Developing a systems-based framework of the factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe - a DEDIPAC study

Background: Some ethnic minority populations have a higher risk of non-communicable diseases than the majority European population. Diet and physical activity behaviours contribute to this risk, shaped by a system of inter-related factors. This study mapped a systems-based framework of the factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe, to inform research prioritisation and intervention development. Methods: A concept mapping approach guided by systems thinking was used: i. Preparation (protocol and terminology); ii. Generating a list of factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe from evidence (systematic mapping reviews) and ‘eminence’ (89 participants from 24 academic disciplines via brainstorming, an international symposium and expert review) and; iii. Seeking consensus on structuring, rating and clustering factors, based on how they relate to each other; and iv. Interpreting/utilising the framework for research and interventions. Similar steps were undertaken for frameworks developed for the majority European population. Results: Seven distinct clusters emerged for dietary behaviour (containing 85 factors) and 8 for physical activity behaviours (containing 183 factors). Four clusters were similar across behaviours: Social and cultural environment; Social and material resources; Psychosocial; and Migration context. Similar clusters of factors emerged in the frameworks for diet and physical activity behaviours of the majority European population, except for ‘migration context’. The importance of factors across all clusters was acknowledged, but their relative importance differed for ethnic minority populations compared with the majority population. Conclusions: This systems-based framework integrates evidence from both expert opinion and published literature, to map the factors influencing dietary and physical activity behaviours in ethnic minority groups. Our findings illustrate that innovative research and complex interventions need to be developed that are sensitive to the needs of ethnic minority populations. A systems approach that encompasses the complexity of the inter-related factors that drive behaviours may inform a more holistic public health paradigm to more effectively reach ethnic minorities living in Europe, as well as the majority host population

The Nutrinet-Santé Study: a web-based prospective study on the relationship between nutrition and health and determinants of dietary patterns and nutritional status

<p>Abstract</p> <p>Background</p> <p>Nutrition-related chronic diseases such as cardiovascular diseases and cancer are of multiple origin, and may be due to genetic, biologic, behavioural and environmental factors. In order to detangle the specific role of nutritional factors, very large population sample cohort studies comprising precisely measured dietary intake and all necessary information for accurately assessing potential confounding factors are needed. Widespread use of internet is an opportunity to gradually collect huge amounts of data from a large sample of volunteers that can be automatically verified and processed. The objectives of the NutriNet-Santé study are: 1) to investigate the relationship between nutrition (nutrients, foods, dietary patterns, physical activity), mortality and health outcomes; and 2) to examine the determinants of dietary patterns and nutritional status (sociological, economic, cultural, biological, cognitive, perceptions, preferences, etc.), using a web-based approach.</p> <p>Methods/design</p> <p>Our web-based prospective cohort study is being conducted for a scheduled follow-up of 10 years. Using a dedicated web site, recruitment will be carried out for 5 years so as to register 500 000 volunteers aged ≥ 18 years among whom 60% are expected to be included (having complete baseline data) and followed-up for at least 5 years for 240 000 participants. Questionnaires administered via internet at baseline and each year thereafter will assess socio-demographic and lifestyle characteristics, anthropometry, health status, physical activity and diet. Surveillance of health events will be implemented via questionnaires on hospitalisation and use of medication, and linkage with a national database on vital statistics. Biochemical samples and clinical examination will be collected in a subsample of volunteers.</p> <p>Discussion</p> <p>Self-administered data collection using internet as a complement to collection of biological data will enable identifying nutrition-related risks and protective factors, thereby more clearly elucidating determinants of nutritional status and their interactions. These are necessary steps for further refining nutritional recommendations aimed at improving the health status of populations.</p

