Socioeconomic inequalities in weight, height and body mass index from birth to 5 years.

BACKGROUND/OBJECTIVES: Studies in high-income countries show that despite the positive association of weight with socioeconomic position at birth, an inverse socioeconomic gradient in overweight (OW) appears later in childhood. The objectives were to understand the natural history of socioeconomic inequalities in weight, height and body mass index (BMI), by investigating their associations with maternal educational level between birth and 5 years, separately in boys and girls. SUBJECTS/METHODS: A published work of growth modelling between birth and 5 years allowed us to calculate predicted weight, height and BMI at 1 month, 6 months, 1, 3 and 5 years for 1735 children from the French EDEN mother-child cohort. Associations between maternal education and predicted measures of body size were analysed with marginal linear and logistic models, stratified by sex. RESULTS: In girls, despite a positive association between maternal education and birthweight, an inverse socioeconomic gradient was observed as early as 1 month for BMI. Girls whose mothers had low education levels were shorter on the whole than their counterparts with better-educated mothers, despite their similar weights. In boys, no socioeconomic gradient in BMI was observed at any age, including birth, but positive associations were found as early as 1 month for both weight and height. CONCLUSIONS: The emergence of an inverse socioeconomic gradient in BMI and OW apparently results from a complex pattern of socioeconomic inequalities in weight and height from 1 month onwards. The very start of life thus appears to be an important window of opportunity for addressing socioeconomic inequalities in growth.

Influence of infant feeding patterns over the first year of life on growth from birth to 5 years.

OBJECTIVES: As early-life feeding experiences may influence later health, we aimed to examine relations between feeding patterns over the first year of life and child's growth in the first 5 years of life. METHODS: Our analysis included 1022 children from the EDEN mother-child cohort. Three feeding patterns were previously identified, i.e. 'Later dairy products introduction and use of ready-prepared baby foods' (pattern-1), 'Long breastfeeding, later main meal food introduction and use of home-made foods' (pattern-2) and 'Use of ready-prepared adult foods' (pattern-3). Associations between the feeding patterns and growth [weight, height and body mass index {BMI}] were analysed by multivariable linear regressions. Anthropometric changes were assessed by the final value adjusted for the initial value. RESULTS: Even though infant feeding patterns were not related to anthropometric measurements at 1, 3 and 5 years, high scores on pattern-1 were associated with higher 1-3 years weight and height changes. High scores on pattern-2 were related to lower 0-1 year weight and height changes, higher 1-5 years weight and height changes but not to BMI changes, after controlling for a wide range of potential confounding variables including parental BMI. Scores on pattern-3 were not significantly related to growth. Additional adjustment for breastfeeding duration reduced the strength of the associations between pattern-2 and growth but not those between pattern-1 and height growth. CONCLUSION: Our findings emphasize the relevance of considering infant feeding patterns including breastfeeding duration, age of complementary foods introduction as well as type of foods used when examining effects of early infant feeding practices on later health. © 2017 World Obesity Federation.

Prospective associations between energy balance-related behaviors at 2 years of age and subsequent adiposity: the EDEN mother-child cohort.

BACKGROUND/OBJECTIVES: Sedentary behavior, physical activity and dietary behavior are formed early during childhood and tend to remain relatively stable into later life. No longitudinal studies have assessed the independent influence of these three energy balance-related behaviors during toddlerhood on later adiposity. We aimed to analyze the associations between TV/DVD watching time, outdoor play time and dietary patterns at the age of 2 years and child adiposity at the age of 5 years, in boys and girls separately. SUBJECTS/METHODS: This study included 883 children from the French EDEN mother-child cohort. TV/DVD watching time, outdoor play time and dietary intakes were reported by parents in questionnaires when the child was aged 2 years. Two dietary patterns, labeled 'Guidelines' and 'Processed, fast foods', were identified in a previous study. The percentage of body fat (%BF) based on bioelectrical impedance analysis and body mass index were measured at the age of 5 years. RESULTS: In boys, TV/DVD watching time at the age of 2 years was positively associated with %BF at the age of 5 years (ß=0.50 (95% confidence interval: 0.001, 1.00) for those boys with ⩾60 min per day of TV/DVD watching time vs those with ⩽15 min per day, P-value for trend 0.05). In girls, outdoor play was inversely associated with %BF (ß=-0.96 (95% confidence interval: -1.60, -0.32) for those in the highest tertile of outdoor play time vs those in the lowest tertile, P=0.001). Overall, at the age of 2 years, dietary patterns were associated with both TV/DVD watching time and outdoor play time, but no significant and independent association was observed between dietary patterns and later adiposity. CONCLUSION: This study shows longitudinal and gender-differentiated relations between both TV/DVD watching time and outdoor play time in toddlerhood and later adiposity, whereas evidence for a relation between dietary patterns and subsequent fat development was less conclusive. Early childhood-by the age of 2 years-should be targeted as a critical time for promoting healthy energy balance-related behaviors.

