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Regional factors interact with educational and income tax levels to influence food intake in France

Abstract

Background/Objectives:

The goal of the present study was to assess whether geographic factors affect the relationship between socioeconomic indicators and adherence to the French National Nutritional Health Programme (Programme National Nutrition Santé (PNNS)) guidelines.

Subjects/Methods:

The MONA LISA-NUT study (2005–2007) is a cross-sectional survey of a representative sample from northern, northeastern and southwestern France. Educational level and household income tax were recorded by trained interviewers. Food intake was assessed with a 3-day food diary in 3188 subjects aged from 35–64 years. Adherence to the PNNS guidelines was assessed with a validated score (the French score of indicators of the PNNS objective (FSIPO)). Multivariate analyses were adjusted for gender, age, marital status, body mass index, energy intake and medically prescribed diets.

Results:

The FSIPO score was higher in southwestern France than in the two other regions (P<0.0001). The FSIPO score was correlated with the educational level in northern and northeastern France (P<0.0001) but not in southwestern France (region–education interaction: P<0.001). This interaction was accounted for by fruit and vegetable (P<0.0001), calcium (P=0.03), saturated fatty acid (P<0.0001), and fibre (P=0.0001) components of the FSIPO score. In contrast, the income tax level and the FSIPO score were positively correlated (P<0.0001) to a similar extent in all three regions (region × income tax interaction: P=0.09).

Conclusions:

The relationship between educational level and adherence to the national nutritional health guidelines differs from one region of France to another, suggesting that nutrition education programmes should perhaps be adapted on a regional basis. In contrast, guideline adherence is correlated with income tax level independently of geographical factors, suggesting that financial constraints on food choices are uniform across France.

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References

  • Babayou P (1996). Les disparités réGionales de la Consommation Alimentaire des Ménages Français. CREDOC: Paris.

    Google Scholar 

  • Braveman PA, Cubbin C, Egerter S, Chideya S, Marchi KS, Metzler M et al. (2005). Socioeconomic status in health research: one size does not fit all. JAMA 294, 2879–2888.

    Article  CAS  PubMed  Google Scholar 

  • CIQUAL AFSSA/ANSES (2008). French Food, Composition Table. http://www.afssa.fr/TableCIQUAL/ (accessed 22 November 2010).

  • Dallongeville J, Dauchet L, de Mouzon O, Requillart V, Soler LG (2011). Increasing fruit and vegetable consumption: a cost-effectiveness analysis of public policies. Eur J Public Health 21, 69–73.

    Article  PubMed  Google Scholar 

  • Darmon N, Briend A, Drewnowski A (2004). Energy-dense diets are associated with lower diet costs: a community study of French adults. Public Health Nutr 7, 21–27.

    Article  PubMed  Google Scholar 

  • Darmon N, Drewnowski A (2008). Does social class predict diet quality? Am J Clin Nutr 87, 1107–1117.

    Article  CAS  PubMed  Google Scholar 

  • Deshmukh-Taskar P, Nicklas TA, Yang SJ, Berenson GS (2007). Does food group consumption vary by differences in socioeconomic, demographic, and lifestyle factors in young adults? The Bogalusa Heart Study. J Am Diet Assoc 107, 223–234.

    Article  PubMed Central  PubMed  Google Scholar 

  • Drewnowski A, Darmon N (2005). Food choices and diet costs: an economic analysis. J Nutr 135, 900–904.

    Article  CAS  PubMed  Google Scholar 

  • Drewnowski A, Darmon N, Briend A (2004). Replacing fats and sweets with vegetables and fruits--a question of cost. Am J Public Health 94, 1555–1559.

    Article  PubMed Central  PubMed  Google Scholar 

  • Estaquio C, Castetbon K, Kesse-Guyot E, Bertrais S, Deschamps V, Dauchet L et al. (2008a). The French National Nutrition and Health Program score is associated with nutritional status and risk of major chronic diseases. J Nutr 138, 946–953.

    Article  CAS  PubMed  Google Scholar 

  • Estaquio C, Druesne-Pecollo N, Latino-Martel P, Dauchet L, Hercberg S, Bertrais S (2008b). Socioeconomic differences in fruit and vegetable consumption among middle-aged French adults: adherence to the 5 a day recommendation. J Am Diet Assoc 108, 2021–2030.

