Gloria Calamassi-Tran

Dietary exposure estimates of 18 elements from the 1st French Total Diet Study.

To estimate the dietary exposure of the main minerals and trace elements from retail food typically consumed by the French population, samples were purchased and then prepared and cooked prior to analysis. A total of 1080 individual food composites samples were collected and analysed for 18 elements (arsenic, lead, cadmium, aluminium, mercury, antimony, chrome, calcium, manganese, magnesium, nickel, copper, zinc, lithium, sodium, molybdenum, cobalt and selenium). Intakes were calculated from different food consumption patterns found in France for average and high consumers among adults and children. Dietary exposures of those consumers estimated from the France 2000 Total Diet Study (FTDS) are reported, and compared with existing nutritional reference values (Lowest threshold Intake, LTI) or toxicological reference values (Provisional Tolerable Weekly Intake, PTWI or Upper Level, UL) of the respective element and from previous French studies. This study confirms for the populations concerned, the low probability of nutritional or health risks due to food consumption.

Trends in child overweight rates and energy intake in France from 1999 to 2007: relationships with socioeconomic status.

Our objectives were (i) to assess the current prevalence of childhood overweight (including obesity) (OWOB) in France and its relationship with comprehensive socioeconomic status (SES) indicators and (ii) to examine trends in OWOB prevalence and changes in energy intake (EI) and sedentary behavior (SED) based on the previous INCA 1 (Individuelle Nationale des Consommations Alimentaires) data (1998–1999). A representative sample of children aged 3–14 (n = 1,030) was taken from the 2006–2007 cross‐sectional INCA 2 food consumption survey. Weight and height were measured. The prevalence of OWOB was estimated according to the IOTF (International Obesity Task Force) definition. Average daily EI was evaluated using a 7‐day food record. SED (screen time) and SES were reported by answering questionnaires. SES indicators included the occupation and level of education of the head of the household (HH), and variables describing household wealth. Composite indices of SES were computed by correspondence analysis, and relationships with OWOB were explored by logistic regression analysis. In total, 14.5% (95% CI: 12.1–17.0) of the children were OWOB. All SES indicators were inversely correlated to OWOB. Average EI was equal to 1,739 kcal/day. Daily, children spent 113.5 min watching television, and 38.5 min playing video games or using a computer. Compared to the INCA 1 study, OWOB prevalence was not significantly different, EI was lower, and SED was higher. These trends were the same across all occupational categories of heads of household. Although overall rates of childhood OWOB are currently stabilizing, no change was observed in the strong inverse socioeconomic gradient of OWOB between the two studies.

Trends in food intake in French children from 1999 to 2007 : results from the INCA (étude Individuelle Nationale des Consommations Alimentaires) dietary surveys

The objectives of the present study were to assess the intake of different food groups in French children aged 3-17 years (n 1455), and to analyse trends since a dietary survey undertaken 8 years ago. Dietary intake was evaluated using data from the 2006-7 cross-sectional INCA2 national dietary survey (étude Individuelle Nationale sur les Consommations Alimentaires), based on a 7 d food record. Dietary intake (percentage of subjects consuming the food group and amount eaten) was assessed for thirty-nine food categories. We observed variations in food consumption by age, sex, North-South regional gradient, seasonal period and educational level of the responding parent. Trends in dietary intake between 1999 and 2007 were determined by comparing the INCA1 (n 1126) and the INCA2 surveys. Both surveys had been carried out using the same methodology. The findings showed a decrease in energy intake in children aged 3-14 years, due to a reduction in the consumption of foods of animal origin and sweetened products. In adolescents aged 15-17 years, energy intake remained rather stable; during this 8-year period, the consumption of meat decreased, whereas the consumption of savoury snacks such as sandwiches and hamburgers significantly increased. These trends occurred during a time of growing concern about overweight and the associated co-morbidities in France. A number of public health measures were implemented over this period to improve dietary habits and physical activity patterns in children and adults. The periodic monitoring of dietary patterns through the INCA surveys is an essential part of the surveillance network in France.

Core food of the French food supply: second Total Diet Study

As first described in the 1980s, the core food intake model allows a precise assessment of dietary nutrient intake and dietary exposure to contaminants insofar as it reflects the eating habits of a target population and covers the most important foods in terms of consumption, selected nutrient and contaminant contribution. This model has been used to set up the sampling strategy of the second French Total Diet Study (TDS) with the aim of obtaining a realistic panorama of nutrient intakes and contaminant exposure for the whole population, useful for quantitative risk assessment. Data on consumption trends and eating habits from the second French individual food consumption survey (INCA2) as well as data from a 2004 purchase panel of French households (SECODIP) were used to identify the core foods to be sampled. A total of 116 core foods on a national scale and 70 core foods on a regional scale were selected according to (1) the consumption data for adults and children, (2) their consumer rates, and (3) their high contribution to exposure to one or more contaminants of interest. Foods were collected in eight French regions (36 cities) and prepared ‘as consumed’ to be analysed for their nutritional composition and contamination levels. A total of 20 280 different food products were purchased to make up the 1352 composite samples of core foods to be analysed for additives, environmental contaminants, pesticide residues, trace elements and minerals, mycotoxins and acrylamide. The establishment of such a sampling plan is essential for effective, high-quality monitoring of dietary exposure from a public health point of view.

