FOOD DIET AND EATING BEHAVIOURS OF THE MOROCCAN INFANTS FROM BIRTH TO TWO YEARS'

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FOOD DIET AND EATING BEHAVIOURS OF THE MOROCCAN
INFANTS FROM BIRTH TO TWO YEARS.

• By NADIA OUZENNOU

Marrakesh, Morocco
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? The primitive function of food is to provide to
the body the nutrients for growth,
development, and vital functions. ? Eating
habits are a part of culture and traditions. They
are influenced by ?
Psychological and economic factors, food
preferences and dislikes, uses and
traditions, culture and social values,
food symbolism, believes and religion, education,
aesthetic factors, age, physiology
and medias. ? Price and taste.
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? So, eating system is different ?
In all the world in all the areas ?
According to social groups to the age
? In Morocco, diet is ? Rich in
cereals, carbohydrates and fibers ? Poor
in animals proteins. ? Consequences are
illness related to poor nutrition, nutrient
deficiencies, overweight and obesity.
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? Malnutrition micro-nutrient deficiencies
still touch an important proportion of moroccan
children less than 5 years. ?
Malnutrition (W/A H/A lt 2SD) 10 to 25.
? Ferriprive anaemia 35 ? Iodine
deficiency 22 ? Vitamin A deficiency
41 ? Vitamin D deficiency 2.5 of the
children less than 2 years.
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The aims of this study are ? To
evaluate the moroccan infants diet. ?
To measure the average daily nutritional
contribution and to compare it with
the nutritional recommendations. ? To
estimate infant nutritional problems nutrient
deficiencies bad eating behaviours
? To check relationships between
infant diet and their nutritional
status.
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SUBJECTS METHODS
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Subjects ? Mothers attending the health
centers for the vaccination of their
infants. ? Infants from birth to 2 years
chosen among those who they didnt
suffer from any diseases at the time of this
investigation. ? Investigation touched about
900 couples mother/infant
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Methods ? For the investigation mothers were
interviewed. ? Queries are related to ?
Demographic, socio-economic and cultural
characteristics (parents profession,
instruction level, number of child...). ?
Infants age, sex.. ? Feeding at birth and
breast-feeding duration. ? Additional
food, and age of their introduction.
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? We have collected information about nature and
quantities of all consumed food on a day,
using the 24h dietetic recall method. ? The
quantities of food were evaluated by domestic
measurements. ? They were
converted into contributions of energy, proteins,
carbohydrates, fats, vitamins and
micro-nutrients, using the Food General
Repertory software REGAL micro. ? The
average daily nutritional contribution was
compared with the nutritional
recommendations (DRI Dietary Reference Intakes
for USA ANC for Frensh).
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RESULTS
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? Parents socio-economic, socio-cultural
bio-demographic characteristics.
The infants living conditions are satisfied. ?
Mothers have also access to the cares and are
sensitizing to medical and nutritional
informations, factors having good effects on the
infants health, and they reduce the incidence of
the nutritional problems.

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? Breast-feeding age of introduction of the
complementary food ? 74.1 of the
infants are exclusively breast-feeded at birth.
? 22 of them received mixed feeding (breast
infant formula). ? Duration of exclusive
breast feeding (mean) 2.2 mths ? Duration
of mixed feeding (mean) 5.2 mths ? Median
age of introduction of the complementary foods
4 mths ? 95 of infants received
complementary food before 6 mths.
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? The WHO recommends exclusively breast-feeding
for the first six mths of life to achieve optimal
growth, development and health.

In this study
Duration of breast feeding is so low, about 2.2
months for exclusive breast feeding and 5.2 for
mixed feeding. Complementary foods will be
introduced early (4 months)
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? Most evidence suggests that early introduction

?
Increases the risk of allergic diseases,
digestive diseases, and nutrient
deficiencies. ? Increases the risk of
iron depletion and anemia because iron
absorption from human milk is depressed when the
milk is in contact with other foods.
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? First foods given to the infants are
? Vegetables 43.6 ? Cereals 43.2 .
? Derivatives of milk (cheese and
yughort) 22.8 ? Fruits 2.5 .
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? Eating bahaviours related to food
groups Cereals Infants received commercial
cereals at 3 mths with soft texture, soaked in
water or added in the feeding-bottle of milk.
replaced by biscuits (soaked in cow's milk or
tea), or by rice or by family soups in 4 mths.
The bread is consumed at 5 mths, it consumed
soaked in milk, in tea or in sauce.

Derivatives of milk yoghurt and cheese are
given to the infant from 4 mths.

Consumption of yoghurt,
biscuits, commercial cereals is encouraged by
their sweetened taste by a mareketing of this
products.
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Vegetables proposed at 4 mths. The vegetables
most consumed by infants are potatoes and
carrots. Vegetables are consumed firstly as a
light soup, or mixed with cheese or eggs.

Fruits consumed from
5 mths. Apples and bananas are the most consumed
fruits. Other fruits are consumed later in 7 mths
when infants start to take part in the family
meal.
Eggs introduced from 5 mths. They are
available, their preparation is easy can be
consumed at any time of the day.
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Meats introduced from 7 mths. Mothers think
that the dental maturity not yet acquired is an
obstacle of the consumption of the meat before
this age. They are often consumed mixed with the
vegetable soup.
Fats the
olive oil constitue the first fatty acid given to
the infant at 5 mths. Butter is given at 7 mths.
The sauce is introduced at 5 mths. The
consumption of sauce is related to its property
"to hydrate" the bread and to soften it.

