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Background and Aims. The prevalence, awareness, and treatment of hypertension, along with their sociodemographic, anthropometric, and lifestyle associations, were evaluated in a cross-sectional survey of childbearing age Tunisian women. Adherence to the Dietary Approaches to Stop Hypertension diet score was also assessed for hypertensive versus nonhypertensive women. Methods and Results. A total of 1689 nonpregnant women, aged 20-49 years, were randomly sampled a regional (Greater Tunis), two-stage, stratified, cross-sectional cluster survey from March 2009 to January 2010. Data on medical history and sociodemographic characteristics were collected using a questionnaire. The average daily intake of energy and nutrients was computed using a specific Tunisian food composition database. The Dietary Approaches to Stop Hypertension diet score (0 to 10) was assessed by adding the individual scores (0 to 1) of ten nutrient components according to dietary guidelines. The overall prevalence of hypertension was 21.4%. Age, obesity, abdominal fat, parity, and family history were significantly associated with hypertension. The mean Dietary Approaches to Stop Hypertension accordance score was 4.93 for hypertensive women and 4.86 for nonhypertensive women ( P = 0.0556 ). After adjustment for age, energy intake, and all nutritional covariates, no associations were observed between hypertension and Dietary Approaches to Stop Hypertension diet components. Conclusion. Though no clear-cut associations between hypertension and environmental or behavioral factors were identified in the study, the association with abdominal obesity and multiparity suggests that interventions aimed at lifestyle modifications to reduce these risk factors could be also useful in the prevention of hypertension.

Vitamins are organic substances that are essential for normal metabolism, growth, development, and regulation of cell function. Mineral elements are non-organic substances. They constitute 4% of the body mass. Multivitamins and minerals are commonly used as dietary supplements to maintain good health and prevent chronic diseases. In this chapter, we described selected vitamins and minerals used as nutritional supplements. We presented their dietary sources as well as their absorption, metabolism, storage and functions in human body. We also discussed their benefits and potential harmful effects associated with deficiency or excess intake. The prevalence, recommended intakes, regulatory status and health effects of supplementation with these micronutrients were also detailed. Finally, the use of vitamins and minerals as food additives was described in this chapter.

The prevention and management of hypertension are untimely associated with a lowering of sodium intake. The present study aimed to evaluate the sodium and potassium intake levels of Tunisian population through measurement of 24‐hr urinary sodium excretions. A randomly, multistage, cross‐sectional study was conducted in an urban region (Bizerte) in Tunisia during 2015. The target population involved adults aged from 25 to 64 years. Sodium, potassium, and creatinine concentrations were determined in each urine sample using indirect potentiometric method. From the 420 selected participants, only 194 gave urine samples complying completeness criteria. A multivariate regression model was used to assess the variables related to sodium and potassium excretion. The daily mean excretion of sodium and potassium was 138.3 ± 46.5 mmol/d (corresponding to 8.1 ± 2.7 g/d of salt intake) and 61.0 ± 22.7 mmol/d, respectively. More than 87.1% of the participants (89.8% for men vs. 84.9% for women; p = .31) exceeded the WHO recommendation of 5 g/d. The upper limit of 10 g salt intake per day was still exceeded by 26.3%. After adjusted analysis, sex (for women, coef = −1.6; (95% CI: −2.4, −0.7)), level of instruction (≥30 kg/m2, coef = +1.1; (95% IC: 0.4–2.0)), and body mass index (≥30 kg/m2, coef = +1.1; (95% CI: 0.1, 2.0)) were associated with the sodium excretion. High sodium intake and inadequate potassium intake were found among participants. This consumption profile complies with the diet westernization context occurring in Tunisia. The initiated strategy focused on the downward of sodium in bread (the main source of salt intake) seems to be promising., Excess of salt intake is one of the major dietary risk factor of chronic diseases. In the following study, we are assessing salt intake using both urinary sodium excretion and dietary assessment among Tunisian adults. Of the food groups, bread is the most important contributor to the daily salt intake.

Excessive fat and fatty acids intake are associated with significant health hazards such as obesity or chronic diseases. This study aimed to provide the first data on total fat, saturated fatty acids (SFA) and trans fatty acids (TFA) intakes and their major food sources in Tunisian children. A total of 1200 children, aged 3 to 9 years old, were randomly selected from primary schools and kindergartens under a cross-sectional design. The 24-h dietary recall method and diet history for the month preceding the survey were used to assess dietary intake. The energy percentages of total fat, SFA and TFA in Tunisian children were 29.6%, 11.4% and 0.15%, respectively. No sex differences were found. The WHO recommendations for total fat, SFA and TFA were adopted by 58%, 39% and 89% of the study population, respectively. The leading food groups of fat and fatty acids were ultra-processed foods, breakfast cereals and dairy products. The meat, fish, eggs, and fish alternatives were the fifth main contributors to Tunisian children’s total fat and SFA intakes. The implementation of a relevant strategy for fat reduction, especially from ultra-processed foods, considered as low nutrient energy-dense products, is needed to promote health among children and prevent diet-related chronic diseases.

International audience; The protective role of high high-density lipoprotein cholesterol (HDL-C) against cardiovascular risk has been questioned recently. Due to the increasing trend of cardiovascular diseases (CVD) in Tunisia, this study aimed to determine the prevalence of high HDL-C and its associated factors in Tunisian women of childbearing age. A cross-sectional survey was conducted among a subsample of 1689 women, aged 20 to 49 years, in the Great Tunis region. Data on socio-demographic and lifestyle factors were collected by a questionnaire. Overall adiposity was assessed by body mass index (BMI). All biological variables were assayed in blood samples coated with anticoagulant ethylene diamine tetra acetic acid (EDTA) by enzymatic methods. Stata software (2015) was used for data management and statistical analysis. High HDL-C values were recorded in 26.6% of selected women. After adjustment for all socio-demographic and lifestyle factors, age, hypertension, and smoking were negatively associated with high HDL-C levels, while family history of cancer was positively associated with high HDL-C in women. An additional investigation on the relationship between high HDL-C and cancer risk should be performed due to controversial results.

Heavy metals are among the most harmful contaminants in the ecosystems due to their persistency, bioaccumulation and high toxicity. In this chapter, we presented the sources, distribution and pathways of heavy metals in soil, water and air. The physico-chemical properties, uses, toxicity and health hazards of the purely toxic heavy metals lead, cadmium and mercury were also described. Other essential heavy metals were briefly presented and the main health effects due to their deficiency or excess were displayed in this chapter. Finally, the various methods used for the removal of heavy metals from soil and aquatic environments were discussed with a focus on nanomaterials.

As bread is the most consumed food by the Tunisian population and the major source of salt, a pilot experiment of salt reduction in bread was begun in Bizerte city. Salt analysis in bread collected from Bizerte city was done with the Volhard titration method. A one-way Anova test was carried out to assess salt content changes over time. Application of the salt reduction programme allowed a gradual decrease of salt content in bread by 35% during three years without detection by Tunisian consumers. The salt concentration in bread was then reduced from 1.7 ± 0.2 g/100 g to 1.1 ± 0.1 g/100 g (p &lt, 0.0001). The establishment of an effective salt reduction strategy with lifestyle education is needed to reduce hypertension, which is the primary cause of death in Tunisia.

Background: The protective role of high HDL-C against cardiovascular risk has been questioned recently. Due to the increasing trend of CVD in Tunisia, this study aimed to determine the prevalence of high HDL-C and its associated factors in childbearing age Tunisian women. Methods: A cross-sectional survey was conducted among a subsample of 1689 women, aged 20 to 49 y in the Great Tunis region. Data on socio-demographic and lifestyle factors were collected by a questionnaire. Overall adiposity was assessed by BMI. All biological variables were assayed in blood samples coated with EDTA by enzymatic methods. Stata software (2015) was used for data management and statistical analysis. Results: High HDL-C values were recorded in 26.6% of selected women. After adjustment for all socio-demographic and lifestyle factors, age, hypertension and smoking were negatively associated with high HDL-C levels while family history of cancer was positively associated with high HDL-C in women. Conclusions: Additional investigation on the relationship between high HDL-C and cancer risk should be performed due to controversial results.

