesterol (β=-0·35 mmol/l, 95 % CI -0·56, -0·14, P=0·001). Dietary changes were significant for fibre intake (β=1·5 g/4184 kJ (1000 kcal), 95 % CI 0·3, 2·7, P=0·016). Compared with the control group, the intervention group reported a decrease in total minutes of physical activity (β=-573 min/week, 95 % CI -1126, -21, P=0·042) and showed improvements in the quality-of-life domains 'health transition' and 'general health'., Conclusions: MetSLIM was shown to be effective in improving waist circumference, total and LDL cholesterol, and quality of life among Dutch and Turkish individuals living in deprived neighbourhoods.

Introduction: Diabetes is a disorder of assimilation, use and storage of sugars provided in the diet. Its management is based on follow-up of overweight and obese patients and on regular glycemic control. This study aimed to analyze overweight, obesity and glycemic control in 2227 patients with different types of diabetes (type 1, 2 and gestational) presenting to the Provincial referral center of diabetes (RCD) in Kenitra, Morocco., Methods: We conducted a study over the period January-December 2015. Overweight and obesity assessment was performed using Body Mass Index calculator (BMI = weight/height 2 (kg/m 2 ). Overweight and obesity were defined by BMI > 25 kg/m 2 and BMI > 30 kg/m 2 respectively; the weight and the height were measured according to World Health Organization's recommendations. Glycemic control was based on glycated hemoglobin levels and fasting blood glucose test. Current guidelines recommend a glycosylated hemoglobin level of 7% and a fasting blood glucose of 0.70g/l - 1.10g/L., Results: The age of patients ranged from 8 months to 80 years, with a prevalence of diabetic patients from the urban environment (74%) compared to those from the rural areas (26%). The entire study population was overweight. The average BMI of women showed a trend toward obesity (BMI≈30): (29.21 kg/m 2 ± 3,1) in patients with gestational diabetes and (29.15 kg/m 2 ± 3.2) in patients with type 2 diabetes. Blood sugar levels were above the standards: 8.5% ± 2.6 > 7% for glycosylated hemoglobin and 1.5 g/L ± 1.3>1.10g/L for fasting blood glucose. The difference between glycosylated hemoglobin levels between men (8.57% ± 2.6) and women (8.1% ± 2.3) were not significant (p > 0.05), it was the same with fasting blood glucose: men (1.44 g/L ± 1,1) and women (1.43 g/L ± 1.2). Pearson's correlation coefficients were highly significant (p<0.005); on the one hand between BMI and fasting blood glucose(r = 0.5) and on the other hand between BMI and glycosylated hemoglobin levels (r = 0.4)., Conclusion: The entire study population had BMI and glycaemic control levels above the standards. More research is needed on diabetic patients in order to develop a remediation plan.

The prevalence of hypertension, diabetes, obesity, and chronic kidney disease (CKD) in an adult Arabic-Berber population was investigated according to 2012 KDIGO guidelines. A stratified, randomized, representative sample of 10,524 participants was obtained. Weight, height, blood pressure, proteinuria (dipstick), plasma creatinine, estimated glomerular filtration rate, and fasting glycemia were measured. Abnormal results were controlled within 2 weeks; eGFR was retested at 3, 6, and 12 months. The population adjusted prevalences were 16.7% hypertension, 23.2% obesity, 13.8% glycemia, 1.6% for eGFR under 60 ml/min/1.73 m(2) and confirmed proteinuria 1.9% and hematuria 3.4%. Adjusted prevalence of CKD was 5.1%; distribution over KDIGO stages: CKD1: 17.8%; CKD2: 17.2%; CKD3: 52.5% (3A: 40.2%; 3B: 12.3%); CKD4: 4.4%; CKD5: 7.2%. An eGFR distribution within the sex and age categories was constructed using the third percentile as threshold for decreased eGFR. A single threshold (under 60 ml/min/1.73 m(2)) eGFR classifying CKD3-5 leads to "overdiagnosis" of CKD3A in the elderly, overt "underdiagnosis" in younger individuals with eGFR over 60 ml/min/1.73 m(2), below the third percentile, and no proteinuria. By using the KDIGO guidelines in a correct way, "kidney damage" (confirmed proteinuria, hematuria) and the demonstration of chronicity of decreased eGFR <60 ml/min/1.73 m(2), combined with the third percentile as a cutoff for the normality of eGFR for age and sex, overcome false positives and negatives, substantially decrease CKD3A prevalence, and greatly increase the accuracy of identifying CKD., (Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

