Evolution of Online Health-Related Information Seeking in France From 2010 to 2017: Results From Nationally Representative Surveys

BACKGROUND: Given the rapid ongoing progression of the internet and increase in health information available from disparate online sources, it is important to understand how these changes impact online health information-seeking behavior of the population and the way of managing one's health. OBJECTIVE: This paper aims at describing the evolution of internet use as a source of health information between 2010 and 2017, as well as the characteristics of online health information seekers, topics of interest, sources of information, and trust in retrieved information and potential impact on behavior. METHODS: Data from the French nationally representative surveys Health Barometers were used (N=4141 in 2010, 4811 in 2014, and 6255 in 2017). Evolutions over time were assessed using chi-square tests. Associations with sociodemographic characteristics and health status were evaluated using logistic regression models. RESULTS: The use of the internet as a source of health information rose between 2010 and 2014 (from 37.3% to 67.9%, P<.001) but decreased significantly in 2017 (60.3%, P<.001). Overall, the profile of health information seekers compared with nonseekers did not change over time. They were more likely to be women, to be younger, to have a higher educational level, to have a higher household income, and to be executives. Between 2014 and 2017, the proportion of those who did not pay attention to the source of information significantly increased to reach 39.7% (P<.001). In 2017 as in 2014, general health-related websites remained the first source of information (38.6%) while institutional websites were the third source (8.1%). Most information seekers trusted the information found online in 2010 (more than 80%), with a slight decrease between 2014 and 2017 (P=.048). Among individual characteristics, trust in the information was the main determinant of the way of managing one's health (odds ratio 4.06, 95% CI 3.26-5.06). CONCLUSIONS: After a rapid growth in the internet use for seeking health information in the 2010 to 2014 period, a decrease was recorded in 2017, in parallel with a decrease in trust in the quality and reliability of information found online. These findings underline the need for public health authorities to increase citizens' eHealth literacy and to provide alternative trustworthy sources combining the popularity and accessibility of general health information websites

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

Approche épidémiologique des choix alimentaires lors de l'approvisionnement et de la préparation des repas : déterminants et associations avec l'alimentation et le tatut pondéral

