REDUIRE LES COUTS DES MALADIES METABOLIQUES

!
!"#$%&'()'(*+,-(#'.(/0)0#%'.(/"-01+)%2$'.(3(41%+5'(67&%)(89:;(
"!
!
#$%&'#$!($)!*+&,)!%$)!-.(.%'$)!-$,./+('0&$)!
!
(1!2343512146!718!34923:;<!71!=3!4:6>969?4!7:!@?4A?>6!16!71!=BCD59E41!8?46!@>:@93:;!F?:>!GH961>!=18!
6>?:I=18!2G63I?=9J:18!14!G=1H351!
!
(18!6>?:I=18!2G63I?=9J:18!8?46!1;6>K212146!@?L61:;!14!G=1H3518!=39691>8M!(3!F=:F3>6!718!23=37918!
2G63I?=9J:18!81!>14@?46>146!au#cours#des#65#premiers#jours#de#lactationM!(18!F>94@9F3:;!A3@61:>8!71!
>98J:1!@?4@1>4146!=1!2343512146!71!=3!4:6>969?4!718!34923:;!16!71!=1:>!@?4A?>6!3:!@?:>8!7:!
63>98812146!16!7:!7GI:6!71!=3@6369?4M!
!
'=!186!>3>1!71!41!>14@?46>1>!J:B:4!81:=!6>?:I=1!2G63I?=9J:1<!9=8!H?D35146!8?:H146!14!18@37>9==18!
3:889!N!!
*B186!F?:>J:?9!9=!186!6?:O?:>8!7G=9@36!7BG63I=9>!:4!@?L6!F3>!6>?:I=1<!2398!@1!J:9!186!@1>6394!@B186!J:1!=1!
@?L6!5=?I3=!186!I914!F=:8!G=1HG!J:1!=1!@?L6!7:!6>39612146!71!=3!23=3791!16!718!F1>618!14!=396M!
(18!1AA168!4G5369A8!8:>!=3!)346G!16!=3!P1>69=96G!8?46!3:889!14!F>147>1!14!@?2F61!16!FG43=98146!14@?>1!
F=:8!=B92F3@6!71!@18!F36C?=?5918!8:>!=3!F1>A?>234@1!G@?4?29J:1!7:!6>?:F13:M!
!
(18!23=37918!2G63I?=9J:18!=18!F=:8!@=3889J:18!8?46!=18!@G6?818<!=3!=9F97?81!CGF369J:1<!=BCDF?@3=@G291!
Q@=949J:1!R!A9EH>1!71!=396!2398!3:889!8:IS@=949J:1T<!=3!4?4!7G=9H>34@1<!=1!7GF=3@12146!71!=3!@39==1661!16!
=18!I?961>918M!(18!23229618!F1:H146!3:889!81!@=3881>!F3>29!=18!23=37918!2G63I?=9J:18!F:98J:1!=18!
>:F6:>18!922:49639>18!J:9!14!8?46!8?:H146!U!=B?>95941<!?46!=3!F=:F3>6!7:!612F8!:41!@3:81!
2G63I?=9J:1M!
#
CALCUL#DU#COUT#
#
(1!@?L6!718!23=37918!2G63I?=9J:18!F>147!14!@?4897G>369?4!=1!@?L6!718!6>396121468<!7:!6>3H39=!16!=3!
F1>61!14!=396<!2398!3:889!=18!I398818!71!=3!F>?7:@69?4!U!H149><!=18!>98J:18!71!6>?:I=18!71!=3!
>1F>?7:@69?4<!71!>GA?>21!16!71!2?>63=96G!8:FF=G214639>18M!(1!@3=@:=!81!@?2F=1;9A91!J:347!?4!946E5>1!
=1!A396!J:1!=3!23=3791!2G63I?=9J:1!186!>3>12146!98?=G1!16!J:1!@C3@:41!7B146>1!1==18!3:521461!=1!
>98J:1!71!8:>H14:1!7B:41!3:6>1M!
!
!

!
