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To determine the prevalence of metabolic syndrome (MetS) and its components and to evaluate the relationship between this diagnosis and cardiovascular risk factors, demographic and socio-economic variables.
A cross-sectional study using a questionnaire including information on sociodemographic and CVD risk factors. Blood pressure, anthropometric indices, fasting glucose and lipid profile were measured. MetS was defined according to the criteria of the National Cholesterol Education Program, Adult Treatment Panel III.
The whole Tunisian territory; Transition and Health Impact in North Africa (TAHINA) project.
A total of 4654 individuals (1840 men and 2814 women), aged 35 to 74 years, who participated in the Tunisian national survey.
The overall prevalence of MetS was 30·0 %, higher in women (36·1 %) than in men (20·6 %; P < 0·001). In both genders MetS prevalence increased significantly with age (P < 0·001), but this increase was more important in women. Multiple regression analyses showed that the odds for MetS increased significantly with urban area for both men and women (P < 0·05 and P < 0·001, respectively). The multivariate models showed also that the odds for MetS increased significantly with increasing level of education and in those with a family history of CVD for men (both P < 0·05) and after the menopausal transition for women (P < 0·05).
The study highlights the MetS problem in a middle-income developing country. There is an urgent need for a comprehensive, integrated, population-based intervention programme to ameliorate the growing problem of MetS in Tunisians.
To assess the nutritional status of Tunisian adolescents and associated factors.
A cross-sectional study based on a national stratified random cluster sample.
Subjects and methods
In 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.
Prevalence 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 urban v. 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.
Overweight 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.
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