Nowadays, obesity is a global societal problem. In developed countries, food abundance has contributed to the development of an "obesogenic" environment by encouraging overconsumption. Thus, promoting healthy food choices is a major public health issue. The objective of this thesis was to provide an epidemiological approach to food choices during grocery shopping and home meal preparation of food. This work was performed on the NutriNet-Santé population, which is a large web-based prospective observational cohort of French adults.During grocery shopping, front-of-pack nutrition labels were evaluated as potential tools to guide consumers in their choices. Four logos were compared: the Guideline Daily Amounts, the Multiple Traffic Light, the simple Pick the Tick label and 5-color nutrition label. Among these labels, the 5-color nutrition label was perceived as the easiest to identify, and that requiring the least effort to understand. It was the most effective in increasing the capacity of individuals to rank three products based on their nutritional quality. Finally, in a situation of simulated online grocery shopping, this label was the one that allowed the most important increase in the nutritional quality of the shopping cart as compared to a situation without label.During home meal preparation, a first objective was to uncover all the determinants involved in food choices, since this topic remains little studied in the literature. Five motives of dish choice were identified: healthy diet, constraints, pleasure, specific diets and organization. Giving importance to a healthy diet was associated with a better nutritional quality of food, and to lower odds of being overweight. The importance attached to specific diet motive was also associated with better diet quality food but lower odds of being overweight. Despite significant associations for other motives, the observed effects were relatively small. These results underscore the importance of promoting healthy food choices when preparing meals.Planning meal, in other words deciding ahead the foods that will be eaten in the next few days, was also evaluated. Overall, individuals who planned their meals were more likely to comply with nutritional guidelines and had a more varied diet, although the results in terms of energy intake and food groups showed limited differences. They were also less likely to be obese (and overweight in women).All these results suggest the interest of providing tools (nutrition labels, tools providing assistance for decision-making when preparing meals, as well as for meal planning) to guide individuals in their food choices and thereby improving the quality of their diet.L’obésité est aujourd’hui un problème sociétal mondial. Dans les pays développés, l’abondance alimentaire a contribué au développement d’un environnement « obésogène » en favorisant la surconsommation. Ainsi, la promotion de choix alimentaires favorables à la santé représente un enjeu de santé publique majeur. L’objectif de cette thèse était de fournir une approche épidémiologique des choix alimentaires lors de l’approvisionnement et de la préparation des repas. Ce travail a été réalisé sur la population NutriNet-Santé, large cohorte prospective d’observation d’adultes français basée sur Internet.Au moment de l’approvisionnement, les logos d’information nutritionnelle ont été évalués comme des outils potentiels pour guider les consommateurs lors de leurs choix. Quatre logos ont été comparés : les Repères Nutritionnels Journaliers, les Traffic Light Multiples, le logo simple Pick the Tick et le logo 5-Couleurs. Des quatre logos testés, le logo 5-Couleurs était perçu comme le plus facile à identifier et celui demandant le moins d’effort à comprendre. Il était le plus efficace pour augmenter la capacité des individus à classer trois produits en fonction de leur qualité nutritionnelle. Enfin, en situation d’achats simulée en ligne, ce logo était celui qui permettait d’accroitre de façon la plus importante la qualité nutritionnelle du panier d’achat par rapport à une situation sans logo.Lors de la préparation des repas, un premier objectif était de comprendre l’ensemble des déterminants mis en jeu, cette thématique restant peu étudiée dans la littérature. Cinq grandes motivations ont été identifiées : alimentation saine, contraintes, plaisir, régimes spécifiques et organisation. Le fait d’attacher de l’importance à avoir une alimentation saine était associé à une alimentation de meilleure qualité nutritionnelle, ainsi qu’à une moindre susceptibilité d’être en surpoids. Attacher de l’importance à un régime spécifique était également associé à une meilleure qualité d’alimentation mais à un surpoids plus important. Malgré des associations significatives pour les autres motivations, les effets observés étaient de faible ampleur. Ces résultats soulignent l’importance de promouvoir des choix alimentaires favorables au moment de la préparation du repas.Le fait de planifier ses repas, c’est-à-dire prévoir à l’avance ce qui va être consommé sur plusieurs jours, a également été évalué. Globalement, les individus qui planifiaient leurs repas avaient une alimentation plus en adéquation avec les recommandations nutritionnelles et plus variée, bien que les résultats en termes d’apports en énergie et groupes d’aliments indiquaient de faibles différences. Ils étaient également moins susceptibles d’être obèses (et en surpoids chez les femmes).L’ensemble de ces résultats suggèrent l’intérêt de fournir des outils (logo, outils d’aide à la décision au moment de la préparation des repas et d’aide à la planification) afin de guider les individus lors de leurs choix alimentaires et ainsi améliorer la qualité de leur alimentation

Association between Motives for Dish Choices during Home Meal Preparation and Weight Status in the NutriNet-Santé Study

Although home cooking has been associated with a lower body mass index in a few studies, no data exists on the motives behind food dish choices during home meal preparation and on their association with overweight. This study aimed to evaluate this association in 50,003 participants from the NutriNet-Santé cohort. Dimensions underlying the importance of 27 criteria possibly influencing dish choices were determined using an exploratory factor analysis. The association between dish choice motives and overweight (including obesity) was estimated using logistic regression models adjusted for sociodemographic and lifestyle characteristics. Five dimensions of dishes choice motives emerged: healthy diet (e.g., “nutritional balance of the dish”), constraints (e.g., “my cooking skills”), pleasure (e.g., “originality of the dish”), specific diets (e.g., “my health status”), and organization (e.g., “what I planned to eat”). A negative association was observed between the healthy diet factor and being overweight (OR = 0.65 (95% CI (confidence interval): 0.62–0.67)), whereas a positive association appeared for factors regarding pleasure (OR = 1.14 (95% CI: 1.10–1.19)) and specific diets (OR = 1.19 (95% CI: 1.17–1.22)). No significant associations were observed for constraints and organization. The significant associations between dish choice motives and overweight suggested the interest of focusing on these motives in order to promote healthier food choices during home cooking

Epidemiological approach of food choices during grocery shopping and home meal preparation : determinants and associations with diet quality and weight status