!"#$%&'()'(*+,-(#'.(/0)0#%'.(/"-01+)%2$'.(3(41%+5'(67&%)(89:;(
V!
!
*B186!39489!J:1!=1!@?L6!718!CDF?@3=@G2918!8:IS@=949J:18!186!I914!8:FG>91:>!3:!@?L6!7B:41!892F=1!A9EH>1!
71!=396M!$4!1AA16!9=!D!3!I914!F=:8!71!H3@C18!14!CDF?@3=@G291!8:IS@=949J:1!4?4!79354?869J:G1!J:1!71!
H3@C18!14!A9EH>1!71!=396M!$6!@1!8?46!=18!CDF?@3=@G2918!8:IS@=949J:18!J:9!H9144146!3=921461>!=1!=?6!718!
34923:;!F>G8146346!F=:891:>8!6>?:I=18!2G63I?=9J:18M!(18!@3=@:=8!2?46>146!39489!J:1!=1!@?L6!718!
CDF?@3=@G2918!8:IS@=949J:18!@?L6146!14!A396!quatre#fois#plus#J:1!=18!A9EH>18!71!=396M!
!
/914!J:1!=1!I:6!8?96!7BGH961>!6?:61!23=3791!2G63I?=9J:1!9=!186!F=:8!8351!71!@?4897G>1>!:4!8:>!@?L6!
=?>8J:1!=3!F>GH3=14@1!7GF3881!:4!@1>6394!81:9=!7348!=1!6>?:F13:M!*1!81:9=!186!:4!?IO1@69A!U!41!F38!
7GF3881>!7348!=1!6>?:F13:M!$4!71WU!71!@1!81:9=!4?:8!F?:H?48!@?4897G>1>!J:1!=1!@?L6!718!
94H186988121468!F?:>!A39>1!I39881>!=3!F>GH3=14@1!71!=3!F36C?=?591!81>3!8:FG>91:>!3:;!IG4GA9@18!
366147:8M!X3>!@?46>1!89!=18!>G8:=6368!7348!=1!6>?:F13:!8?46!8:FG>91:>8!U!@1!81:9=!7GA949<!9=!A3:7>3!
145351>!:4!6>3H39=!71!@?>>1@69?4M!
X?:>!=3!F=:F3>6!718!23=37918!2G63I?=9J:18!F>G@G7122146!@96G18!=18!81:9=8!8?46!6?:8!94AG>91:>8!U!YZM!!
(3!>G7:@69?4!F3>!1;12F=1!71!=3!F>GH3=14@1!71!A9EH>1!71!=396!7348!:4!6>?:F13:!71![Y!H3@C18!71!\Z!U!
YZ!F1>216!39489!une#économie#de#800€!16!=92961!G53=12146!=1!>98J:1!71!@G6?818!16!71!6>?:I=18!71!=3!
>1F>?7:@69?4M!
!
!
<0=-$&'(#>"*&05(#'()>0==)%*0-%+5(?%)05(@0%-(A.+&-%'(=&+*B0%5'C(
!
'=!14!186!71!2K21!F?:>!=18!23229618M!&41!H3@C1!94A1@6G1!14!@?4632941!"!U!]!7348!=18!"^!O?:>8!J:9!
8:9H146!8?4!94A1@69?4M!$6!F?:>6346!:41!H3@C1!J:9!4B186!F38!5:G>91!I3@6G>9?=?59J:12146!3![_Z!71!
>98J:1!71!F3>3`6>1!5:G>91!@=949J:12146<!7?4@!71!>1861>!7348!=1!6>?:F13:<!7?4@!71!@?4632941>!=18!
3:6>18M!!
*B186!39489!J:1!=1!@?L6!7B:41!2322961!5>92F1!3881a!>3F9712146!U!F=:8!71!600€#par#mammiteM!*B186!
I914!F=:8!J:1!=1!@?L6!7:!6>39612146!16!=1!=396!F1>7:<!@B186!I914!F=:8!G53=12146!J:1!@1!J:1!I13:@?:F!
?46!14!6K61M!$6!F?:>6346!89!@1!@C9AA>1!G6396!F3>635G!F3>!=1!F=:8!5>347!4?2I>1!9=!81>396!3=?>8!A3@9=1!71!
@?2F>147>1!J:1!=3!219==1:>1!G@?4?291<!4B186!F38!=1!F>?7:96!71!6>39612146!=1!2?948!@C1>!F?889I=1<!
2398!=3!79294:69?4!7:!4?2I>1!71!@38M!*1!71>491>!F?946!F3881!3=?>8!F3>!:41!23`6>981!71!=B922:496G!
718!34923:;!R!GJ:9=9I>1!3=9214639>1<!Q=B32395>98812146!G6346!:41!@3:81!23O1:>1!7B3AA39I=98812146!71!
=B922:496GT<!:41!51869?4!F>G@981!16!>95?:>1:81!718!3FF?>68!14!?=95?SG=G21468!16!H96329418!Q=18!
@3>14@18!8?46!:4!A3@61:>!71!>98J:1!6>E8!92F?>6346!71!>:F6:>1!922:49639>1T!16!:41!23`6>981!71!=3!
J:3=96G!71!=B14H9>?4412146!R!@?463294369?4!71!=3!=969E>1<!8:>A3@1!71!@?:@C351<!F=3918!3:;!6>3D?48!
4?6322146M!

!
!"#$%&'()'(*+,-(#'.(/0)0#%'.(/"-01+)%2$'.(3(41%+5'(67&%)(89:;(
]!
!
REDUIRE#LES#RISQUES#
!
(1!4?2I>1!71!23=37918!2G63I?=9J:18!F1:6!K6>1!89549A9@369H12146!79294:G!14!32G=9?>346!=1!
2343512146!718!34923:;!7:>346!=1!63>98812146!16!=1!7GI:6!71!=3!=3@6369?4M!!
(3!4:6>969?4<!=1!@?4A?>6!16!=BCD59E41!718!34923:;!8?46!=18!F?9468!@=G8!F?:>!23`6>981>!@18!F>?I=E218M!(3!
5G4G69J:1!9461>H9146!3:889!2398!7348!:41!2?947>1!218:>1M!
'=!A3:6!F>147>1!53>71!U!41!@?4897G>1>!J:1!=!b3=92146369?4!@?221!A3@61:>!71!>98J:1!92F?>6346M!'=!186!
6?:O?:>8!:69=1!71!>3FF1=1>!J:1!l’alimentation#intervient#dans#moins#de#la#moitié#des#causes#de#
maladies#métaboliquesM!'=!A3:6!7?4@!:41!3FF>?@C1!J:9!145=?I1!3:S71=U!71!=B3=92146369?4!16!71!=3!
4:6>969?4<!=18!3:6>18!A3@61:>8!71!8:@@E8!F>G@G7122146!@96G8!U!83H?9>!=1!@?4A?>6!16!=BCD59E41!718!
34923:;M!!
!
STRATEGIES#DE#PREVENTION#
!
):AA98322146!71!F=3@1!F?:>!=18!H3@C18!63>918<!:4!@?46>c=1!7:!>12F=988351!71!=1:>!>:214<!7?4@!71!
=1:>!9451869?4<!:4!86>9@6!@?46>c=1!71!=3!J:3=96G!71!=1:>!3I>1:H12146<!=3!F?889I9=96G!F?:>!1==18!71!I?:51>!
8:AA98322146!16!=1!@?46>c=1!71!=1:>!7GF=3@12146!3A94!71!7G61@61>!3:!F=:8!H961!=18!I?961>918!A?46!
F3>6918!718!>?:69418!U!2166>1!14!F=3@1M!
%:!@c6G!71!=3!4:6>969?4!:41!23`6>981!7:!/M.M*M.!Q/9=34!.=9214639>1!*369?4!.49?4T<!:4!3FF?>6!8:AA98346!
