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Karoune, R., & Colette Dahel-Mekhancha, C. (2023). Association Between Dietary Quality, Socioeconomic Level, Body Mass Index, and Age in Adolescents (Eastern Algeria): A Cross-sectional Study. Arab Journal of Nutrition and Exercise (AJNE), 7(1), 2–18. https://doi.org/10.18502/ajne.v7i1.13425
https://doi.org/10.18502/ajne.v7i1.13425
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Rabiâa Karoune
Rabiâa Karoune
Institut de la Nutrition, de l’Alimentation et des Technologies Agro-Alimentaires (INATAA), Université Frères Mentouri-Constantine 1 (UFMC1), route d’Aïn-El-Bey, 25 000 Constantine, Algérie
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Corinne Colette Dahel-Mekhancha
Corinne Colette Dahel-Mekhancha
Institut de la Nutrition, de l’Alimentation et des Technologies Agro-Alimentaires (INATAA), Université Frères Mentouri-Constantine 1 (UFMC1), route d’Aïn-El-Bey, 25 000 Constantine, Algérie
Published Date
- May 31, 2023
Association Between Dietary Quality, Socioeconomic Level, Body Mass Index, and Age in Adolescents (Eastern Algeria): A Cross-sectional Study
Abstract
Aim: This article aims to evaluate the quality of adolescents’ diet in Constantine (Eastern Algeria) and investigate factors associated with this quality: Socio-economic Level (SEL), nutritional status (BMI), and age.
Methods: A cross-sectional survey was conducted in Constantine (Eastern Algeria) in 2019 with 1126 adolescents (aged 11–19 years). The dietary data were collected by a 24-hr recall. The diet quality was assessed by a diet diversity score (DDS) calculated for 9 food groups (DDS above the mean reflects a diversified diet) and a mean adequacy ratio (MAR) calculated for 12 nutrients. MAR’s cut-off value was "one." Weight and height were measured, and BMI was interpreted according to the World Health Organization reference values. The SEL was assessed using a socioeconomic classification score (SECS) according to parents' education level, profession, and other household information.
Results: The mean DDS was 3.97 ± 1.25. It was shifted to the lowest values compared to the theoretical mean value (4.5). Insufficient scores (DDS ≤4.5) were found in 65.0% of subjects. The mean MAR was 0.59 ± 0.20 and values <1 represented 79.1%. A significant negative correlation was recorded between age and MAR (r = −15%; P < 0.0001), and a positive correlation was found between it and SECS (r = 18%; p < 0.0001). BMI is inversely and significantly associated with MAR (r = −9.9%; P = 0.0009).
Conclusion: In addition to highlighting a low diversity and a poor adequacy with nutritional recommendations among adolescents in Algeria, this study underlines the significant effect of age, BMI, and socioeconomic level on the quality of diet.
Keywords: dietary diversity score (DDS), mean adequacy ratio (MAR), BMI, socioeconomic level, adolescents
References
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[20] Food and Agricuture Organization (FAO). Guide pour mesurer la diversité alimentaire au niveau des [Guide to measuring dietary diversity at the individual and household level] individus et des ménages, FAO. 2013: 22p. Available from : www.fao.org/3/a-i1983f.pdf [cited 2021 January 9].
[21] Hatloy A, Torheim LE, Oshaug A Food variety-a good indicator of nutritional adequacy of the diet? A case study from an urban area in Mali, West Africa. European Journal of Clinical Nutrition. 1998;52:891–898.
[22] Mekhancha DE. Aspects alimentaires et nutritionnels de la restauration collective en Algérie - applications en milieu universitaire [Thèse]. [Food and nutritional aspects of collective catering in Algeria - applications in academia], INATAA, Université Frères Mentouri Constantine 1. 2018. p 1-164 T Available from : http://archives.umc.edu.dz/handle/ 123456789/136842.[cited 2021 murch 2].
[23] Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (ANSES). Table de composition nutritionnelle des aliments, [Food composition Table] version 2020. Available from : https://ciqual.anses.fr [cited 2021 May 5].
