Sandrine Bertrais

Effects of Long-Term Daily Low-Dose Supplementation With Antioxidant Vitamins and Minerals on Structure and Function of Large Arteries

Objective—Limited data exist from randomized trials evaluating, noninvasively, the impact of antioxidant supplementation on vascular structure and function. Methods and Results—This is a substudy of the SU.VI.MAX Study, which is a randomized, double-blind, placebo-controlled, cardiovascular and cancer primary prevention trial. Eligible participants (free of symptomatic chronic diseases and apparently healthy) were randomly allocated to daily receive either a combination of antioxidants (120 mg vitamin C, 30 mg vitamin E, 6 mg beta carotene, 100 μg selenium, and 20 mg zinc) or placebo and followed-up over an average of 7.2±0.3 years. At the end-trial examination, the carotid ultrasound examination and carotid–femoral pulse-wave velocity (PWV) measurement were performed blindly in 1162 subjects aged older than 50 years and living in the Paris area. The percentage of subjects with carotid plaques was higher in the intervention group compared with the placebo group (35.2% versus 29.5%, P = 0.04). Common carotid intima-media thickness (mean±SD) was not different between the 2 groups (0.70±0.08 versus 0.70±0.08 mm, P = 0.38). Mean PWV tended to be lower (indicating less stiff aortic arteries) in the intervention group but the difference did not reach statistical significance (P = 0.13). Conclusion—These results suggest no beneficial effects of long-term daily low-dose supplementation of antioxidant vitamins and minerals on carotid atherosclerosis and arterial stiffness.

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.

Changes in leisure-time physical activity and sedentary behaviour at retirement: a prospective study in middle-aged French subjects.

BackgroundLongitudinal studies on physical activity patterns around retirement age are scarce and provide divergent findings. Little is known about changes in sedentary behaviour in this context. Our aim was to investigate relationships between retirement and 3-year changes in leisure-time physical activity (LTPA) patterns and sedentary behaviour in middle-aged French adults.MethodsPast-year LTPA and sedentary behaviour (watching television) were assessed in 1998 and 2001 using the Modifiable Activity Questionnaire on participants in the SU.VI.MAX (Supplementation with Antioxidants and Minerals) study. A total of 698 men and 691 women aged 45-64 were included in this analysis. Comparisons were made between subjects who had retired between 1998 and 2001 and those who continued to work, using the Chi-square test, Student t-test, Wilcoxon rank test or covariance analysis where appropriate.Results20.1% of men and 15.6% of women retired during follow-up. The baseline LTPA level was similar between subjects who retired during follow-up and those who continued to work. Mean LTPA increased by about 2 h/week in men and women who had retired, whereas no change was observed in employed persons. The positive change in LTPA following retirement was mainly related to an increase in activities of moderate intensity, such as walking. Retirement did not modify the ranking of the most frequently performed LTPAs, but the number of participants and the duration increased through retirement. In men, the increase in time spent watching TV was more than twice as high in retirees as in workers (+40.5 vs. +15.0 min/day, P < 0.0001). The same tendency was observed among women, but was borderline non-significant (+33.5 vs. +19.9 min/day, P = 0.05). In women, retirees who increased their walking duration by 2 h/week or more also decreased time spent watching TV by 11.5 min/day.ConclusionsRetirement was associated with both an increase in LTPAs and in time spent watching TV, suggesting that retirement is an important period not only for promoting physical activity, but also for limiting sedentary behaviour.

Effect of supplementation with antioxidants upon long-term risk of hypertension in the SU.VI.MAX study: association with plasma antioxidant levels.

Objective To assess the effects of supplementation with a combination of antioxidant vitamins and trace elements, at nutritional doses, upon the 6.5-year risk of hypertension in the SU.VI.MAX trial. To describe the association between baseline plasma antioxidant levels and the same long-term risk using observational data from the study. Setting A total of 5086 adults from the SU.VI.MAX trial, a randomized primary prevention trial. Results Compared with the placebo group, no effect of supplementation upon the 6.5-year risk of hypertension could be detected (odds ratio, 1.04 and 95% confidence interval, 0.87–1.23 in men; and odds ratio, 1.10 and 95% confidence interval, 0.95–1.29 in women). Furthermore, compared with men in the first tertile, those in the second and third tertiles of serum baseline levels of β-carotene presented a lower risk of hypertension in both the placebo and supplementation groups. Multivariate-adjusted odds ratios (95% confidence interval) were 0.70 (0.44–1.12) and 0.53 (0.33–0.86) in the placebo group, and were 0.59 (0.37–0.94) and 0.67 (0.42–1.07) in the supplementation group. In women, a decreasing trend was observed with vitamin C levels and risk of hypertension in the intervention group. No association could be shown between vitamin E and trace element plasma levels and the risk of hypertension. Conclusions Despite an inverse association between baseline plasma levels of β-carotene in men and the risk of developing hypertension, we could not demonstrate any beneficial effect of low-dose antioxidant supplementation upon the 6.5-year risk of hypertension in the randomized analysis.

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.

Complement component 3 polymorphisms interact with polyunsaturated fatty acids to modulate risk of metabolic syndrome

BACKGROUND Complement component 3 (C3) is a novel determinant of the metabolic syndrome (MetS). Gene-nutrient interactions with dietary fat may affect MetS risk. OBJECTIVES The objectives were to determine the relation between C3 polymorphisms and MetS and whether interaction with plasma polyunsaturated fatty acids (PUFAs), a biomarker of dietary PUFA, modulate this relation. DESIGN C3 polymorphisms (rs11569562, rs2250656, rs1047286, rs2230199, rs8107911, rs344548, rs344550, rs2241393, rs7257062, rs163913, and rs2230204), biochemical measurements, and plasma fatty acids were measured in the LIPGENE-SUpplementation en VItamines et Minéraux AntioXydants (SU.VI.MAX) study in MetS cases and matched controls (n = 1754). RESULTS Two single nucleotide polymorphisms were associated with MetS. rs11569562 GG homozygotes had decreased MetS risk compared with minor A allele carriers [odds ratio (OR): 0.53; 95% CI: 0.35, 0.82; P = 0.009], which was augmented by high plasma PUFA status (OR: 0.32; 95% CI: 0.11, 0.93; P = 0.04). GG homozygotes had lower C3 concentrations than those in AA homozygotes (P = 0.03) and decreased risk of hypertriglyceridemia compared with A allele carriers (OR: 0.54; 95% CI: 0.34, 0.92; P = 0.02), which was further ameliorated by an increase in long-chain n-3 (omega-3) PUFAs (OR: 0.46; 95% CI: 0.22, 0.97; P = 0.04) or a decrease in n-6 PUFAs (OR: 0.32; CI: 0.16, 0.62; P = 0.002). rs2250656 AA homozygotes had increased MetS risk relative to minor G allele carriers (OR: 1.78; CI: 1.19, 2.70; P = 0.02), which was exacerbated by low n-6 PUFA status (OR: 2.20; CI: 1.09, 4.55; P = 0.03). CONCLUSION Plasma PUFAs may modulate the susceptibility to MetS that is conferred by C3 polymorphisms, which suggests novel gene-nutrient interactions. This trial was registered at clinicaltrials.gov as NCT00272428.

Contribution of ready-to-eat cereals to nutrition intakes in French adults and relations with corpulence.

Aims: The nutrient impact of ready-to-eat (RTE) cereal consumption was assessed in adults (men 45–60 years; women 35–60 years old) who regularly consumed RTE cereals anytime during the day, compared to those who did not or who were occasional eaters. Methods: Data were obtained for 2,188 men and 2,851 women living in France and participating in the SU.VI.MAX cohort, who reported twelve 24-hour dietary records during 2 years of follow-up (60,468 records). Results: In the heavy consumers group, RTE cereals provided 193 kcal/day for men and 168 kcal/day for women and contributed 8–10% of total daily energy intake; 15–17% of total daily carbohydrates intake; 4% of total daily lipids intake; 5–6% of total protein intake; and 19–23% of total fiber intake. Moreover, RTE cereals contributed 20–30% of total daily intake for vitamins B1, B2, B6 and folic acid, and 7% for vitamin B12. For minerals, they provided, respectively, for men and women, 22 and 25% of total daily intake for iron, 12 and 14% for magnesium, and 4% for calcium. In both genders, heavy consumers of RTE cereals derived a greater proportion of daily energy from carbohydrates and a lesser proportion of energy from fats. Total daily fiber intake is higher for RTE cereal consumers than for nonconsumers and increases with the frequency of consumption. Frequent consumers of RTE cereals have higher dietary intakes of calcium, magnesium, iron, vitamins B1, B2, B6, and folic acid than do nonconsumers. BMI and waist/hip ratio were significantly lower in heavy consumers of RTE cereals than in nonconsumers. Conclusion: The present data suggest that the consumption of RTE cereals contributes to a balanced diet. The strong association between cereal consumption and vitamin and mineral intakes confirm previous studies suggesting that RTE cereals make a major contribution to micronutrient intakes. The consumption of RTE cereals also appears to be associated with lower corpulence.

Gene-nutrient interactions with dietary fat modulate the association between genetic variation of the ACSL1 gene and metabolic syndrome.