14!-354G89:2!16!14!*3=@9:2!8?46!94798F1483I=18!F?:>!F>GH149>!=18!CDF?@3=@G2918!14!F1>9SF3>6:2M!
&4!@?46>c=1!718!Fd!:>9439>18!7?96!K6>1!:41!F>369J:1!U!94863:>1>!?I=9536?9>12146!8:>!:4!G@C3469==?4!
>1F>G8146369A!718!H3@C18!63>918!Q3:!2?948!V_Z!71!=B1AA1@69A!14!H3@C1TM!
&4!I?;!71!HK=351!71!VY2V<!F>?F>1<!4166?DG!146>1!@C3J:1!HK=351<!798F?8346!7B:41!8?:>@1!7B13:!14!
J:3=96G!16!14!J:34696G!8:AA9834618!16!7B:4!e!3I>9!f!F1>2166346!U!=B34923=!71!8B98?=1>!8?46!92F?>63468!U!
>18F1@61>M!'=!@?4H9146!G53=12146!7B946>?7:9>1!=3!H3@C1!J:9!H3!HK=1>!3:!2?948!^[d!3H346!8?4!HK=351!
7348!@1!I?;!3A94!71!=:9!=39881>!=1!612F8!71!8B3@@=92361>!U!8?4!4?:H1=!14H9>?4412146M!
!
SUIVRE#LES#NOTES#D’ETAT#CORPOREL#ET#LES#REMPLISSAGES#DU#RUMEM#
!
(1!8:9H9!718!g?618!7B$636!*?>F?>1=!Qg$*T!F1>216!71!2166>1!14!GH9714@1!:41!/3=34@1!$41>5G69J:1!
gG5369H1!79>1@612146!=9G1!3:;!@G6?818<!@=949J:18!16h?:!8:IS@=949J:1!16!3:!8D47>?21!71!86G36?81!
CGF369J:1M!(B:41!718!8?=:69?48!=18!F=:8!1AA9@3@18!F?:>!GH961>!=18!23=37918!2G63I?=9J:18!186!71!
8B388:>1>!J:1!=18!H3@C18!63>918!4B3>>9H146!F38!14!G636!6>?F!92F?>6346!3:!HK=351!16!J:1!=1:>!9451869?4!
186!F>G81>HG1!14!A94!71!5186369?4!16!14!7GI:6!71!=3@6369?4M!X?:>!@1=3!:41!g$*!71!]!U!]<Y!5>347!
23;92:2!3:!HK=351!16!:4!)@?>1!71!#12F=988351!7:!#:214!Q)##T!71!^!14!A94!71!i186369?4!8?46!718!
>1FE>18!U!@?46>c=1>!6?:8!=18!2?98M!
!
!

!
!"#$%&'()'(*+,-(#'.(/0)0#%'.(/"-01+)%2$'.(3(41%+5'(67&%)(89:;(
^!
!
<0=-$&'(#>"*&05(#'()>0==)%*0-%+5(<+D(E+-'.(
!
.661469?4!U!41!F38!8:>S4?:>>9>!=18!H3@C18!14!7GI:6!71!63>98812146M!*B186!:41!FC381!7:>346!=3J:1==1!
=18!I18?948!718!34923:;!8?46!3881a!A39I=18!16!F1:H146!K6>1!A3@9=12146!7GF388G8M!&41!C1>I1!71!I?441!
J:3=96G!4?4!>369?44G1!186!8:AA983461!F?:>!7GF3881>!=18!I18?948!718!34923:;M!+4!?I81>H1!3=?>8<!
8:>6?:6!@C1a!=18!d?=861948<!:4!7GFc6!71!5>38!9461>41!J:9!81>3!2?I9=98G!14!A94!71!5186369?4!?:!14!7GI:6!
71!=3@6369?4!16!J:9!@?48696:1!U!=3!A?98!:4!A3@61:>!71!>98J:1!23O1:>!F?:>!=18!6>?:I=18!-G63I?=9J:18!16!
=18!F1>A?>234@18!71!#1F>?7:@69?4!!
(BGJ:9=9I>1!71!=3!>369?4!4B186!F38!F=:8!92F?>6346!J:1!=3!23`6>981!71!=B9451869?4!7:>346!=18!FC3818!71!A94!
71!5186369?4!16!71!7GI:6!71!=3@6369?4M!'=!A3:6!8B388:>1>!G53=12146!7B:41!6>348969?4!@?>>1@61!146>1!=18!
>369?48!718!63>918!16!718!H3@C18!14!=3@6369?4<!F?:>!D!F3>H149><!53>71>!:41!23O?>96G!7B3=921468!
971469J:18!186!=3!8?=:69?4!=3!F=:8!892F=1!F?:>!D!F3>H149>M!+4!O?:1!3=?>8!:49J:12146!8:>!=3!714896G!
G41>5G69J:1!16!=18!J:34696G8!71!A?94!?:!71!F39==1!J:9!H9144146!388:>1>!=1!>12F=988351!7:!>:214!16!
8692:=1>!=B9451869?4M!.!@?2F=G61>!3:!I18?94!F3>!718!81=8!349?49J:18!16!718!3FF?>68!@?2F=G214639>18!
14!?=95?SG=G21468!16!H96329418M!
!
AU#DELA#DE#L’ALIMENTATION#:#LE#CONFORT#ET#L’HYGIENE#
!
%1F:98!=1!]"!23>8!V_"j!71!4?:H1==18!>E5=18!F1:H146!@?47:9>1!U!=3!839891!6?63=1!7B:4!34923=!U!
=B3I366?9>!89!83!4?61!71!F>?F>16G!186!8:FG>91:>1!U!]!Q8:>!^TM!-398!3H346!@1661!988:1!9=!A3:6!I914!3H?9>!14!
6K61!J:B:41!IK61!F>G8146346!:4!G636!71!F>?F>16G!718!F9178<!71!=3!@:9881!?:!71!=3!2321==1!7G5>37G!
F>G81461!718!>98J:18!6>E8!92F?>63468!71!@?463294369?4!16!7?4@!71!/?961>918!16!71!-3229618!6>E8!
A?>612146!3:52146G8M!!
'=!186!94798F1483I=1!71!2166>1!14!F=3@1!:41!8:>H19==34@1!718!8@?>18!71!F>?F>16G!718!34923:;!6?:6!3:!
=?45!71!=1:>!F>?7:@69?4M!
!
X?:>!=18!H3@C18!63>918!:4!@?:@C351!9>>GF>?@C3I=1!R![_Z!71!714896G!81:=12146!3H1@!:4!@?4A?>6!Y!
G6?9=18!R!I13:@?:F!71!F39==1<!F38!7BC:29796G<!F38!71!@?:>346!7B39><!:4!3@@E8!=9I>1!U!=B3=92146369?4!16!U!
=B3I>1:H12146!16!:4!I?;!71!HK=351!@?>>1@612146!?>53498G!8?46!6?:6!3:889!92F?>63468<!H?9>1!F=:8<!J:1!
=BGJ:9=9I>1!718!>369?48M!
!

!
!"#$%&'()'(*+,-(#'.(/0)0#%'.(/"-01+)%2$'.(3(41%+5'(67&%)(89:;(
Y!
!
<0=-$&'(#>"*&05(#'()>0==)%*0-%+5(<+D(E+-'.(
!
!
Coût#mammite#R!FG(H+D5(I(H0%&J(K*%LM(89:NM(O;P;N9:Q;N:R!
Coût#des#maladies#métaboliques#R!H&(S')'5(T0&&'5(3(?&%-%.B(K+*%'-J((+U(65%/0)(K*%'5*'(V5#$.-&J!
Stress#et#immunité#R!F&+$#U++-(W@Q(H'=0&-/'5-(+U(X'-'&%50&J(G'#'*%5'(F&'7'5-%7'(3(4B%+(K-0-'(
Y5%7'&.%-J(P(=)$.%'$&.(=$1)%*0-%+5.!