Background: The protective role of high HDL-C against cardiovascular risk has been questioned recently. Due to the increasing trend of CVD in Tunisia, this study aimed to determine the prevalence of high HDL-C and its associated factors in childbearing age Tunisian women. Methods: A cross-sectional survey was conducted among a subsample of 1689 women, aged 20 to 49 y in the Great Tunis region. Data on socio-demographic and lifestyle factors were collected by a questionnaire. Overall adiposity was assessed by BMI. All biological variables were assayed in blood samples coated with EDTA by enzymatic methods. Stata software (2015) was used for data management and statistical analysis. Results: High HDL-C values were recorded in 26.6% of selected women. After adjustment for all socio-demographic and lifestyle factors, age, hypertension and smoking were negatively associated with high HDL-C levels while family history of cancer was positively associated with high HDL-C in women. Conclusions: Additional investigation on the relationship between high HDL-C and cancer risk should be performed due to controversial results.

Background: Excessive intake of fat and fatty acids is associated with major health hazards such as obesity or chronic diseases. The aim of this study is to provide the first data on total fat, SFA and TFA intakes and their major food sources in Tunisian children. Methods: A total of 1200 children, aged 3 to 9 years old, were randomly selected from primary schools and kindergarten under a cross-sectional design. The 24hour recall method and food frequency questionnaire were used to assess dietary intake over a period of one week.Results: The energy percentages of total fat, SFA and TFA in Tunisian children were respectively 29.6, 11.4 and 0.15. No sex differences were found. The WHO recommendations for total fat, SFA and TFA were adopted by 58 %, 39 % and 89 % of the study population, respectively. The leading food groups of fat and fatty acids were ultra-processed foods, bread and cereals and dairy products. The meat, fish, eggs and fish alternatives were the fifth main contributors to the total fat and SFA intakes in Tunisian children.Conclusions: The implementation of a relevant strategy for fat reduction, especially from ultra-processed foods, considered as low nutrient energy-dense products, is needed to promote health among children and prevent diet-related chronic diseases.

Background In the Middle East and North Africa (MENA) region, universal salt iodization (USI) programs defaults were sometimes shown to increase the risk of iodine excess. Also, the nutrition transition which underlies the obesity epidemic in the MENA region is characterized by salt-rich diets, so that there could be a cumulative effect with respect to iodine status. We assess the within-subject co-existence of overweight and inadequate iodine intake, and associated factors.Methods A national cross-sectional study used a stratified, clustered random sample and conducted among Tunisian school-age children aged from 6 to 12 y. (n = 1560). Overweight (Ow) was body mass index (BMI)-for-age ≥ + 1z. Iodine deficiency was UIC (Urinary Iodine Content) Results The prevalences of Ow-ID or Obe-ID were marginal, but not so for excess adiposity and IAR as for example prevalence of Ow-IAR was 9.8% (95% CI:[7.7–12.3]). OW and IAR were found to co-occur independently (P = 0.29). Socio-economic patterning of Ow-IAR was mild. Nevertheless, prevalence were the lowest among children of mother with no formal schooling and in the South-East region. Beyond school-age children, we estimated that this double burden of overweight and excess iodine could concern a third of Tunisian adults (all the more for women).Conclusions Among Tunisian children, iodine deficiency coupled with excess adiposity was quite marginal. Coexistence of overweight and excess iodine may affect a tenth of these children. More data would be needed to document a possibly even higher rate among adults. Cumulative effects of unhealthy lifestyle due to the nutrition transition interacting with metabolic pathways may be involved in this potential overweight-high iodine intake double burden. In the MENA region, obesity and salt reduction policies should continue to be monitored.