Social disparities in food preparation behaviours: a DEDIPAC study

BACKGROUND: The specific role of major socio-economic indicators in influencing food preparation behaviours could reveal distinct socio-economic patterns, thus enabling mechanisms to be understood that contribute to social inequalities in health. This study investigated whether there was an independent association of each socio-economic indicator (education, occupation, income) with food preparation behaviours. METHODS: A total of 62,373 adults participating in the web-based NutriNet-Santé cohort study were included in our cross-sectional analyses. Cooking skills, preparation from scratch and kitchen equipment were assessed using a 0-10-point score; frequency of meal preparation, enjoyment of cooking and willingness to cook better/more frequently were categorical variables. Independent associations between socio-economic factors (education, income and occupation) and food preparation behaviours were assessed using analysis of covariance and logistic regression models stratified by sex. The models simultaneously included the three socio-economic indicators, adjusting for age, household composition and whether or not they were the main cook in the household. RESULTS: Participants with the lowest education, the lowest income group and female manual and office workers spent more time preparing food daily than participants with the highest education, those with the highest income and managerial staff (P < 0.0001). The lowest educated individuals were more likely to be non-cooks than those with the highest education level (Women: OR = 3.36 (1.69;6.69); Men: OR = 1.83 (1.07;3.16)) while female manual and office workers and the never-employed were less likely to be non-cooks (OR = 0.52 (0.28;0.97); OR = 0.30 (0.11;0.77)). Female manual and office workers had lower scores of preparation from scratch and were less likely to want to cook more frequently than managerial staff (P < 0.001 and P < 0.001). Women belonging to the lowest income group had a lower score of kitchen equipment (P < 0.0001) and were less likely to enjoy cooking meal daily (OR = 0.68 (0.45;0.86)) than those with the highest income. CONCLUSION: Lowest socio-economic groups, particularly women, spend more time preparing food than high socioeconomic groups. However, female manual and office workers used less raw or fresh ingredients to prepare meals than managerial staff. In the unfavourable context in France with reduced time spent preparing meals over last decades, our findings showed socioeconomic disparities in food preparation behaviours in women, whereas few differences were observed in men

III.2. Inégalités sociales de nutrition

Aujourd’hui, de fortes inégalités sociales de santé persistent entre les individus les plus favorisés socioéconomiquement et ceux vivant dans des situations moins favorables, en France comme dans l’ensemble des pays industrialisés (Inserm, 2014). Ces inégalités se retrouvent tant en matière de mortalité et d’espérance de vie qu’en matière de morbidité ou de situation d’incapacité. Les maladies chroniques telles que le diabète, l’obésité, l’hypertension, les cancers ou les maladies cardiovascu..

Influence des facteurs socio-économiques, de l'alimentation et des modes de vie sur les maladies non transmissibles liées à l'alimentation chez les immigrés tunisiens vivant en Languedoc-Roussillon

Cette étude s intéresse aux maladies non transmissibles liées à l alimentation chez les immigrés tunisiens en Languedoc-Roussillon, comparés aux Français nés en France et aux Tunisiens non-migrants. Des facteurs de risque ont été testés comme médiateurs de l effet de la migration sur la morbidité. L influence de l acculturation et de l exposition à la culture tunisienne sur les modes de vie a aussi été évaluée. Les immigrés ont un meilleur état de santé que les Franc ais et Tunisiens non migrants. Des facteurs culturels (faible consommation d alcool, consommation de fruits élevée) sont à l origine des différences entre immigrés et Français. Des facteurs environnementaux (mode de vie plus actif, tabagisme moins prévalent) expliquent le meilleur état de santé des migrants, comparés aux Tunisiens. Les modes de vie convergent vers ceux des Français avec l acculturation mais l exposition à la culture tunisienne permet de conserver un régime traditionnel tunisien plus favorable à la santéPARIS-BIUSJ-Thèses (751052125) / SudocPARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

II.3. Activité physique et sédentarité

L’activité physique est un déterminant majeur de l’état nutritionnel. La littérature scientifique sur les effets bénéfiques d’une activité physique régulière contre l’apparition de pathologies chroniques et métaboliques est abondante (Oppert, 2004 ; Depiesse et Coste, 2016). Elle joue un rôle majeur dans la prévention et la prise en charge de nombre de maladies : obésité, diabète, hypertension artérielle, certains cancers… La pratique régulière d’une activité physique est associé à une diminu..

The analysis of a set of questionnaires composed of 151 items on salt-, sweet- and fat-liking using LISREL-type and PLS-PM techniques leads to equivalent results

International audienceMeasure of salt-, sweet- and fat-liking is commonly assessed using sensory testing. However, this might become cumbersome with large number of subjects and products to assess. Thus, a questionnaire has been developed and administered through internet (Nutrinet-Sante Study) to a large sample (n=43 807) from the French population. The present study aimed to estimate the structural models underlying each sensory sensation (sweet, salty, fatty and sweet, fatty and salty) and to compute an overall score for each subject over each sensation using structural equation modeling (SEM). Subjects completed 151 questions based on (1) liking towards foods containing high amounts of sugar, or ‘sugar and fat’, or ‘salt and fat’ (9-point scale); (2) favorite level of seasoning with sugar, salt or fat on various foods (6-point scale); (3) favorite dishes (maximum 4) in a restaurant menu; (4) salt-, sweet- and fat-related behavior. The latent variables underlying each sensory sensation were determined using an exploratory factor analysis (principal component solution, varimax rotation; SAS® procedure FACTOR). Second-order models based on these latent variables were subjected to SEM using LISREL-type techniques (SAS® procedure CALIS) and Partial Least Squares-Path Model (PLS-PM, XLStat). Incidentally, PLS-PM (XLStat) consumed much more time than PROC CALIS (SAS®) for second-order models. Nonetheless, both regression coefficient and individual score vectors were highly correlated between the two types of SEM with Pearson’s coefficients greater than 0.75 and 0.95, respectively. In the present study, both types of SEM gave the same interpretation in terms of individual scoring

