Mokhtar N, Elati J, Chabir R, Bour A, Elkari K, Schlossman N P, Caballero B, Aguenaou H
Laboratory of Physiology and Nutrition, Ibn Tofaïl University, Kenitra, Morocco.
J Nutr. 2001 Mar;131(3):887S-892S. doi: 10.1093/jn/131.3.887S.
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.
北非肥胖症的病因尚未完全明确，很少有研究能够揭示其在女性群体中的发展情况。本研究汇总了摩洛哥和突尼斯肥胖症患病率及其决定因素的相关已知信息。作者对育龄妇女（样本量：2800）及其子女（1200名5岁以下儿童和500名青少年）进行的两项营养相关疾病调查结果，与四项国民收入和支出调查（始于1980年）的数据相结合，以评估摩洛哥和突尼斯的肥胖趋势及发展情况。通过体重指数（BMI）≥30kg/m²确定的总体肥胖水平，在摩洛哥为12.2%，在突尼斯为14.4%。在这两个国家，女性肥胖率均显著高于男性（突尼斯为22.7%对6.7%，摩洛哥为18%对5.7%），且过去20年里女性肥胖患病率增长了两倍。所有女性中有一半超重或肥胖（BMI>25），突尼斯为50.9%，摩洛哥为51.3%。超重率随年龄增长而上升，且似乎在青春期开始显现，尤其是在女孩中。在突尼斯，9.1%的青春期女孩有超重风险（BMI/年龄≥第85百分位数）。城市地区女性以及受教育程度较低的女性超重和肥胖患病率更高。两国肥胖女性摄入的热量和常量营养素均显著高于体重正常的女性。脂肪、蛋白质和碳水化合物对热量的贡献百分比似乎在正常范围内，然而突尼斯的脂肪摄入量较高（31%），摩洛哥的碳水化合物摄入量较高（65 - 67%）。对于仍在应对营养不良和微量营养素缺乏对公众健康影响的国家而言，这些趋势令公共卫生专业人员和政策制定者深感忧虑。这些国家的卫生机构面临着巨大挑战，即改变不认可肥胖问题的文化规范，以防止肥胖对公众健康造成重大损害。
