Luc Dauchet

Adherence to the French Programme National Nutrition Santé Guideline Score is associated with better nutrient intake and nutritional status.

BACKGROUND The Nutrition and Health Program (Programme National Nutrition Santé), which has been carried out in France since 2001, includes diet and physical activity recommendations that are being widely disseminated to the general population. OBJECTIVES To develop a score based on adherence to these recommendations and retrospectively estimated its association with demographic and behavior factors, nutrient intake, and serum biomarkers. The Programme National Nutrition Santé Guideline Score (PNNS-GS) includes 13 components. Scoring and cut-off values were determined using information provided by national guidelines. At least one point was attributed when the behavior reported was in accordance with the recommendation. DESIGN/SUBJECTS Adults participating in the SU.VI.MAX study with a minimum of three 24-hour dietary records were included in our analysis (n=5,500). STATISTICAL ANALYSIS Data were analyzed by sex, and sex-specific quartiles of scores were estimated. Multiple logistic regression models adjusted for social and demographic variables were used to estimate the odds ratios for having a relatively high score (quartile 4 vs others). Multivariate linear regression models were used to examine associations of nutrient intake or biomarkers with PNNS-GS quartiles. When applicable, we included a linear contrast to test for trend. RESULTS The authors found statistical associations between the top PNNS-GS quartile and older age, higher occupational categories, nonsmoking status, and normal body mass (P < or = 0.05). Higher PNNS-GS was also associated with lower intake of energy, cholesterol, and added simple sugars, and higher intake of various protective micronutrients. In addition, higher levels of serum beta-carotene and vitamin C were positively associated with increasing quartiles of PNNS-GS. CONCLUSIONS This score is a useful tool for monitoring compliance with the French recommendations.

Dietary patterns and their sociodemographic and behavioural correlates in French middle-aged adults from the SU.VI.MAX cohort.

Background/Objectives:Few studies have investigated dietary patterns among French adults. We aimed to identify dietary patterns and their relation with nutrient intakes, sociodemographic, lifestyle and other health indicators in a large population of middle-aged subjects living in France.Subjects/Methods:Dietary patterns were identified using factor analysis in 5194 women and men aged 45–60 years enrolled in the SU.VI.MAX (Supplémentation en Vitamines et Minéraux Antioxydants) study. Dietary data were based on repeated 24-h dietary records (at least six records during 2 years).Results:Four patterns were identified: (1) ‘alcohol and meat products’; (2) ‘prudent diet’; (3) ‘convenience foods’; and (4) ‘starch, sauces, and vegetables’. The first pattern was positively associated with low education, smoking and overweight in both genders, as well as with abdominal obesity in women and treated hyperlipidaemia and/or hypertension in men. The second pattern was positively correlated with high education and being older than 55 years and negatively correlated with current smoking. This pattern was also associated with overweight and low waist circumference in women and with hyperlipidaemia treatment in men. The third pattern was inversely related to age and positively related to higher education in both genders. In men, higher scores were related to living alone and an urban residence. The fourth pattern was associated with high education and an urban residence in men only.Conclusions:Our study identified four dietary patterns in this population of French middle-aged adults. Associations with sociodemographic, behavioural and health-related factors were found to differ according to dietary patterns. Sex-specific relationships were also found.

Socioeconomic differences in fruit and vegetable consumption among middle-aged French adults: adherence to the 5 A Day recommendation.

BACKGROUND Numerous studies support the protective effect of high fruit and vegetable consumption on chronic disease risk, mainly against cancer and cardiovascular diseases. The increase of fruit and vegetable intake has become a public health priority in many countries. OBJECTIVE The aim of the study was to investigate the relationships of socioeconomic, demographic, and behavioral factors with both quantity and variety of fruit and vegetable consumption. DESIGN/SUBJECTS Fruit and vegetable intake was assessed using repeated 24-hour dietary records collected during a 2-year period from 4,282 French subjects (2,373 men and 1,909 women), aged 45 to 62 years, who participated in a large prospective study. STATISTICAL ANALYSIS Both education level and occupation categories were used as socioeconomic indicators. Logistic regression models were applied to assess factors related to meeting the 5 A Day fruit and vegetable recommendation. Covariance analyses were performed to compare the fruit and vegetable variety scores and the contributions of fruit and vegetables to the total daily diet cost across socioeconomic indicators within each sex. RESULTS Meeting the 5 A Day recommendation was more likely in subjects aged 50 years and older, higher education levels, nonsmokers, moderate alcohol drinkers and in women engaging in regular physical activity. The odds ratio (95% confidence interval) for the lower vs higher education level was 0.70 (0.54 to 0.92) in men and 0.65 (0.48 to 0.85) in women. No significant difference was observed between occupation categories. A positive relationship between vegetable variety and education level was found in both sexes. Fruit variety was positively associated with both education and occupation categories, but only in men. The contribution of fruits to the total daily diet cost increased with occupation (P<0.02) and education (P<0.0001) in men, but decreased with occupation in women (P<0.05). CONCLUSIONS Although cost constraints may explain the lower fruit and vegetable intake in lower socioeconomic groups, the relative influence of budgetary resources, nutrition knowledge, and social and environmental barriers in socioeconomic disparities need further investigation.

