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.

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Anemia is a multifactorial condition, with a complex etiology that involves nutritional and non-nutritional factors. The misconception that iron deficiency is equivalent to anemia may mask the need to address other potential causative factors. This review paper aims to (1) assess the burden of anemia vs. iron deficiency anemia (IDA) amongst women of reproductive age (WRA), pregnant women (PW), and children under five years old (underfive children, U5C) in the Eastern Mediterranean region (EMR); (2) evaluate trends in anemia prevalence and whether countries are on track towards meeting the World Health Assembly (WHA) target for 2025; and (3) characterize anemia reduction efforts and provide a road map for future programs. A search of pertinent literature and databases was conducted. Anemia prevalence in the EMR ranged between 22.6% and 63% amongst PW, 27% and 69.6% amongst WRA, and 23.8% and 83.5% amongst U5C. Data showed that the EMR is not on course towards meeting the WHA target. The contribution of IDA to anemia was found to be less than half. Other potential contributors to anemia in the region were identified, including micronutrient deficiencies, parasitic infestations, and poor sanitation. A framework of action was proposed as a roadmap to meet the targets set by the WHA.

ResumenObjetivo: el objetivo de este estudio fue poner de relieve la prevalencia del sobrepeso y la obesidad en los adolescentes de ocho países árabes. Métodos: estudio transversal basado en escolares, que se llevó a cabo en ocho países árabes: Irak, Jordania, Kuwait, Libia, Palestina, Arabia Saudí, Sudán y Túnez. La muestra total estuvo compuesta por 6.447 adolescentes de 15-18 años (3.111 hombres, 3.336 mujeres). Se utilizaron para determinar los niveles de obesidad de la Fuerza Internacional de Obesidad (IOTF) y los patrones de referencia de la Organización Mundial de la Salud (OMS). Resultados: el estándar de la OMS presentó menor prevalencia de sobrepeso, pero mayor prevalencia de obesidad que el estándar de la IOTF. De acuerdo con la norma IOTF, el sobrepeso entre los varones fue más alto en los adolescentes kuwaitíes (24,8%), seguido de Arabia Saudí (23,2%). Entre las mujeres, se informó de la más alta prevalencia en adolescentes kuwaitíes (22,1%), seguido por las jordanas (20,0%). En cuanto a la obesidad, los adolescentes kuwaitíes presentaron la mayor prevalencia de obesidad tanto en hombres (28,6%) como en mujeres (21,1%). Conclusión: los resultados revelaron que no se ha conseguido ningún progreso en la reducción de la prevalencia de la obesidad. AbstractObjective: The aim of this study was to highlight the prevalence of overweight and obesity among adolescents in eight Arab countries. Methods: A school-based cross-sectional study was conducted in eight Arab countries: Iraq, Jordan, Kuwait, Libya, Palestine, Saudi Arabia, Sudan and Tunisia. The total sample included was 6,447 adolescents aged 15-18 years (3,111 males, 3,336 females). The International Obesity Task Force (IOTF) and World Health Organization (WHO) reference standards were used to determine obesity levels. Results: The WHO standard provided lower prevalence of overweight but higher prevalence of obesity than the IOTF standard. According to the IOTF standard, overweight among males was highest in Kuwaiti adolescents (24.8%), followed by Saudi Arabian (23.2%). Among females, the highest prevalence was reported in Kuwaiti adolescents (22.1%), followed by Jordanian (20.0%). Regarding obesity, Kuwaiti adolescents showed the highest prevalence of obesity for both males (28.6%) and females (21.1%). Conclusion: Findings revealed no progress in reducing prevalence of obesity.