Given their geographical, economic, and demographic circumstances, France’s overseas territories face nutritional challenges that vary from one region to another. Understanding these challenges makes it possible to identify priority targets for public health initiatives…

The Escal Study: Survey on Health and Eating Habits in Martinique

The study on health and dietary habits in Martinique (Escal) was conducted in 2003–2004 by Santé publique France Antilles-Guyane and the Martinique Health Observatory with the aim of determining, among other things, the nutritional status of the population and its dietary intake. The analyses provided a description of the dietary intakes of the Martinique population aged 16 and older in relation to consumption benchmarks and target indicators of the National Nutrition and Health Program (PNNS). Food
intake data were collected via two 24-hour recall surveys conducted one month apart among individuals aged 16 and older, following a random selection of households to be included. Underreporters were excluded from the analyses. The results were adjusted for the age and sex of the Martinique population and account for the sampling design and clustering effects. The association between sociodemographic characteristics and low consumption of fruits and vegetables, dairy products, and fish was also analyzed.

Click here to access the publications from the Escal study.

The Nutrimay Study: Diet, Nutritional Status, and Health on the Island of Mayotte

The department of Mayotte is undergoing profound socioeconomic and cultural change, characterized, among other things, by strong population growth (half the population is under 20 years old) and a precarious health situation. In terms of nutrition, cases of undernutrition—brutally revealed in 2004 by an epidemic of infantile beriberi—coexist with a high prevalence of obesity among women. To guide public health initiatives in this area, a general population study was conducted in 2006 at the request of the Ministry of Health.
The objectives of the Nutrimay study were to describe the following parameters among the population residing in Mayotte:

• dietary intake,

• physical activity,

• sedentary behavior,

• nutritional status.

Particular attention was paid to the most vulnerable groups: young children (0–4 years) and women of childbearing age (15–49 years).
A secondary objective of the study was also to estimate the prevalence of hypertension among adults.
The study was conducted among 993 individuals. Household characteristics, sociodemographic data, and data on lifestyle habits and medical history were collected via face-to-face questionnaires at participants’ homes. Anthropometric measurements (weight, height, waist and hip circumferences), systolic and diastolic blood pressure (individuals >15 years of age), and an assessment of physical activity among those over 15 years of age, based on the International Physical Activity Questionnaire (IPAQ), were also conducted at participants’ homes. Dietary intake was estimated using two 24-hour dietary recalls, also conducted face-to-face at home, covering two days one month apart.

Access the publications from the Nutrimay study by clicking here.

The Kannari Study: Health, Nutrition, and Chlordecone Exposure in the French West Indies

While the National Nutrition and Health Program (PNNS) and the 2010–2013 Obesity Plan include a version for the French overseas territories formalized in 2012, it was important to update the data on dietary behaviors reported through the Escal study.

Among the findings from Escal, it was shown that the dietary habits of younger generations and the most vulnerable populations had shifted significantly toward unhealthy eating patterns in Martinique.

Ten years later, the Kannari study aimed to examine whether these trends persisted and how they might manifest in Guadeloupe. The ultimate goal of such a study was thus to strengthen the measures implemented to improve the local nutritional situation.

Regarding nutrition, the objectives of the Kannari survey were to:

• Describe the dietary and nutritional intakes of the populations of Guadeloupe and Martinique, both overall and by subgroups of interest (sociodemographic and economic characteristics, health status, etc.), in accordance with current recommendations, particularly those issued under the National Nutrition and Health Program (PNNS);

• Assess the health status of the populations of Guadeloupe and Martinique in terms of the prevalence of overweight and obesity and nutritional biological indicators;

• Describe changes in dietary behaviors and the prevalence of overweight and obesity among the population of Martinique since 2003–2004 (ESCAL survey).

Other specific aspects are also examined in this study:

• The sugar content of products such as sodas and dairy products, which had been found to be higher in Martinique than in mainland France.

• Measurement of exposure to chlordecone and bioaccumulation.

After randomly selecting households to survey from INSEE census data, interviewers visited the sites to randomly select individuals to interview (1 adult and 1 to 3 children per household, depending on age). They administered questionnaires on household composition, health (an age-appropriate questionnaire including anthropometric measurements), and the frequency of consumption of approximately 100 food items. All individuals aged 11 and older were then interviewed twice by telephone to describe in detail their food consumption from the day before the call (24-hour recall). Finally, adults aged 18 and older were offered the option of visiting a laboratory or having a nurse come to their home to collect biological samples. Data
collection took place from September 2013 to February 2014, while biological sample collection continued through the end of June 2014. Approximately 1,800 households with at least one eligible individual in Martinique or Guadeloupe were surveyed. Nearly 3,000 24-hour recalls were conducted by phone by dietitians. Ultimately, approximately 780 adults had biological samples collected.

Click here to access the publications resulting from the Kannari study.