Free Metabolism Status: The Case For Marrakech And Tighza Research Proposal Example

ABSTRACT

This study explores metabolic status for residents of one urban, Marrakech, and one rural, Tighza, community. Against a backdrop of cultural, social and economic differences between Moroccan urban and rural dwellers, proposed study purports to identify if Tighza needs a clinic facility or monthly visits from doctors to cater for health issues and if Tighza experiences a metabolic status of concern.

INTRODUCTION

The indigenous people of Morocco (Berber or Amazigh) span a broad range of ethnic communities in North Africa. Their cultures and daily lifestyles and habits vary considerably according to area and community values. The ethnic differences of Berbers across North Africa still receive much research attention, particularly as regards linguistic, political and social differences. Being oldest and largest culture in Morocco (Sadiqi, 2009), Berber culture has rarely being studied as regards dietary habits. True, urbanity / rurality question has been investigated in aforementioned contexts. Moreover, local food in different Moroccan cities has been discussed mainly as part of a broader discussion of cultural differences between different Moroccan cities and/or communities. Rarely, however, has urbanity / rurality question been investigated for dietary habits in different communities. Less investigated still is how different dietary habits in urban and rural communities impact on metabolic status of residents in urban and rural areas. Indeed, literature on Berber public health is scarce. Berbers are studied, mainly, for comparison reasons not to address specific communal issues, particularly health ones. For example, one study has focused on genetic makeup of Berbers and Arab-speakers in Morocco (Harich et al, 2002). This raises research questions as to significance of Berbers per se as not only a significant ethnicity in Morocco but also Morocco's largest and native ethnicity. Further, in order to formulate a better informed public health policy, greater insights are required for specific Berber communities. Given current proposal purposes, by comparing food offerings, dietary habits as well as community's overarching culture and space design, a more in-depth investigation into specific communities is required. By narrowing down investigation into specific communities, moreover, tapping into rich literature on Berbers from cultural, social and economic perspectives, an urban / rural dichotomy could be used in order to qualify health needs in urban as opposed to rural community. This proposal aims, hence, to investigate metabolic status for one urban, Marrakech, and one rural, Tighza, community in order to better qualify health issues and hence formulate more informed health strategies.

