We are discussing how to include obesity or overweight rates in the America's Health Rankings here at the annual meeting of the Scientific Advisory Committee. Jonathan Fielding, Leah Devlin, Glen Mays, Steve Teutsch, Marthe Gold, and others are pitching in to the discussion. The French have largely avoided the trend toward greater obesity rates. Why is this?
Antoine Flahault, Dean of the École des Hautes Études en Santé Publique (EHESP) commented on this recently in his blog on the EHESP web site. Here's a translation.
Among the 30 OECD countries, France is the seventh from the bottom in rates of obesity. How did France get to this point with the fattest national diet in Europe (42% of food energy in France comes from fat). France is the largest sugar producer of Europe and the largest consumer of bread and cheese, the two largest providers of salt in food today.
Could it be that the French exercise? This is unlikely; we have the second worst place in terms of proportion of adults exercising at a recommended level in Europe (less than 25%, compared to an EU average above 30% with the Netherland at the top at 41%). It is probably not the "genetics" of the French; it must be heterogeneous. It is almost impossible to believe that it is the consumption of wine, which has steadily decreased since 1960, parallel to the decrease in cardiovascular disease.
Determinants of control of obesity in France might be essentially cultural: we are one of the few European countries to continue to have three meals a day and eat nothing (or almost nothing) between meals. Our children continue, for the most part are raised this way. Thus it would seem that even with a diet with the worst possible nutritional composition, if it is small (the new French cuisine providing the model), and if it is eaten only three times a day, it is not easy to get obese. Obesity rates in French children are the lowest in Europe and did not tend to increase in last decade. There are a few studies (North American) showing the link between regular family meals, exposure to television screens and video games for less than two hours a day associated with a low prevalence of obesity. As long as the French retain that cultural advantage, they may be protected against the obesity epidemic across our borders and almost everywhere else in the world.