Long-chain acyl CoA synthetase 1 (ACSL1) plays an important role in fatty acid metabolism and triacylglycerol (TAG) synthesis. Disturbance of these pathways may result in dyslipidemia and insulin resistance, hallmarks of the metabolic syndrome (MetS). Dietary fat is a key environmental factor that may interact with genetic determinants of lipid metabolism to affect MetS risk. We investigated the relationship between ACSL1 polymorphisms (rs4862417, rs6552828, rs13120078, rs9997745, and rs12503643) and MetS risk and determined potential interactions with dietary fat in the LIPGENE-SU.VI.MAX study of MetS cases and matched controls (n = 1,754). GG homozygotes for rs9997745 had increased MetS risk {odds ratio (OR) 1.90 [confidence interval (CI) 1.15, 3.13]; P = 0.01}, displayed elevated fasting glucose (P = 0.001) and insulin concentrations (P = 0.002) and increased insulin resistance (P = 0.03) relative to the A allele carriers. MetS risk was modulated by dietary fat, whereby the risk conferred by GG homozygosity was abolished among individuals consuming either a low-fat (<35% energy) or a high-PUFA diet (>5.5% energy). In conclusion, ACSL1 rs9997745 influences MetS risk, most likely via disturbances in fatty acid metabolism, which was modulated by dietary fat consumption, particularly PUFA intake, suggesting novel gene-nutrient interactions.

ACC2 gene polymorphisms, metabolic syndrome, and gene-nutrient interactions with dietary fat

Acetyl-CoA carboxylase β (ACC2) plays a key role in fatty acid synthesis and oxidation pathways. Disturbance of these pathways is associated with impaired insulin responsiveness and metabolic syndrome (MetS). Gene-nutrient interactions may affect MetS risk. This study determined the relationship between ACC2 polymorphisms (rs2075263, rs2268387, rs2284685, rs2284689, rs2300453, rs3742023, rs3742026, rs4766587, and rs6606697) and MetS risk, and whether dietary fatty acids modulate this in the LIPGENE-SU.VI.MAX study of MetS cases and matched controls (n = 1754). Minor A allele carriers of rs4766587 had increased MetS risk (OR 1.29 [CI 1.08, 1.58], P = 0.0064) compared with the GG homozygotes, which may in part be explained by their increased body mass index (BMI), abdominal obesity, and impaired insulin sensitivity (P < 0.05). MetS risk was modulated by dietary fat intake (P = 0.04 for gene-nutrient interaction), where risk conferred by the A allele was exacerbated among individuals with a high-fat intake (>35% energy) (OR 1.62 [CI 1.05, 2.50], P = 0.027), particularly a high intake (>5.5% energy) of n-6 polyunsaturated fat (PUFA) (OR 1.82 [CI 1.14, 2.94], P = 0.01; P = 0.05 for gene-nutrient interaction). Saturated and monounsaturated fat intake did not modulate MetS risk. Importantly, we replicated some of these findings in an independent cohort. In conclusion, the ACC2 rs4766587 polymorphism influences MetS risk, which was modulated by dietary fat, suggesting novel gene-nutrient interactions.

Acknowledgement to the 2000 Reviewers

Adam, O., München, Germany Bauer, C.P., Gaissach, Germany Berdel, D., Wesel, Germany Boeing, H., Bergholz-Rehbrücke, Germany Eder, K., Halle, Germany Elmadfa, I., Wien, Austria Erbersdobler, H., Kiel, Germany Flynn, A., Cork, Ireland Goldenberg, H., Wien, Austria Götz, M., Wien, Austria Grimm, H., Giessen, Germany Hagemeister, H., Rostock, Germany Heymsfield, G., New York, USA Krawinkel, M., Giessen, Germany Krempf, M., Nantes, France Laplace, J.P., Paris, France Lemmens, R., Wien, Austria Linseisen, J., Heidelberg, Germany Martinez, J.A., Pamplona, Spain Metges, C., Bergholz-Rehbrücke, Germany Moser, U., Basel, Switzerland Müller, M.J., Kiel, Germany Pfeuffer, E., Kiel, Germany Pietrzik, K., Bonn, Germany Pils, K., Wien, Austria Roth, H.P., Freising-Weihenstephan, Germany Rust, P., Wien, Austria Saris, W., Mastricht, Netherlands Schrezenmeir, J., Kiel, Germany Schümann, K., München, Germany Schweigert, F.J., Bergholz-Rehbrücke, Germany Seiler, W., Basel, Switzerland Thorsdottir, I., Reykjavik, Iceland Van den Berg, H., AJ Zeist, Netherlands Vasson, M.P., Clermont-Ferrand, France Vermeer, C., Mastricht, Netherlands Wernermann, J., Huddinge, Sweden Zunft, H.J., Bergholz-Rehbrücke, Germany