Nicole Darmon

Energy-dense diets are associated with lower diet costs: a community study of French adults

OBJECTIVEnHigh consumption of energy-dense foods has been linked to high energy intakes and excess weight gain. This study tested the hypothesis that high energy density of the total diet is associated with lower diet costs.nnnDESIGNnDietary intakes of 837 French adults, aged 18-76 years, were assessed using a dietary history method. Dietary energy density (MJ kg(-1)) was calculated by dividing total energy by the edible weight of foods consumed. Daily diet cost ( in day(-1)) was estimated using mean national food prices for 57 food items. The relationship between dietary energy density and diet cost at each level of energy intake was examined in a regression model, adjusted for gender and age.nnnRESULTSnThe more energy-dense refined grains, sweets and fats provided energy at a lower cost than did lean meats, vegetables and fruit. Within each quintile of energy intake, diets of lower energy density (MJ kg(-1)) were associated with higher diet costs ( in day(-1)).nnnCONCLUSIONnIn this observational study, energy-dense diets cost less whereas energy-dilute diets cost more, adjusting for energy intakes. The finding that energy-dilute diets are associated with higher diet costs has implications for dietary guidelines and current strategies for dietary change.

Low-cost diets: more energy, fewer nutrients.

Energy-dense diets offer a low-cost dietary option to the consumer. However, they are more likely to be nutrient-poor. In this study, based on the French national food consumption survey, the diet costs were estimated using retail food prices in France. Adult participants were stratified by quartiles of energy cost (in [euro ;[sol;10u2009MJ). Dietary energy density, energy and nutrient intakes were then compared across groups. Participants in the lowest quartile of energy cost had the highest energy intakes, the most energy-dense diets and the lowest daily intakes of key vitamins and micronutrients. Participants in the highest quartile of energy cost had lower energy intakes, and diets that were higher in nutrients and lower in energy density. However, their daily diet costs were 165% higher. In this observational study, the more nutrient-dense diets were associated with higher diet costs.

Local Food Price Analysis by Linear Programming: A New Approach to Assess the Economic Value of Fortified Food Supplements:

Linear programming can be applied to identify a nutritionally adequate diet of the lowest cost, since price and nutrient contents are linearly related to food weight. Most computer spreadsheets now include an easy-to-use solver function that is suitable for this purpose. This approach can also be used to estimate the effect of introducing a food supplement on the minimal cost required to provide a nutritionally adequate diet. It can also provide an estimate of the expenses saved by families in relation to the sums spent by the donor after the distribution of a food supplement. This method is illustrated by comparing the economic value of two food supplements, a traditional blended flour and a nutrient-dense spread (a “foodlet”) in rural Chad. The limitations of this approach and the need to interpret its findings carefully in relation to field observations are discussed.

Socio-economic characteristics, living conditions and diet quality are associated with food insecurity in France.

OBJECTIVEnTo assess the prevalence of household food insecurity (FI) in France and to describe its associations with socio-economic factors, health behaviours, diet quality and cost (estimated using mean food prices).nnnDESIGNnCross-sectional nationally representative survey. FI was assessed using an adapted version of the US Department of Agricultures Food Insufficiency Indicator; dietary intake was assessed using a 7 d open-ended food record; and individual demographic, socio-economic and behavioural variables were assessed using self-administered questionnaires and interviews. Individuals experiencing FI were compared with food-secure individuals, the latter being divided into four categories according to quartiles of their income per consumption unit (FS1 to FS4). Differences among categories were analysed using χ² tests, ANOVA and tests for trend.nnnSETTINGnIndividual and National Dietary Survey (INCA2), 2006-2007.nnnSUBJECTSnAdults aged 18-79 years (n 2624).nnnRESULTSnIndividuals experiencing FI represented 12·2% of the population. They were on average younger, more frequently women and single parents with children compared with those in the other four categories. Their mean income per consumption unit was higher than that in the FS1 category, but they reported poorer material and housing conditions. The prevalence of smoking and the mean daily time spent watching television were also higher in the FI category. No significant difference among categories was found for energy intake, but mean intakes of fruits, vegetables and fish were lower, and diet quality was slightly but significantly poorer in the FI category. Daily diet cost was also lower in the FI category.nnnCONCLUSIONSnFrance is not spared by FI. FI should be routinely monitored at the national level and research should be promoted to identify effective strategies to reduce nutrition inequalities in France.

Linear programming can help identify practical solutions to improve the nutritional quality of food aid

OBJECTIVESnTo assess the nutritional quality of food aid delivered by food banks in France and to identify practical modifications to improve it.nnnDESIGNnNational-level data were collected for all food aid distributed by French food banks in 2004, and its nutrient content per 2000 kcal was estimated and compared with French recommendations for adults. Starting with the actual donation and allowing new foods into the food aid donation, linear programming was used to identify the minimum changes required in the actual donation to achieve the French recommendations.nnnRESULTSnFrench food-bank-delivered food aid does not achieve the French recommendations for dietary fibre, ascorbic acid, vitamin D, folate, magnesium, docosahexaenoic acid, alpha-linolenic acid and the percentage of energy from saturated fatty acids. Linear programming analysis showed that these recommendations are achievable if more fruits, vegetables, legumes and fish were collected and less cheese, refined cereals and foods rich in fat, sugar and/or salt. In addition, new foods not previously collected are needed, particularly nuts, wholemeal bread and rapeseed oil. These changes increased the total edible weight (42%) and economic value (55%) of the food aid donation, with one-third of its edible weight coming from fruits and vegetables, one-third from staples, one-quarter from dairy products and approximately a tenth from meat/fish/eggs.nnnCONCLUSIONSnImportant changes in the types and amounts of food collected will improve the nutritional quality of food-bank-delivered food aid in France. Such changes are recommended to improve the diets of deprived French populations.

