Regional factors interact with educational and income tax levels to influence food intake in France

Wyndels, K; Dallongeville, Jean; Simon, Chantal; Bongard, Vanina; Wagner, Anne; Ruidavets, J.B.; Arveiler, Dominique; Ferrières, Jean; Amouyel, Philippe; Dauchet, Luc

doi:10.1038/ejcn.2011.73

Cited by 19 publications

(27 citation statements)

References 35 publications

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“…Although the contribution of these attitudes may have been underestimated, it is likely that other variables are also mediators. These might include social support for healthy eating, 12 nutritional knowledge, 11 family values, 13 self-efficiency (i.e., organizational ability), limited skills and experience with food, snacking opportunities 4,41 and the consumption of 'less healthy' takeaway food. 42 In conclusion, our results suggest that poor attitudes toward healthy eating in groups with low SES constitute an additional factor (along with cost constraints) in the choice of unhealthy foods.…”

Section: Discussionmentioning

confidence: 99%

“…We studied the MONA LISA-NUT 4 population, which is a subsample from the 2005-2007 MONA LISA cross-sectional survey of cardiovascular risk factors and nutrition carried out by the three French centres participating in MONICA programme. 22,23 The initial MONA LISA sample of 4827 men and women (age range: 35-74 years) from the Lille urban area (northern France), the Bas-Rhin county (north-eastern France) and the HauteGaronne county (south-western France) had been randomly selected from the electoral rolls.…”

Section: Methodsmentioning

confidence: 99%

“…4 Hence, we performed a pilot analysis to establish the presence or absence of an interaction between educational level and compliance with the PNNS-GS 2 on one hand and the region on the other. Percentage mediation of a nonsignificant relationship would have a very small denominator, and thus the confidence interval of the percentage mediation would be very wide and the results would not be interpretable.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…1 However, dietary guidelines are often not followed, 2 and compliance with dietary guidelines steadily falls as socioeconomic status (SES) decreases. 3,4 In fact, SES is multidimensional 5 and can be assessed in terms of income, occupation and/or educational level. Each of these dimensions has its own causal pathway toward dietary habits.…”

Section: Introductionmentioning

confidence: 99%

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Attitudes toward healthy eating: a mediator of the educational level–diet relationship

Dallongeville

Wagner

et al. 2013

Eur J Clin Nutr

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BACKGROUNG/OBJECTIVES: A higher educational level is associated with a healthier diet. The goal of this study was to establish whether this association is mediated by attitudes toward healthy eating. SUBJECTS/METHODS: The cross-sectional MONA LISA-NUT study was performed in 2005-2007 on adults aged 35-64 years from northern and north-eastern France. Diet quality was assessed on the basis of a 3-day food record and a validated score based on French national dietary guidelines. Specific questions investigated attitudes toward healthy eating. Multivariate analyses were used to quantify the proportion of the educational level-diet relationship that was mediated by attitudes toward healthy eating. RESULTS: Among the 1631 subjects, favourable attitudes toward healthy eating were associated with both higher educational level and diet quality. In the mediation analysis, 'organic food consumption' explained 14% (95% confidence interval (8;24)) of the educational level-diet relationship and 'attention paid to health when buying food' explained 9% (3;16). In contrast, 'attention to food choice', 'searching for information about food' and 'perceived role of eating' were not mediators of the association between educational level and diet. In a multivariate model, the attitude items together accounted for 25% (10;45) of the relationship. The mediation was more pronounced in women than in men (37% (15;54) vs 16% (1;27), respectively) and was significant for consumption of fruits and vegetables (23% (13;37)), whole-grain food (32% (15;58)) and seafood (22% (9;55)). CONCLUSIONS: Our results suggest that poor attitudes toward healthy eating in groups with low socioeconomic status constitute an additional factor (along with cost constraints) in the choice of unhealthy foods.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Attitudes toward healthy eating: a mediator of the educational level–diet relationship

Dallongeville

Wagner

et al. 2013

Eur J Clin Nutr

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“…[1][2][3][4][5][6] Given the moderate strength of the relationship, the relative impact of residual confounding is elevated, which hampers the interpretation of a causal relationship. 7,8 In fact, F&V consumers differ from nonconsumers in many respects, such as educational level, social and economic status, 9 smoking habits and vitamin supplement intake. 5 These characteristics are not always adjusted for in cohort studies.…”

Section: Introductionmentioning

confidence: 99%

Fruit and vegetable intake and smoking cessation

et al. 2012

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BACKGROUND/OBJECTIVES:In cohort studies, fruit and vegetable (F&V) intake is associated with lower cardiovascular diseases (CVDs). Former smokers often have a higher F&V intake than current smokers. If a high intake of F&V precedes smoking cessation, the latter may explain the favorable association between F&V intake and CVD among smokers. The objective was to assess whether higher F&V intake precedes smoking cessation. SUBJECTS/METHODS: The study population comprised 1056 male smokers from Lille (France) and Belfast (Northern Ireland) aged 50-59 years on inclusion in 1991. At baseline, participants completed self-administered questionnaires related to smoking habits, demographic, socioeconomic factors and diet. At the 10-year follow-up, smoking habits were assessed by mailed questionnaire. RESULTS: After 10 years, 590 out of 1056 smokers had quit smoking (70.7% of smoker in Lille and 37.8% in Belfast). After adjusting for center, consumption of F&V was associated with quitting (odds ratio (OR) for high versus low F&V intake: 1.73; 95% confidence interval (CI): (1.22-2.45); P-trend ¼ 0.002). After further adjustment for sociodemographic factors, body mass index and medical diet, the association was still statistically significant (OR: 1.59; 95% CI (1.12-2.27); P-trend ¼ 0.01). In a model fully adjusted for age, smoking intensity, alcohol consumption and physical activity, the association was no longer significant (P ¼ 0.14). CONCLUSIONS: Higher F&V intake precedes smoking cessation. Hence, smoking cessation could affect the causal interpretation of the association between F&V and CVD in smokers.

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Influence of a cancer diagnosis on changes in fruit and vegetable consumption according to cancer site, stage at diagnosis and socioeconomic factors: Results from the large E3N‐EPIC study

Affret

His

Severi

et al. 2018

Intl Journal of Cancer

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Many studies have demonstrated that lifestyle factors, including diet, may influence cancer survival. The number of cancer survivors is increasing worldwide and little is known about long-term diet changes in people who had cancer. We studied 53,981 women from the prospective E3N-EPIC cohort study with available dietary data in 1993 and 2005, among whom 4,619 had a cancer diagnosis inbetween (including n = 2,699 breast cancers). We evaluated the potential impact of a cancer diagnosis (comparing women with cancer to women with no cancer) on changes in FV consumption using multivariable linear regression models considering cancer site, stage at diagnosis and socioeconomic factors. Compared to women with no cancer, a statistically significant increase in FV consumption (β=+2.65%, [1.22-4.09]) was observed in women who had cancer, and this association appeared to be driven by breast cancer exclusively. The increase in FV consumption was larger in women who had an advanced stage of breast cancer (stages II-IV) (β=+7.23%, [3.92-10.5]) than in women with stages 0-I (β=+2.03%, [-0.20 to 4.26]). Women with no partner and no children were those having the highest increase in FV consumption (β=+18.71%, [6.51-30.91]). These changes were only observed in specific SE groups. When considering adherence to guidelines, the proportion of women who consumed less than 7.5 portions a day in 1993 and more in 2005 was greater in women with advanced breast cancer. More research is now needed to understand how the inequities we observed impact the long-term health after cancer.

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Regional factors interact with educational and income tax levels to influence food intake in France

Cited by 19 publications

References 35 publications

Attitudes toward healthy eating: a mediator of the educational level–diet relationship

Attitudes toward healthy eating: a mediator of the educational level–diet relationship

Fruit and vegetable intake and smoking cessation

Influence of a cancer diagnosis on changes in fruit and vegetable consumption according to cancer site, stage at diagnosis and socioeconomic factors: Results from the large E3N‐EPIC study

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