Diet Quality Measures and Cardiovascular Risk Factors in France: Applying the Healthy Eating Index to the SU.VI.MAX Study

Objective: To examine associations between diet quality measures, lifestyle variables, and cardiovascular risk factors in a large cohort of French adults. Methods: Participants were 5,081 French men and women aged 35-61 y, voluntarily enrolled in a long-term clinical trial of cancer and CVD prevention (SU.VI.MAX study). Participants provided 12 days of dietary recalls. Data on heights, weights, blood pressure, and lipid profiles were obtained from clinic visits. Statistical Analysis: Healthy Eating Index (HEI) scores were calculated for each participant. The association between dietary and lifestyle variables and health was tested using analyses of variance and regression models in a cross sectional design. Results: Mean age was 51.7 y for men and 47.0 y for women. Mean body mass index (BMI) values were 24.9 for men and 22.6 for women. Obesity rate was 4% and cardiovascular risk factors were low. Mean percent energy from fat was 37% (saturated fat 16%) and very few respondents met US dietary guidelines for fat, saturated fat, and cholesterol. Higher diet quality, as indexed by HEI scores, was associated with being older, married, better educated, physically active, and having never smoked. For men only, higher HEI scores were weakly associated with lower BMI and lower blood pressure. HEI was not associated with plasma lipid measures. Conclusions: In this sample of adult men and women in France, higher HEI scores were associated with healthier lifestyles and higher socioeconomic status. However, HEI scores were only weakly linked to health parameters or to body weight. Linking diet quality to health outcomes is a continuing challenge.

Effects of light to moderate alcohol consumption on thyroid volume and thyroid function

Objective  To examine a possible relationship between alcohol consumption and thyroid volume and function.

Relationships between different types of fruit and vegetable consumption and serum concentrations of antioxidant vitamins

Increased fruit and vegetable consumption has become a health priority in many countries. Therefore, data investigating the influence of different types of fruits and vegetables on serum antioxidant levels would be useful. The objective of the study was to assess the relationship between fruit and vegetable consumption and vitamin serum antioxidant concentrations. Specific fruit and vegetable groups are evaluated. A total of 3521 subjects (1487 men and 2034 women), aged 35-60 years, participating in the SU.VI.MAX cohort were included in this study. Blood samples of participants were analysed for beta-carotene, vitamin C and alpha-tocopherol. Each subject had completed at least six dietary records during the first 2 years of the study. It was found that women had higher mean beta-carotene and vitamin C serum concentrations than men, but lower alpha-tocopherol serum concentrations. Serum beta-carotene and vitamin C concentrations were positively correlated with consumption of both fruit and vegetables, as well as with most of the fruit and vegetable groups tested. These relationships persisted after adjustment for confounding factors. Regression analysis showed a linear dose-response relationship. Root vegetables and citrus fruits were particularly associated with beta-carotene serum status as were citrus fruits for vitamin C. Fruit and vegetable consumption was either not or weakly associated with alpha-tocopherol serum concentrations. These results describe antioxidant serum concentrations according to fruit and vegetable consumption in a large sample and support the findings of previous studies involving a more limited number of subjects.

Socio-economic differences in fruit and vegetable consumption among middle-aged adults in France: adherence to the ‘five-a-day’ recommendation

A high consumption of fruit and vegetables (F&V) has been associated with a lower incidence of many chronic diseases. Increasing F&V intake has become an international public health priority in many countries. The aim of the present study was to investigate relationships between socio-demographic and behavioural factors and both quantity and variety of F&V consumption in a national sample of middle-aged French subjects. The Supplementation en Vitamines et Mineraux Antioxydants (SU.VI.MAX) study included middle-aged adults (aged 45–60 years) who were followed for an 8-year period. All subjects were invited to complete a 24 h dietary record every 2 months. The subjects selected were those who completed at least six dietary records during the first 2 years of follow-up and for whom data were available for all sociodemographic variables and behavioural characteristics. Furthermore, to take into account seasonal variations in F&V consumption the sample was restricted to subjects having at least one-third of their reported 24 h dietary records in the autumn–winter period (November– April) and one-third in the spring–summer period (May–October). Older subjects, non-smokers and moderate alcohol consumers of both genders and women undertaking regular physical activity were more likely to achieve the ‘five-a-day’ F&V recommendation. Educational level was associated with a higher quantity of F&V in the study population. Men with a higher education level consumed a higher variety of F&V, whereas for women variety was significantly higher for vegetables only. No association was found with occupation in multivariate analyses for women, whereas higher fruit variety was observed for higher occupational categories for men. The contribution of F&V to the cost of the total daily diet also differed between socio-economic groups, with some gender-specific relationships. Most of the nutritional policies developed in Western countries to improve F&V intakes are based on general actions for the whole population. However, low socio-economic groups should be targetted with specific actions to improve F&V intake in low consumers.