BACKGROUND

The Moroccan culture is, largely, discussed in an urbanity / rurality dichotomy. The image of a Western-style urban vis-à-vis a conventional, local-style resident has been well investigated. Further, given local as well as global influences, whereas urbanity has been associated with affluence, rurality has been associated with paucity (Dike, 2012). This affluence / paucity should, when viewed in dietary light, be an indication for more than a City vs. Village dichotomy but one in which urban (as opposed to rural) distribution and consumption of food is problematized. A gender obesity gap, for example, has been registered for High Atlas Moroccan population (Lahmam et al, 2007). This, research finds, is due to higher intakes of carbohydrate, calories and macronutrients for obese women than for normal weight women (Mokhtar et al, 2001). Broad as is, metabolism status differences are not still justified – which require a deeper nutritional-cultural analysis into dietary habits in specific communities.
Projected as a global crisscross of conventional, Moroccan culture and modern, international entertainment, Marrakech is recognized as an urban destination of food enjoyment. Like most Moroccan cities, Marrakech remains Berber at heart. This is manifested, for current paper's purposes, in city's repertoire of typical Moroccan dishes, mainly tanjia marrakchia (Hal, 2007). Typically prepared of mutton or lamb, whole cloves of peeled garlic, saffron, preserved lemon, ras el hanout and water (The World Wide Gourmet, n.d.a), tanjia marrakchia is rich in meat (mutton / lamb) and salty ingredients (in ras el hanout, which is a conventional Moroccan spice mix). Given reciprocity between high blood pressure and higher levels of meat and fat intakes (Appel, 2005), tanjia marrakchia factors in as a potential, major cause of high blood pressure for residents and visitors of Marrakech alike.
Typical of all globally-styled cities, Marrakech is projected as a local and international destination for food not only for consumption but also as an entertainment activity. Indeed, food is viewed as an essential component of a cultural experience in Marrakech. Moreover, given Marrakech's broad options of Western and local bistro-styled restaurants, residents and visitors of Marrakech alike are subject to much broader variants of "conventional dishes", offerings which, in fact, emphasize higher metabolic intakes and hence higher blood pressure levels. As an urban space of self-expression, Marrakech becomes one conventional, local hub made into an international one in which not only daily social and economic activities are re-oriented such as to maintain a global image of local hospitality but dietary habits of native, urban Berbers are metamorphosed into a global feel. Thanks, again, to sprouting restaurants competing for frequenters hungry for a local dietary experience, conventional, staple dishes such as tanjia marrakchia are remade into highly metabolic ones in which health concerns are raised and implications for public health policies still undecided.
One additional dietary habit contributes, moreover, to Marrakech's defining metabolic status. Against a backdrop of urban depression and similar to big cities centered on modern economic activities, residents and visitors of Marrakech consume popular meals in open spaces and more frequently than in less cosmopolitan communities. Indeed, frequency of food consumption – and hence potential abnormality in metabolic status and – has shown to be correlated to stress and depression (Liu, 2007).
Yet, for all Marrakech's metabolic status – presumably of high fat, protein and sugar ingredients of tanjia marrakchia as well as international dishes – sprouting exercise and body shape shops seem to balance out metabolic status, particularly in more upscale city areas. The omnipresent clinics in Marrakech appears, further, to raise public awareness of dietary intakes.
As mentioned earlier, Morocco is more often than not dichotomized, for analysis purpose, into urbanity / rurality. Set against Marrakech, hence, Tighza can be been seen as no more than decidedly antithetic to Marrakech. However, commonalities exist. That Tighza is rural and Marrakech is urban are not a once and for all designations. Like all communities world over, a mix of urbanization and ruralization cannot be missed in both communities. If Tighza is assumed rural, local and international urban influences still contribute to Tighza's cultural scene in general and dietary patterns in particular. Similarly, if Marrakech is assumed urban, indeed one notable phenomenon in Morocco's urban life is creeping rural residents into city space. In addition to city's resident have-nots, rural would-be urbans assume urban manners, including urban dietary habits and food consumption patterns, as part of an acculturation process. Therefore, a careful distinction should be marked between urban and rural. After all, urbanity / rurality remains only one analysis approach by which dietary habits and food consumption habits are dissected.
A rural community which depends on subsistence farming and agriculture (Rachel, 2012), Tighza appears as an ideal idyll for residents and visitors alike. Not unlike many Moroccan cities and villages, Tighza has tajines and couscous as staple Berber dishes. Both made of similar ingredients as tanjia marrakchia – but for semolina and pumpkin in case of couscous (The World Wide Gourmet, n.d.b) – variants of tajines and couscous in Tighza still do not entertain much variety as in Marrakech's tanjia. Indeed, Tighza's very locale restricts consumption of food à la Marrakech style.
Given Tighza's rural nature, food is consumed as a local deli within a context of a global entertainment of world foods, like in Marrakech, but as a decidedly local food consumed as has been for centuries. Further, given limited number of local residents, Tighza hosts visitors as part of daily subsistence agrarian routines which visitors choose to participate in and share as an actual self-help, self-made tajines and couscous. Unlike Marrakech, in which tanjia is consumed as a global deli, Tighza offers tajines and couscous as decidedly local dishes. Moreover, unlike Marrakech, in which daily social and economic activities are centered on hospitality businesses, Tighza integrates locals and visitors into area's rural setting and hence food consumption, manifested in metabolic status, is preserved such as to keep normal, conventional macronutrient intakes. Contrary to Marrakech, Tighza's locals and resident's still follow conventional dietary patterns. Admittedly rural, Tighza offers locals and residents alike a metabolic status which is characterized by lower blood pressure and sugar levels and hence different health and public policy implications. Although of insignificant population, Tighza offers a valuable comparison example for Marrakech if not only because both are recognized as travel destinations but for different reasons.
Against such a background, pronounced differences in Tighza vis-à-vis Marrakech spell out a wide range of clinical investigation questions as to which public health policies should be adopted and pursued as part of an investigation into Tighza's metabolic status. Denied, for example, access to clinical care similar to Marrakech, Tighza appears to endure unhealthy dietary habits not compensated for by specific clinical care, notwithstanding possible impact from healthy rural habits such as walking long distances in fresh air and hence lowering sugar and fat levels – a practice not performed by Marrakech residents who largely have access to motorized means of transportation.
Indeed, no sharp line splits urban and rural in Morocco. For urban poor residents might follow dietary patterns similar to ones adopted in rural communities and rich, rural residents might follows ones adopted in urban communities. To complicate patterns, creeping rural residents into Morocco's urban spaces contributes to rural resident's changing dietary habits – and hence health concerns – in an acculturation process in which city ways replace village ones. Still, urbanity / rurality dichotomy remains useful to study Berber's dietary habits. As well, urbanity / rurality dichotomy has proven insightful in light of Morocco's diverse populations.

