Stabilization of overweight prevalence and improvement of dietary habits in French children between 2004 and 2008.

OBJECTIVE: The objective of the present study was to describe changes in overweight and obesity prevalence and eating habits among 7.5-10.5-year-old children in Aquitaine (France) between 2004 and 2008, and to assess how the programme 'Nutrition, Prevention and Health of children and teenagers in Aquitaine' implemented in 2004 may have impacted these changes. DESIGN: Two cross-sectional studies were conducted in two samples of children: the 'before programme' sample during the school year 2004/2005 and the 'after programme' sample during the school year 2008/2009. Settings Data were collected on gender, age, weight, height, area of residence (rural/urban) and socio-economic status of the school (non-low socio-economic/low socio-economic). Multivariate analyses were used to assess the effect of the regional programme intervention on the evolution of overweight and obesity prevalence and eating habits independently. SUBJECTS: The 'before programme' sample included 1836 children from 163 schools during the school year 2004/2005 and the 'after programme' sample included 3483 children from 210 schools during the school year 2008/2009. RESULTS: After adjustment of the model for age, residential area and socio-economic status of the area of residence, the prevalence of overweight including obesity (OR = 1.05; 95% CI 0.89, 1.23, P = 0.56) and of obesity (OR = 0.99; 95% CI 0.71, 1.39, P = 0.96) was found to have stabilized and eating habits had improved: intake of light afternoon meals had increased (OR = 1.38; 95% CI 1.13, 1.69, P = 0.002) while snacking in the morning (OR = 0.50; 95 % CI 0.45, 0.57, P < 0.001) and nibbling (OR = 0.81; 95% CI 0.70, 0.93, P < 0.001) had decreased. CONCLUSIONS: These results encourage the promotion and implementation of regional and national interventions among children regarding their eating habits in order to stabilize or decrease the prevalence of overweight.

Prevalence and factors associated with overweight and obesity in French primary-school children.

OBJECTIVE: To determine the prevalence of, and identify associated factors with, overweight and obesity in two samples of French children. DESIGN: We conducted two cross-sectional studies among two samples of children. Weight status, eating behaviour, sedentary activity, physical activity and parents' socio-economic status (SES) were collected using questionnaires filled by doctors during school health check-ups. Overweight and obesity were defined according to the age- and sex-specific BMI cut-off points of the International Obesity Taskforce. Multivariate analysis (logistic regression) was used to identify independent factors associated with overweight including obesity and obesity alone. SETTING: Aquitaine region (south-west France). SUBJECTS: Analyses were conducted among children aged 5-7 years (n 4048) and 7-11 years (n 3619). RESULTS: Overweight prevalence was 9·5 % including 2·2 % of obesity in 5-7-year-old children and 15·6 % including 2·9 % of obesity in 7-11-year-old children. In both samples, overweight and obesity prevalence were higher in children whose parents had low or medium SES (P < 0·05). Factors associated significantly (P < 0·05) and independently with higher overweight or obesity prevalence were female gender, low or medium parental SES, never or sometimes having breakfast, never eating at the school canteen, never having a morning snack, never or sometimes having a light afternoon meal and having high sedentary activity. CONCLUSIONS: Our data confirm that low SES, absence of breakfast and high sedentary activity are associated with a higher risk of being overweight or obese, but also highlight original potential protective factors such as eating at the canteen and high meal frequency.

Evolution of overweight prevalence among 5-6-year-old children according to socio-economic status.

AIM: To assess time trends in overweight and obesity prevalence among 5-6-year-old children of Bordeaux city (France) over seven school years from 2004-2005 to 2010-2011. METHODS: For each year, all 5-6-year-old children from 63 of the 69 schools of Bordeaux were included: 2005, 2100, 2010, 1952, 2040, 2017 and 2111 subjects, respectively. Weight and height were collected by school doctors, and weight status was defined according to the age- and sex-specific body mass index cut-off points of the International Obesity Task Force (IOTF) for obesity and to the French age- and gender-specific child cut-off (close to the IOTF cut-off) for overweight including obesity. RESULTS: From 2004-2005 to 2010-2011, an overall decrease was observed in overweight including obesity (from 8.9% to 5.2%, p < 0.001) and obesity prevalences (from 2.8% to 1.4%, p = 0.046). Similar results were observed in non-low socio-economic status (SES) areas (p < 0.001), whereas the prevalence did not vary significantly in low-SES areas (p > 0.05). CONCLUSION: Overweight prevalence has decreased between 2004 and 2011 in 5-6-year-old children from Bordeaux. However, the gap between low and non-low-SES areas has persisted during these years.

Dietary behaviors as associated factors for overweight and obesity in a sample of adolescents from Aquitaine, France.

This study aimed to identify dietary behaviors that might be considered as associated factors for overweight or obesity among French adolescents. Forty-nine of the 536 middle and high schools in Aquitaine (southwest of France) were invited to take part in the study. For each school, participating adolescents were selected using stratification by grade. A self-report questionnaire, including information about sex, age, dietary behaviors, physical and sedentary activities, and parental socioeconomic status (SES), was filled in by adolescents during class. Overweight and obesity were defined according to the age- and sex-specific body mass index cutoff points of the International Obesity Task Force. Multivariate analysis (logistic regression) was used to identify independent dietary factors associated with overweight including obesity and obesity alone (adjustment on sex, age, parental SES, and weight status and adolescents' sedentary activity). In addition to parental SES and weight status and adolescents' sedentary activity, some dietary behaviors are also independently and significantly associated with a higher prevalence of overweight including obesity: absence (OR 1.43, 0.91-2.23) or rare (OR 1.57, 1.23-2.01) breakfast intake (p < 0.01) and absence (OR 5.03, 3.19-7.92) or rare (OR 1.90, 1.46-2.47) light afternoon meal intake (p < 0.001). All variables were also significantly and independently associated with obesity alone. This study shows that socioeconomic factors and individual behaviors are associated with overweight or obesity. These results confirm the importance to carry out multifaceted educational actions among adolescents, by promoting physical activity and healthy food choices in order to prevent overweight and promote healthy lifestyle behaviors.