Early factors related to carbohydrate and fat intake at 8 and 12 months: results from the EDEN mother-child cohort.

BACKGROUND/OBJECTIVES: Few studies have examined the factors explaining the variability in fat and carbohydrate intake during infancy. We aimed to describe infants' fat and carbohydrate intake and analyse the associations with infant and maternal characteristics and feeding practices. SUBJECTS/METHODS: This study included 1275 infants aged 8 months from the French EDEN mother-child cohort. Carbohydrate intake, fat intake, added fat (vegetable oils and animal fats) and added sugar (honey, white sugar, brown sugar, jam and sweetened beverages) consumption were calculated at 8 and 12 months. Associations between these variables and infant and maternal characteristics as well as maternal dietary patterns during pregnancy, breast-feeding duration and age at complementary feeding introduction were analysed using multivariable linear and logistic regressions. RESULTS: Less than 5% of non-breast-fed infants reached the recommendation of consuming at least 40% of total energy from fat, whereas more than 95% of them reached 45% of energy from carbohydrates. Overall, infant and maternal characteristics and maternal diet during pregnancy were marginally associated with both carbohydrate/added sugar and fat/added fat intake. Nevertheless, age at complementary feeding introduction was associated with all outcomes. CONCLUSIONS: Our results suggest that only a small proportion of non-breast-fed infants at 8 and 12 months reached the recommendations for fat intake, whereas a majority of them reached the recommendations for carbohydrate intake. As subgroups of infants with a higher risk of inadequate diet were not identified, the present results call for an improved dissemination of information regarding infant-specific dietary fat needs in the entire population.

Dietary patterns of French adults: associations with demographic, socio-economic and behavioural factors.

BACKGROUND: Although the French eating model may differ from those of other countries, no studies to date have investigated dietary patterns in a wide age range of adults and at the national level. We aimed to identify dietary patterns (DP) of French adults and assess their associations with demographic, socio-economic and behavioural factors. METHODS: The present study included 2624 adults (1087 men, 1537 women) aged 18-79 years from the cross-sectional national French INCA2 dietary survey. Dietary data were collected using a 7-day estimated food record. Clusters of DP were derived using principal component analysis and clustering, conjointly. Age-adjusted logistic regression analyses were used to investigate the association between DP and correlates. RESULTS: Five DP were identified, namely 'traditional', 'prudent', 'diversified', 'processed' and 'sandwiches'. Men were more likely to follow a traditional diet and women the 'prudent' pattern. Members of the 'processed' and 'sandwiches' patterns were younger compared to non-members. Healthier dietary patterns were overall positively associated with a higher socio-economic position, healthier behaviours (in terms of sedentary behaviours and smoking status) and lower body mass index. Under-reporting of energy intake, restrictive diet to lose weight and dietary supplement consumption were also related to specific DP, although differentially in men and women. Associations with contextual factors (i.e. household composition, agglomeration size and region) were also observed. CONCLUSIONS: The identification of adults' dietary patterns and associated behaviours (all modifiable) is important for the conceptualisation of multi-behavioural programs. The additional information on social and environmental correlates is also essential for targeting the most vulnerable population groups in the context of such public health interventions.