    Article  PubMed  Google Scholar 

  • Estaquio C, Kesse-Guyot E, Deschamps V, Bertrais S, Dauchet L, Galan P et al. (2009). Adherence to the French Programme National Nutrition Sante Guideline Score is associated with better nutrient intake and nutritional status. J Am Diet Assoc 109, 1031–1041.

    Article  PubMed  Google Scholar 

  • Ferrieres J, Bongard V, Dallongeville J, Arveiler D, Cottel D, Haas B et al. (2009). Trends in plasma lipids, lipoproteins and dyslipidaemias in French adults, 1996–2007. Arch Cardiovasc Dis 102, 293–301.

    Article  PubMed  Google Scholar 

  • Hart Jr A, Tinker L, Bowen DJ, Longton G, Beresford SA (2006). Correlates of fat intake behaviors in participants in the eating for a healthy life study. J Am Diet Assoc 106, 1605–1613.

    Article  PubMed  Google Scholar 

  • Hercberg S, Chat-Yung S, Chaulia M (2008). The French National Nutrition and Health Program: 2001–2006–2010. Int J Public Health 53, 68–77.

    Article  PubMed  Google Scholar 

  • Hu FB (2002). Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 3–9.

    Article  CAS  PubMed  Google Scholar 

  • Hulshof KF, Brussaard JH, Kruizinga AG, Telman J, Lowik MR (2003). Socio-economic status, dietary intake and 10 y trends: the Dutch National Food Consumption Survey. Eur J Clin Nutr 57, 128–137.

    Article  CAS  PubMed  Google Scholar 

  • Irala-Estevez JD, Groth M, Johansson L, Oltersdorf U, Prattala R, Martinez-Gonzalez MA (2000). A systematic review of socio-economic differences in food habits in Europe: consumption of fruit and vegetables. Eur J Clin Nutr 54, 706–714.

    Article  CAS  PubMed  Google Scholar 

  • Johansson L, Thelle DS, Solvoll K, Bjorneboe GE, Drevon CA (1999). Healthy dietary habits in relation to social determinants and lifestyle factors. Br J Nutr 81, 211–220.

    Article  CAS  PubMed  Google Scholar 

  • Joint WHO/FAO Experts (2003). Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation (Geneva, 28 January to 1 February 2002). WHO Technical Report Series; 916. WHO Library: Geneva.

  • Kant AK, Graubard BI (2007). Secular trends in the association of socio-economic position with self-reported dietary attributes and biomarkers in the US population: National Health and Nutrition Examination Survey (NHANES) 1971–1975 to NHANES 1999–2002. Public Health Nutr 10, 158–167.

    Article  PubMed  Google Scholar 

  • Keys A, Menotti A, Karvonen MJ, Aravanis C, Blackburn H, Buzina R et al. (1986). The diet and 15-year death rate in the seven countries study. Am J Epidemiol 124, 903–915.

    Article  CAS  PubMed  Google Scholar 

  • Lallukka T, Laaksonen M, Rahkonen O, Roos E, Lahelma E (2007). Multiple socio-economic circumstances and healthy food habits. Eur J Clin Nutr 61, 701–710.

    Article  CAS  PubMed  Google Scholar 

  • Maynard M, Gunnell D, Ness AR, Abraham L, Bates CJ, Blane D (2006). What influences diet in early old age? Prospective and cross-sectional analyses of the Boyd Orr cohort. Eur J Public Health 16, 316–324.

    Article  PubMed  Google Scholar 

  • Monceau C, Blanche-Barbat E, Echampe J (2002). La consommation alimentaire depuis quarante ans. De plus en plus de produits élaborés [Fourty years of food consumption in France: more and more processed foods]. INSEE Première 846, 1–4.

    Google Scholar 

  • Perrin AE, Dallongeville J, Ducimetiere P, Ruidavets JB, Schlienger JL, Arveiler D et al. (2005). Interactions between traditional regional determinants and socio-economic status on dietary patterns in a sample of French men. Br J Nutr 93, 109–114.

    Article  CAS  PubMed  Google Scholar 

  • Pigeyre M, Dauchet L, Simon C, Bongard V, Bingham A, Arveiler D et al. (2011). Effects of occupational and educational changes on obesity trends in France: the results of the MONICA-France survey 1986–2006. Prev Med 52, 305–309.