The aim of the present study is to explore the association between the APOA5 polymorphisms and haplotypes with obesity in Moroccan patients. The study was performed in 459 subjects, Obese (n=164) and non-obese (n=295). All subjects were genotyped for the APOA5 -1131T>C (rs662799) and c.56C>G (rs3135506) polymorphisms. The contribution of APOA5 polymorphisms and haplotypes in the increased risk of obesity were explored using logistic regression analyses. The -1131T>C and c.56C>G polymorphisms were significantly associated with obesity. Both polymorphisms were strongly associated with increased BMI. Analysis of constructed haplotypes showed a significant association between CG haplotype and susceptibility to obesity (OR [95%CI]=3.09 [1.93-4.97]; P<0.001). These results support a potential role for APOA5 common variants and related haplotypes as risk factors for obesity., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Background: The correction of serum ferritin (SF) concentrations for inflammation because of infectious or parasitic diseases was recently proposed, especially in developing countries, but in many countries, adiposity has become the main cause of inflammation., Objective: We assessed, overall and by adiposity status, the bias in the estimation of iron deficiency (ID) on the basis of uncorrected SF., Design: A cross-sectional survey in 2010 in Rabat-Salé, Morocco, used a random sample of 811 women aged 20-49 y. Adiposity was assessed by body mass index (BMI) (in kg/m²) (normal: BMI <25; overweight: BMI ≥25 to <30; obese: BMI ≥30), waist circumference, and body fat. Inflammation was indicated by a C-reactive protein (CRP) concentration >2 mg/L. ID was indicated by an SF concentration <15 μg/L. The correction factor of SF for inflammation was derived from our sample. Differential effects of SF correction on ID status on the basis of adiposity were assessed by models that included adiposity × correction interactions and accounted for the within-subject correlation., Results: The prevalence of overweight was 33.0% and of obesity was 34.0%. Inflammation (42.3%) was strongly linked with adiposity (20.1%, 37.6%, and 68.4% in normal, overweight, and obese subjects, respectively; P < 0.0001). SF increased from a CRP concentration >2 mg/L. The correction factor of SF was 0.65. The prevalence of ID (37.2% compared with 45.2%; difference -8.0%, P < 0.0001) was underestimated by not correcting SF, and the difference increased with adiposity (-2.9%, -8.5%, and -12.4% in normal, overweight, and obese subjects, respectively; P-interaction < 0.0001). Analogous results were observed for other adiposity measures., Conclusion: In developing countries where ID remains prevalent but rates of obesity are already high, corrected SF should be used when assessing ID status, even if infectious or parasitic diseases are no longer widespread. This trial was registered at clinicaltrials.gov as NCT01844349.

Objectives: Study of overweight and obesity among women from modest neighborhoods in Casablanca and the related factors influencing this phenomenon., Design: A survey was conducted in 6 neighborhoods of Casablanca using multistage cluster sampling. Anthropometric parameters and body composition were measured, and information about food habits, sociodemographic situation and body image perception were collected using a questionnaire., Participants: 425 adult women from popular neighborhoods in Casablanca., Results: We found a prevalence of 47% obesity and 36% overweight. Obesity and overweight exceeded 80% in all age categories except among women < 25 years, where we found a prevalence of 44% overweight. Furthermore, abdominal obesity prevalence was high in all age categories with an overall prevalence of 67%. Body image perception data showed that 62% women perceived their weight as being either normal or insufficient, 46% of those women were, in fact, either overweight or obese. Fattening products were used by 12% of the population at least once, especially by women < 35 years, 68% of these women were overweight or obese at the time of the study., Conclusions: The problem of obesity in this society is amplified by its perception of a regular weight and by the use of fattening substances even among young and educated women.