Urinary iodine concentration (UIC) is commonly used to assess iodine status of subjects in epidemiological surveys. As pre-analytical factors are an important source of measurement error and studies about this phase are scarce, our objective was to assess the influence of urine sampling conditions on UIC, i.e., whether the child ate breakfast or not, urine void rank of the day, and time span between last meal and urine collection. A nationwide, two-stage, stratified, cross-sectional study including 1560 children (6–12 years) was performed in 2012. UIC was determined by the Sandell-Kolthoff method. Pre-analytical factors were assessed from children’s mothers by using a questionnaire. Association between iodine status and pre-analytical factors were adjusted for one another and socio-economic characteristics by multivariate linear and multinomial regression models (RPR: relative prevalence ratios). Skipping breakfast prior to morning urine sampling decreased UIC by 40 to 50 μg/L and the proportion of UIC

This study is the first investigation of potassium bromate as a food additive in Tunisian breads. In this study, levels of residual bromate were determined in 91 commercial breads from 31 bakeries randomly selected in two Tunisian cities. In total, 13 different types of bread were analyzed using a spectrophotometric method of bromate analysis. Bromate concentrations ranged from 5.95 to 49.31 μg g−1, with an overall mean concentration of 19.92 μg g−1. Significant differences were noticed between bromate levels in breads from bakeries of the two cities (P

In the framework of a worldwide policy to eliminate iodine deficiency (ID) disorders, universal salt iodization was adopted in Tunisia two decades ago. The present study aims to evaluate this strategy, using both performance and impact indicators. A total of 1560 children, aged 6–12 years, were randomly sampled using a national, two-stage, stratified, cross-sectional cluster survey in 2012. Urinary iodine concentration (UIC) of the subjects, and household salt iodine content, were analyzed. The national median UIC was 220 µg/L (95% confidence interval (CI): 199–241), indicating an acceptable iodine status at the population level. Only 11.4% (95% CI: 8.6–14.9) of the children had UIC 90% of households. Regular monitoring of iodized salt production lines must be strengthened with involvement by producers.

Lack of iodine intake may promote a spectrum of disorders termed iodine deficiency disorders. Universal salt iodization laws were adopted in Tunisia to overcome this problem. This study examines the adequacy of iodized salt in the distribution chain two decades after its last assessment. A cross-sectional design was carried out in 2012 using the multi-stage cluster sampling technique. Salt samples from 24 govemorates were collected at wholesaler level (n = 635), retailer level (n = 1440) and household level (n = 1560), and analyzed using a validated iodometric titration method. Iodine concentration at each level of distribution chain was within the recommended range of 15-27 mg/kg. Iodine content in household salt was significantly different according to the salt manufacturer and also between geographical regions (p < 0,0001). Moreover, an insufficient coverage of adequately iodized salt consumption (less than 90%) was found with reference to international standards (>= 15 mg/kg). About 85.6% (95%CI: 78.3-90.8) of analyzed samples were adequately iodized at the intermediate levels of supply-chain (wholesalers and retailers). Our study demonstrates a decrease in the availability of iodized salt in households. It can thus be concluded that universal salt iodization legislation has not been sufficient to ensure an adequate supply of iodine in the population, and an evaluation system needs to be reactivated.

Iodine deficiency especially during pregnancy causes neurological disorders in the fetus. Actually, about two billion people are suffering from iodine deficiency through the world. The assessment of iodine intake is based on the determination of urinary iodine in the target population. Despite the complexity of the urinary matrix, a reliable assay must be achieved. After a review of pathophysiological interest of urinary iodine, various techniques for its measurement and their analytical performance were analyzed in order to select a reliable technique and enhance results interpretation.

