French schools on front line of obesity fight

Editor's note: France and Italy are at the forefront of European efforts to promote nutrition and exercise in schools, according to GlobalPost contributors in Paris and Rome. Read about a government-sponsored program to promote healthful eating in Italy's schools, and a return to market-based grocery shopping.

PARIS, France – It's almost an unthinkable admission: the French concerned about their weight?   

Yet when the French school year begins this fall, more than 7,000 students will find themselves the volunteers in an experiment to improve awareness about health and physical fitness — and which coincides with official concerns about rising obesity rates in France.

The project, baptized “Morning Classes, Afternoon Sports,” and taking effect in 124 middle and high schools across the country and in overseas departments, was devised as an antidote to school violence and absenteeism and as a way to help students develop team-building skills, according to Luc Chatel, the French education minister.

But the program’s other inevitable benefits are consistent with recommendations by a panel of health experts commissioned in 2009by President Nicolas Sarkozy to devise a plan for addressing rising obesity in France.

More physical activity at school – whether as a result of installing basketball courts or game posts in schoolyards – promotes physical activity as a way of life, according to one of the 19 suggestions intended to help France stay ahead of the prevention curve.

Not that the average French person needs to give up buttery pastries, rich sauces and red wine tomorrow. 

“The so-called obesity epidemic is about 20 years behind the United States and 10 years behind Great Britain,” said Arnaud Basdevant, a nutritionist and expert on obesity tapped by Elysee to lead the team that will ultimately implement the country’s three-year action plan to fight obesity that came out of the commission’s findings. “This time lag shows that France was committed to the prevention and management of obesity somewhat earlier than the U.S. and the U.K.”

Roughly 14.5 percent of the adult population – about 6.5 million people – was considered obese in 2009 compared with 8.5 percent in 1997, according to figures from the latest ObEpi Roche survey, which has been monitoring the nation’s expanding waistline since 1997. Every three years,the national institute of health and medical research, Inserm, and market research company TNS Sofres distribute 20,000 questionnaires to households in order study the evolution of obesity.

Despite the progressive increase, France’s obesity levels are close to those of the United States in the late 1970s, said Basdevant and Susan Yager, a New York City-based writer and lecturer on nutrition and food. But an average of 250,000 people joining those ranks every year is helping to close that gap, whether the reason is the creep of fast food into the French diet, people working outside the home having less time for long meals or evolving values.

The country’s early adoption of a proactive approach is credited with some successes. Since 2001, Basdevant said, France has had an established National Health and Nutrition Program, a Ministry of Health initiative that has included obesity prevention.

In 2004, when health officials found that the percentage of overweight young people had climbed to 17 percent in 20 years, the government responded by removing all soda and snack machines from the 20 percent of middle schools and 50 percent of high schools that carried them.

The national health program is credited with stabilizing weight gain and obesity in children, improving the amount of fruit and vegetables consumed by adults and helping to reduce the population’s salt intake, according to a national health survey conducted in 2006 and presented in 2007 by the French Institute for Public Health Surveillance, a public institution that reports to the Ministry of Health.

There are plans to go further. Following the presidential panel’s reportissued in December, Sarkozy announced in a letter addressed to Basdevant in June that he was setting aside 140 million euros to implement a national obesity planover the next three years. 

The plan is three-pronged, Basdevant said. The first component aims to create centers for medical care and surgical treatment of obesity and to organize a “care chain.” A research component, as a second element, will look at various factors that contribute to obesity, including economic and social dimensions while prevention, as a third component, will be established gradually.

“It is a multi-factorial disease resulting from the interaction of biological, behavioral, environmental and economic factors,” Basdevant explained in an email message. “The preventive strategy is therefore highly complex and can only be multi-focal and multi-partner.”

The national approach contrasts with that of weight-loss programs like Jenny Craig, as it “pushes ahead with a successful solution to address a major public health issue,” according to a press release issued by Nestlé in March when the program that “combines its ready-made meals with individual consultation” arrived on the French market. Jenny Craig offers a personalized program that requires customers seeking to lose weight to eat pre-packaged meals available for purchase at the company’s weight loss centers.

Valerie Berrebi, a spokeswoman for Nestlé who handles the Jenny Craig account, said colleagues with direct knowledge of how the program was faring in France so far were unavailable for comment since most were just returning from summer holiday.

“They were indeed a solution looking for a problem,” Yager said, referring to Jenny Craig. Her latest book, "The Hundred Year Diet," focuses on America’s $55 billion diet industry and the “national obsession with food, dieting, deprivation, and weight loss.” 

The French attitude toward food, she noted, is very different, as France has always put such a premium on nutrition. To illustrate just how much, Yager, who is based in New York but said she travels to France at least once a year, cited examples of French children being weighed at schools and letters sent home to parents to alert them about any weight-related problems. In the United States, she said, such intervention might yield a reaction from parents of “don’t tell us what to feed our children.”

“They have got to resist the impulse to give in to the quick and easy fixes,” said Yager, who said she would be disappointed to see France go down the diet route. “That is going to catch up with people.”

Closing the nutritional divide is one of the areas Basdevant and his colleagues will focus on in implementing a national plan. They’ll also be looking more closely at economic factors, since obesity has greater impact on the lower socio-economic segment of society,  according to research cited by Basdevant and Jean-Michel Oppert, both of whom worked with the government commission.

“It’s not about finding a scapegoat and believing that in beating that we’ve solved the problem,” Basdevant said. He advocates acting on a variety of axes, ranging from the environment to a city’s transport policy, from the meals served to children at school to individual behavior.

“It is a lengthy process,” he said, “but any preventive action requires time.”