In Morocco, the beginning of the nutritional transition is closely linked to social and economic transformations and changes in behaviour and traditional lifestyles. The objective of this study is to describe the current pattern of food consumption and the nutritional status of adolescents in the province of Ouarzazate and its association with parents' educational level. The sample comprises 327 high school students from Ouarzazate: 135 (41.3%) boys and 192 (58.7%) girls (age range 15-20 years). For both boys and girls, the results show lower height and BMI z-scores than the WHO reference values. Adolescents whose parents have a low educational level have lower height/age and BMI/age z-scores than those whose fathers have a high educational level. No differences are observed in total daily energy intake depending on fathers' educational level, but the energy provided by lipids is higher in adolescents whose fathers have a high educational background. The quality of fats consumed (MUFA+PUFA/SFA) is better among those boys whose fathers have low education, but no differences are observed for girls. The process of nutritional transition is not uniform in the sample, but depends on the socioeconomic characteristics of population groups, which include, among others, accessibility of certain food, differences in habits and lifestyles related to energy expenditure, and higher prevalence of overweight and obesity in more favoured groups.

Objective: We aimed to estimate the prevalence of overweight among Moroccan children and adolescents with juvenile idiopathic arthritis (JIA)., Methods: Fifty-eight patients with JIA according to the International League of Association of Rheumatology (ILAR) criteria were included consecutively in this study. The median age of patients was 11±3.3years (range 2-16). Overweight and obesity were defined by using the Body Mass Index (matched on age and sex and in reference to the French curves. Following data were collected: age, gender, age at onset, disease duration, subtype of JIA, functional disability (determined using the Moroccan version of Childhood Health Assessment Questionnaire [CHAQ]), disease activity (assessed using a 0-10 visual analogical scale, the number of tender and swollen joints and the erythrocyte sedimentation rate); medical treatment and socioeconomic status of patients., Results: Twenty-four patients (41.4%) were overweight, 13 (22.4%) were obese and 21(36.2%) have normal. Patients with normal weight, obese and overweight represented successively 16.7%, 33.3% and 50% of systemic forms, 33.3%, 8.3% and 58.3% of seronegative polyarticular forms, 40%, 40% and 20% of seropositive polyarticular forms, 36.4%, 27.3% and 36.4% of persistent oligoarticular forms, 75%, 25% and 0% of extensive oligoarticular forms and 57.1%, 0% and 42.9% of forms with arthritis and enthesitis. In our data, there was no psoriatic arthritis. Overweight and obesity were more prevalent in older patients (P=0.01), with significant functional impairment (P=0.04) and with active disease (increased VAS) (P=0.005). There were no relationships with the subtype of JIA or with corticosteroid treatment (P=0.451)., Conclusion: Approximatively more than 60% of our patients were overweight. Severe functional limitation and active disease are the most correlated parameters with overweight. Better management of the activity and functional status of the disease seems to be of interest to prevent overweight in children with JIA. More studies with a larger number of patients seem to be necessary in order to confirm our results., (Copyright © 2011. Published by Elsevier SAS.)

Background and Aims: We undertook this study to assess the prevalence of obesity and overweight in children enrolled in government primary schools in the city of Rabat, Morocco., Methods: Twenty three schools were randomly selected. A cross-sectional study was conducted between April 2010 and June 2010. The survey was conducted on the basis of two questionnaires for both parents and children. The references used are those of the WHO (2007)., Results: Our study involved a sample of 1570 children with an average age of 9.7 ± 0.95 years. The prevalence of overweight and obesity was 8.7%. Overweight affected 5.1% and obesity affected 3.6%. The majority of our population consisted of children of low socioeconomic status where 59% of fathers are laborers and 85% of mothers are unemployed., Conclusion: Overweight and obesity do not spare the most underprivileged social strata of our country. Therefore, prevention strategies and programs to raise awareness of risks and threats involved must be a public health priority., (Copyright © 2011 IMSS. Published by Elsevier Inc. All rights reserved.)

