ANSES examines a poorly documented topic: socio-economic inequalities in the diets of children and adolescents

According to the data available in France and in Europe, the nutrition of adults with low socio-economic status is less satisfactory than that of more privileged populations. This issue has rarely been studied in children and adolescents in France. In light of this, ANSES's objective is to provide a comprehensive review of the bibliographical data available and describe the diet of these children and adolescents based on the data from its national INCA 2 survey.

A snapshot of food consumption

The ANSES survey confirms that underprivileged children and adolescents:

• have a diet of lower nutritional quality in general and lower dietary diversity, although the differences observed are limited in range; 
• eat less fruits and vegetables (up to one portion less per day);
• drink more soft drinks (up to 2.5 glasses more per week). 

Therefore, concerning intake of fruits and vegetables and soft drinks, the divergence with regard to the PNNS nutritional guidelines (5 fruits and vegetables and half a glass of soft drinks per day), already observed for children and adolescents in the general population, is even higher in underprivileged groups.

Certain unexpected results are also highlighted:

• the study shows no differences in fish consumption for children and adolescents regardless of their socio-economic status, in contrast with the bibliographical data;
• it shows lower intake levels for certain sugar-based products, such as confectionery and cakes, by underprivileged children and adolescents, which contradicts certain generally accepted ideas;
• overall intake of dairy products does not differ depending on socio-economic status, but the types of dairy products consumed do vary (underprivileged children eat less yoghurt and drink more milk).

Nutritional quality of the diet and socio-economic status 

Although the diet of underprivileged children and adolescents was shown to be of lower nutritional quality, this should however be qualified, since 25% of the children in this group do eat a high-quality diet (compared to 40% in less disadvantaged groups). 

ANSES therefore sought to determine the specific socio-economic factors (household income, occupational category, education, etc.) that are most closely linked to dietary disparities. The parents’ education level appears to be an essential factor for the nutritional quality of the diet. Accordingly, for those with equivalent incomes, nutritional quality increased when the parents' education level increased.

In addition, this study shows no differences in energy intake with regard to socio-economic status. However, underprivileged children and adolescents are generally more at risk of weight problems. Since energy balance is linked to a balance between energy intake and energy expenditure, these observations highlight the possible role of a sedentary lifestyle and physical activity levels in excess weight and obesity in children and adolescents. 

ANSES recommendations

Due to the fact that the intake of soft drinks in over one-third of all children and adolescents greatly exceeds the PNNS nutritional recommendations for these drinks, the Agency strongly recommends pursuing and intensifying policy initiatives which aim to reduce the intake of sugars added to foods, and especially those from soft drinks. 

Lastly, while an analysis of the data from the national INCA 2 survey has made it possible to document the relationship between diet and socio-economic status in children and adolescents in France, it has not been able to study the poorest groups. Therefore, specific studies on children and adolescents living in situations of extreme poverty must be initiated.