International Journal of Public Health

, Volume 58, Issue 6, pp 855–864 | Cite as

Metabolic syndrome and socioeconomic status in France: The French Nutrition and Health Survey (ENNS, 2006–2007)

  • M. VernayEmail author
  • B. Salanave
  • C. de Peretti
  • C. Druet
  • A. Malon
  • V. Deschamps
  • S. Hercberg
  • K. Castetbon
Original Article



The main objective was to estimate, in France, the prevalence of metabolic syndrome (MetS) and to investigate the association between socioeconomic position and MetS.


The French National Nutrition and Health Survey (ENNS) cross-sectional national multistage sampling was carried out in 2006–2007. Data collection included waist circumference and blood pressure measurements, blood sample and sociodemographic and medication information. The prevalence of MetS was assessed using several definitions, including Joint Interim Statement (JIS). Association with sociodemographic covariates was assessed using logistic regression models.


Among the 1,856 participants 18–74 years of age, MetS prevalence was found to vary from 14.6 % (National Cholesterol Education Program definition) to 21.1 % (JIS), with no difference between genders. After adjustment, risk of MetS increased with age in both men and women. In women, MetS risk was inversely associated with education level. Risk of MetS was higher in men born outside France than in French-born males.


MetS prevalence appeared to be lower in France than in most industrialised countries. The promoting of public health measures to reduce MetS, for example, lifestyle changes, is of utmost importance, particularly among less favourable socioeconomic categories and among migrants.


Metabolic syndrome Socioeconomic status Prevalence Prevention Adults National 



ENNS was funded by the French Institute for Health Surveillance (InVS) and Paris 13 University. The authors are particularly grateful to the dieticians who collected data, the physicians, nurses and laboratory staff from the health examination centres of the French National Health Insurance System (Caisse nationale d’assurance maladie des travailleurs salariés) who participated in the survey and the Cetaf (Centre technique d’appui et de formation des centres d’examens de santé).