Sex and dieting modify the association between emotional eating and weight status

International audienceBackground: Unlike other psychological correlates of weight status, emotional eating (EmE) has received relatively limited attention in the literature. Objectives: We aimed to examine the association between the EmE score and weight status and the influence of sex and dieting on this association. Design: A total of 8580 men and 27,061 women aged >= 18 y who participated in the NutriNet-Sante cohort study were selected in this cross-sectional analysis. Self-reported weight and height, EmE scores of the revised 21-item version of the Three-Factor Eating Questionnaire, and dieting status data were collected. The relation between EmE and weight status was estimated by using multiple linear and logistic regression models adjusted for sociodemographic and lifestyle factors. Interactions of EmE with sex and dieting history were assessed. Results: Median EmE scores were greater in women than in men and in former or current dieters than in subjects without a history of dieting. Strong associations appeared between the EmE score and weight status in most categories of sex X dieting status. The strongest associations between EmE and weight status were observed in women, particularly in never dieters [body mass index slope (95% CI): 2.61 (2.43, 2.78); overweight OR (95% CI): 5.06 (4.24, 6.05)]. Conclusions: These observations support the existence of an association between EmE and weight status. The effect modification of sex and dieting on the EmE score and on the association of the EmE score with weight status should be taken into account in obesity prevention

Le degré de transformation des aliments les plus largement consommés par les personnes âgées françaises est associé à la satiété, l’impact glycémique et au profil nutritionnel

Le degré de transformation des aliments les plus largement consommés par les personnes âgées françaises est associé à la satiété, l’impact glycémique et au profil nutritionnel. Société Francophone du Diabète Congrès Annue

Association between degree of processing, glycaemic impact and satiety potential of 279 ready-to-eat foods commonly consumed by French elderly population

International audienceEpidemiological studies clearly show that a high adherence to ultra-processed products is associated with increased prevalence of diet-related chronic diseases [1]. Ultra-processed foods are made of recombined ingredients and added with various additives. They are also characterized by the loss of food structure and micronutrient density through refining. Yet, food structure plays an essential role in food glycaemic impact and satiety potential. In a preliminary study, we showed on 98 ready-to-eat foods usually consumed by diabetic subjects that the more foods are processed the higher their glycaemic impact and the lower their satiety potential [2]. The objective of this study was to test this association on a broader range of ready-to-eat foods usually consumed by the French elderly population. The most consumed foods (n = 279) were extracted from the NutriNet-Santé study (consumption > 5%). They were classified into 3 groups according to their degree of processing by using the international NOVA classification [minimally-processed (1), processed (2) and ultra-processed (3)]. Their satiety potential was calculated from the Fullness Factor (FF). Their glycaemic impact was evaluated by either glycaemic index (GI, equi-carbohydrate comparison) or glycaemic glucose equivalent (GGE in g/100 g of food, equi-food comparison) [3]. The data for the GI, GGE, FF and degree of processing were correlated using the nonparametric Spearman’s rank correlation coefficient (Rs) for quantitative data. Results showed that the more processed are foods the less satiating they are and the higher their glycaemic impact.The correlation between GI and degree of processing (Rs = 0.35, p = 0.0023) was less strong than with GGE (Rs = 0.44, p = 6.5 x 10-5). The study suggests that complex, natural, minimally and/or processed foods should be encouraged for consumption rather than highly unstructured and ultra-processed foods. Further works are being carried out to quantify degree of processing more accurately via both nutritional composition and food structure parameters. Keywords: Ready-to-eat foods; degree of processing; glycaemic impact; satiety potential References [1] Monteiro, CA, Cannon, G, Moubarac, JC, Martins, AP, Martins, CA, Garzillo, J, et al. Dietary guidelines to nourish humanity and the planet in the twenty-first century. A blueprint from Brazil. Public Health Nutr 2015;18:2311-22. [2] Fardet, A. Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: a preliminary study with 98 ready-to-eat foods. Food & Function 2016; [3] Monro, JA, Shaw, M. Glycemic impact, glycemic glucose equivalents, glycemic index, and glycemic load: definitions, distinctions, and implications. American Journal of Clinical Nutrition 2008;87:237S-243