Tracking of dietary intakes in early childhood: the Melbourne InFANT Program.

BACKGROUND/OBJECTIVES: The objectives of the present study were to describe food and nutrient intakes in children aged 9 and 18 months, and to assess tracking of intakes between these two ages. SUBJECTS/METHODS: Participants were 177 children of first-time mothers from the control arm of the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program. Dietary intake was collected at 9 and 18 months using three 24 h diet recalls. Tracking was assessed for food and nutrient intakes using logistic regression analysis and estimating partial correlation coefficients, respectively. RESULTS: Although overall nutrient intakes estimated in this study did not indicate a particular risk of nutrient deficiency, our findings suggest that consumption of energy-dense, nutrient-poor foods occurred as early as 9 months of age, with some of these foods tracking highly over the weaning period. Intakes of healthier foods such as fruits, vegetables, dairy products, eggs, fish and water were also relatively stable over this transition from infancy to toddlerhood, along with moderate tracking for riboflavin, iodine, fibre, calcium and iron. Tracking was low but close to ρ=0.3 for zinc, magnesium and potassium intakes. CONCLUSIONS: The tracking of energy-dense, nutrient-poor foods has important implications for public health, given the development of early eating behaviours is likely to be modifiable. At this stage of life, dietary intakes are largely influenced by the foods parents provide, parental feeding practices and modelling. This study supports the importance of promoting healthy dietary trajectories from infancy.

Associations between usual school lunch attendance and eating habits and sedentary behaviour in French children and adolescents.

BACKGROUND/OBJECTIVE: Our objective was to investigate whether school lunch attendance was associated with overall eating habits and sedentary behaviour in a French sample of children and adolescents. SUBJECTS/METHODS: Data for the study were taken from the second French cross-sectional dietary survey (INCA2-2006-07). In total, 1413 school children aged 3-17 years old were classified according to their school type and their usual school lunch attendance. Eating habits included meal regularity, dietary diversity, purchase in vending machine, snacking habits and frequency of eating in fast-foods. Two composite indices of eating habits were derived from multiple correspondence analyses. Sedentary behaviour was assessed by the average daily screen times for TV and computer. The association between school lunch attendance and each variable was tested. Multivariate association between school lunch attendance and the composite indices of eating habits and sedentary behaviours was studied. RESULTS: In all, 69.0% (CI(95%): 64.2-73.9) of secondary school children and 63.0% (CI(95%): 58.5-67.5) of pre- and elementary school children usually attended school lunch at least once a week. Pre- and elementary school children attending school lunches showed a higher dietary diversity score (P=0.02) and ate morning snacks more frequently (P=0.02). In secondary school children, attending school canteen was related to a lower rate of skipping breakfast (P=0.04) and main meals (P=0.01). In all school children, school lunch attendance was simultaneously associated with healthier overall eating habits and less sedentary behaviour. CONCLUSION: In France, children attending school canteens seem to have healthier eating habits and display less sedentary behaviour, independently of their socio-economic and demographic background.

Socioeconomic variation in diet and activity-related behaviours of Australian children and adolescents aged 2-16 years.

BACKGROUND: Evidence for age-related variation in the relationship between obesity-related behaviours and socioeconomic position may assist in the targeting of dietary and physical activity interventions among children. OBJECTIVE: To investigate the relationship between different indicators of socioeconomic position and obesity-related behaviours across childhood and adolescence. METHODS: Data were from 4487 children aged 2 to 16 years participating in the cross-sectional 2007 Australian National Children's Nutrition and Physical Activity Survey. Socioeconomic position was defined by the highest education of the primary or secondary carer and parental income. Activity was assessed using recall methods with physical activity also assessed using pedometers. Intake of energy-dense drinks and snack foods, fruits and vegetables was assessed using 2 × 24-h dietary recalls. RESULTS: A socioeconomic gradient was evident for each dietary measure (although in age-specific analyses, not for energy-dense snacks in older children), as well as television viewing, but not physical activity. Whether each behaviour was most strongly related to parental income or education of the primary or secondary carer was age and sex dependent. The socioeconomic gradient was strongest for television viewing time and consumption of fruit and energy-dense drinks. CONCLUSIONS: A strong socioeconomic gradient in eating behaviours and television viewing time was observed. Relationships for particular behaviours differed by age, sex and how socioeconomic position was defined. Socioeconomic indicators define different population groups and represent different components of socioeconomic position. These findings may provide insights into who should be targeted in preventive health efforts at different life stages.