Impact of food consumption habits on the pesticide dietary intake: Comparison between a French vegetarian and the general population

This study aims to compare the pesticide residue dietary intake of the French general population and the vegetarian population, separated into five specific diets: omnivorous (OMN), lacto-vegetarian (LV), ovo-lacto-vegetarian (OLV), pesco-lacto-vegetarian (PLV) and vegan (VG). Theoretical Maximum Daily Intakes (TMDIs) based on Maximum Residue Levels (MRLs) were calculated as a percentage of the Acceptable Daily Intake (ADI). Among the 421 pesticides studied, only 48 had TMDI above ADI for at least one population subgroup. An excessive exposure was noticed for 44, 43, 42, 41 and 30 pesticides in the OLV, VG, OMN, LV and PLV groups, respectively, versus 29 in the general population. Meat and egg products consumption was responsible for higher intakes of organochlorine pesticides in the general population than in the vegetarian population (TMDI = 348% versus 146–183% ADI for aldrin). However, as the limited consumption of animal-origin commodities was largely offset by a higher fruit, vegetable and cereal intake in the vegetarian diets, vegetarians appear to be preferentially exposed to pesticides, for which fruit, vegetables and cereals are the main contributors, such as tri-allate, chlorpyrifos-methyl and diazinon. This study illustrates that consumption habits have a real impact on pesticide exposure in terms of intake levels, number and type of pesticides, representing a potential risk of dietary exposure. Except for organochlorine compounds, the vegetarian population may be more exposed to pesticide residues than the general population due to specific dietary habits. Thus, this population should be considered for risk assessment of pesticide residues.

School meals in French secondary state schools with regard to the national recommendations.

In 2001, a circular addressing both the composition of school meals and food safety issues was introduced in France to improve the nutrient composition of school meals and provided food-frequency guidelines to guarantee dietary balanced meals. The present study assesses the extent to which secondary state schools are familiar with and implement this circular. In 2005, a nationally representative sample of 1440 secondary state schools received a questionnaire on their catering service and the implementation of the circulars recommendations, and were requested to enclose all menus (lunches and dinners) served over 1 month. Menu analysis shows that progress is still required to achieve a meal composition in accordance with the food-group frequency guidelines appended to the circular. Some recommendations are followed by most of the schools, such as limiting high-fat products and providing plenty of raw fruits and vegetables, cooked vegetables and starchy foods. Other guidelines should be implemented further, especially with regard to the nutritional quality of main courses and dairy products, which are met by less than a third and a half of schools, respectively. Specific efforts are necessary for evening meals to ensure that the nutritional requirements of boarders are covered. Some recommendations, such as the food purchasing manager being trained in nutrition (38 % of schools) and the involvement of dietetic expertise when designing meals (6 %), seem to be linked to better dietary balance of meals. Implementation of the circular must therefore be promoted in schools and may require stronger regulatory nutrition standards and better cooperation between schools.

Comparison of different maximum safe levels in fortified foods and supplements using a probabilistic risk assessment approach

Different European institutions have developed mathematical models to propose maximum safe levels either for fortified foods or for dietary supplements. The objective of the present study was to compare and check the safety of these different maximum safe levels (MSL) by using a probabilistic risk assessment approach. The potential maximum nutritional intakes were estimated by taking into account all sources of intakes (base diet, fortified foods and dietary supplements) and compared with the tolerable upper intake levels for vitamins and minerals. This approach simulated the consequences of both food fortification and supplementation in terms of food safety. Different scenarios were tested. They are the result of the combination of several MSL obtained using the previous models. The study was based on the second French Individual and National Study on Food Consumption performed in 2006-7, matched with the French food nutritional composition database. The analyses were based on a sample of 1918 adults aged 18-79 years. Some MSL in fortified foods and dietary supplements obtained independently were protective enough, although some others could lead to nutritional intakes above the tolerable upper intake levels. The simulation showed that it is crucial to consider the inter-individual variability of fortified food intakes when setting MSL for foods and supplements. The risk assessment approach developed here by integrating the MSL for fortified foods and dietary supplements is useful for ensuring consumer protection. It may be subsequently used to test any other MSL for vitamins and minerals proposed in the future.