[24] Beaufrère B, Bresson JL, Briend A, et al. Nourrissons, enfants et adolescents, [Infants, children and adolescents]. In : Martin A Apports nutritionnels conseillés pour la population française, [Recommended dietary allowances for the French population] Lavoisier, Technique & Documentation, 3ème édition ; 2001. 255–291 (p. 605).
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[26] Mersha Birru S, Tariku A, Kassahun Belew A. Improved dietary diversity of school adolescent girls in the context of urban Northwest Ethiopia: 2017. Italian Journal of Pediatrics. 2018;44:48.
[27] Golpour-Hamedani S, Rafie N, Pourmasoumi M, Saneei P, Sayyed MS. The association between dietary diversity score and general and abdominal obesity in Iranian children and adolescents. BMC Endocrine Disorders. 2020;20:181.
[28] Maire B, Tessier S, Delpeuch F, et al. La nutrition, un défi pour la planète (2) - Transitions alimentaires et nutritionnelles, [Nutrition, a challenge for the planet (2) - Food and nutritional transitions] les dossiers thématiques de l’IRD. 2009:10.
[29] Beghin L, Dauchet L, De Vriendt T, et al. Influence of parental socio-economic status on diet quality of European adolescents: results from the HELENA study. British Journal of Nutrition. 2014;111:1303–1312.
[30] Grosso G, Galvano F. Mediterranean diet adherence in children and adolescents in southern European countries. Nutrition & Food Science Journal. 2016;3:13–19.
[31] Michels N, Vynckier L, Moreno LA, et al. Mediation of psychosocial determinants in the relation between socio-economic status and adolescents’ diet quality. European Journal of Nutrition. 2018;57:951–963.
[32] Omorou AY, Langlois J, Legrand K, et al. Impact d’une intervention en milieu scolaire sur le gradient social de corpulence chez l’adolescent: étude Pralimap-Ines, [mpact of a school-based intervention on the social gradient of corpulence in adolescents: Pralimap-Ines study]. Nutrition Clinique et metabolisme. 2017;33(3):241.
[33] Brancato L, Miéville M. L'influence du milieu socio-économique sur le comportement alimentaire des adolescents européens âgés de 12 à 18 ans. [The influence of socio-economic background on the eating behavior of European adolescents aged 12 to 18] Haute école de santé, Filière nutrition et diététique, Genève. 2018:73. Available from : www.hesge.ch/heds. [cited 2021October 16].
[34] Salehi-Abargouei A, Akbari F, Bellissimo N, Azadbakht L. Dietary diversity score and obesity: A systematic review and meta-analysis of observational studies. Europeen Journal of Clinical Nutrition. 2016;70:1–9.
[35] Karimbeiki R, Pourmasoumi M, Feizi A, et al. Higher dietary diversity score is associated with obesity: A case-control study. Public Health. 2018;157:127–134.
[36] Serra-Majem L, Ribas L, Ngo J, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutrition. 2004;7:931–935.
[37] Gómez G, Kovalskys I, Leme ACB, et al. Socioeconomic status impact on diet quality and body mass index in eight Latin American Countries: ELANS study results. Nutrients. 2021;13:2404.
[38] Aounallah-Skhiri H, Traissac P, El Ati J, 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. Nutrition Journal. 2011;10:17.
[39] Karoune-Bechara R. Scores et indices nutritionnels, un moyen pour évaluer la qualité de l’alimentation des adolescents: enquête auprès de 1 126 adolescents (Constantine, 2015/2016). [Nutritional scores and indices, a method to assess the diet quality of adolescent: Survey of 1 126 adolescents (Constantine, 2015/2016)] [Thèse] INATAA, Université Frères Mentouri Constantine 1. 2018. 1-150 T. Available from : https://bu.umc.edu.dz/theses/agronomie/KAR7240.pdf. [cited 2021 April 15].
