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Theses

Comportements alimentaires des adultes et des enfants résidant dans les Antilles françaises : déterminants sociaux et évolution

Abstract : The French West Indies, like all Caribbean territories, are facing a public health emergency with a large and rapid increase of the obesity and chronic disease prevalence in recent decades. These prevalence exceed French national averages, leading to many health and economic challenges. This nutritional health change in the French West Indies suggests a nutritional transition described in the literature as concomitant with the development of a sedentary lifestyle, and characterized by a significant change in the structure of diets, in relation to global social, economic and demographic changes. Despite the current major public health challenge, the mechanisms of the nutrition transition are poorly documented in the Caribbean, including the French West Indies. However, it is essential to study the French West Indian nutrition transition and its determinants to propose a realistic, effective, and appropriate approach to improve the diet and nutritional status of these populations. This is even more crucial in the French West Indian context where poverty and social inequalities are higher than in mainland France. The objective of this thesis is to characterize the nutrition transition in the French West Indies and its determinants, and to identify population groups at higher nutritional risk. Based on principal components analysis followed by cluster analysis, 4 co-existing dietary patterns were identified (prudent, traditional, convenient, and transitioning), and the study of factors associated to these profiles shows a persistence of the traditional diet in older individuals but a convenient diet in young individuals, suggesting an advanced but still in progress nutrition transition. Model analysis of the decomposition of changes in nutritional status and consumption over 10 years (2003-2013) in Martinique confirms this result, showing a deterioration in health status and food quality, with an increase in the consumption of highly processed foods and a decrease in the consumption of traditional foods. However, the models show that demographic and socioeconomic shifts, marked by the ageing of the Martinican population and the higher educational attainment, have not been the main drivers of this nutrition transition. This result highlights the importance of other factors in the nutrition transition, such as changes in the food environment, changes in nutritional quality or product prices. Finally, social inequalities in health were highlighted in this thesis. For example, low-educated adults and those receiving social assistance benefits were at higher risk of metabolic syndrome than high-educated and those not receiving social assistance benefits. These effects were independent, reflecting different social processes leading to social inequalities in health and highlighting the need to understand their mechanisms. However, dietary quality contributed little to explain social inequalities in health in our cross-sectional analysis, except in the youngest (16-53 years), highlighting the importance of diet in the early-onset diet-related pathologies. All my results suggest an advanced nutritional transition in the French West Indies. If no action is taken, this nutrition transition could continue, and with it, the prevalence of chronic diseases will continue to increase. To accompany this transition, it is now necessary to develop nutritional policies and recommendations adapted to the Caribbean populations. The identification of population groups at higher risk is therefore key to better target public health actions.
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https://hal.inrae.fr/tel-03157619
Contributor : Jean-Walter Schleich <>
Submitted on : Wednesday, March 3, 2021 - 12:18:05 PM
Last modification on : Thursday, March 4, 2021 - 11:52:47 AM

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  • HAL Id : tel-03157619, version 1

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Zoé Colombet. Comportements alimentaires des adultes et des enfants résidant dans les Antilles françaises : déterminants sociaux et évolution. Alimentation et Nutrition. Montpellier SupAgro, 2020. Français. ⟨tel-03157619⟩

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