Recommendations for a trans-European dietary assessment method in children between 4 and 14 years.

BACKGROUND/OBJECTIVES: The main objective of European Food Consumption Validation (EFCOVAL)-child Project is to define and evaluate a trans-European methodology for undertaking national representative dietary surveys among children in the age group of 4-14 years. In the process of identifying the best dietary assessment methodologies, experts were brought together at a workshop. The paper presents the discussion of the best available method and the final recommendations for a trans-European dietary assessment method among 4- to 14-year-old children. SUBJECTS/METHODS: The starting point was to investigate whether the method (two non-consecutive 24-h dietary recalls (24-HDRs)) suggested for the adults in European Food Consumption Survey Method (EFCOSUM) would be usable for children in the age group between 4 and 14 years. However, all available dietary assessment methods were included in the discussion to ensure that the final recommendation would be based on the best evidence. Six criteria were defined and used as additional guidance in the process. RESULTS: The literature does not give a clear recommendation on the dietary assessment methods that are most suitable for children in the age group of 4-14 years. Nevertheless, on the basis of the literature, the recommendations were separated for preschoolers (4-6 years) and schoolchildren (7-14 years). CONCLUSION: For preschoolers, two non-consecutive days of a structured food record are recommended, using a (for children adapted) picture booklet and household measures for portion-size estimation. For schoolchildren, repeated 24-HDRs are recommended, using a picture booklet and household measures for portion-size estimation. In addition, the child should bring a booklet to register what is eaten out of home. One parent should assist the schoolchild at the 24-HDR interview, and therefore face-to-face interviews are required.

Feasibility of 2 × 24-h dietary recalls combined with a food-recording booklet, using EPIC-Soft, among schoolchildren.

BACKGROUND/OBJECTIVES: The aim of this study was to evaluate the feasibility of the suggested trans-European methodology for undertaking representative dietary surveys among schoolchildren: 2 × 24-h dietary recalls (24-HDRs) combined with a food-recording booklet, using EPIC-Soft (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) pc-program. SUBJECTS/METHODS: A total of 75 children aged 7-8 years and 70 children aged 12-13 years old were recruited through the Civil Registration System in Denmark, and 57 children aged 7-8 years and 47 children aged 12-13 years were recruited through schools in Spain. Each child with one parent completed two face-to-face 24-HDRs, combined with optional use of a food-recording booklet (FRB) to be filled in by the child, a parent or other proxy persons for preparing the recalls. Feasibility was evaluated by questionnaires completed by parents, children and interviewers, and by selected data from the 24-HDRs. RESULTS: The face-to-face interviews with the child and a parent together are confirmed as feasible. The children participated actively in the interviews, the oldest children being most active. The children, parents and interviewers agreed that children needed help from the parents, and that parents were of help to the child. In both countries, other proxy persons, such as teachers or the school cafeteria staff, were involved before the interview, and the majority of the parents and children reported that the FRB had been a help for the child during the interview. Further results point at specific needed improvements of the tools. CONCLUSIONS: The evaluated method is shown feasible in two culturally diverse European populations. However, the feasibility study also points to specific improvements of tools and data collection protocol that are strongly recommended before implementation of the method in each country of a pan-European dietary survey.

Evaluation of 2 × 24-h dietary recalls combined with a food-recording booklet, against a 7-day food-record method among schoolchildren.