Conflict of interest



  1. Alberti KG, Zimmet P, Shaw J (2005) The metabolic syndrome–a new worldwide definition. Lancet 366:1059–1062CrossRefPubMedGoogle Scholar
  2. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645CrossRefPubMedGoogle Scholar
  3. Alkerwi A, Donneau AF, Sauvageot N, Lair ML, Scheen A, Albert A, Guillaume M (2011) Prevalence of the metabolic syndrome in Luxembourg according to the Joint Interim Statement definition estimated from the ORISCAV-LUX study. BMC Public Health 11:468–478CrossRefGoogle Scholar
  4. Athyros VG, Ganotakis ES, Tziomalos K, Papageorgiou AA, Anagnostis P, Griva T, Kargiotis K, Mitsiou EK, Karagiannis A, Mikhailidis DP (2010) Comparison of four definitions of the metabolic syndrome in a Greek (Mediterranean) population. Curr Med Res Opin 26:713–719CrossRefPubMedGoogle Scholar
  5. Au N, Hollingsworth B (2011) Employment patterns and changes in body weight among young women 8. Prev Med 52:310–316CrossRefPubMedGoogle Scholar
  6. Balkau B, Valensi P, Eschwege E, Slama G (2007) A review of the metabolic syndrome. Diabetes Metab 33:405–413CrossRefPubMedGoogle Scholar
  7. Bonaldi C, Vernay M, Roudier C, Salanave B, Oleko A, Malon A, Castetbon K, Fagot-Campagna A (2011) A first national prevalence estimate of diagnosed and undiagnosed diabetes in France in 18- to 74-year-old individuals: the French Nutrition and Health Survey 2006/2007. Diabet Med 28:583–589CrossRefPubMedGoogle Scholar
  8. Brussaard JH, Lowik MR, Steingrimsdottir L, Moller A, Kearney J, De Henauw S, Becker W (2002) A European food consumption survey method—conclusions and recommendations. Eur J Clin Nutr 56(Suppl 2):S89–S94CrossRefPubMedGoogle Scholar
  9. Castetbon K, Vernay M, Malon A, Salanave B, Deschamps V, Roudier C, Oleko A, Szego E, Hercberg S (2009) Dietary intake, physical activity and nutritional status in adults: the French nutrition and health survey (ENNS, 2006–2007). Br J Nutr 102:733–743CrossRefPubMedGoogle Scholar
  10. Crespo CJ, Ainsworth BE, Keteyian SJ, Heath GW, Smit E (1999) Prevalence of physical inactivity and its relation to social class in US adults: results from the Third National Health and Nutrition Examination Survey, 1988–1994. Med Sci Sports Exerc 31:1821–1827CrossRefPubMedGoogle Scholar
  11. Cuypers K, De RK, Kvaloy K, Knudtsen MS, Krokstad S, Holmen J, Holmen TL (2012) Leisure time activities in adolescence in the presence of susceptibility genes for obesity: risk or resilience against overweight in adulthood? The HUNT study 3. BMC Public Health 12:820CrossRefPubMedCentralPubMedGoogle Scholar
  12. Dallongeville J, Cottel D, Ferrieres J, Arveiler D, Bingham A, Ruidavets JB, Haas B, Ducimetiere P, Amouyel P (2005) Household income is associated with the risk of metabolic syndrome in a sex-specific manner. Diabetes Care 28:409–415CrossRefPubMedGoogle Scholar
  13. Darmon N, Drewnowski A (2008) Does social class predict diet quality? Am J Clin Nutr 87:1107–1117PubMedGoogle Scholar
  14. de Onis M, Habicht JP (1996) Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee 80. Am J Clin Nutr 64:650–658PubMedGoogle Scholar
  15. Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 285:2486–2497CrossRefGoogle Scholar
  16. Ford ES (2005) Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabetes Care 28:1769–1778CrossRefPubMedGoogle Scholar
  17. Fosse, Fagot-Campagna A (2011) Prévalence du diabète et recours aux soins en fonction du niveau socio-économique et du pays d’origine en France métropolitaine. Enquête décennale santé 2002–2003 et enquêtes santé et protection sociale 2002 et 2004. Institut de veille sanitaire, p 74. Accessed 19 Sep 2012
  18. Fung TT, Rexrode KM, Mantzoros CS, Manson JE, Willett WC, Hu FB (2009) Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 119:1093–1100CrossRefPubMedCentralPubMedGoogle Scholar
  19. Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM (2007) Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49:403–414CrossRefPubMedGoogle Scholar
  20. Gavrila D, Salmeron D, Egea-Caparros JM, Huerta JM, Perez-Martinez A, Navarro C, Tormo MJ (2011) Prevalence of metabolic syndrome in Murcia Region, a southern European Mediterranean area with low cardiovascular risk and high obesity. BMC Public Health 11:562–571CrossRefPubMedCentralPubMedGoogle Scholar
  21. Godet-Mardirossian H, Girerd X, Vernay M, Chamontin B, Castetbon K, de PC (2012) Patterns of hypertension management in France (ENNS 2006–2007). Eur J Prev Cardiol 19:213–220CrossRefPubMedGoogle Scholar
  22. Grundy SM (2008) Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 28:629–636CrossRefPubMedGoogle Scholar
  23. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112:2735–2752CrossRefPubMedGoogle Scholar
  24. Hildrum B, Mykletun A, Hole T, Midthjell K, Dahl AA (2007) Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the National Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health 7:220–229CrossRefPubMedCentralPubMedGoogle Scholar
  25. Julia C, Vernay M, Salanave B, Deschamps V, Malon A, Oleko A, Hercberg S, Castetbon K (2010) Nutrition patterns and metabolic syndrome: a need for action in young adults (French Nutrition and Health Survey—ENNS, 2006–2007). Prev Med 51:488–493CrossRefPubMedGoogle Scholar
  26. Laaksonen DE, Lakka HM, Salonen JT, Niskanen LK, Rauramaa R, Lakka TA (2002) Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome 24. Diabetes Care 25:1612–1618CrossRefPubMedGoogle Scholar
  27. Le Jeannic T, Ribera J (2006) Hausse des départs en vacances, mais 21 millions de Français ne partent pas. Insee Première 1093:1–4Google Scholar