Objective: This study investigates differences in overweight and body fat distribution between Turkish and Moroccan migrants and the ethnic Dutch population, and the contribution of socio-economic status to their higher obesity prevalence., Methods: Data were collected as part of a general health survey, in Amsterdam, the Netherlands (2004). From 1,285 adults information on physical and psychological health, lifestyle and demographic background was obtained through health interviews. In a physical examination body height and weight as well as waist and hip circumference were measured., Results: Overweight was more common among Turkish migrants and Moroccan migrant women as compared to their Dutch counterparts. Obesity prevalence rates were more than twice as high among Turkish (39.6%) and Moroccan (39.1%) women than among Dutch women (16.5%). Controlling for level of education and unemployment attenuated ethnic differences in overweight. Abdominal obesity was more common among Turkish and Moroccan than among Dutch women. After controlling for BMI, migrant men had a relatively low waist circumference compared to Dutch men., Conclusion: Overweight is relatively common among Turkish and Moroccan migrants, especially women. Education and employment are relevant in explaining ethnic differences in overweight. Compared to Dutch men, migrant men seem to have a more favourable fat distribution with less abdominal fat., (Copyright © 2011 S. Karger AG, Basel.)

Objective: In Morocco, the association between obesity/overweight and socio-demographic and lifestyle factors is poorly understood. The present study aimed to investigate this association in a representative sample of the Moroccan population aged 18 years and above., Design: This is a cross-sectional study using a questionnaire including demographic, socio-economic and physical activity items. Height and weight were measured and BMI was computed. The association between obesity (BMI ≥ 30.0 kg/m2) or overweight (25.0 ≤ BMI < 29.9 kg/m2) and the other variables was analysed using multiple binomial logistic regression, separately in men and women., Setting: The whole Moroccan territory., Subjects: A total of 2891 subjects took part in the survey (1430 men and 1461 women)., Results: The prevalence of obesity was 20.9 % in women and 6.0 % in men (P < 0.0001). The prevalence of overweight was 32.9 % in women v. 26.8 % in men (P < 0.0001). In women, the risk of obesity and overweight increased with age, with the highest risk being in individuals aged 45-54 years (OR = 3.02, 95 % CI 2.06, 4.44) compared to individuals <35 years old. Married women were more prone to obesity and overweight (OR = 2.42, 95 % CI 1.50, 3.91) than single women. In men, the risk of obesity and overweight increased with average family income (OR = 2.62, 95 % CI 1.40, 4.87 for family income ≥5000 MAD/month compared to <2000 MAD/month) and in married persons (OR = 3.75, 95 % CI 1.78, 7.81) compared to single individuals., Conclusions: These results contribute to target groups in whom prevention programmes could be implemented.

This article presents data from an in-depth qualitative study of overweight and diabetic women in Morocco, a North African country experiencing a rapid increase in obesity according to national statistics. This case study explores the heterogeneous relationship among health, culture and religion in Morocco by highlighting the relationship between the intricacies of women's everyday lives and their body sizes. My findings suggest that although the Body Mass Index (BMI) of adult women has been documented to have increased in Morocco along with other macroeconomic changes (i.e., increases in urbanization, etc.), "obesity" has yet to be universally medicalized in the Moroccan context. As such women do not generally utilize a medicalized concept of obesity in reference to their larger body sizes. Rather, cultural constructions of "obesity" are understood through cultural understandings of a larger body size, religious beliefs about health and illness, and the nature of women's religious participation. This stands in contrast to dominant accounts about the region that promote an overall veneration of a larger body size for women., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Obesity and asthma are both public health problems that have been increasing for several years. This increase suggests that there may be a connection between these two pathologies. The aim of this study was to examine the relationship between obesity and asthma by measuring the prevalence of obesity in asthmatic children compared with a control population, by analysing the impact of obesity on the severity of the asthma, and by examining the relationship between obesity and atopy. The study was based on 100 children aged from 4 to 16 years in whom the diagnosis of asthma was confirmed; obesity being defined as a body mass index greater than the 97th percentile. The prevalence of obesity in these patients was 14%. Obesity was not a factor in the severity of the asthma as 14.5% of the severe asthmatics were obese compared with 18.75% of the mild and moderate asthmatics. 13% of the atopic subjects were obese compared with 13% of the non-atopics. Obesity does not constitute, therefore, a risk factor for asthma and does not contribute to the severity of the disease. In addition there is no relationship between obesity and atopy.

