Which Dietary Changes to Achieve Nutritional Adequacy While Reducing Diet Cost in the French West Indies?

Objectives

The French West Indies are facing increasing rates of obesity and diet-related chronic diseases. Food prices are ∼30% higher in these territories compared with mainland France, while a large part of their populations is socioeconomically disadvantaged. Economic affordability of a healthy diet is a key issue in this region. Our objective was to identify dietary changes that would allow Guadeloupean and Martinican adults to achieve nutritional adequacy while reducing the cost of their diets.

Methods

Dietary intakes of 1061 adults were obtained from a cross-sectional survey (2013–2014) conducted on a representative sample of the Guadeloupean and Martinican populations. Diet cost was based on mean prices of 1357 foods compiled from a Martinican supermarket website. For each adult, optimized diets respecting all nutritional recommendations and with minimized departure from initial diet were designed with linear programming under 3 scenarios: 1) all nutritional constraints, 2) all nutritional constraints without exceeding initial diet cost, and 3) all nutritional constraints while reducing diet cost by 30%.

Results

When cost was not constrained, achieving nutritional adequacy while departing the least from individual food intakes induced an increase in cost for most adults (74%). When cost was not allowed to increase, achieving nutritional adequacy induced an increase in the consumption of fruit & vegetables, unrefined starches, dairy products (especially milk), eggs and vegetable fats, and a decrease in sweetened beverages (especially for < 30 y), refined starches, sweetened products, meat and fish. When a 30% reduction of cost was imposed, achieving nutritional adequacy induced the same types of dietary changes than with scenario 2, but modified their magnitude (and thus the effort for consumers), notably a smaller increase in vegetables (+7 vs. +86g/d) but a larger increase in dairy (+90 vs. +72 g/d) and starchy foods (+112 vs. +54 g/d), and a larger reduction in meat (−48 vs. −12 g/d). Increases in fruits (∼+80g/d) and unrefined starches (+127 g/d) and decrease in sweetened beverages (∼−100 g/d) were still observed.

Conclusions

Nutrition prevention programs promoting the affordable dietary changes identified in this study could help improve nutritional adequacy of the Guadeloupean and Martinican populations.

Funding Sources

French National Research Agency.

Correction to: Improving lifestyles sustainability through community gardening: results and lessons learnt from the JArDinS quasi-experimental study

An amendment to this paper has been published and can be accessed via the original article.

Improving lifestyles sustainability through community gardening: results and lessons learnt from the JArDinS quasi-experimental study

BACKGROUND

Despite an increasing number of studies highlighting the health benefits of community gardening, the literature is limited by cross-sectional designs. The "JArDinS" quasi-experimental study aimed to assess the impact of community garden participation on the adoption of more sustainable lifestyles among French adults.

METHODS

Individuals entering a community garden in Montpellier (France) in 2018 (n = 66) were compared with pairwise matched individuals with no experience in community gardening (n = 66). Nutritional quality, environmental impact and cost of monthly household food supplies, level of physical activity measured by accelerometers, as well as mental and social well-being, sensitivity to food waste, and connection with nature were evaluated at baseline (t0) and 12 months later (t1) to explore sustainability of lifestyles in social/health, environmental and economic dimensions. Linear mixed models were used to determine the independent effect of community gardening on investigated lifestyles components. In-depth interviews were conducted at t1 with 15 gardeners to better understand changes that may have occurred in gardeners' lives during the first year of gardening.

RESULTS

At t0, gardeners had lower education level, lower BMI and their household reported lower percentage of meals consumed outside of the home compared to non-gardeners (p <  0.05). Participating in the community garden had no significant impact, in spite of sufficient statistical power, on fruit and vegetables supplies (main outcome), nor on physical activity parameters, nor on others of the social/health, environmental and economic lifestyles components investigated. Qualitative interviews suggested the existence of pre-established health and environmental consciousness in some gardeners and revealed several barriers to the participation such as lack of time, lack of gardening knowledge, physical difficulty of gardening, health problems and conflicts with other gardeners.

CONCLUSIONS

The health benefits of community gardening previously reported by cross-sectional studies might be confounded by selection bias. The JArDinS study highlights the need to identify solutions to overcome barriers related to community garden participation when designing relevant public health interventions for the promotion of sustainable lifestyles.

TRIAL REGISTRATION

The study was registered at clinicaltrials.gov as NCT03694782 . Date of registration: 3rd October 2018, retrospectively registered.

Acculturation and Food Intake Among Ghanaian Migrants in Europe: Findings From the RODAM Study

OBJECTIVE

This study examined the role of migration and acculturation in the diet of Ghanaian migrants in Europe by (1) comparing food intake of Ghanaian migrants in Europe with that of Ghanaians living in Ghana and (2) assessing the association between acculturation and food intake.

DESIGN

Data from the cross-sectional multicenter study Research on Obesity and Diabetes among African Migrants were used. Food intake was assessed using a Ghana-specific food propensity questionnaire (134 items and 14 food groups); foods were grouped based on a model of dietary change proposed by Koctürk-Runefors.