L’obésité est aujourd’hui un problème sociétal mondial. Dans les pays développés, l’abondance alimentaire a contribué au développement d’un environnement « obésogène » en favorisant la surconsommation. Ainsi, la promotion de choix alimentaires favorables à la santé représente un enjeu de santé publique majeur. L’objectif de cette thèse était de fournir une approche épidémiologique des choix alimentaires lors de l’approvisionnement et de la préparation des repas. Ce travail a été réalisé sur la population NutriNet-Santé, large cohorte prospective d’observation d’adultes français basée sur Internet.Au moment de l’approvisionnement, les logos d’information nutritionnelle ont été évalués comme des outils potentiels pour guider les consommateurs lors de leurs choix. Quatre logos ont été comparés : les Repères Nutritionnels Journaliers, les Traffic Light Multiples, le logo simple Pick the Tick et le logo 5-Couleurs. Des quatre logos testés, le logo 5-Couleurs était perçu comme le plus facile à identifier et celui demandant le moins d’effort à comprendre. Il était le plus efficace pour augmenter la capacité des individus à classer trois produits en fonction de leur qualité nutritionnelle. Enfin, en situation d’achats simulée en ligne, ce logo était celui qui permettait d’accroitre de façon la plus importante la qualité nutritionnelle du panier d’achat par rapport à une situation sans logo.Lors de la préparation des repas, un premier objectif était de comprendre l’ensemble des déterminants mis en jeu, cette thématique restant peu étudiée dans la littérature. Cinq grandes motivations ont été identifiées : alimentation saine, contraintes, plaisir, régimes spécifiques et organisation. Le fait d’attacher de l’importance à avoir une alimentation saine était associé à une alimentation de meilleure qualité nutritionnelle, ainsi qu’à une moindre susceptibilité d’être en surpoids. Attacher de l’importance à un régime spécifique était également associé à une meilleure qualité d’alimentation mais à un surpoids plus important. Malgré des associations significatives pour les autres motivations, les effets observés étaient de faible ampleur. Ces résultats soulignent l’importance de promouvoir des choix alimentaires favorables au moment de la préparation du repas.Le fait de planifier ses repas, c’est-à-dire prévoir à l’avance ce qui va être consommé sur plusieurs jours, a également été évalué. Globalement, les individus qui planifiaient leurs repas avaient une alimentation plus en adéquation avec les recommandations nutritionnelles et plus variée, bien que les résultats en termes d’apports en énergie et groupes d’aliments indiquaient de faibles différences. Ils étaient également moins susceptibles d’être obèses (et en surpoids chez les femmes).L’ensemble de ces résultats suggèrent l’intérêt de fournir des outils (logo, outils d’aide à la décision au moment de la préparation des repas et d’aide à la planification) afin de guider les individus lors de leurs choix alimentaires et ainsi améliorer la qualité de leur alimentation.Nowadays, obesity is a global societal problem. In developed countries, food abundance has contributed to the development of an "obesogenic" environment by encouraging overconsumption. Thus, promoting healthy food choices is a major public health issue. The objective of this thesis was to provide an epidemiological approach to food choices during grocery shopping and home meal preparation of food. This work was performed on the NutriNet-Santé population, which is a large web-based prospective observational cohort of French adults.During grocery shopping, front-of-pack nutrition labels were evaluated as potential tools to guide consumers in their choices. Four logos were compared: the Guideline Daily Amounts, the Multiple Traffic Light, the simple Pick the Tick label and 5-color nutrition label. Among these labels, the 5-color nutrition label was perceived as the easiest to identify, and that requiring the least effort to understand. It was the most effective in increasing the capacity of individuals to rank three products based on their nutritional quality. Finally, in a situation of simulated online grocery shopping, this label was the one that allowed the most important increase in the nutritional quality of the shopping cart as compared to a situation without label.During home meal preparation, a first objective was to uncover all the determinants involved in food choices, since this topic remains little studied in the literature. Five motives of dish choice were identified: healthy diet, constraints, pleasure, specific diets and organization. Giving importance to a healthy diet was associated with a better nutritional quality of food, and to lower odds of being overweight. The importance attached to specific diet motive was also associated with better diet quality food but lower odds of being overweight. Despite significant associations for other motives, the observed effects were relatively small. These results underscore the importance of promoting healthy food choices when preparing meals.Planning meal, in other words deciding ahead the foods that will be eaten in the next few days, was also evaluated. Overall, individuals who planned their meals were more likely to comply with nutritional guidelines and had a more varied diet, although the results in terms of energy intake and food groups showed limited differences. They were also less likely to be obese (and overweight in women).All these results suggest the interest of providing tools (nutrition labels, tools providing assistance for decision-making when preparing meals, as well as for meal planning) to guide individuals in their food choices and thereby improving the quality of their diet