This study aimed to examine the relationship between metabolic syndrome (MS) and different types of obesity in urban Moroccan women. On 213 women aged 25-55 years, Triglycerides (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-c), lower-density lipoprotein cholesterol (LDL-c), and fasting blood glucose levels were assessed. Body mass index (BMI), waist to hip ratio (WHR), Waist circumference (WC), and blood pressure (BP) were also measured. Globally 36.6% of women were overweight (25 < or = BMI < 30 m2), 23.9% obese (BMI > 30 m2), 19.7% had WHR > 0.85 and 28.8% had WC > or = 88 cm. Indicators of obesity increased with age and the prevalence of co-morbid factors increased with obesity. The women with android obesity (WHR > 0.85) and central obesity (WC > or = 88 cm) had greater risk compared to those with overweight and general obesity. The prevalence of MS was 17.8% and increased (31.49%) with high BMI and high WHR (50%). MS and its co-morbidity factors are prevalent among Moroccan women aged 35 years and over. The exaggerated influence of obesity in this prevalence suggests that the prevention of obesity could prevent MS and its complications., (Copyright 2008 Wiley-Liss, Inc.)

Often referred to as the developing world's new burden of disease, obesity constitutes a major and growing health epidemic in Morocco, in particular for women (22% of women versus 8% of men). Through an analysis of qualitative data, I demonstrate how gender roles influence obesity risk in the Moroccan context. Current social and economic theories, including the nutrition transition theory, are inadequate in explaining the persistent gender differentials in health status across time and place. I suggest that Moroccan women's higher prevalence of obesity is predominantly the outcome of different risks acquired from their distinct roles. In the Moroccan context, we can gain insight into how men and women divide household labour and how the overall non-egalitarian nature of social roles may deleteriously affect women's health. I hypothesise that marital status, age and socioeconomic status determine Moroccan women's household roles and help to explain why women are more likely to be obese than men. The main findings support this hypothesis and demonstrate the interactive relationship between culture and structure in influencing obesity risk.

In order to study the prevalence of obesity and overweight and to understand how the human body is perceived among Moroccan mountain populations, we carried out a survey that covered a sample of 436 Amazigh individuals aged 20 years and more from the High Moroccan Atlas. Through this survey, we noticed that obesity is still low among men (2.4%), whereas the prevalence of obesity among women is alarming and reaches 13.3%. The prevalence of overweight is also high, especially among women, with 32.8% vs. 21.8% among men. Obesity prevalence, especially overweight, is higher than that recorded in the national rural level. The high prevalence of overweight that can develop to obesity should be taken into account mainly when dealing with women that still value overweight. In fact, women in our sample underestimate their overweight more than men and wish to have a heavier body.

Data on measured heights and weights indicate that the prevalence of obesity has increased among Moroccan population over the past 15 years. In 1984/1985, 4.1% of the adult population was obese, and the prevalence increased to 10.3% in 1998/1999. In the most recent survey in the year 2000, 13.3% of individuals aged 20 years and more were obese (22% among women and 8% among men). Excessive weight is more prevalent in urban than in rural areas, varies by geographical residence, positively associated with age and negatively with education level. The increasing prevalence of obesity poses challenges for researchers and policy makers.