SETTING

Ghana, London, Amsterdam, and Berlin.

PARTICIPANTS

A total of 4,534 Ghanaian adults living in Ghana and Europe, with complete dietary data. Of these, 1,773 Ghanaian migrants had complete acculturation data.

MAIN OUTCOME MEASURE

Food intake (the weighted intake frequency per week of food categories).

ANALYSIS

Linear regression.

RESULTS

Food intake differed between Ghanaians living in Ghana and Europe. Among Ghanaian migrants in Europe, there were inconsistent and small associations between acculturation and food intake, except for ethnic identity, which was consistently associated with intake only of traditional staples.

CONCLUSIONS AND IMPLICATIONS

Findings indicate that migration is associated with dietary changes that cannot be fully explained by ethnic, cultural, and social acculturation. The study provides limited support to the differential changes in diet suggested by the Koctürk-Runefors' model of dietary change.

Impact of community gardens on the sustainability of lifestyles: baseline data of the JArDinS study

Introduction

Despite growing evidence for the multiple health benefits of community gardening, longitudinal studies based on quantitative data are needed. JArDinS is a quasi-experimental study aimed at assessing the impact of community garden participation in the adoption of more sustainable lifestyles.

Materials and

Methods

Gardeners starting gardening in a community garden in Montpellier (France) were recruited in 2018. Volunteers with no experience in community gardening and matched for age range, gender, household income and household composition were recruited in a control group. A recruitment goal of 80 participants per group was determined to detect a 30% increase in F&V supply in the gardeners group. Participant were issued with three tools: a Food Supply Dairy to collect data on monthly household’s food supply, a triaxial accelerometer to measure physical activity and an online questionnaire on mental and social health, sensitivity to food waste, and connection with nature. Measures have been collected at baseline and will be repeated 12 months later. Data collected are examined conjointly to assess the sustainability of lifestyles in its social/health, environmental and economic dimensions. Change of outcomes after 1 year will be compared between the natural experiment and the control groups, to evaluate the effect of access to a community garden on the sustainability of lifestyles.

Results

A final number of 77 participants per group were enrolled at baseline, which is 4% less the original recruitment goal. Baseline data for the natural experiment group and the control group are currently being analysed and will be presented.

Discussion

This study will provide valuable information about the potential of community gardens to favor sustainable lifestyles, based on a robust quasi-experimental design allowing causality evaluation. Findings could help developing policies toward more sustainable urban planning favoring both human and environmental health.

Key messages

For the first time, the JArDinS study will allow testing, the impact of community gardens on the sustainability of lifestyles. Results will help orient urban planning decisions towards healthier options.

Does participating in community gardens promote sustainable lifestyles in urban settings? Design and protocol of the JArDinS study

Background

Despite growing evidence for the multiple health benefits of community gardening, longitudinal studies based on quantitative data are needed. Here we describe the protocol of JArDinS, a quasi-experimental study, aimed at assessing the impact of community garden participation (a natural experiment) in the adoption of more sustainable lifestyles.

Methods

Gardeners (n = 80) starting gardening in a community garden in Montpellier (France) will be recruited. Volunteers with no experience in community gardening and matched for age range, gender, household income and household composition will be recruited in a control group (n = 80). The sustainability of lifestyles in its social/health, environmental and economic dimensions will be assessed from a food supply diary (recording type, quantity and price of foods acquired in a 1-month period and the carbon impact of relevant food trips), a triaxial accelerometer (measuring physical activity) and online questionnaires on mental and social health, sensitivity to food waste, and connection with nature. Change of outcomes after 1 year will be compared between the natural experiment and the control groups.

Discussion

This study will provide information on the impact of participation in a community garden on the different dimensions of sustainability, based on a robust quasi-experimental design allowing causality evaluation.

Trial registration

The JArDinS study was registered at clinicaltrials.gov as NCT03694782. Date of registration: 3rd October 2018, retrospectively registered.

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.

Electronic supplementary material

The online version of this article (10.1186/s12966-017-0608-6) contains supplementary material, which is available to authorized users.

Consumer acceptability and understanding of front-of-pack nutrition labels

BACKGROUND

Front-of-pack (FOP) nutrition labelling has been proposed as a tool for helping consumers make healthy choices. Before determining its effects on consumer behaviour, factors involved in its use must be elucidated, i.e. understanding and acceptability on the part of the consumer. Among five FOP labels, we sought to determine which formats were most easily understood and accepted by a large sample of adults.

METHODS

Among 39 370 adults who participated in the French Nutrinet-Santé cohort study, understanding and indicators of acceptability (attitude, liking, visual attractiveness and perceived cognitive workload) were measured for five FOP labels: The currently used 'multiple traffic lights' (MTL) and 'simple traffic lights' (STL), and the 'colour range' logo (CR), the 'green tick' and the PNNS logo. We investigated the contribution of the different elements to consumer perception of FOP labels using multiple correspondence analyses.

