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Eating Together, a PNNS Recommendation. How Can it be Put Into Practice?
Margot DYEN1 and Lucie SIRIEIX2
1 Institut de Recherche en Gestion et en Économie (IREGE), University of Savoie Mont Blanc, Chambéry, France
2 UMR MoISA, Institut Agro-Montpellier SupAgro, France
1.1. Introduction
What is eating well? There are many answers to this seemingly simple question. First of all, we need to define what we mean by “eating well”. Historically, the issue of health through food was, quite obviously, mainly dealt with by nutritionists, who had an almost exclusively metabolic and physiological approach to nutrition. This led to campaigns promoting a balanced diet, making individuals aware of the nature of the foods to be consumed according to their category (carbohydrates, fibers, proteins, etc.). This functional vision of food prevailed in France until the 1960s and was perpetuated in English-speaking countries, but the book Manger: Français, Européens et Américains face à l’alimentation (Fischler and Masson 2008) shows how, contrary to this vision, the French preferred to conceive food another way. Today, nutritionists are increasingly interested in the issues of social relations around food and highlight that they are determining factors in a balanced diet. Therefore, eating well does not only depend on what we eat, it is also taking the time to sit down, in the company of people who allow us to enjoy a good time. It is also about sharing a dish, about a family meal established at well-defined times. This change can be seen in the recommendations that are made and the French National Nutrition and Health Plan (Plan National Nutrition Santé, PNNS). “Eat and Move” campaign devotes an entire section to this dimension. Thus, eating together is now part of the promotion of eating well, which is no longer just a balanced diet, but an “art of living”. Eating together helps in regulating food intake and invites people to cook more and to take more time to eat, which in turn helps in better perceiving the signals of satiation. As mentioned above, this “art of living” is particularly central to French culture, whereas English-speaking societies have retained a vision that is focused on the nutritional characteristics of food.
In the context of this book, which asks the question “Can we still eat together?”, this chapter is therefore not about all the recommendations of the PNNS but about a specific recommendation: eating together.
Eating together underlines the PNNS’s concerns, as will be detailed in section 1.2. However, this recommendation is not supported by the PNNS. In order to better support these practices of eating together, it is therefore necessary to better understand them and to question the conditions of their implementation. To do this, we adopt a practice-based approach in this chapter to understand how individuals eat together: a qualitative study conducted with 23 participants is presented in section 1.3. Section 1.4 more specifically addresses the questions “what are the materials, skills and meanings associated with these practices?” Section 1.5 focuses on the interactions between these three elements – materials, necessary skills and associated meanings – to show that together they can give rise to particular practices or help overcome obstacles to eating together. On this basis, in section 1.6, we examine the links between eating together and well-being, and in section 1.7, we open up perspectives for accompanying or facilitating eating together practices.
1.2. Eating together, a recommendation of the National Nutrition and Health Plan
Since 2001, France has had a real public policy targeting food, through the Plan National Nutrition Santé (PNNS, French National Nutrition and Health Plan). This initiative, launched by Prime Minister François Fillon in December 2000, had as its general objective “to improve the health status of the population by acting on the major determinant represented by nutrition” (Hercberg 2006). The PNNS materials include food guides, poster campaigns, press articles, support documents and television campaigns. Most of the communication tools are aimed at the general public, but some of the productions are intended for health professionals. The PNNS is intended to be applied in all areas of food consumption, with interventions in schools, health systems, the workplace, neighborhoods and cities, as well as in collective catering. The overall goal of the PNNS is to “contribute to the creation of an overall nutritional environment, facilitating positive choice for the health of consumers” (Chauliac 2011). As a public policy, the PNNS is equipped with evaluation systems to assess the effects of its actions. Thus, it “integrates the regular evaluation of its quantified objectives and, as much as possible, of the actions or measures it implements (effectiveness indicators or process evaluation)”. Its objectives can be summarized in four main points:
– reduce obesity and excess weight among the population;
– increase physical activity and decrease sedentary behavior at all ages;
– improve dietary practices and nutritional intakes, particularly in at-risk populations;
– reduce the prevalence of nutritional diseases.
An assessment of the achievement of these objectives was carried out in 2006–2007 via the Étude Nationale Nutrition Santé (Castetbon et al. 2011), supplemented by the Étude Individuelle Nationale des Consommations Alimentaires (INCA2, National Individual Food Consumption Study (Afssa 2009)), the Baromètre santé-nutrition (Health and Nutrition Barometer) and regional studies (HCSP 2010). These assessments revealed that the objectives had only partially been achieved and that the program needed to be strengthened to continue to promote the desired behaviors (e.g. only a very slight increase in the purchase of fruits and vegetables had been observed) (Hercberg 2006). From this observation, the PNNS2 (2006–2010) emerged.
At the end of the PNNS2, the evaluation report noted that the expected results had not been obtained (particularly in terms of obesity screening (IGAS 2010)). This report recommends, among other things, revising the feasibility of certain objectives, correcting the formulation of certain principles that are sometimes the source of a binary vision of nutrition (“good” vs. “bad” products) and systematically citing the programs with which the PNNS is linked for better coherence between the public policy programs (Menninger et al. 2010). The PNNS is also criticized for not taking sufficient account of local specificities or social groups, which risks stigmatizing certain sectors of the population (Poulain 2006). For example, the PNNS3 includes a special section on overseas territories and emphasizes the importance of social, economic and cultural determinants of diet. This version explicitly emphasizes that it aims to banish “any stigmatization of people based on a particular dietary behavior or