[40] Mirmiran P, Azadbaht L, Esmailzadeh A, et al. Dietary diversity score in adolescents-a good indicator of the nutritional adequacy of diets: Tehran lipid and glucose study. Asian Pacific Journal of Clinical Nutrition 2004;13(1):56–60.
[41] Habte TY, Krawinkel M. Dietary diversity score: A measure of nutritional adequacy or an indicator of healthy diet? Journal of Nutrition and Health Sciences. 2016;3(3).
[42] Verger EO, Ballard TJ, Dop MC, Martin-PrevelaY. Systematic review of use and interpretation of dietary diversity indicators in nutrition-sensitive agriculture literature. Global Food Security. 2019;20:156–169.
[2] United Nations. Department of Economic and Social Affairs. Word population prospects 2019. Available from: https://population.un.org/wpp/Publications/ [cited 2021 September 11].
[3] Office National des Statistiques, Algérie. Population. 2015. Available from: http://www.ons.dz/collections/population.html, [cited 2021 jun 10].
[4] Centre international de hautes études agronomiques méditerranéennes (CIHEAM)/Food and Agriculture Organization (FAO). Mediterranean food consumption patterns: Diet, environment, society, economy and health. A White Paper Priority 5 of Feeding Knowledge Programme, Expo Milan 2015. CIHEAM-IAMB, Bari/FAO, Rome.
[5] De Andrade SC, Previdelli AN, Galvão Cesar CL, Marchioni DML, Fisberg RM. Trends in diet quality among adolescents, adults and older adults: A population-based study. Preventive Medicine Reports. 2016;4:391–396.
[6] Tamer M, Gharaibah, Al-sheyab NA, Shiyab WY. “Prevalence and correlates of disordered eating attitudes among Jordanian Adolescents.” Arab Journal of Nutrition and Exercise. 2018;3(2):35–53. DOI 10.18502/ajne.v3i2.2745
[7] Allam F, Sais Z, Ouchefoun A, et al. Étude du surpoids, de l’obésité et des facteurs associés au surpoids chez les élèves du cycle moyen scolarisés dans les collèges publics de l’EPSP Bouzaréah, [Study of overweight, obesity and factors associated with overweight among middle school students enrolled in public colleges of EPSP Bouzaréah] SEMEP, Algérie. 2011. p. 69. Available from: http://www.sante.dz/semep_epsp_bouzareah.pdf, [cited 2020 March 4].
[8] Sayed A, Daoudi H, Rouabah A, Khan NA, Rouabah L. Dietary patterns among overweight/obese school children of District of Constantine (Algeria): A longitudinal study. International Journal of Science and Research. 2014;3(8):1975–1979.
[9] Allioua M, Djaziri R, Mahdad MY, et al. Dietary fat intake, micronutrient and obesity among adolescent in Tlemcen (Western Algeria). Food and Nutrition Sciences. 2015;6:860–868.
[10] Karoune R, Dahel-Mekhancha CC. Score de diversité alimentaire, un moyen pour une évaluation globale de l’alimentation chez l’adolescent. [Dietary diversity score, a method for an overall assessment of adolescent diet]. Nutrition et Santé. 2015;04(02):45–52.
[11] Dahel-Mekhancha CC, Karoune R, Yagoubi-Benatallah L, Badaoui B, Mekhancha D, Nezzal L. Statut pondéral et pratiques alimentaires des jeunes en Algérie [Weight status and dietary practices of young people in Algeria]. Nutrition et Santé. 2016;05(02):69–80.
[12] Karoune R, Mekhancha DE, Benlatreche C, Badaoui B, Nezzal L, Dahel-Mekhancha CC. Évaluation de la qualité de l’alimentation d’adolescents algériens par le score d’adéquation aux recommandations nutritionnelles du PNNS (France). [Assessment of diet quality of Algerian adolescents by the food adequacy score with nutritional recommendations of the PNNS (France)]. Nutrition Clinique et Métabolisme. 2017;31:125 –133.
