Malon Aurélie, Deschamps Valérie, Salanave Benoit, Vernay Michel, Szego Emmanuelle, Estaquio Carla, Kesse-Guyot Emmanuelle, Hercberg Serge, Castetbon Katia
Nutritional Surveillance and Epidemiology Unit, French Institute for Health Surveillance, Bobigny, France.
J Am Diet Assoc. 2010 Jun;110(6):848-56. doi: 10.1016/j.jada.2010.03.027.
In many countries, nutrition policies such as the Programme National Nutrition Santé (PNNS), implemented in France since 2001, have been developed to prevent and reduce the risk of chronic disease. However, the way in which such programs might benefit persons having different socioeconomic characteristics is unknown. The French nutrition and health survey (Etude Nationale Nutrition Santé [ENNS]) represented an opportunity to address this issue.
To describe compliance with PNNS recommendations in the general population and to investigate the relationship between social, economic, and educational characteristics and poor compliance with French nutrition recommendations.
A national cross-sectional multistage sampling survey. Food intake was estimated through three 24-hour recalls. Adherence to French nutrition recommendations was estimated using the PNNS guideline score (15 possible points).
Two thousand five hundred seventy-seven adults aged 18 to 74 years living in France in 2006-2007 were included in these analyses.
All analyses were carried out in men and women separately. Sex-specific quartiles of score were estimated. Multiple logistic models were used to identify socioeconomic characteristics (ie, age, marital status, occupational status, education level, and holiday trip in the past 12 months) associated with poor compliance with recommendations (first PNNS guideline score quartile vs three other quartiles), estimating odds ratios (ORs), and their 95% confidence intervals (CIs).
The mean PNNS guideline score was 7.67+/-0.17 in men and 8.55+/-0.12 in women. In both sex groups, a difference of approximately four attained recommendations (out of 13 maximum) was observed between the lowest and highest quartiles. In multivariate models, being in the first PNNS guideline score quartile was significantly associated with lower age and lower occupational status for both sexes. Moreover, women living without a partner were at higher risk of poor compliance with recommendations (adjusted OR 1.43; 95% CI 1.01 to 2.04, vs women living with a partner), as were men not having taken a holiday trip during the past 12 months (adjusted OR 1.78, 95% CI 1.05 to 3.02, vs at least one holiday trip).
Compliance with nutrition recommendations can be improved despite several years of public health interventions carried out by the PNNS. Identification of characteristics associated with poor compliance should help to target future public health measures.
在许多国家，自2001年起在法国实施的诸如国家营养与健康计划（PNNS）等营养政策，旨在预防和降低慢性病风险。然而，此类计划如何使具有不同社会经济特征的人群受益尚不清楚。法国营养与健康调查（ENNS）为解决这一问题提供了契机。
描述普通人群对PNNS建议的依从情况，并调查社会、经济和教育特征与对法国营养建议依从性差之间的关系。
一项全国性横断面多阶段抽样调查。通过三次24小时饮食回顾来估计食物摄入量。使用PNNS指南评分（满分15分）来估计对法国营养建议的依从性。
纳入了2006 - 2007年居住在法国的2577名年龄在18至74岁的成年人进行分析。
所有分析分别在男性和女性中进行。估计了按性别划分的评分四分位数。使用多元逻辑模型来确定与建议依从性差相关的社会经济特征（即年龄、婚姻状况、职业状况、教育水平以及过去12个月内的度假旅行情况），估计比值比（OR）及其95%置信区间（CI）。
男性的PNNS指南平均评分为7.67±0.17，女性为8.55±0.12。在两个性别组中，最低四分位数和最高四分位数之间在达到的建议数量上（最多13条建议中）相差约4条。在多变量模型中，处于PNNS指南评分最低四分位数与两性的较低年龄和较低职业地位显著相关。此外，没有伴侣的女性依从建议差的风险更高（调整后的OR为1.43；95%CI为1.01至2.04，与有伴侣的女性相比），过去12个月内没有度假旅行的男性也是如此（调整后的OR为1.78，95%CI为1.05至3.02，与至少进行过一次度假旅行的男性相比）。
尽管PNNS开展了数年的公共卫生干预措施，但对营养建议的依从性仍可提高。识别与依从性差相关的特征应有助于确定未来的公共卫生措施目标。