Objective: The goal of the present work was to examine the prevalence and associated risk factors of undiagnosed diabetes among urban Moroccan Sahraoui women., Design and Setting: Randomised sample of adult women living in the city of Laayoune in south Morocco who visited public health centres during an immunisation campaign. Body weight, height, waist and hip circumferences, blood pressure, fasting plasma glucose (FPG), triglycerides, dietary intake and physical activity were collected., Subjects: Data were obtained on 249 urban women aged 15 years and older, who were not pregnant. Only subjects identified as of Sahraoui origin were eligible for this investigation., Results: The prevalence of impaired fasting glucose (IFG) was 5.5% and that of undiagnosed diabetes 6.4%. Diabetes and IFG were more common among older and obese women as well as among women with hypertension or a family history of diabetes. In addition, sucrose intakes were higher in women with diabetes than in those with normal FPG. Also, physical activity estimated as the time spent in walking was negatively associated with FPG. Regression analyses showed an independent association of age, obesity, family history of diabetes and triglycerides with diabetes., Conclusion: The high proportion of unknown diabetes suggests the need for increased diabetes awareness in this population. The data suggest also the involvement of obesity in diabetes and the potential importance of intervention strategies to reduce population adiposity for the prevention and management of cardiovascular risk factors.

To study obesity in Moroccan Saharawi culture, 249 women were questioned about their desired body size and diet practices. The majority of women (90.4%) reported wanting to gain weight currently or at some time in the past. To gain weight, women used a fattening period (tablah) of at least 40 days of overeating with a reduction of physical activity and special traditional meals. Appetite enhancers (therapeutic drugs or fenugreek) and traditional suppositories were also used. Some women used corticosteroids to gain weight rapidly. The study highlights the need for health education about the dangers of obesity and steroid use in this culture.

Objectives: To estimate the prevalence of obesity in Moroccan Sahraoui women; to describe their distribution of body fat; and to examine the influence of age, calorie intake, physical activity, marital status, education level, and desire to lose weight on obesity., Design: Randomized samples of adult women who visited the public health centers during a immunization campaign period., Participants: Data were obtained on 249 non-pregnant urban women aged 15 and older, who live in the city of Laayoune in South Morocco. Only subjects identified as Sahraoui origin were eligible for this investigation., Main Outcome Measure: The following data were collected: body weight, height, circumference of waist and hip, calorie intake, physical activity, marital status, education level, and desire to lose weight., Results: The overall prevalence of overweight and obesity was 30% and 49%, respectively, and was found to be very high in younger age groups. The prevalence of abdominal obesity was also high and increased with age. Sixty-eight percent of women had a waist-to-hip ratio (WHR) > 0.85 and 76% had a waist circumference (WC) > or = 88. The calorie intake, the time spent in a walking activity, and the time spent in traditional sedentary occupation were associated with obesity. The prevalence of obesity was higher among married women compare to unmarried women and was not influenced by education level. A very small percentage of the female population expressed a desire to lose weight., Conclusion: High prevalence of obesity, even in young adult women, needs immediate attention in terms of prevention and health education among the urban Sahraoui women.

Objective: To determine the prevalence of obesity and body fat distribution of Moroccan women of childbearing age, using a panel of anthropometric measurements., Design and Setting: A cross-sectional survey conducted in 1995 in an agricultural community, El Jadida province of Morocco. Weight, height, waist and hip circumferences and triceps, biceps, subscapular and supra-iliac skinfold thicknesses were measured. Body mass index (BMI), waist/hip ratio (WHR), sum of all and sum of trunk skinfold thicknesses were determined., Subjects: In total, 1269 women aged 15-49 years from urban and rural areas were surveyed., Results: The means of all anthropometric measurements including body fat were higher in urban than in rural women and increased with age. Trunk fat contributed 50% of total fat. Globally, 4.7% of women were underweight (BMI<18.5 kg m(-2)), 35.2% were overweight or obese (BMI> or =25 kg m(-2)), 10.1% were obese (BMI> or =30 kg m(-2)) and 16.8% had central obesity (WHR>0.85). The prevalence of overweight and obesity was higher in the urban than in the rural area. Underweight prevalence decreased with age, whereas that of overweight and obesity increased. All anthropometric parameters adjusted for age increased with the increase of BMI and WHR., Conclusions: Although undernutrition is still prevalent, there is an alarming prevalence of overweight and obesity in Moroccan women of childbearing age. The results indicate a shift in this country from the problem of dietary deficiency to the problem of dietary excess, and alert one to the necessity of establishing an intervention to prevent obesity-related diseases. It is necessary to address which of the anthropometric variables studied here is the best predictor of obesity-related diseases in this population.

