C. Méjean

Prevalence of overweight in 6- to 15-year-old children in central/western France from 1996 to 2006: Trends toward stabilization

Objective:The prevalence of overweight in children has markedly increased over the past few decades in France, as in all Western countries. We sought to describe the yearly prevalence of childhood overweight from 1996 to 2006 and to assess whether a shift in trends could be observed dating from the time the Nutrition and Health National Program (PNNS) was set up in France in 2001, in particular according to gender, age and family economic status.Design:We used annual overweight prevalence of standardized 6- to 15-year-old populations (total=26u2009600) with weight and height measured at health examination centers in the central/western part of France between 1996 and 2006. Regression slopes of overweight prevalence were evaluated between 1996 and 2006, and specifically between 1996 and 2001, and 2001 and 2006. The annual prevalence and estimated slopes were compared in subgroups, taking into account gender, age and economic status of the family.Results:The prevalence increased between 1996 (11.5%) and 1998 (14.8%) and was stable between 1998 and 2006 (15.2%). According to linear regression, the overall trend in prevalence of overweight children between 1996 and 2006 was stable (slope=0.19, P=0.08). Similarly, the prevalence of overweight increased between 1996 and 1998 in boys and girls, in 6–10 year olds, in 11–15 year olds and in non-disadvantaged children, and remained stable thereafter. The prevalence of overweight in the disadvantaged group increased between 1996 (12.8%) and 2001 (18.9%) (slope=1.16, P=0.004) and was stable between 2001 and 2006 (18.2%) (slope=0.09, P=0.78).Conclusion:The results of this study reveal a stable prevalence of overweight since 1998 in most groups studied, and since 2001 in the disadvantaged group.

Impact of fruit and vegetable vouchers and dietary advice on fruit and vegetable intake in a low-income population

Background/Objectives:Lower-income subgroups consume fewer servings of fruit and vegetables (FVs) compared with their more advantaged counterparts. To overcome financial barriers, FV voucher delivery has been proposed.Subjects/Methods:In a 12-month trial, 302 low-income adults 18–60 years old (defined by evaluation of deprivation and inequalities in health examination centers, a specific deprivation score) were randomized into two groups: dietary advice alone (‘advice’), or dietary advice plus FV vouchers (‘FV vouchers’) (10–40u2009euros/month) exchangeable for fresh fruits and vegetables. Self-reported data were collected on FV consumption and socioeconomic status at baseline, 3, 9 and 12 months. Anthropometric and blood pressure measurements were conducted at these periods, as well as blood samples obtained for determination of vitamins. Descriptive analyses, multiple linear regression and logistic regression were performed to evaluate the impact of FV.Results:Between baseline and 3-month follow-up, mean FV consumption increased significantly in both the ‘advice’ (0.62±1.29u2009times/day, P=0.0004) and ‘FV vouchers’ groups (0.74±1.90, P=0.002), with no difference between groups. Subjects in the FV vouchers group had significantly decreased risk of low FV consumption (<1 time/day) compared with those in the advice group (P=0.008). No change was noted in vitamin levels (vitamin C and β-carotene). The high number of lost-to-follow-up cases did not permit analysis at 9 or 12 months.Conclusion:In the low-income population, FV voucher delivery decreased the proportion of low FV consumers at 3 months. Longer-term studies are needed to assess their impact on nutritional status.

Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort

Abstract Objective To assess the prospective associations between consumption of ultra-processed food and risk of cancer. Design Population based cohort study. Setting and participants 104u2009980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Santé cohort (2009-17). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items. These were categorised according to their degree of processing by the NOVA classification. Main outcome measures Associations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer assessed by multivariable Cox proportional hazard models adjusted for known risk factors. Results Ultra-processed food intake was associated with higher overall cancer risk (n=2228 cases; hazard ratio for a 10% increment in the proportion of ultra-processed food in the diet 1.12 (95% confidence interval 1.06 to 1.18); P for trend<0.001) and breast cancer risk (n=739 cases; hazard ratio 1.11 (1.02 to 1.22); P for trend=0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (lipid, sodium, and carbohydrate intakes and/or a Western pattern derived by principal component analysis). Conclusions In this large prospective study, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer. Further studies are needed to better understand the relative effect of the various dimensions of processing (nutritional composition, food additives, contact materials, and neoformed contaminants) in these associations. Study registration Clinicaltrials.gov NCT03335644.