[13] Bouquet E, Lourme-Ruiza A, Bichard A. La mesure de la sécurité alimentaire des individus et des ménages: potentiel et défis de la collaboration entre sciences de la nutrition et sciences sociales. [Measuring the food security of individuals and households: Potential and challenges of collaboration between nutrition sciences and social sciences]. In : Lepiller O, Fournier T, Bricas N et al. Méthodes d’investigation de l’alimentation et des mangeurs [Diet and eater investigation methods]- MIAM. Versailles, éditions Quæ; 2021. 39-53 (p. 244).
[14] Korkalo L, Erkkola M, Heinonen AE, Freese R, Selvester K, Mutanen Marja. Associations of dietary diversity scores and micronutrient status in adolescent Mozambican girls. Européen Journal of Nutrition. 2017;56(3):1179–1189.
[15] Amirhamidi Z, Omidvar N, Eini-Zinab H, et al. Association of weight status with dietary intake and dietary diversity score in 10 - 12-year-old children in Tehran: A cross-sectional study. Iranian Journal of Pediatrics. 2019;29(4):e85317.
[16] Jikamo B, Samuel M. Does dietary diversity predict the nutritional status of adolescents in Jimma Zone, Southwest Ethiopia? BMC research notes. 2019;12:402.
[17] Organisation Mondiale de le Santé (OMS). Utilisation et interprétation de l’anthropométrie, [Use and interpretation of anthropometry], Rapport d’un comité d’experts. Edition OMS, Série de Rapports techniques 854, Genève ; 1995. p. 498.
[18] World Health Organisation (WHO). Growth reference 5–19 years, 2007. Available from: https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age [cited 2021 August 19].
[19] Karoune R, Mekhancha-Dahel CC, Benlatreche C, et al. Approche de réalisation d’un score de classification socio-économique. [Approach to achieving a socio-economic classification score]. Journale Algerien de Medecine. 2008;XVI(2):57-62.
[20] Food and Agricuture Organization (FAO). Guide pour mesurer la diversité alimentaire au niveau des [Guide to measuring dietary diversity at the individual and household level] individus et des ménages, FAO. 2013: 22p. Available from : www.fao.org/3/a-i1983f.pdf [cited 2021 January 9].
[21] Hatloy A, Torheim LE, Oshaug A Food variety-a good indicator of nutritional adequacy of the diet? A case study from an urban area in Mali, West Africa. European Journal of Clinical Nutrition. 1998;52:891–898.
[22] Mekhancha DE. Aspects alimentaires et nutritionnels de la restauration collective en Algérie - applications en milieu universitaire [Thèse]. [Food and nutritional aspects of collective catering in Algeria - applications in academia], INATAA, Université Frères Mentouri Constantine 1. 2018. p 1-164 T Available from : http://archives.umc.edu.dz/handle/ 123456789/136842.[cited 2021 murch 2].
[23] Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (ANSES). Table de composition nutritionnelle des aliments, [Food composition Table] version 2020. Available from : https://ciqual.anses.fr [cited 2021 May 5].
[24] Beaufrère B, Bresson JL, Briend A, et al. Nourrissons, enfants et adolescents, [Infants, children and adolescents]. In : Martin A Apports nutritionnels conseillés pour la population française, [Recommended dietary allowances for the French population] Lavoisier, Technique & Documentation, 3ème édition ; 2001. 255–291 (p. 605).
[25] Aboussaleh Y, Ahami A, Afechtal M. Food diversity and nutritional status in school children in Morocco. In: Behnassi M, Pollmann O, Kissinger G (eds.) Sustainable food security in the era of local and global environmental change. Springer Dordrecht Heidelberg New York London; 2013. 203-215 (p. 338) .DOI 10.1007/978-94-007-6719-5_13
[26] Mersha Birru S, Tariku A, Kassahun Belew A. Improved dietary diversity of school adolescent girls in the context of urban Northwest Ethiopia: 2017. Italian Journal of Pediatrics. 2018;44:48.