BACKGROUND/OBJECTIVES: The aim of this study was to evaluate the estimated energy, nutrient and food intake from the suggested trans-European methodology for undertaking representative dietary surveys among schoolchildren: 2 × 24-h dietary recalls (24-HDRs) combined with a food-recording booklet (FRB), using EPIC-Soft pc-program (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study), against a 7-day food-record (7-dFR) method among Danish schoolchildren. SUBJECTS/METHODS: A total of 74 children aged 7-8 years and 70 children aged 12-13 years were recruited through the Civil Registration System in Denmark. Each child and one of their parents completed two face-to-face 24-HDRs, combined with optional use of a FRB, followed by a 7-day-estimated FR. RESULTS: Energy intake was significantly higher with the 24-HDR method than with the 7-dFR method for both age groups. Mean energy intake was 6% higher for the youngest (P = 0.02) and 11% for the oldest children (P = 0.01); underreporting of energy occurs among the oldest children, being less present with the 24-HDR method. The intakes of carbohydrate and dietary fiber (absolute and related to energy) were significantly higher with the 24-HDR than with the 7-dFR for both age groups (P < 0.001). No significant differences between the two methods were observed for absolute intake of fat and added sugar between both age groups, and for intake of protein among the 7- to 8-year olds. The percentage of energy intake from fat from the 24-HDR, however, was significantly lower for both age groups and for energy intake from added sugar for the 12- to 13-year olds. CONCLUSIONS: The 2 × 24-HDR method compared with the 7-dFR yields relatively good values on the group level for many macronutrients and foods. However, some differences in estimated intakes of macronutrients suggest the need to carefully adapt the tools to be age and country specific. There is a tendency for parents and schoolchildren to report a healthier diet with the 24-HDR than with the FRs; this results in some concern about the method and has to be studied further.

Feasibility of repeated 24-h dietary recalls combined with a food-recording booklet, using EPIC-Soft, among preschoolers.

BACKGROUND/OBJECTIVES: This study evaluates the feasibility among preschoolers of the 2 × 24-h dietary recalls (24-HDRs) method combined with a food-recording booklet (FRB), using EPIC-Soft pc-program for the 24-HDR (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study). SUBJECTS/METHODS: A total of 20 and 25 (4- to 5-year-old) children were recruited, as a convenience sample, through worksites or day or healthcare in Denmark and Spain, respectively. One parent (or both parents together) completed two face-to-face 24-HDR, combined with an optional use of a FRB. Feasibility was evaluated by evaluation questionnaires completed by parents and interviewers. RESULTS: The face-to-face interviews were primarily conducted with the mothers. The FRB was used by 90% of the participants, and proxy persons, other than the parent, were also involved; involvement of proxy persons seems necessary in a majority of the recalls in both the countries. CONCLUSIONS: The results suggest that 2 × 24-HDR with one parent combined with a FRB is feasible for registering preschoolers' diet. An FRB and/or information from proxy persons, other than the parent, is needed for a majority of the parents. In future studies, it may be beneficial to develop the FRB more like a structured food record (FR), which might, in principle, change the method to a one-day FR method from more than a 24-HDR method. It is recommended then to further investigate the use of EPIC-Soft as a data-entry tool.

Accounting for the multidimensional nature of the relationship between adult obesity and socio-economic status: the French second National Individual Survey on Food Consumption (INCA 2) dietary survey (2006-07).

The objective was to study the multidimensional nature of the relationship between adult obesity (OB) and socio-economic status (SES), using comprehensive indices of SES taken separately or synthesised in an overall index. A nationally representative sample of adults aged 18-79 years was taken from the French second National Individual Survey on Food Consumption (INCA 2) dietary survey (2006-07). Weight and height were measured and OB defined as BMI ≥ 30 kg/m2. SES variables were reported in questionnaires and included occupation, education and characteristics of household wealth. Composite indices of SES (household wealth and overall SES indices) were computed by correspondence analysis, and relationships with OB were investigated with logistic regression analysis. In total, 11·8 (95 % CI 10·1, 13·4) % of French adults were obese, without significant difference by sex. While no significant relationship was observed in men, all SES indicators were inversely correlated to OB in women. Both education and the household wealth index were retained in the stepwise multivariate model, confirming that different socio-economic variables are not necessarily proxies of each other regarding the OB issue. On the other hand, 'controlling for SES' while including several measures of SES in multivariate models may lead to collinearity, and thus over-adjustment. A more integrative approach may be to derive a synthetic index by including the SES factors available in a given study. Beyond this methodological perspective, understanding how OB is related to the different dimensions of SES should help to target the more vulnerable groups and increase the effectiveness of prevention.