Health and dietary traits of organic food consumers: results from the NutriNet-Santé study

The dietary and health traits of organic food (OF) consumers have not been comprehensively described. The aim of this study was to identify factors associated with OF consumption. Data were collected from 54 283 participants from the NutriNet-Santé cohort using self-administered web-based questionnaires. Occasional organic food consumers and regular organic food consumers (ROFC) were compared with non-organic food consumers (NOFC) using logistical regression providing an OR and 95 % CI. Adherence to the French food-based guidelines and interactions between nutritional knowledge and OF consumption in adherence to dietary guidelines were investigated. Medical history was also assessed in relation to OF consumption. Compared with NOFC, ROFC were more likely to be vegetarian (OR 9·93; 95 % CI 7·42, 13·29 in women; OR 13·07; CI 7·00, 24·41 in men) and were less likely to be aware of nutritional guidelines regarding meat consumption (OR 0·37; CI 0·34, 0·40 in women; OR 0·41; CI 0·36, 0·47 in men). Compared with NOFC, ROFC had a lower risk of type II diabetes, hypertension and CVD; however, this effect was only significant for men. In contrast, organic consumers were more likely to report food allergies. Consuming OF appeared to affect the relationship between nutritional knowledge and adequate intake of meat/poultry/seafood/eggs and starchy food among both sexes. Our study provides new insights into the diet- and health-related behaviours of OF consumers in a large sample of participants residing in France. This should be taken into account in future studies investigating relationships between health and OF consumption.

L’adéquation au modèle alimentaire français est associée à un statut pondéral plus faible dans un large échantillon de population générale

Introduction et but de l’etude Le modele alimentaire francais se caracterise par une structuration des prises alimentaires et par une importance attachee a la convivialite au moment des repas. Ces dernieres decennies, l’evolution des modes de vie, puis de l’offre alimentaire a conduit a une modification des pratiques culinaires et des modes de consommation posant ainsi la question du maintien de ce modele alimentaire en France. Il a souvent ete suggere que ce modele pourrait avoir un impact positif sur les consommations alimentaires et donc, potentiellement sur l’etat de sante. Neanmoins, peu d’etudes ont evalue l’existence de telles associations en population generale. Ainsi, les objectifs de cette etude etaient, d’une part, d’evaluer le maintien du modele alimentaire francais au sein d’un large echantillon de la population francaise et, d’autre part, de tester l’association entre l’adequation a ce modele alimentaire et le statut ponderal. Materiel et methodes Un questionnaire auto-administre a permis d’evaluer les pratiques de 49xa0784xa0participants a l’etude NutriNet-Sante lors des repas en semaine (midi et soir) et le week-end (midi). Differentes caracteristiques du modele alimentaire francais ont ete evalueesxa0: nombre de repas pris par jour, creneau horaire du repas, duree du repas, nombre de plats, situation physique (assis/debout), presence de convives et plaisir ressenti. Les donnees de poids et de taille auto-declarees ont ete collectees. Une analyse descriptive des pratiques a ete realisee sur un echantillon redresse sur certaines caracteristiques sociodemographiques (sexe, âge, categorie socioprofessionnelle, lieu de residence et presence d’enfant dans le foyer). Les associations entre les differentes composantes du modele alimentaire francais et un score composite (de 0xa0a 6), et l’indice de masse corporelle ont ete evaluees par des modeles de regression logistique ajustes sur les caracteristiques sociodemographiques et de modes de vie. Resultats et analyse statistique Une majorite d’individus prend trois repas par jour, entre 12xa0h et 13xa0h le midi et entre 19xa0h et 20xa0h le soir. Les repas se deroulent generalement assis a une table en compagnie d’autres convives et sont un moment de plaisir pour une importante majorite. Toutefois, la duree est en moyenne de 15xa0a 30xa0minutes seulement et une structuration du repas en 2xa0plats est le plus souvent observee, notamment en semaine. Globalement, les individus ayant des pratiques davantage en adequation avec le modele francais avaient moins tendance a etre en surpoids (incluant l’obesite) ( odds ratio [OR]xa0: 0,90xa0; intervalle de confiance a 95xa0% [IC95xa0%]xa0: [0,87–0,92]). En particulier, le fait de prendre trois repas par jour (0,80 [0,72–0,89]), de manger a heures fixes (0,83 [0,74–0,92]), de prendre le temps de manger (0,72 [0,67–0,78]), de prendre son repas assis (0,74 [0,63–0,86]) et de considerer le repas comme un moment de plaisir (0,56 [0,51–0,62]) etaient negativement associes au surpoids. Cependant, aucune association significative n’a ete observee pour le nombre de plats consommes au cours du repas et la presence de convives. Conclusion Le modele alimentaire francais caracterise par des prises alimentaires structurees et une convivialite des repas est encore preponderant au sein de la population francaise. De plus, ces resultats suggerent un benefice potentiel de telles pratiques pour limiter la prevalence du surpoids.

Additional file 1: Figure S1. of Impact of the front-of-pack 5-colour nutrition label (5-CNL) on the nutritional quality of purchases: an experimental study

(FSA score computation and 5-CNL attribution) and Supplemental material (communication leaflet). (ZIP 464xa0kb)