For the last few years, the establishment of a French nutritional policy has become a public health priority. Nutrition has been recognized as a key element for the prevention and the protection against non-communicable diseases, like cancer, obesity or heart diseases. Indeed, the inadequacy of nutritional intake, linked to the lack of physical activity, contributes to the spread of these diseases, which represent today more than 55% of annually deaths in France.
Launched in January 2001 and driven by the Ministry of Health, the National Health and Nutrition Program (Programme National Nutrition Santé – PNNS) aims to improve the health of the entire French population by acting on one of its major determinants, nutrition. The program was extended in 2006 and in 2011. The PNNS involves not only the Ministries of Health and Agriculture but also the Ministries of Education, Sports, Consumption and Research. This strong inter-ministerial dimension shows the complexity of this issue.
This plan provides a reference framework and many incentive tools, used as supports for different actions. It allows the mobilization of many actors (ministries, local representatives, health and education professionals, volunteers…).
THE GENERAL OBJECTIVES AND PRINCIPLES OF THE PNNS
The public health nutrition goals set by the High Council of Public Health structure the strategic baseline and constitute the basis for defining the actions planned for the PNNS. These objectives have been grouped into four main categories:
- To reduce obesity among the French population by stabilizing the prevalence of obesity among adults and decreasing it among children and teenagers
- To increase physical activity and decrease physical inactivity, regardless of age
- To improve eating habits and the nutrient intake: by increasing the consumption of fruits and vegetables, reducing the sodium consumption, increasing calcium intakes, struggling against iron deficiency among women experiencing poverty
- To reduce the prevalence of nutritional disorders: malnutrition, eating disorders.
To achieve these objectives, the PNNS uses the resources and the skills of different sectors, plans or programs implemented by other ministries, especially the one implemented by the Ministry of Agriculture and Food, the National Plan for Food (Programme National pour l’Alimentation – PNA).
At the national level, the PNNS ensures the coordination and the monitoring of the implementation of actions and provides scientific supports, essential to the development of actions. At the regional level, the regional health agencies implement the public health actions defined in the PNNS, in partnership with all stakeholders.
The PNNS is led by several general principles:
- The word “Nutrition” includes issues related to food (nutrients, the social, cultural, economic, sensory and cognitive determinants of eating behaviors) and physical activity.
- This plan takes into account the biological, social and symbolic act of eating and of physical activity.
- The goals and messages promoted through the PNNS are based on a scientific expertise, coordinated by public authorities.
- The plan aims to promote certain diet and lifestyle habits to protect health and reduce the risk of chronic diseases. All these actions include in their design and development the issue of social inequalities in health.
- The nutritional guidelines of the PNNS are designed to promote a diet and a physical activity in favour of an optimal health. No specific product is forbidden but some food groups are promoted, and some others are subject to recommendations as to their limitation.
- Given that living conditions and food environment determine behavior, the PNNS must help to build global dietary environment, to facilitate positive choice for consumers’ health.
- The PNNS promotes and organizes real dialogue between the different stakeholders of the plan at the national, regional and local level.
- The PNNS regularly assess its progress (using efficiency indicators or process evaluation).
Several initial goals have been partially or fully achieved, such as reducing the prevalence of obesity among children, reducing the sodium and sugar consumption or increasing the consumption of fruits. However, these improvements have not uniformly affected all segments of the population and health inequalities have become more pronounced in the field of nutrition.
To learn more: