In addition to surveys covering the general population, specific studies of children provide insights into their nutritional status: overweight and obesity among 7- to 9-year-olds, infant feeding, and lifestyle habits among adolescents.

The Corpulence Study for 7- to 9-Year-Olds: Prevalence of Overweight and Obesity Among Second- and Third-Grade Students

In France, one of the priority objectives of the National Nutrition and Health Program (PNNS) was to “halt the rise in the prevalence of overweight and obesity among children.” Indeed, overweight and obesity in children have major consequences in terms of morbidity and mortality, both in the short term (respiratory, orthopedic, metabolic, and psychosocial problems, etc.) and in the long term (persistent obesity, cardiovascular diseases, diabetes, certain cancers, etc.).
The studies conducted by Santé publique France focused on students in second and third grade, mostly aged 7 to 9. Indeed, the rebound in adiposity occurs around the age of 6, following the lowest point on the body mass index (BMI) curve. Before the age of 6, the distribution of individual BMI values relative to the reference curve is often transient. It is only after age 6 that obesity provides a reliable predictor of adult adiposity status.
An initial study involving 1,582 first- and second-grade students from 70 randomly selected elementary schools in 11 of the 26 school districts in metropolitan France was conducted in 2000. Anthropometric data were collected to estimate the prevalence of overweight and obesity among these children aged 7 to 9 years.
This study was repeated in 2007. Its objective was to describe these same prevalence rates among 7- to 9-year-old children enrolled in second and third grade in 2007, and to analyze how they had changed since 2000. The 2007 study involved 2,525 second- and third-grade students from 81 elementary schools selected at random in 64 of the 96 metropolitan departments.
A third study was conducted in 2016. It involved 5,071 CE1-CE2 students from 196 randomly selected elementary schools in 90 of the 96 metropolitan departments. The prevalence of overweight and obesity among 7- to 9-year-olds was described, along with trends observed since 2000 and 2007.
These three studies have been the subject of reports, scientific articles, and presentations (oral and poster) at various conferences. Data from the most recent study (the 2016 study) were also used by the World Health Organization’s (WHO) “Childhood Obesity Surveillance Initiative (COSI).” This initiative, launched in 2007 by the WHO European Office, promotes the monitoring of childhood obesity by standardizing data collection to enable international and temporal comparisons. France has thus been providing national data as part of this European initiative since 2016.

Access the publications from the Corpulence Study for 7- to 9-year-olds by clicking here.

The Épifane Study: Epidemiology in France of Children’s Diet and Nutritional Status During Their First Year of Life

Gaining a Better Understanding of Infant Feeding Practices
Nutrition plays a major role in an infant’s growth and healthy motor and cognitive development. It is also a crucial factor for their future health. For this reason:

• Promoting breastfeeding is one of the objectives of the National Nutrition and Health Program (PNNS) launched in 2001;

• Information on the use of commercial infant formula and the introduction of complementary foods has been disseminated.

To better understand how mothers are following these recommendations and the nutritional status of infants at the national level, Santé publique France has established a surveillance system for children’s diet and nutritional status from birth through the national Epifane study. This study was designed to be repeated regularly to track changes in these data.
Its purpose is to assess the potential impacts of initiatives aimed at promoting breastfeeding and the appropriate introduction of complementary foods for children. This surveillance system is necessary to inform the public and guide public health policies.
The Epifane study focuses specifically on:

• The frequency, duration, and exclusivity of breastfeeding;

• The type, duration, and quantities of infant formula used;

• The methods of introducing solid foods.

A pilot study, conducted in 2010 with a sample of 190 mothers and their newborns in 10 maternity wards in France, concluded that the study was feasible and acceptable to mothers.

The National Study in 2012–2013

The national Epifane study enrolled 3,368 mother-infant pairs in 136 maternity wards across France between January 16 and April 5, 2012. The participation rate among mothers in the maternity wards was 81%. The follow-up period was one year, with families being interviewed in the maternity ward, and at 1 month, 4 months, 8 months, and 12 months of the child’s life. Among the newborns included in the maternity wards, 83% were followed up to 12 months. Self-administered questionnaires were completed 80% online and 20% on paper via mail.
The results of this study were the subject of two articles published in BEH No. 34 on September 18, 2012, and No. 27 on October 7, 2014, as well as a report and several presentations at various conferences. The analysis of this study’s data was also the subject of a doctoral thesis in Public Health with a specialization in Epidemiology, focusing on “Maternal obesity before pregnancy, infant breastfeeding, and postpartum weight change.”
The Epifane study is scheduled to be renewed in 2021, in conjunction with the next National Perinatal Survey (ENP), which will serve as its sampling frame.

Click here to access the publications from the Epifane study.

School Health Surveys

The Directorate for Research, Studies, Evaluation, and Statistics (Drees) has been conducting a series of school health surveys since the early 2000s. Initially conducted every three years, and every other year since 2012, a survey is carried out on a national sample of schoolchildren from one of the following three grade levels: children in the final year of preschool, fifth-grade students, and ninth-grade students (general, technological, vocational, or SEGPA tracks).
The school health surveys are led by the Drees, the General Directorate of School Education (DGESCO), the General Directorate of Health (DGS), and the Directorate of Evaluation, Forecasting, and Performance (DEPP) of the Ministry of National Education, with methodological support from the Institute for Health Surveillance (now Santé publique France). Data collection is carried out in schools by nurses and doctors from the Ministry of National Education.
The data from the 2003–2004 survey of ninth-grade students were analyzed by Santé publique France.
Access publications based on the school-based health surveys by clicking here.