@article{fdi:010053551,
  title = {{N}utrition transition among adolescents of a south-{M}editerranean country : dietary patterns, association with socio-economic factors, overweight and blood pressure. {A} cross-sectional study in {T}unisia},
  author = {{A}ounallah-{S}khiri, {H}. and {T}raissac, {P}ierre and {E}l {A}ti, {J}. and {E}ymard-{D}uvernay, {S}abrina and {L}andais, {E}dwige and {A}chour, {N}. and {D}elpeuch, {F}rancis and {B}en {R}omdhane, {H}. and {M}aire, {B}ernard},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he 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 {M}editerranean countries and adolescents are at the forefront of these changes. {T}his study assessed dietary intake and association with socio-economic factors and health outcomes among adolescents in {T}unisia. {M}ethods: {C}ross-sectional survey (year 2005); 1019 subjects 15-19 y. from a clustered random sample. {D}ietary intake was assessed by a validated semi-quantitative frequency questionnaire (134 items) as was physical activity; the {D}iet {Q}uality {I}ndex {I}nternational measured diet quality; dietary patterns were derived by multiple correspondence analysis from intakes of 43 food groups. {B}ody {M}ass {I}ndex ({BMI}) >= 85(th) and 95(th) percentile defined overweight and obesity. {W}aist {C}ircumference ({WC}) assessed abdominal fat. {H}igh blood pressure was systolic ({SBP}) or diastolic blood pressure ({DBP}) >= 90(th) of the international reference for 15-17 y., and {SBP}/{DBP} >= 120/80 mm {H}g for 18-19 y. {R}esults: {E}nergy intake levels were quite high, especially for females. {T}he 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. {A}djusted for age, energy and physical activity, this modern pattern was associated with increased overweight in males (2(nd) vs. 1(st) tertile: {P}revalence {O}dds-{R}atio ({POR}) = 4.0[1.7-9.3], 3(rd) vs. 1st: {POR} = 3.3[1.3-8.7]) and a higher {WC}. {A}djusting also for {BMI} and {WC}, among females, it was associated with decreased prevalence of high blood pressure (2(nd) vs. 1(st) tertile: {POR} = 0.5[0.3-0.8], 3(rd) vs. 1(st) tertile: {POR} = 0.4[0.2-0.8]). {C}onclusion: {T}he dietary intake contrasts among {T}unisian adolescents, linked to socio-economic differentials are characteristic of a nutrition transition situation. {T}he 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.},
  keywords = {},
  booktitle = {},
  journal = {{N}utrition {J}ournal},
  volume = {10},
  numero = {},
  pages = {38},
  ISSN = {1475-2891},
  year = {2011},
  DOI = {10.1186/1475-2891-10-38},
  URL = {https://www.documentation.ird.fr/hor/fdi:010053551},
}