Alimentation et inégalités sociales de santé en France

Relationship between children's eating behavior (1-6 years) and body mass index: a cross-sectional study in French maternal-infant protection centers within the Parisian region

BACKGROUND

Early detection of obesity-promoting dietary behavior patterns improves the identification of at-risk families and the implementation of interventions. This is accomplished through the use of the Child Eating Behavior Questionnaire (CEBQ). No study has been conducted using the CEBQ in children followed in Essonne's Maternal-Infant Protection (PMI) centers. We investigated, in a cross-sectional design, the differences in children's eating behavior with PMI follow-up according to their weight status.

METHODS

A questionnaire addressed to parents was collected in PMI centers. Multiple hierarchical regression analysis was used to investigate the predictability of the child's CEBQ on body mass index (BMI).

RESULTS

From January to April 2022, 850 children were selected, from which 500 (aged 1-6 years) were included, and of whom 10.6% were obese. There was a significant positive association between 'Food Responsiveness', 'Enjoyment of Food' and BMI. In contrast, there was a significant negative association between 'Satiety Responsiveness', 'Slowness in Eating' and BMI. Besides, 'Food approach' and 'food avoidance' behaviors were positively and negatively related to BMI z-scores, respectively.

CONCLUSION

Due to significant differences in children's eating behavior according to their weight, it is needed to raise awareness among parents about their impact on them.

Recruitment of precarious families in an interventional study: Lessons from the French "Fruits and vegetables at home" (FLAM) trial

Background

The FLAM study was set up in order to assess the effectiveness of FV vouchers allowed to low-income households, on their FV consumption. The aim of the present study was to investigate issues associated with conducting interventional trials in disadvantaged populations using the FLAM study as an example of reaching target populations and recruitment difficulties.

Methods

Families were recruited in Saint-Denis city (North Paris suburb), via social and municipal structures. Main interest variables in the study (food consumptions) were collected using face-to-face food interviews, either at home or municipal facilities. A qualitative analysis was performed among people who refused to participate in order to understand the barriers to participation.

Results

A total of 95 parents-child pairs were included from May 2015 to May 2016. The families were mostly in precarious situation (63.3%), and most of parents were unemployed (71.3%). Almost the two third of children and 79.4% of parents were small consumers of FV (less than 3.5 servings per day). Several reasons for non-participation were reported including time constraints, understanding and mistrust issues.

Conclusions

Though using facilitating strategies, we recruited fewer participants than expected. The population finally included was mainly made of precarious families with a low consumption of FV. These results highlight the importance of identifying effective facilitating strategies to improve recruitment in disadvantaged populations.

Trial registration

ClinicalTrial.gov no. NCT02461238, on June 3, 2015, retrospectively registered.

How much sugar do consumers add to plain yogurts? Insights from a study examining French consumer behavior and self-reported habits

In France, 50% of consumers sweeten plain yogurts prior to consumption. This study measured how much sugar consumers added under contextualized testing conditions. Participants (199 French adults who regularly consume plain yogurt adding sugar) were given a plain yogurt (125 g) at the end of a full meal and were allowed to sweeten it with their usual sweetener (caster sugar, honey, or jam). The quantities added were measured indirectly by weighing the sweetener containers before and after use; they were then converted into equivalent quantities of sucrose, or "added sugar." Participants were asked to describe their relative hunger, thirst, and liking for plain yogurt and to estimate the quantity of sweetener they had added. On average, participants added 13.6 g of sugar to their yogurts, which is higher than the 10.2 g of sugar contained in pre-sweetened commercial yogurts (125 g). More sugar was added when subjects used jam (24.4 g/yogurt, n = 36) as opposed to caster sugar (11.0 g/yogurt, n = 134) or honey (12.1 g/yogurt, n = 29). Age, socio-professional category, and BMI had a significant influence on added-sugar quantity. Based on behavior and attitude, participants could be separated into three evenly sized groups: "low sugar users" (n = 67, median = 6.1 g/yogurt), who tended to control their food intake, "medium sugar users" (n = 66, median = 11.4 g/yogurt), and "heavy sugar users" (n = 66, median = 19.9 g/yogurt) who sought immediate satisfaction. To our knowledge, this study is the first to provide robust data on the amount of sugar consumers add to plain yogurts in contextualized conditions (self preparation during a real meal). Our findings show that consumers underestimated by half the quantity of sweetener they added.