RESULTS

Over half of the sample population showed a high level of understanding and perceived no discomfort in terms of the different logos. Label formats were positioned along an acceptability gradient ranging from acceptance to rejection, consisting of 'liking', 'attractiveness' and indicators of perceived cognitive workload. MTL was significantly more often liked and was viewed as reliable and informative. MTL, STL and the green tick performed better than the CR and PNNS logos in terms of ease of identification and comprehension. CR was clearly the least appreciated and it had the most complex format.

CONCLUSIONS

Consumers prefer FOP labels which give complete, reliable and simplified information on the nutrient quality of foods.

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

Background

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.

Methods/design

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.

Discussion

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.

Sociodemographic factors and attitudes toward food affordability and health are associated with fruit and vegetable consumption in a low-income French population

Determinants of fruit and vegetable consumption, including affordability and attitudes, have been poorly investigated, especially in European deprived populations. Our objective was to analyze various determinants of low consumption of fruits and vegetables in disadvantaged participants. Our participants were randomized into 2 groups, 1 which received nutritional advice alone and 1 that also received vouchers that were exchangeable for fruits and vegetables during a 12-mo period. Socioeconomic characteristics, food insufficiency, affordability, and motivation for eating fruits and vegetables were assessed. A short FFQ was administered. Determinants of consumption of <1 fruit or vegetable/d were analyzed using multivariate logistic regression. A total of 295 participants were included (mean age 44.8 y; 133 men, 162 women). At baseline, mean daily consumption of fruits and vegetables was 2.13 +/- 1.57 times/d. Nearly 30% of the sample did not eat fruits and vegetables every day. Determinants of low fruit and vegetable consumption were: age younger than 55 y, education level lower than tertiary, and absence of financial means for buying fruits and vegetables daily. Other determinants were affordability (whether fruits and vegetables are affordable, lack of money in preventing healthy diet) and attitudes (whether one's own diet is healthy, whether or not fruits and vegetables improve health, whether eating fruits and vegetables is a pleasure). Thus, determinants of inadequate consumption of fruits and vegetables in this deprived French population are numerous. The impact of financial difficulties is crucial, as is the perception of affordability of fruits and vegetables.

Anti-actin antibodies. An immunological approach to the myosin-actin and the tropomyosin-actin interfaces

The topography of the rigor complex between subfragment-1 (S-1) of myosin and actin was investigated by using several specific antibodies directed to well-located sequences in actin. A major contact area for S-1 was characterized in the hydrophilic 18-28 constant sequence, and the variable 1-7 sequence was only found to be in close proximity to the interface. The C-terminal extremity of actin situated around Cys-374 appeared to be included in a region close to the S-1 heavy chain and the N-terminal part of actin. The interaction between tropomyosin and actin was also studied. Neither of the terminal parts of actin were involved in this interaction. Thus, the regions involved in the interactions of S-1 and tropomyosin with actin do not overlap.

Anti-actin antibodies. Detection and quantitation of total and skeletal muscle actin in human plasma using a competitive ELISA

A competitive ELISA has been used to titrate skeletal muscle and total actins in human plasma. Specific antibodies directed against the variable N-terminal 1-7 sequence and conserved sequences respectively were used. The N-terminus of actin appears to be accessible in native and brevin-complexed actins. The skeletal muscle actin isoform represents about 1% of the total circulating actin (mean: 50 micrograms/ml plasma), but is markedly increased after severe muscle tissue injuries.

Bacterial formation of omega-muricholic acid in rats

In the feces of conventional rats, the amount of omega-muricholic and hyodeoxycholic acids vary according to the diet. To understand this phenomenon, we investigated the bacterial formation of these bile acids. The present paper reports the first isolation, from conventional rat feces, of a strain of Clostridium group III which transforms beta-muricholic acid, the main bile acid in germfree rats, into omega-muricholic acid.

Measurement of fecal bile acid excretion in gnotobiotic rats: comparison of gas-liquid chromatography and [4(-14C)] cholesterol isotopic equilibrium

Gas-liquid chromatography (G.L.C.) and the method of [4(-14C)] cholesterol isotopic equilibrium (C.I.E.) were used to determine the fecal bile acid excretion in gnotobiotic rats. The same samples were submitted to both methods. In these conditions, it was observed that the fecal bile acid excretions determined by G.L.C. were 38% of lower than when determined by C.I.E. In thin-layer chromatographic analyses (T.L.C.) of the bile acid extracts obtained from rats in which a [4(-14C)] cholesterol isotopic equilibrium was established, 33 to 35% of the radioactivity of this fraction was not observed in the rat primary bile acids. No bile acids could be observed in G.L.C. made with eluates obtained from the T.L.C. areas containing this radioactivity. It therefore appears that the difference observed in the results obtained by G.L.C. and C.I.E. is due to the fact that chemical species which are not measured by the former method can be determined by the latter one. T.L.C. analyses of bile acid extracts from axenic rats in which either a [26(-14C)] cholesterol or a [2,4(-3H)] cholic acid and [24(-14C)] chenodeoxycholic acid equilibrium were established, lead to the conclusion that the chemical composition of these undetermined substances is complex: part of these substances comes from the transformation of bile acids; another part is made of molecules which maintain the 26(-14C) of cholesterol.