Objective: To analyse the nutritional transition in Morocco., Design: Examination of Moroccan national survey data., Results: Morocco is undergoing a demographic, epidemiological and social transition. The urban population increased from 29% in 1960 to 53% in 1997. Per capita gross domestic product increased steadily from 1972 to 1999. Life expectancy at birth increased to 70 years in 1999 from 47 years in 1962. Both infant and juvenile mortalities have decreased, from 92/1000 and 69/1000 in 1982-87 to 46/1000 and 37/1000 in 1992-97, respectively. In parallel, the diet changed considerably: the intake of animal products increased while that of cereals and sugar remained relatively high, reflecting the specificity of Moroccan dietary habits. The rise in the consumption of meats and vegetables was accompanied by a steady consumption of bread, used to eat the sauce in which the meat and vegetables are cooked. Sugar is mainly used in tea, the very sweet, national drink consumed throughout the day. Under-nourishment persists among children under five (23% stunting and 10% underweight in 1997) while overweight is rising (9% in 1997 compared with 3% in 1987 for children under three). Among adults, overweight (body mass index (BMI) > 25 kg m(-2)) increased from 26% in 1984 to 36% in 1998. It is higher among women (32% in 1984 and 45% in 1998) than among males (19% in 1984 and 25% in 1998). It is also higher among urban populations (30% in 1984 and 40% in 1998) than rural populations (20% in 1984 and 29% in 1998). Obesity (BMI > 30kg m(-2)) increased from 4% in 1984 to 10% in 1998. Overweight seems to be positively associated with economic status but negatively with education level., Conclusion: Overweight and obesity constitute major health problems in Morocco.

The etiology of obesity in North Africa is not well understood and few studies shed any light on its development among women. This study compiles what is known about the prevalence of obesity and its determinants in Morocco and Tunisia. Results from the authors' two surveys on nutrition-related disease among reproductive-age women (sample size: 2800) and their children (1200 children under 5 y and 500 adolescents) were combined with data from four national income and expenditure surveys (dating from 1980) to assess obesity trends and development in Morocco and Tunisia. Overall levels of obesity, identified by body mass index (BMI) > or = 30 kg/m(2), were 12.2% in Morocco and 14.4% in Tunisia. Obesity is significantly higher among women than among men in both countries (22.7% vs. 6.7% in Tunisia and 18% vs. 5.7% in Morocco) and prevalence among women has tripled over the past 20 y. Half of all women are overweight or obese (BMI > 25) with 50.9% in Tunisia and 51.3% in Morocco. Overweight increases with age and seems to take hold in adolescence, particularly among girls. In Tunisia, 9.1% of adolescent girls are at risk for being overweight (BMI/age > or = 85th percentile). Prevalence of overweight and obesity are greater for women in urban areas and with lower education levels. Obese women in both countries take in significantly more calories and macronutrients than normal-weight women. The percentage contribution to calories from fat, protein and carbohydrates seems to be within normal limits, whereas fat intake is high (31%) in Tunisia and carbohydrate intake (65-67%) is high in Morocco. These are alarming trends for public health professionals and policy makers in countries still grappling with the public health effects of malnutrition and micronutrient deficiencies. Health institutions in these countries have an enormous challenge to change cultural norms that do not recognize obesity, to prevent significant damage to the public's health from obesity.