Socio-economic and demographic variations in school lunch participation of French children aged 3–17 years

OBJECTIVE To assess school canteen attendance in a French nationally representative sample of children and to analyse its association with the socio-economic and demographic characteristics of the children and their families. DESIGN Data from the second French national cross-sectional food consumption survey (INCA2), performed in 2006-2007, were used. Information on usual weekly school canteen attendance was collected through a self-reported questionnaire, and demographic and socio-economic variables through a face-to-face questionnaire. The associations between school canteen attendance and the socio-economic and demographic variables were investigated by multivariate logistic regression analyses. SETTING The INCA2 sample was representative of the children aged 3-17 years in France. SUBJECT Analysis was performed on 1413 schoolchildren who completed the school canteen attendance questions. RESULTS Some 65·6 % of schoolchildren aged 3-17 years had school lunch at least once weekly. This rate of attendance was positively correlated with age. Whatever the school level, school canteen attendance was positively associated with the educational level of the caregiver/parent. In pre- and elementary-school children, enrolment at the school canteen was also higher when the caregiver/parent worked, or in single-parent families. In secondary-school children, school lunch participation decreased with children living in more densely populated areas and increased with the level of the households living standards. CONCLUSIONS School canteen attendance was positively associated with childrens socio-economic background. This could reduce the effectiveness of the forthcoming school meal composition regulations designed to improve the diet of children from deprived backgrounds, who are more likely to have unhealthy food habits.

The relationship between school lunch attendance and the food intakes of French schoolchildren aged 3–17 years

OBJECTIVE Recently, school meal composition regulations have been implemented in France in order to improve the nutritional status of children. The present study investigated the link between school lunch attendance and the food intakes of schoolchildren aged 3-17 years. DESIGN Second French cross-sectional dietary survey (2006-2007). Eating frequencies were assessed for twenty-four food groups with a 7 d food record. Eating locations were recorded for main meals. Food group intakes at weekday lunches were compared for the school canteen and for other locations. The childrens overall dietary intake was compared based on school lunch attendance. SETTING Mainland France. SUBJECTS Schoolchildren aged 3-17 years (n 1068). RESULTS Lunchtime food intake differed between the school canteen and other locations. Some intakes at school canteens were more in accordance with the regulations (more fruit and vegetables, fish and dairy products, and less sandwiches, soft drinks, chocolate and confectionery), whereas others highlighted needs for improvement (more sweet biscuits and pastries, ice cream and dairy desserts, pizzas and salty pastries). Many of these differences were also observed in the childrens overall diet: children regularly attending school lunches ate more mashed fruit, fish and sweet biscuits or pastries, and less sandwiches and soft drinks. The link between school lunch attendance and overall diet was less pronounced in secondary-school children. CONCLUSIONS School canteen attendance is associated with both potentially beneficial and deleterious differences in the lunchtime and overall diets of French children. These findings are important to consider when setting national regulations for school meal composition.

La restauration scolaire dans les établissements publics français du second degré : respect des recommandations nationales et profils d’établissements

BACKGROUND Recent reports on the lack of nutritional quality of meals served in schools have led public authorities to draft, in 1999, recommendations for restoring a balanced food supply. Following the survey carried out by the French food safety Agency in 2005-2006, which highlighted gaps in the implementation of these recommendations, a law passed in July 2010 plans to make these recommendations mandatory, as their 2007 revised version. Thus, the objective of this study was to assess initial school compliance with regard to this last revised version of the recommendations and to identify school patterns through their catering management and implication in a dietary project. METHODS Seven hundred and seven secondary state schools were questioned (570 were administrated by the Ministry of Education and 137 by the Ministry of Agriculture) on their catering practices. Twenty consecutive menus from each school were also analyzed with a specific coding system to establish its nutritional composition for comparison with the 2007 recommendations. RESULTS On average, schools complied with half of the recommendations. Good compliance was observed with the 2007 recommendations concerning fried products, starchy foods, fruits, and dairy products whereas very few schools were in compliance with recommendations concerning fish, cheeses and sweetened desserts containing less than 15 % fat and more than 20 g of sugar per portion. Furthermore, compliance with recommendations was significantly better for lunch meals, and even better for agricultural establishments. A 5-component meal was also associated with greater compliance with the recommendations. In addition, four school patterns were identified based on catering management practices. The first two categories of establishments had knowledge of the recommendations but exhibited different levels of application. The last two types of establishments had no knowledge of the recommendations and differed in their catering management practices. CONCLUSION Compliance with recommendations was contrasted, with high adequacy for some guidelines and low for others. Nevertheless, application of the current guidelines and real implication of the school in a dietary project did improve the dietary offer in such schools.