  28. Luksiene DI, Baceviciene M, Tamosiunas A, Reklaitiene R, Radisauskas R (2011) Comparison of four definitions of the metabolic syndrome and odds of ischemic heart disease in the Lithuanian urban population. Int J Public Health 3:543–550Google Scholar
  29. Malon A, Deschamps V, Salanave B, Vernay M, Szego E, Estaquio C, Kesse-Guyot E, Hercberg S, Castetbon K (2010) Compliance with French nutrition and health program recommendations is strongly associated with socioeconomic characteristics in the general adult population. J Am Diet Assoc 110:848–856CrossRefPubMedGoogle Scholar
  30. Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, Rinfret S, Schiffrin EL, Eisenberg MJ (2010) The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 56:1113–1132CrossRefPubMedGoogle Scholar
  31. Muller-Nordhorn J, Binting S, Roll S, Willich SN (2008) An update on regional variation in cardiovascular mortality within Europe. Eur Heart J 29:1316–1326CrossRefPubMedGoogle Scholar
  32. Park C, Kang C (2008) Does education induce healthy lifestyle? 1. J Health Econ 27:1516–1531CrossRefPubMedGoogle Scholar
  33. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB (2003) The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 163:427–436CrossRefPubMedCentralPubMedGoogle Scholar
  34. Pettinger C, Holdsworth M, Gerber M (2006) Meal patterns and cooking practices in Southern France and Central England. Public Health Nutr 9:1020–1026CrossRefPubMedGoogle Scholar
  35. Pulkki-Raback L, Elovainio M, Kivimaki M, Mattsson N, Raitakari OT, Puttonen S, Marniemi J, Viikari JS, Keltikangas-Jarvinen L (2009) Depressive symptoms and the metabolic syndrome in childhood and adulthood: a prospective cohort study 39. Health Psychol 28:108–116CrossRefPubMedCentralPubMedGoogle Scholar
  36. Qiao Q (2006) Comparison of different definitions of the metabolic syndrome in relation to cardiovascular mortality in European men and women. Diabetologia 49:2837–2846CrossRefPubMedGoogle Scholar
  37. Riediger ND, Clara I (2011) Prevalence of metabolic syndrome in the Canadian adult population. CMAJ 183:E1127–E1134CrossRefPubMedCentralPubMedGoogle Scholar
  38. Scuteri A, Vuga M, Najjar SS, Mehta V, Everson-Rose SA, Sutton-Tyrrell K, Matthews K, Lakatta EG (2008) Education eclipses ethnicity in predicting the development of the metabolic syndrome in different ethnic groups in midlife: the Study of Women’s Health across the Nation (SWAN). Diabet Med 25:1390–1399CrossRefPubMedCentralPubMedGoogle Scholar
  39. Sun K, Liu J, Ning G (2012) Active smoking and risk of metabolic syndrome: a meta-analysis of prospective studies 17. PLoS ONE 7:e47791CrossRefPubMedCentralPubMedGoogle Scholar
  40. Szigethy E, Szeles G, Horvath A, Hidvegi T, Jermendy G, Paragh G, Blasko G, Adany R, Voko Z (2012) Epidemiology of the metabolic syndrome in Hungary. Public Health 126:143–149CrossRefPubMedGoogle Scholar
  41. Tazi MA, Abir-Khalil S, Chaouki N, Cherqaoui S, Lahmouz F, Srairi JE, Mahjour J (2003) Prevalence of the main cardiovascular risk factors in Morocco: results of a National Survey, 2000. J Hypertens 21:897–903CrossRefPubMedGoogle Scholar
  42. Tentolouris N, Liatis S, Katsilambros N (2006) Sympathetic system activity in obesity and metabolic syndrome. Ann N Y Acad Sci 1083:129–152CrossRefPubMedGoogle Scholar
  43. Turrell G, Hewitt B, Patterson C, Oldenburg B (2003) Measuring socio-economic position in dietary research: is choice of socio-economic indicator important? 102. Public Health Nutr 6:191–200PubMedGoogle Scholar
  44. Ujcic-Voortman JK, Baan CA, Seidell JC, Verhoeff AP (2012) Obesity and cardiovascular disease risk among Turkish and Moroccan migrant groups in Europe: a systematic review. Obes Rev 13:2–16CrossRefPubMedGoogle Scholar
  45. Vernay M, Malon A, Oleko A, Salanave B, Roudier C, Szego E, Deschamps V, Hercberg S, Castetbon K (2009) Association of socioeconomic status with overall overweight and central obesity in men and women: the French Nutrition and Health Survey 2006. BMC Public Health 9:215–223CrossRefPubMedCentralPubMedGoogle Scholar
  46. Wardle J, Steptoe A (2003) Socioeconomic differences in attitudes and beliefs about healthy lifestyles. J Epidemiol Community Health 57:440–443CrossRefPubMedCentralPubMedGoogle Scholar
  47. Winkleby MA, Jatulis DE, Frank E, Fortmann SP (1992) Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health 82:816–820CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Swiss School of Public Health 2013

Authors and Affiliations

  • M. Vernay
    • 1
    • 2
    Email author
  • B. Salanave
    • 1
    • 2
  • C. de Peretti
    • 3
  • C. Druet
    • 3
  • A. Malon
    • 1
    • 2
  • V. Deschamps
    • 1
    • 2
  • S. Hercberg
    • 4
    • 5
  • K. Castetbon
    • 1
    • 2
  1. 1.Département maladies chroniques et traumatismesInstitut de veille sanitaire (InVS), Unité de surveillance et d’épidémiologie nutritionnelle (USEN)Saint-MauriceFrance
  2. 2.Université Paris 13, Sorbonne Paris Cité, Unité de surveillance et d’épidémiologie nutritionnelle (USEN)BobignyFrance
  3. 3.Département maladies chroniques et traumatismesInstitut de veille sanitaire (InVS), Unité multi-programmes (UMUP)Saint-MauriceFrance
  4. 4.Université Paris 13, Sorbonne Paris Cité, Unité de recherche en épidémiologie nutritionnelle (UREN)BobignyFrance
  5. 5.Département de santé publiqueInstitut national de la santé et de la Recherche médicale (U557)/Institut national de la recherche agronomique (U1125), Hôpital AvicenneBobignyFrance

Personalised recommendations