HYPOTHESIS

Given food consumption and overall cultural space makeup, urban, Marrakech-based Berbers show different dietary habits and hence metabolic status than, rural, Tighza-based Berbers.

METHODOLOGY

This proposal assumes a case study design. Participant selection criteria are:
Berber;
Male / Female; and
30-80-old age group.
The number of participants for each group in Marrakech and Tighza is seventy five (75). Indigenous populations are sampled from urban Marrakech and rural Tighza. For both populations, sample size is one hundred and fifty (150). Selection is random for each criterion.
Data collection strategies should, further, be considered for in order to avoid confusion, delays and errors. For instance, a number of considerations should be factored in blood pressure measurement, including, but are not limited to,

Time of participant arrival;

5-10 minutes rest;
Used apparatus (standard, calibrated);
Assigned room;
Measurement position: Seated or lying down;
Right or left / randomized arm measurement;
Cuff placement and details; and
Assignee for pressure measurement.
As well, sugar levels should be checked, after pressure measurement, manually using a glucose monitor on tip of participant's index finger. Participants are presented with a questionnaire on breakfast, lunch and dinner intakes. A specific question should address occupation as well as day / afternoon / night activity.
Data analysis addresses form design, data processing and coding as well as statistical method for each data set. Procedures accounting for missing, unused or spurious data should be considered for. Then, data should be imputed into an Excel spreadsheet and interpreted into adequate graphs and charts each showing:

Most consumed foods, frequency of consumption and meal-by-meal consumption;

Activity level of males vs. females for Marrakech;
Activity level of males vs. females for Tighza;
Sugar level of males vs. females for Marrakesh;
Sugar level of males vs. females for Tighza;
Blood pressure of males vs. females for Marrakesh; and
Blood pressure of males vs. females for Tighza.
Finally, ethical considerations are of particular significance in current proposed study. Given sub-cultural diversity within Berber community in Morocco, sensitivity in catering for participants is of particular significance. For Tighza, due to community's rural nature, confidentiality should be considered for. The absence of close by clinics and/or health care units should, indeed, be considered for since clinical set-ups to carry out sugar, blood and pressure measurements are projected to not only disturb local community but also to result in low show-up rates. For Marrakech, however, given Marrakech's urbanity, clinical measurements should appeal to health-and-fitness as an inducing model for participation.

SIGNIFICANCE

Against a backdrop of cultural, social and economic differences between Moroccan urban and rural dwellers, current study purports to differentiate between one urban, Marrakech, and one rural, Tighza and hence identify if Tighza needs a clinic facility or monthly visits from doctors to cater for health issues and if Tighza experiences a metabolic status of concern.

REFERNCES

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