[27] Golpour-Hamedani S, Rafie N, Pourmasoumi M, Saneei P, Sayyed MS. The association between dietary diversity score and general and abdominal obesity in Iranian children and adolescents. BMC Endocrine Disorders. 2020;20:181.
[28] Maire B, Tessier S, Delpeuch F, et al. La nutrition, un défi pour la planète (2) - Transitions alimentaires et nutritionnelles, [Nutrition, a challenge for the planet (2) - Food and nutritional transitions] les dossiers thématiques de l’IRD. 2009:10.
[29] Beghin L, Dauchet L, De Vriendt T, et al. Influence of parental socio-economic status on diet quality of European adolescents: results from the HELENA study. British Journal of Nutrition. 2014;111:1303–1312.
[30] Grosso G, Galvano F. Mediterranean diet adherence in children and adolescents in southern European countries. Nutrition & Food Science Journal. 2016;3:13–19.
[31] Michels N, Vynckier L, Moreno LA, et al. Mediation of psychosocial determinants in the relation between socio-economic status and adolescents’ diet quality. European Journal of Nutrition. 2018;57:951–963.
[32] Omorou AY, Langlois J, Legrand K, et al. Impact d’une intervention en milieu scolaire sur le gradient social de corpulence chez l’adolescent: étude Pralimap-Ines, [mpact of a school-based intervention on the social gradient of corpulence in adolescents: Pralimap-Ines study]. Nutrition Clinique et metabolisme. 2017;33(3):241.
[33] Brancato L, Miéville M. L'influence du milieu socio-économique sur le comportement alimentaire des adolescents européens âgés de 12 à 18 ans. [The influence of socio-economic background on the eating behavior of European adolescents aged 12 to 18] Haute école de santé, Filière nutrition et diététique, Genève. 2018:73. Available from : www.hesge.ch/heds. [cited 2021October 16].
[34] Salehi-Abargouei A, Akbari F, Bellissimo N, Azadbakht L. Dietary diversity score and obesity: A systematic review and meta-analysis of observational studies. Europeen Journal of Clinical Nutrition. 2016;70:1–9.
[35] Karimbeiki R, Pourmasoumi M, Feizi A, et al. Higher dietary diversity score is associated with obesity: A case-control study. Public Health. 2018;157:127–134.
[36] Serra-Majem L, Ribas L, Ngo J, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutrition. 2004;7:931–935.
[37] Gómez G, Kovalskys I, Leme ACB, et al. Socioeconomic status impact on diet quality and body mass index in eight Latin American Countries: ELANS study results. Nutrients. 2021;13:2404.
[38] Aounallah-Skhiri H, Traissac P, El Ati J, 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. Nutrition Journal. 2011;10:17.
[39] Karoune-Bechara R. Scores et indices nutritionnels, un moyen pour évaluer la qualité de l’alimentation des adolescents: enquête auprès de 1 126 adolescents (Constantine, 2015/2016). [Nutritional scores and indices, a method to assess the diet quality of adolescent: Survey of 1 126 adolescents (Constantine, 2015/2016)] [Thèse] INATAA, Université Frères Mentouri Constantine 1. 2018. 1-150 T. Available from : https://bu.umc.edu.dz/theses/agronomie/KAR7240.pdf. [cited 2021 April 15].
[40] Mirmiran P, Azadbaht L, Esmailzadeh A, et al. Dietary diversity score in adolescents-a good indicator of the nutritional adequacy of diets: Tehran lipid and glucose study. Asian Pacific Journal of Clinical Nutrition 2004;13(1):56–60.
[41] Habte TY, Krawinkel M. Dietary diversity score: A measure of nutritional adequacy or an indicator of healthy diet? Journal of Nutrition and Health Sciences. 2016;3(3).
[42] Verger EO, Ballard TJ, Dop MC, Martin-PrevelaY. Systematic review of use and interpretation of dietary diversity indicators in nutrition-sensitive agriculture literature. Global Food Security. 2019;20:156–169.