Overweight and obesity in infants and pre-school children in the European Union: a review of existing data.

The objective of this study was to synthesize available information on prevalence and time trends of overweight and obesity in pre-school children in the European Union. Retrieval and analysis or re-analysis of existing data were carried out. Data sources include WHO databases, Medline and Google, contact with authors of published and unpublished documents. Data were analysed using the International Obesity Task Force reference and cut-offs, and the WHO standard. Data were available from 18/27 countries. Comparisons were problematic because of different definitions and methods of data collection and analysis. The reported prevalence of overweight plus obesity at 4 years ranges from 11.8% in Romania (2004) to 32.3% in Spain (1998-2000). Countries in the Mediterranean region and the British islands report higher rates than those in middle, northern and eastern Europe. Rates are generally higher in girls than in boys. With the possible exception of England, there was no obvious trend towards increasing prevalence in the past 20-30 years in the five countries with data. The use of the WHO standard with cut-offs at 1, 2 and 3 standard deviations yields lower rates and removes gender differences. Data on overweight and obesity in pre-school children are scarce; their interpretation is difficult. Standard methods of surveillance, and research and policies on prevention and treatment, are urgently needed.

Is food portion size a risk factor of childhood overweight?

BACKGROUND/OBJECTIVES: Food portion sizes have been increasing in industrialized countries and this is thought to be one of the risk factors of overweight. France is also facing the development of adiposity, particularly in its child population, where overweight rates are rising faster than in adults. Given this background, the objectives of the present study were, for each food category, to describe dietary intake in French children aged 3-11 years, and to assess the relationship between childhood overweight and portion size, adjusting for dietary energy density, physical activity and sedentary behaviour. SUBJECTS/METHODS: A representative sample of 748 French children aged 3-11 years was taken from the 1998-1999 cross-sectional French INCA1 (Enquête Individuelle et Nationale sur les Consommations Alimentaires) food consumption survey. Dietary intake was assessed using a 7-day food record. Portion sizes were estimated for 23 food categories. Weight and height, physical activity and sedentary behaviour were reported by parents or children in questionnaires. RESULTS: In multivariate logistic regression adjusted models, overweight in children aged 3-6 years was positively correlated to portion sizes of croissant-like pastries and other sweetened pastries. Conversely, portion sizes of liquid dairy products were inversely associated with overweight in children aged 7-11 years. CONCLUSIONS: At very young ages, the increase in overweight may be driven in part by a shift in eating patterns towards larger portion size of energy-dense and nutrient-poor foods.

Dietary patterns associated with vitamin/mineral supplement use and smoking among women of the E3N-EPIC cohort.

BACKGROUND/OBJECTIVES: An understanding of the relationships between dietary habits and supplement use or smoking is useful for aetiological studies and surveillance purposes. The objective of this study is to describe dietary patterns associated with vitamin/mineral supplement use and smoking habits in French women. METHODS: Scores for dietary patterns were obtained by factor analysis in 64,252 women from the French E3N-EPIC cohort. The association with supplement and tobacco use was investigated by logistic regression analysis. RESULTS: We identified three dietary patterns: 'processed meat/starchy foods' (fast foods, processed meat, rice/pasta/semolina and cakes and few vegetables); 'fruit/vegetables' (fruits, vegetables, seafood, vegetable oils and yoghurt); and 'alcohol/meat products' (alcohol, meat and meat products, and coffee, and few fruits and soup). Supplement use was positively associated with the fruit/vegetables pattern (multivariate OR for quartile 4 versus 1 (OR(4))=1.55, 95% confidence interval: 1.47-1.63), and inversely associated with the processed meat/starchy foods (OR(4)=0.84; 0.80-0.89) and alcohol/meat products (OR(4)=0.69; 0.66-0.73) patterns (P trend for all associations <0.0001). As compared with never smoking, current smoking was inversely associated with the fruit/vegetables pattern (OR(4)=0.85; 0.78-0.92), while former smoking was positively associated with the fruit/vegetables pattern (OR(4)=1.32; 1.25-1.40); both current and former smoking were inversely associated with the processed meat/starchy foods pattern (OR(4)=0.57; 0.53-0.62 and 0.64; 0.60-0.67, respectively); whereas current and former smoking were both strongly positively associated with the alcohol/meat products pattern (OR(4)=5.78; 5.26-6.36 and 2.03; 1.91-2.15, respectively); P trend for all associations was <0.001. CONCLUSIONS: Supplement use and smoking are strongly associated with dietary patterns.

