55 research outputs found
Study protocol for a pragmatic cluster randomized controlled trial to improve dietary diversity and physical fitness among older people who live at home (the âALAPAGE studyâ)
Background : Diet and physical activity are key components of healthy aging. Current interventions that promote healthy eating and physical activity among the elderly have limitations and evidence of French interventionsâ effectiveness is lacking. We aim to assess (i) the effectiveness of a combined diet/physical activity intervention (the âALAPAGEâ program) on older peoplesâ eating behaviors, physical activity and fitness levels, quality of life, and feelings of loneliness; (ii) the interventionâs process and (iii) its cost effectiveness. Methods : We performed a pragmatic cluster randomized controlled trial with two parallel arms (2:1 ratio) among people â„60âyears old who live at home in southeastern France. A cluster consists of 10 people participating in a âworkshopâ (i.e., a collective intervention conducted at a local organization). We aim to include 45 workshops randomized into two groups: the intervention group (including 30 workshops) in the ALAPAGE program; and the waiting-list control group (including 15 workshops). Participants (expected total sample size: 450) will be recruited through both local organizationsâ usual practices and an innovative active recruitment strategy that targets hard-to-reach people. We developed the ALAPAGE program based on existing workshops, combining a participatory and a theory-based approach. It includes a 7-week period with weekly collective sessions supported by a dietician and/or an adapted physical activity professional, followed by a 12-week period of post-session activities without professional supervision. Primary outcomes are dietary diversity (calculated using two 24-hour diet recalls and one Food Frequency Questionnaire) and lower-limb muscle strength (assessed by the 30-second chair stand test from the Senior Fitness Test battery). Secondary outcomes include consumption frequencies of main food groups and water/hot drinks, other physical fitness measures, overall level of physical activity, quality of life, and feelings of loneliness. Outcomes are assessed before the intervention, at 6âweeks and 3âmonths later. The process evaluation assesses the fidelity, dose, and reach of the intervention as its causal mechanisms (quantitative and qualitative data). Discussion : This study aims to improve healthy aging while limiting social inequalities. We developed and evaluated the ALAPAGE program in partnership with major healthy aging organizations, providing a unique opportunity to expand its reach
Development of a tailored nutrition counselling approach for individuals, taking into account several dimensions of diet sustainability
Promouvoir des choix alimentaires en accord avec les quatre dimensions de lâalimentation durable, Ă savoir la nutrition (en lien avec la santĂ©), lâĂ©conomie, le socio-culturel et lâenvironnement, est une prioritĂ© nationale et mondiale.Lâobjectif de cette thĂšse Ă©tait de proposer une approche de prĂ©vention nutritionnelle sur-mesure, Ă destination des individus, prenant en compte diffĂ©rentes dimensions de lâalimentation durable. Pour cela, nous avons i) compilĂ© des donnĂ©es hĂ©tĂ©rogĂšnes issues de sources variĂ©es ; ii) proposĂ© une mĂ©thode dâanalyse multicritĂšre ; iii) rĂ©alisĂ© un outil permettant de gĂ©nĂ©rer des conseils en accord avec les prĂ©fĂ©rences de chacun.Nous avons rĂ©alisĂ© une revue de la littĂ©rature, qui souligne lâintĂ©rĂȘt dâutiliser lâoptimisation des consommations alimentaires pour identifier des rĂ©gimes durables. Une mĂ©thodologie reproductible de compilation de donnĂ©es a Ă©tĂ© dĂ©veloppĂ©e et appliquĂ©e Ă la construction dâune base de donnĂ©es unique, nommĂ©e « SUStable », intĂ©grant les mĂ©triques associĂ©es Ă chaque dimension de la durabilitĂ© pour plus de 200 aliments couramment consommĂ©s en France.Sur la base de thĂ©ories du changement de comportement, nous avons dĂ©veloppĂ© « Mon Alimentation Sur-Mesure », un prototype dâapplication web de conseils alimentaires sur-mesure. Un questionnaire de frĂ©quence alimentaire de 94 items, intĂ©grĂ© dans lâapplication, a Ă©tĂ© validĂ© thĂ©oriquement afin dâestimer lâerreur de mesure induite par la structure du questionnaire (utilisation dâune liste finie dâitems et de tailles de portions). Avec « Mon Alimentation Sur-Mesure », lâutilisateur peut connaitre la qualitĂ© de ses consommations alimentaires, le coĂ»t de son alimentation et son niveau dâactivitĂ© physique. Lâutilisateur est acteur de son changement : il prĂ©cise ses prĂ©fĂ©rences alimentaires ; il choisit, parmi trois modĂšles dâoptimisation des consommations alimentaires, celui qui correspond le