Low-cost foods: how do they compare with their brand name equivalents? A French study.

OBJECTIVEnConsumers are increasingly relying on low-cost foods, although it is not clear if the nutritional quality of these foods is fully maintained. The aim of the present work was to analyse the relationship between cost and quality within a given food category.nnnDESIGN AND SETTINGnThe relationship was analysed between nutritional quality and cost for 220 food products belonging to seventeen different categories, controlling for package type and package size. Given that a summary of nutrient information was not available on the product label, a novel ingredient quality score was developed based on listed product ingredients.nnnRESULTSnWithin a given category, the lowest-priced foods were not different from the equivalent branded products in terms of overall energy or total fat content. Nevertheless, a positive relationship, small but significant, was observed between the price and the ingredient quality score. On average, the branded products cost 2.5 times more than the low-cost products, for an equivalent energy and lipid content, and had a slightly higher (1.3 times) ingredient quality score.nnnCONCLUSIONSnMore studies are necessary to evaluate the nutritional quality of low-cost foods. This evaluation would be facilitated if nutrition labelling was mandatory. Yet in view of the present results, it does not seem to be justified to divert consumers, especially the poorest, from low-cost foods because this may have an adverse effect on the nutritional quality of their diet, by reducing further the fraction of their food budget spent on fresh fruit and vegetables.

Quantifying the contribution of foods with unfavourable nutrient profiles to nutritionally adequate diets

That all foods can fit into a healthy diet is a long-standing principle of dietetic practice. The present study quantified the relative contributions of foods to encourage and foods to limit, using new techniques of individual diet optimisation and nutrient profiling. Individual foods from every food group were assigned to four nutrient profile classes based on the French SAIN,LIM system. Foods with the most favourable nutrient profiles were in class 1, and foods with the least favourable nutrient profiles were in class 4. An optimised diet that met the recommendations for thirty-two nutrients and that respected the existing eating habits was designed for each adult in the nationally representative Enquête Individuelle et Nationale sur les Consommations Alimentaires 1 dietary survey (n 1171). The relative proportions of the four nutrient profiling classes were assessed before and after the optimisation process. The contribution of fruits and vegetables, whole grains, milk and fish was significantly increased, whereas the contribution of refined grains, meats, mixed dishes, sugars and fats was decreased. The optimised diets derived more energy (30 v. 21xa0% in the observed diets) from class 1 foods and less energy (41 v. 56xa0%) from class 4 foods. They also derived a higher amount of class 1 foods (61 v. 51xa0%) and a lower amount of class 4 foods (22 v. 32xa0%). Thus, nutrient adequacy was compatible with the consumption of foods with an unfavourable nutrient profile (one-fifth the basket weight), provided that the diet also contained almost two-thirds of foods with the most favourable profile. Translating these results into concrete and quantified advice may have very tangible public health implications.

Eating at the university canteen. Associations with socioeconomic status and healthier self-reported eating habits in France

French university canteens offer structured meals at a fixed moderate price. We examined whether eating regularly at university canteens was associated with socioeconomic status (SES) or dietary practices. The study data came from a cross-sectional study of a random sample of 1723 students aged 18-24 years, in their first year of university in 2005-2006, enrolled in the universities of southeastern France (response rate=71%). Self-reported dietary practices were collected with a behavioral questionnaire. Adjusted logistic regressions showed that eating regularly at university canteens was less frequent among students with less than € 300 monthly resources and not living with their families (OR=0.68 [95%CI: 0.49-0.94]). It was also positively associated, regardless of SES, with the consumption of at least five servings of fruit/vegetables daily (OR=1.42 [1.05-1.92]) and one serving of meat/fish daily (OR=1.41 [1.13-1.76]) but not with either restricting fatty food (OR=1.04 [0.81-1.33]) or never/rarely adding salt to food (OR=1.06 [0.85-1.32]). Eating regularly at university canteens was less frequent among less well-off students and was positively associated with some healthier self-reported dietary habits. Further research is needed to confirm these results in the overall student population in France and to understand the determinants of university canteen utilization.

L’évolution des achats alimentaires: 30 ans d’enquêtes auprès des ménages en France

Resume Nous decrivons l’evolution de la consommation alimentaire en France au cours des trois dernieres decennies a partir de donnees representatives des menages. De telles donnees microeconomiques existent dans les enquetes « Consommation alimentaire » de l’Insee et dans les panels de consommateurs de SECODIP. En couvrant la periode 1969-2001, l’analyse de ces sources permet de faire le point sur la consommation alimentaire avant la mise en place de tout programme institutionnel de prevention par la nutrition. Nous constatons que les achats diminuent dans la majorite des grandes categories d’aliments. Au sein de cette evolution, on peut noter la chute d’achats de produits traditionnels et de maniere concomitante le developpement d’achats de produits manufactures. La part croissante des aliments transformes s’observe au sein de toutes les familles d’aliments par le biais des substitutions entre produits. La transformation de la structure des achats alimentaires et les mouvements de substitution entre produits sont discutes a la lumiere de l’evolution de l’environnement economique, des changements du mode de vie et de l’environnement culturel des Francais.

O60 Impact carbone et qualité nutritionnelle de l’alimentation en France

L’objectif de l’etude etait d’analyser l’impact carbone de l’alimentation en fonction de sa qualite nutritionnelle