Sugar at the first mth, infant
receives sweetened water and herb tea. Thus, the
saccharose is introduced very precociously.
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? Food diversification Sample was divided into
2 groups from 6 to 12 months
nutritional
needs are different from 12 to 24 months
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? Frequency of food groups consumed by
infants in each age.
Milk

Sugar
Milk derivatives

Starchy food
Fats

Vegetables
Juice tea


Fruits
Meat

Eggs
12 to 24 mths
6 to 12 mths
The two infant groups consumed any groups of food
with different frequency. Infants from 12 to 24
month consumed more fruits, eggs, meat, juice,
tea, fats and sugar than the other infants group.
The difference is statistically significant.
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? Quantities of food groups consumed
by infants in each age.
For each group of food, difference is
statistically significant according to the age
groups. Excepted of milk and vegetables, infants
aged from 12 to 24 months eat more than the
infants aged from 6 to 12 months.
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Moroccan infants Reference Dietary Intakes

Energy Proteins Carbohydrats Fats

(Kcal) (g) (g)
(g)

Magnesium Sodium Copper
Iron Iodine Zinc Calcium
Potassium Phosphorus
(mg) (mg) (µg)
(mg) (mg) (mg)
(mg) (mg)
(mg)


Thiamin Riboflavin Niacin
Pant acid Peridoxin
Folate
Daily quantities of nutrients/RDI 6 to 12
mths
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Moroccan infants Reference Dietary Intakes

Energy Proteins Carbohydrats Fats

(Kcal) (g) (g)
(g)



Magnesium Sodium Copper
Iron Iodine Zinc
Calcium Potassium Phosphorus
(mg) (mg)
(µg) (mg) (mg)
(mg) (mg) (mg)
(mg)





Thiamin Riboflavin Niacin
Pant acid Peridoxin
Folate
Daily quantities of nutrients/RDI 12 to 24
mths
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? 93.7 of infants aged from 6 to 12 mths and
95.9 aged from 12 to 24 mths have less Iron
contribution than the recommandations.

? 99.4 of infants aged from 6 to 12
mths, and 98.8 aged from 12 to 24 mths have less
vitamin D contribution than the recommandations.

? 79.9 of infants aged
from 6 to 12 mths , and 88.4 aged from 12 to 24
mths have less Niacin contribution than the
recommandations.

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? Moroccan infant diet is caracterised by
? High consumption of dairy products
starchy food. ? High consumption of fat
provided from dairy products of
the family sauce. ? Few portions of meats.
Diet is rich in carbohydrates fats and poor in
animals proteins
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? Deficiencies in vitamin D, Niacin, Iron touch
infants from the two groups.

? Infants aged from 1 to 2
years have more deficiencies, related to food
insufficiency quantitatively because of their
participation to the family meal their food
habits arent controled any more by mothers.

What is
likely to expose the infants to many diseases and
health problems. ? Deficiencies of vitamin A and
Iodine werent reported in our study because of
the consumption of more dairy products


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? Deficiencies of vitamin D, Niacin Iron are
related to ? Their low availability in
food. ? The less consumption of food which
contains sufficient quantities of them
(meat and fish .). ? Energy deficiency is
related to carbohydrates deficiency. ?
Folate, thiamin, vitamin B6, potassium
deficiencies are related to less consumption
of the meat, vegetables and fruits. ?
Sodium deficiency ??? We dont measure quantities
of salt.
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In fact Deficiencies in vitamin D, vitamin A,
Iodine and Iron are public health problems in
Morroco.
But for few years ago, Morocco has
adopted strategies (with a support of the WHO,
the Unicef, USAID and the Helen Keller
international ONG) of prevention and fight
against micro-nutrients deficiencies in children
aged less than two years.

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? Supplementation of the infants in vitamin A and
vitamin D from the birth. However, no
measurement for the prevention against the Iron
and Iodine deficiency in a low age. ? Concerning
Iron and Iodine, the strategies are fortification
of ? Meal by Iron ? Salt by
Iodine ? Food fortification in Morocco concernes
also ? Milk by vitamins A and D.
? Oil by vitamin A. ? Butter by vitamins
A and E.
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? What are the consequences of the diet on
infants nutritional status? ? We evaluated
infant nutritional status (NS) by the BMI, using
frensh reference population curves. The diet was
evaluated by the energy, proteins, carbohydrates
and fats daily contributions. ?
Infants were classified on 3 groups related to
their NS BMI lt P3 of the reference population
thinness, underweight P3ltBMIltP97 of
the reference population normal
range BMI gt P97 of the reference population
overweight, obesity.
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? Frequencies of the infants having nutrients
deficits or excesses by nutritional status range.
Double nutritional burden, underweight and
overweight and obesity. ? deficiencies of energy
carbohydrates in underweight infants group ?
excess of energy, proteins, fats carbohydrates
in overweight infants group
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CONCLUSION
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? Childhood is a period of great vulnerability,
when people have the greatest risk to contract
nutritional problems, which can be extended on
the adulthood.
? Thus, Morocco
has made many programs related to infant health
? Improvement of the perinatalogy care.
? Generalization of vaccination for the all
population. ? Supplementation in vitamins
food fortification. ? Systematic follow-up
of the infant nutritional status. ?
Family planning.
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? These strategies in favour of the child health
cannot be succeful if the women situation is not
improved in particular their health, their
nutrition and their education, which would
determine their level of conscience and their
engagement to apply the recommendations. ? By
the way, Morocco is engaging in a process of
human development (NIHD National Initiative for
the Human Development), which aims to promote
moroccan population health, education and
wellbeing.
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