Nutri-Score: Awareness, Perception and Self-Reported Impact on Food Choices among French Adolescents

To date, no studies have evaluated the appropriation of the front-of-pack Nutri-Score labeling among adolescents, although they are both consumers and buyers of food products. Therefore, the objectives of the present study were (1) to assess Nutri-Score awareness, perception and self-reported impact on food choices in French adolescents and (2) to identify the determinants associated with higher Nutri-Score awareness and self-reported impact on food choices. A web-based survey was conducted in November 2021 among 1201 adolescents. Multivariate logistic models were used to evaluate the relationships between individual factors and Nutri-Score awareness and self-reported impact on food choices. Almost all the adolescents reported to know the Nutri-Score (97.0%) and more than 9 out of 10 considered this logo easy to understand and easy to identify on food packages. Finally, 54% self-reported that the label had already impacted their food choices. Girls (2.28 (1.09&ndash;4.77), p = 0.028) and the 15&ndash;17-year-olds (3.12 (1.32&ndash;7.35), p = 0.0094) were more likely to be aware of the label compared with their respective counterparts (i.e., boys and the 11&ndash;14-year-olds). Regarding the impact of food choices, the use of the Nutri-Score by the parents was the most determinant criterion (7.74 (5.74&ndash;10.42), p &lt; 0.0001). Thus, promotion campaigns should target both adolescents and parents

Appropriation of the Front-of-Pack Nutrition Label Nutri-Score across the French Population: Evolution of Awareness, Support, and Purchasing Behaviors between 2018 and 2019

International audienceSince the implementation of the Nutri-Score on a voluntary basis in 2017 in France, very few studies have evaluated how the label was recognized and used by consumers. The goal of this study was to assess the evolution of awareness, support, and perceived impact on purchasing behaviors of the Nutri-Score in France. Between April 2018 and May 2019, a total of 4006 participants were recruited across three successive waves and answered questions regarding awareness of the Nutri-Score, support of the measure, and change of behavior following the implementation of the Nutri-Score via an online survey. Descriptive analyses to assess the evolution over time were performed, as well as logistic regression models to evaluate associations between the different outcomes and individual characteristics. From April 2018 to May 2019, the awareness of the Nutri-Score increased considerably, reaching 81.5% in May 2019. Since April 2018, a steady proportion of participants—9 out of 10—showed strong support toward the measure and a similar proportion, 87.2%, declared being in favor of making the Nutri-Score mandatory. The impact on purchasing behaviors appeared promising given the limited implementation of the label, with 42.9% of the participants reporting they modified their purchasing behaviors thanks to the measure. Multivariate analyses showed that the impact on purchasing behaviors of the Nutri-Score was greater over time, on younger populations and on frequent labeling readers. Our results suggested that the labeling system was well received and used by all socioeconomic groups, including subgroups who are more likely to have a lower-quality diet

The perceptions and needs of french parents and pediatricians concerning information on complementary feeding

International audienceAppropriate complementary feeding (CoF) is the key to preventing childhood obesity and promoting long-term health. Parents must be properly informed through the CoF process. Pediatricians have opportunities to interact with parents during the CoF transition and influence parental feeding decisions. They can convey public health nutrition messages to parents. With the release of new CoF recommendations in France in 2019, and from the perspective of their conversion into official public health communication material, the aim of this study was to explore parents’ and pediatricians’ perceptions and needs regarding information on CoF. Two online surveys were disseminated to gather information on CoF communication and guidance: one for parents (n = 1001, January 2020); one for pediatricians (n = 301, October 2019). The results showed that the importance of CoF for children’s healthy growth was well recognized by both parents and pediatricians. Parents acknowledged pediatricians as the most influential source of advice; and pediatricians were aware of their responsibility in counselling parents on CoF. However, pediatricians neglected the fact that parents gave high trust to their personal network when looking for advice. The Internet was a well-recognized source of information according to all. Diverging from what pediatricians considered useful, parents were interested in practical advice for implementing CoF. This study highlights common expectations and points of divergence between parents’ needs and pediatricians’ perceptions of those needs with regard to CoF information