Nutritional surveillance of the general population is conducted through cross-sectional studies of national samples of children and adults living in ordinary households in metropolitan France.
These studies provide a description of dietary intake, physical activity, sedentary behavior, and the nutritional status of the population, particularly in light of current nutritional recommendations.
This nutritional surveillance focuses on the National Nutrition and Health Survey (ENNS), conducted in 2006–2007, and on the nutrition component of the Esteban study, conducted in 2014–2016.

The National Nutrition and Health Survey (ENNS 2006–2007)

The primary objective of the National Nutrition and Health Survey (ENNS) was to describe dietary intakes, nutritional status, and physical activity among a national sample of adults aged 18 to 74 and children aged 3 to 17 living in metropolitan France in 2006–2007.
The secondary objectives were to:

• Describe the prevalence of diabetes, metabolic syndrome, hypertension, and dyslipidemia, along with their nutritional risk factors and their pharmacological and nutritional management among adults;

• Describe the population’s exposure to certain heavy metals (arsenic, cadmium, mercury, lead) and pesticides, as well as their determinants.

The results presented in the report published in 2007 describe the nutritional situation in France according to the target indicators and consumption benchmarks of the National Nutrition and Health Program (PNNS).
Participants were recruited by randomly selecting individuals from households that were themselves selected at random. This recruitment process lasted one year to account for seasonal variations in diet (February 2006–March 2007). In the end, 3,115 adults aged 18 to 74 and 1,675 children aged 3 to 17 living in ordinary households (i.e., people sharing the same primary residence, whether or not they are related) in metropolitan France were included.
The dietary survey involved asking the selected individuals to describe as accurately as possible, during three interviews randomly scheduled over a 15-day period, all the foods and beverages consumed the day before the interview.
A biological, nutritional, and environmental assessment was offered to participants to complement this dietary survey:

• For children: measurement of weight and height, and collection of a hair sample (to assess their exposure to mercury);

• For adults: measurement of weight, height, waist circumference, and hip circumference; blood pressure; and levels of biological markers (total cholesterol, HDL and LDL, triglycerides, hemoglobin, ferritin, blood glucose, glycated hemoglobin, creatinine, urinary iodine, folates, vitamin D) and environmental contaminants (pesticides, lead, cadmium, arsenic, mercury, etc.) via blood, urine, and hair samples.

Physical activity and sedentary behavior were assessed using data collected via questionnaires tailored to the age of the respondents.
This information was supplemented by sociodemographic data, information regarding specific diets, medication use, smoking and alcohol consumption, prior knowledge of diabetes, hypercholesterolemia, or hypertension, environmental exposures, etc.
The ENNS study did not include children under 3 years of age or individuals over 75 years of age, who were instead considered in specific investigations (see the Epifane study for children under 3, and the Anaïs study for older adults living in institutions).
The survey staff consisted of health or nutrition professionals (dietitians, nurses, physicians) recruited and trained by Santé publique France.
Since the 2007 conference and the drafting of the study report, numerous analyses have been conducted using the database created during the ENNS study, whether as part of the nutrition program or other Santé publique France programs. The data have also been used in international projects as reference data for France.

• Access publications from the ENNS study by clicking here.

The Esteban Study (Study on Health, the Environment, Biomonitoring, Physical Activity, and Nutrition) 2014–2016

The third edition of the National Nutrition and Physical Activity Program (PNNS) included among its objectives for 2011–2015 the renewal of the ENNS study in order to obtain reliable data on trends in nutritional surveillance. This renewal is the subject of the Nutrition component of the Study on Health, Environment, Biomonitoring, Physical Activity, and Nutrition (Esteban), which was conducted by Santé publique France in 2014–2016.
The Esteban study is a national study combining surveillance of three health themes, namely: exposure to certain environmental substances, nutrition (diet, physical activity, sedentary lifestyle, and nutritional status), and certain chronic diseases or health risk factors (diabetes, allergies, respiratory diseases, high blood pressure, high cholesterol, etc.). This is a descriptive cross-sectional survey conducted in metropolitan France (excluding Corsica) using a three-stage stratified random sample. It targeted children aged 6–17 and adults aged 18–74.
Subjects were enrolled from April 2014 to March 2016 to account for seasonal variations in diet and potential exposures. The study protocol included a questionnaire survey (sociodemographic and economic characteristics, health, physical activity and sedentary behavior, behaviors, exposures, etc.), a dietary survey (three 24-hour recalls conducted by a dietitian), and a health examination including anthropometric measurements (weight and height), blood pressure measurement, a pulmonary function test (PFT), and biological samples (blood, urine, and hair) to measure certain environmental and nutritional biomarkers and IgE levels. Physical activity was also measured using an accelerometer in a subsample of children and adults. Ultimately, 2,503 adults and 1,104 children were included.
The objectives of the Nutrition component were to describe dietary intake, physical activity, sedentary behavior, and the nutritional status of the population residing in metropolitan France. The aim was to analyze the determinants of dietary behaviors and to track changes in indicators that had already been collected using the same methodology during the 2006–2007 ENNS survey.
The results of the Nutrition component of the Esteban study are published in the form of thematic chapters.

Conducted approximately every seven years, the Esteban survey will make it possible to track changes in numerous health indicators over the long term and identify certain emerging trends.

• Access publications from the Esteban survey by clicking here.