Child overweight in France and its relationship with physical activity, sedentary behaviour and socioeconomic status.

OBJECTIVE: (1) To assess the prevalence of childhood overweight (OW) and obesity in France; (2) to examine how physical activity and sedentary behaviour are involved in the association between socioeconomic status (SES) and OW, while taking into account total energy intake. DESIGN AND SUBJECTS: Representative sample of French children aged 3-14 years (n=1016) taken from the 1998-1999 cross-sectional French INCA (Enquête Individuelle et Nationale sur les Consommations Alimentaires) food consumption survey. MEASUREMENTS: Weight and height, leisure-time physical activity (LTPA), sedentary behaviour (TV viewing and video-game use), and SES were reported by parents or children by answering questionnaires; total energy intake was assessed using a 7-day food record. RESULTS: In total, 15.2% (95% CI: 13.0-17.6) of the children are OW (including obese), according to the IOTF (International Obesity Task Force) definition. OW is inversely associated with SES in children over 6 years of age. LTPA is negatively correlated to OW among the 3 to 5-year-old children only, whereas sedentary behaviour is positively related to OW in childhood and adolescence. From 6 years old on, SES is inversely associated with sedentary behaviour, which consequently may partly mediate the relationship between SES and OW. CONCLUSION: This study confirms the association between SES, sedentary behaviour and childhood OW in France. It was performed before the launching of the French Program of Nutrition and Health (PNNS) in 2001 and will be repeated in 2006. This will contribute to monitoring both childhood OW and its main determinants at the population scale.

[Comparison of two national food surveys (INCA 1 1998-99 and Health Nutrition Barometer 2002) with regard to five food recommendations of the National Nutrition and Health Program]. / Comparaison de deux enquêtes nationales de consommations alimentaires (INCA 1 1998/99 et Baromètre santé nutrition 2002) au regard de cinq objectifs alimentaires du Programme national nutrition santé.

BACKGROUND: Monitoring the dietary intake of the French population requires the implementation and regular renewal of representative national survey. As these surveys can use different methodologies (food frequency questionnaire, 24 hour recall, 3 or 7-day dietary record...), it seems useful to check whether they supply similar results. The aim of this study is to determine whether two representative national surveys with different methodologies can be used alternately to monitor changes in food consumption of the French population. METHOD: Percentages of consumers aged 15-75 were compared between two national food surveys (Health Nutrition Barometer 2002 and INCA 1 1998-99) with respect to five food frequency recommendations of the French National Nutrition and Health Program. RESULTS: The same public health priorities were found in both surveys: the food groups were graded according to the same hierarchy of adequate food intake prevalences (ascending: fruits and vegetables, dairy products, fish, starchy foods and meat-fish-egg products). On the other hand, significant statistical different elements were pointed out in a few food groups which may be explained by methodological patterns. Definitions of portions and food groups, survey duration and seasons are indeed important parameters to be considered when comparing surveys. CONCLUSION: The results show the need to elaborate standardized methods for comparison of food consumption surveys, which can be useful for the evaluation of the national nutritional recommendations. The methodological limitations described in this study also indicate that the quantitative description of food intake trends should improve when established by the results of the same regularly repeated survey.