    Article  PubMed  Google Scholar 

  • Prattala RS, Groth MV, Oltersdorf US, Roos GM, Sekula W, Tuomainen HM (2003). Use of butter and cheese in 10 European countries: a case of contrasting educational differences. Eur J Public Health 13, 124–132.

    Article  PubMed  Google Scholar 

  • Roos E, Talala K, Laaksonen M, Helakorpi S, Rahkonen O, Uutela A et al. (2008). Trends of socioeconomic differences in daily vegetable consumption, 1979–2002. Eur J Clin Nutr 62, 823–833.

    Article  CAS  PubMed  Google Scholar 

  • Roos G, Johansson L, Kasmel A, Klumbiene J, Prattala R (2001). Disparities in vegetable and fruit consumption: European cases from the north to the south. Public Health Nutr 4, 35–43.

    Article  CAS  PubMed  Google Scholar 

  • Ruidavets JB, Bataille V, Dallongeville J, Simon C, Bingham A, Amouyel P et al. (2004). Alcohol intake and diet in France, the prominent role of lifestyle. Eur Heart J 25, 1153–1162.

    Article  PubMed  Google Scholar 

  • Slimani N, Fahey M, Welch AA, Wirfalt E, Stripp C, Bergstrom E et al. (2002). Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project. Public Health Nutr 5, 1311–1328.

    Article  CAS  PubMed  Google Scholar 

  • Trichopoulo A (2007). Traditional foods: a science and society perspective. Trends Food Sci Technol 18, 420–427.

    Article  Google Scholar 

  • Trichopoulou A, Lagiou P (1997). Healthy traditional Mediterranean diet: an expression of culture, history, and lifestyle. Nutr Rev 55, 383–389.

    Article  CAS  PubMed  Google Scholar 

  • Turrell G, Hewitt B, Patterson C, Oldenburg B (2003). Measuring socio-economic position in dietary research: is choice of socio-economic indicator important? Public Health Nutr 6, 191–200.

    PubMed  Google Scholar 

  • Turrell G, Kavanagh AM (2006). Socio-economic pathways to diet: modelling the association between socio-economic position and food purchasing behaviour. Public Health Nutr 9, 375–383.

    Article  PubMed  Google Scholar 

  • Vereecken CA, Inchley J, Subramanian SV, Hublet A, Maes L (2005). The relative influence of individual and contextual socio-economic status on consumption of fruit and soft drinks among adolescents in Europe. Eur J Public Health 15, 224–232.

    Article  PubMed  Google Scholar 

  • Vlismas K, Stavrinos V, Panagiotakos DB (2009). Socio-economic status, dietary habits and health-related outcomes in various parts of the world: a review. Cent Eur J Public Health 17, 55–63.

    Article  PubMed  Google Scholar 

  • Wagner A, Sadoun A, Dallongeville J, Ferrieres J, Amouyel P, Ruidavets JB et al. (2011). High blood pressure prevalence and control in a middle-aged French population and their associated factors: the MONA LISA study. J Hypertens 29, 43–50.

    Article  CAS  PubMed  Google Scholar 

  • World Cancer Research Fund/American Institute for Cancer Research (2007). Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. http://www.dietandcancerreport.org/ (accessed on 8 March 2011).

Download references

Acknowledgements

We thank the nurses, physicians, dieticians, computer scientists and secretaries in Lille, Strasbourg and Toulouse, and the Centre de Médecine Préventive de Lille, the Laboratoire d′Analyses Génomiques and the Service de Biologie Spécialisée de l′Institut Pasteur de Lille, the Centre de Santé de la MGEN de Strasbourg, the Unité de Coordination de la Biologie des Essais Cliniques des Hôpitaux Universitaires de Strasbourg, the Departments of Cardiology of the Toulouse University Hospital and the city halls, which participated in the three regions. The third MONA LISA survey was made possible by an unrestricted grant from Pfizer and a grant from the French National Research Agency (ANR-05-PNRA-018).

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Correspondence to J Dallongeville.

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Wyndels, K., Dallongeville, J., Simon, C. et al. Regional factors interact with educational and income tax levels to influence food intake in France. Eur J Clin Nutr 65, 1067–1075 (2011). https://doi.org/10.1038/ejcn.2011.73

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  • DOI: https://doi.org/10.1038/ejcn.2011.73

Keywords

  • food score
  • dietary patterns
  • Mediterranean diet
  • geographical determinants
  • educational level
  • fruit

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