mieux Ă ses attentes ; il choisit les conseils qui lui semblent rĂ©alistes.Le prototype dâapplication dĂ©veloppĂ© est innovant dans la mesure oĂč il considĂšre lâalimentation dans sa globalitĂ© et rend lâutilisateur actif pour gĂ©nĂ©rer les conseils qui lui conviennent le mieux. Cette application pourrait ĂȘtre un futur outil de prĂ©vention en santĂ© qui contribuerait Ă la reprise en main des individus sur leur alimentation.Promoting food choices in line with the four dimensions of diet sustainability, namely nutrition related to health, economy, socio-cultural and environment, is a national and global priority.The aim of this thesis was to develop a tailored nutrition counselling approach for individuals, taking into account several dimensions of diet sustainability. To achieve this, we have: i) compiled heterogeneous data from various sources; ii) proposed a method for multi-criteria assessment; iii) developed a tool to provide dietary advices which are in accordance with individualâs preferences.We have written a narrative review that demonstrates the added value of diet optimization to identify sustainable diets. A reproducible methodology was developed and applied to the creation of a unique food database, named SUStable, integrating metrics associated with each dimension of diet sustainability for more than 200 foods representative of the French food consumption.We developed a theory-based web application, named âMon Alimentation Sur-Mesureâ, which provides tailored dietary advices. A food frequency questionnaire of 94 items was validated theoretically in order to estimate the error due to the inherent structure of the questionnaire (use of a finite list of items and portion sizes). With âMon Alimentation Sur-Mesureâ, the user can obtain a picture of the nutritional quality of her/his diet, her/his diet cost and her/his level of physical activity. The user is actor in her/his own dietary changes: she/he specifies her/his food preferences; she/he selects, among three diet optimization models, the one that best suits her/his expectations; she/he chooses dietary advices that she/he considers achievable.The application prototype is innovative: it uses a whole-diet approach and allows the user to act to choose her/his advices. This prototype could be a future online health promotion tool which could help individuals to take in hand their diet
Drinking Water Intake Is Associated with Higher Diet Quality among French Adults
This study aimed to examine the association between drinking water intake and diet quality, and to analyse the adherence of French men and women to the European Food Safety Authority 2010 Adequate Intake (EFSA AI). A representative sample of French adults (â„18) from the Individual and National Survey on Food Consumption (INCA2) was classified, by sex, into small, medium, and large drinking water consumers. Diet quality was assessed with several nutritional indices (mean adequacy ratio (MAR), mean excess ratio (MER), probability of adequate intakes (PANDiet), and solid energy density (SED)). Of the total sample, 72% of men and 46% of women were below the EFSA AI. This percentage of non-adherence decreased from the small to the large drinking water consumers (from 95% to 34% in men and from 81% to 9% in women). For both sexes, drinking water intake was associated with higher diet quality (greater MAR and PANDiet). This association remained significant independently of socio-economic status for women only. Low drinking water consumers did not compensate with other sources (beverages and food moisture) and a high drinking water intake was not a guarantee for reaching the EFSA AI, meaning that increasing consumption of water should be encouraged in France
Structural Validation of a French Food Frequency Questionnaire of 94 Items
BackgroundFood frequency questionnaires (FFQs) are used to estimate the usual food and nutrient intakes over a period of time. Such estimates can suffer from measurement errors, either due to bias induced by respondentâs answers or to errors induced by the structure of the questionnaire (e.g., using a limited number of food items and an aggregated food database with average portion sizes). The âstructural validationâ presented in this study aims to isolate and quantify the impact of the inherent structure of a FFQ on the estimation of food and nutrient intakes, independently of respondentâs perception of the questionnaire.MethodsA semi-quantitative FFQ (nâ=â94 items, including 50 items with questions on portion sizes) and an associated aggregated food composition database (named the item-composition database) were developed, based on the self-reported weekly dietary records of 1918 adults (18â79 years-old) in the French Individual and National Dietary Survey 2 (INCA2), and the French CIQUAL 2013 food-composition database of all the foods (nâ=â1342 foods) declared as consumed in the population. Reference intakes of foods (âREF_FOODâ) and nutrients (âREF_NUTâ) were calculated for each adult using the food-composition database and the amounts of foods self-reported in his/her dietary record. Then, answers to the FFQ were simulated for each adult based on his/her self-reported dietary record. âFFQ_FOODâ and âFFQ_NUTâ intakes were estimated using the simulated answers and the item-composition database. Measurement errors (in %), spearman correlations and cross-classification were used to compare âREF_FOODâ with âFFQ_FOODâ and âREF_NUTâ with âFFQ_NUTâ.ResultsCompared to âREF_NUT,â âFFQ_NUTâ total quantity and total energy intake were underestimated on average by 198âg/day and 666 kJ/day, respectively. âFFQ_FOODâ intakes were well estimated for starches, underestimated for most of the subgroups, and overestimated for some subgroups, in particular vegetables. Underestimation were mainly due to the use of portion sizes, leading to an underestimation of most of nutrients, except free sugars which were overestimated.ConclusionThe âstructural validationâ by simulating answers to a FFQ based on a reference dietary survey is innovative and pragmatic and allows quantifying the error induced by the simplification of the method of collection
Application web de conseils alimentaires sur-mesure par optimisation des consommations alimentaires
International audienceContexte : Les approches de conseils sur-mesure sont, par dĂ©finition, des approches dans lesquelles les messages sont adaptĂ©s, gĂ©nĂ©ralement via lâutilisation dâoutils informatiques, au profil et aux besoins de chaque individu. Les interventions basĂ©es sur des conseils alimentaires construits selon une approche sur-mesure sont reconnues comme efficaces pour changer le comportement alimentaire des individus, mais ces changements sont gĂ©nĂ©ralement de faible ampleur. La majoritĂ© de ces interventions ciblent quelques groupes dâaliments ou nutriments, sans Ă©valuer lâalimentation dans sa globalitĂ©. Lâoptimisation des consommations alimentaires, est une mĂ©thode mathĂ©matique puissante qui permet de traduire un ensemble de recommandations nutritionnelles en choix alimentaires plus sains. Cette mĂ©thode est de plus en plus utilisĂ©e en recherche en nutrition, dans les champs de la santĂ© publique et de lâalimentation durable. Objectif : Ce travail vise Ă utiliser le potentiel des nouvelles technologies (câest-Ă -dire, lâinteractivitĂ©, la puissance de calcul, la facilitĂ© de personnalisation), pour combiner approche sur- mesure et optimisation des consommations alimentaires dans une application web de conseils alimentaires sur-mesure. MĂ©thode et rĂ©sultats : Lâapplication web « Mon Alimentation Sur-Mesure » a Ă©tĂ© dĂ©veloppĂ©e sur la base de thĂ©ories du changement de comportement. Dans une premiĂšre fonctionnalitĂ©, Ă partir des consommations alimentaires recueillies via un questionnaire de frĂ©quence alimentaire en ligne et dâautres informations, « Mon Alimentation Sur-Mesure » informe lâutilisateur sur la qualitĂ© de ses consommations alimentaires, le coĂ»t de son alimentation et son niveau dâactivitĂ© physique. Dans une seconde fonctionnalitĂ©, « Mon Alimentation Sur-Mesure » propose Ă lâutilisateur une liste de conseils alimentaires adaptĂ©s Ă ses besoins et prĂ©fĂ©rences pour avoir une alimentation plus saine. Au sein de lâapplication, lâutilisateur est acteur de son changement : il peut prĂ©ciser ses prĂ©fĂ©rences alimentaires ; il peut choisir, parmi trois modĂšles dâoptimisation des consommations alimentaires, celui qui correspond le mieux Ă ses attentes ; il peut choisir, parmi une liste de conseils alimentaires spĂ©cifiquement proposĂ©s par rapport Ă son profil, quelques conseils, comme Ă©tant ceux qui lui sembleraient les plus rĂ©alistes. Conclusion : Cette application pourrait ĂȘtre un futur outil pĂ©dagogique de prĂ©vention primaire et qui contribuerait Ă permettre aux individus de reprendre leur alimentation en main
Structural validation of a French Food Frequency Questionnaire of 94 items