Plasma zinc and copper status of 1689 non pregnant Tunisian women, aged 20-49 years old, was determined by flame atomic absorption spectrometry. A multiple regression was run to predict plasma trace element concentrations from age, BMI, marital status, menopause, education level, professional activity, economic level and area of living. The mean zinc and copper values were similar to those measured among comparable populations in earlier studies. However, a high prevalence of low plasma zinc and copper concentrations was observed assuming that women at childbearing age are at high risk of zinc and copper deficiencies and specific intervention may be considered. In univariate analysis, the mean values of plasma zinc and copper were associated with sitting areas and professional activity. For only plasma copper levels, there was an increase with BMI and parity, and a decrease with increasing schooling level and economic score. After adjustment for all variables, profession and parity showed a significant relationship between plasma levels copper.

In this paper, a screening approach, involving the use of the Plackett–Burman experimental design, permitted the evaluation of the effects of 25 parameters from the sample pretreatment stage (furnace heating temperature, furnace heating duration, cooling, filtration, addition of HCl…) on the Pb, Cr and Al determination in macroalgae by graphite furnace atomic absorption spectrometry (GF-AAS). According to the found results, the influences of the different factors depend on the selected metal. Nevertheless, addition of the concentrated acids HF and HCl enhanced the analytical signals of all the metals. The effects of some parameters, such as filtration or cooling of samples, were negligible. These factors could be eliminated from the pretreatment stage to gain cost and time. The obtained results allowed the proposition of a method for the pretreatment of algae. This method was validated against BCR-CRM 279 sea lettuce ( Ulva lactuca ).

Objectives The aim of this study was the optimization of selenium determination in plasma samples with electrothermal atomic absorption spectrometry using experimental design methodology. Design and methods 11 variables being able to influence selenium analysis in human blood plasma by electrothermal atomic absorption spectrometry (ETAAS) were evaluated with Plackett–Burman experimental design. These factors were selected from sample preparation, furnace program and chemical modification steps. Both absorbance and background signals were chosen as responses in the screening approach. Doehlert design was used for method optimization. Results Results showed that only ashing temperature has a statistically significant effect on the selected responses. Optimization with Doehlert design allowed the development of a reliable method for selenium analysis with ETAAS. Samples were diluted 1/10 with 0.05% (v/v) TritonX-100 + 2.5% (v/v) HNO3 solution. Optimized ashing and atomization temperatures for nickel modifier were 1070 °C and 2270 °C, respectively. A detection limit of 2.1 μg L− 1 Se was obtained. Accuracy of the method was checked by the analysis of selenium in Seronorm™ Trace element quality control serum level 1. The developed procedure was applied for the analysis of total selenium in fifteen plasma samples with standard addition method. Concentrations ranged between 24.4 and 64.6 μg L− 1, with a mean of 42.6 ± 4.9 μg L− 1. Conclusions The use of experimental designs allowed the development of a cheap and accurate method for selenium analysis in plasma that could be applied routinely in clinical laboratories.

L’iode urinaire en bref : donnees physiologiques, cliniques et epidemiologiquesL’iode est un nutriment essentiel a la production des hormones par la glande thyroidienne. Il est associe a des pathologies par exces et plus frequemment a des troubles par carence communement nommes TDCI (troubles dus a la carence en iode).En 2012, l’Organisation mondiale de la sante a declare qu’environ 1,9 milliard de personnes sont carencees en iode dans le monde [1].Le tableau clinique [...]

cited By 4; International audience; Optimal conditions of headspace solid-phase microextraction followed by gas chromatography coupled to pulsed flame photometric detection (SPME-GC-PFPD) have been investigated to validate the analysis of 11 organotin compounds in plant matrices including methyl-, butyl-, and phenyltin compounds. The extraction of organotin compounds from vegetal matrices has been carried out using optimized conditions of HCl-based extraction. The use of headspace SPME to preconcentrate the analytes allowed most of the detection limits to be obtained sub-0.5 ng(Sn) g -1 . The precision evaluated using RSD with six replicates ranges between 5 and 10% (except for triphenyltin: 17%). The accuracy of the method was validated on spiked or polluted vegetal samples taken from Bizerte Lagoon (Tunisia) and by comparison with classical liquid-liquid extraction (LLE). These results highlight the suitability of the selected method for organotin control in complex environmental matrices such as aquatic plants. © 2006 Taylor & Francis.