Nutritional status of Tunisian adolescents: associated gender, environmental and socio-economic factors

• DOI: 10.1017/s1368980008002693
• Publication Date: 2008-06-19T08:09:28Z
• Authors: Hajer Aounallah-S...; Habiba Ben Romdhane; Pierre Traissac; Sabrina Eymard-Du...; Francis Delpeuch; Noureddine Achour; Bernard Maire
• Keywords: Male; Rural Population; Youth; Adolescent; Adolescent Nutritional Physiological Phenomena; 610; Nutritional Status; Environment; 03 medical and health sciences; Sex Factors; 0302 clinical medicine; Thinness; Risk Factors; 11. Sustainability; Prevalence; Cluster Analysis; Humans; Underweight; Obesity; Life Style; 2. Zero hunger; 4. Education; 1. No poverty; Feeding Behavior; Overweight; North Africa; 3. Good health; Cross-Sectional Studies; Socioeconomic Factors; Health behaviour; Educational Status; Female

AbstractObjectiveTo assess the nutritional status of Tunisian adolescents and associated factors.DesignA cross-sectional study based on a national stratified random cluster sample.Subjects and methodsIn all, 1295 boys and 1577 girls aged 15–19 years, of whom 28·4 % had already left school. Socio-economic characteristics of the parents, anthropometric measurements, food behaviours and physical activity of the adolescents were recorded during home visits.ResultsPrevalence of underweight, overweight and obesity (WHO/National Center for Health Statistics reference) were, respectively, 8·1 %, 17·4 % and 4·1 % among boys and 1·3 %, 20·7 % and 4·4 % among girls; abdominal obesity was highly prevalent among both sexes. Prevalence of overweight differed by region (from 11·5 % to 22·2 %) and was higher in urbanv. rural areas for males (21·7 %v. 10·4 %) but not for females (21·7 %v. 19·2 %). These differences were partially mediated by socio-economic and lifestyle factors for males. For females, influence of cultural factors is hypothesised. In rural areas, overweight was more prevalent among boys of higher economic level households, having a working mother or a sedentary lifestyle; for girls, prevalence increased with the level of education of the mother. In urban areas, prevalence of overweight was related to eating habits: it was higher for boys with irregular snacking habits and for girls skipping daily meals. Urban girls having left school were also more overweight.ConclusionOverweight and abdominal obesity in late adolescence have become a true public health problem in Tunisia with the combined effects of cultural tradition for girls in rural areas, and of rapid economic development for boys and girls in cities.