International audienceBackground: Food frequency questionnaires (FFQs) are used to estimate the usual food and nutrient intakes over a period of time. Such estimates can suffer from measurement errors, either due to bias induced by respondentâs answers or to errors induced by the structure of the questionnaire (e.g., using a limited number of food items and an aggregated food database with average portion sizes). The âstructural validationâ presented in this study aims to isolate and quantify the impact of the inherent structure of a FFQ on the estimation of food and nutrient intakes, independently of respondentâs perception of the questionnaire. Methods: A semi-quantitative FFQ (n = 94 items, including 50 items with questions on portion sizes) and an associated aggregated food composition database (named the item-composition database) were developed, based on the self-reported weekly dietary records of 1918 adults (18â79 years-old) in the French Individual and National Dietary Survey 2 (INCA2), and the French CIQUAL 2013 food-composition database of all the foods (n = 1342 foods) declared as consumed in the population. Reference intakes of foods (âREF_FOODâ) and nutrients (âREF_NUTâ) were calculated for each adult using the food-composition database and the amounts of foods self-reported in his/her dietary record. Then, answers to the FFQ were simulated for each adult based on his/her self-reported dietary record. âFFQ_FOODâ and âFFQ_NUTâ intakes were estimated using the simulated answers and the item-composition database. Measurement errors (in %), spearman correlations and cross-classification were used to compare âREF_FOODâ with âFFQ_FOODâ and âREF_NUTâ with âFFQ_NUTâ. Results: Compared to âREF_NUT,â âFFQ_NUTâ total quantity and total energy intake were underestimated on average by 198 g/day and 666 kJ/day, respectively. âFFQ_FOODâ intakes were well estimated for starches, underestimated for most of the subgroups, and overestimated for some subgroups, in particular vegetables. Underestimation were mainly due to the use of portion sizes, leading to an underestimation of most of nutrients, except free sugars which were overestimated. Conclusion: The âstructural validationâ by simulating answers to a FFQ based on a reference dietary survey is innovative and pragmatic and allows quantifying the error induced by the simplification of the method of collection
MS-Diet, a tailored nutrition counselling web-application based on mathematical diet optimization
Background:By definition, messages in tailored approaches are built to reach a given person, based on her/his specific characteristics and needs. Tailored dietary behavior change interventions have a small but significant effect on dietary behavior change. The majority of these interventions target a few food groups or nutrients, without evaluating the overall diet. Diet optimization is a powerful mathematical method to translate nutrient recommendations into individual-specific food choices. This method is increasingly used in nutrition research, in the fields of public health and diet sustainability. Objective: The aim was to combine tailored approaches and diet optimization in a web application of tailored nutrition counselling.Method and results:The web application, called MS-Diet, was developed based on behavior changes techniques, such as: self-monitoring, self-regulatory, tailored feedback and engaging communication techniques. In a first feature, based on userâs data collected online (including answers to a food frequency questionnaire), the user can obtain a picture of the nutritional quality of her/his diet, the diet cost and the level of physical activity. In a second feature, MS-Diet suggests to the user a list of tailored dietary advices to get a healthier diet (i.e., a nutritionally adequate diet), adapted to her/his specific needs and food preferences. With the application, the user is actor in her/his own dietary changes: she/he specifies her/his food preferences and; chooses dietary suggestions that she/he considers achievable.Conclusions:This prototype could be a future online health promotion tool which could help individuals to improve their diet or serve as a decision-support tool for health professionals. The evaluation of the tool (e.g. whether the use of the tool results in changes of dietary habits) is warranted before use on health promotion
Un rĂ©fĂ©rentiel actualisĂ© de lâaide alimentaire pour concevoir des dons Ă©quilibrĂ©s
En intĂ©grant lâensemble des derniĂšres recommandations dâapports en nutriments de lâAgence nationale de sĂ©curitĂ© sanitaire de lâalimentation, de lâenvironnement et du travail (ANSES), ainsi que les recommandations de consommation alimentaire du PNNS 4, ce travail met Ă jour le « rĂ©fĂ©rentiel de lâaide alimentaire », câest-Ă -dire la rĂ©partition idĂ©ale des catĂ©gories dâaliments dans les dons.Cette rĂ©partition a Ă©tĂ© obtenue par programmation linĂ©aire Ă partir des donnĂ©es de consommation alimentaire des adultes de lâĂ©tude INCA 3.Le rĂ©fĂ©rentiel fournit aux associations les moyens dâĂ©valuer lâĂ©quilibre nutritionnel de leurs stocks et de leurs dons et facilite lâidentification de voies dâamĂ©lioration. Un outil permettant de traduire le rĂ©fĂ©rentiel en dons alimentaires a Ă©galement Ă©tĂ© dĂ©veloppĂ© et des exemples de paniers ainsi gĂ©nĂ©rĂ©s sont prĂ©sentĂ©s
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