AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France INRA, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France; and Global Nutrition Department, Danone Research, Palaiseau, France
Global Nutrition Department, Danone Research, Palaiseau, France.
J Nutr. 2014 Jun;144(6):929-36. doi: 10.3945/jn.113.188284. Epub 2014 Apr 3.
Identifying the dietary changes with the greatest potential for improving diet quality is critical to designing efficient nutrition communication campaigns. Our objective was to simulate the effects of different types of dietary substitutions to improve diet quality at the individual level. Starting from the observed diets of 1330 adults participating in the national French Nutrition and Health Survey (Etude Nationale Nutrition Santé), we simulated the effects of 3 different types of food and beverage substitutions with graded implementation difficulty for the consumer in a stepwise dietary counseling model based on the improvement in the PANDiet index, which measures diet quality in terms of nutrient adequacy. In scenario 1, substitutions of a food or beverage for its "lighter" version resulted in a modest improvement in the PANDiet score (Δ = +3.3 ± 0.1) and a decrease in energy intake (Δ = -114 ± 2 kcal/d). In scenario 2, substitutions of a food or beverage within the same food subgroup resulted in a marked improvement in the PANDiet score (Δ = +26.4 ± 0.2) with no significant change in energy intake. In this second scenario, the improvement in nutrient adequacy was due to substitutions in many subgroups, with no single subgroup contributing >8% to the increase in the PANDiet score. In scenario 3, substitutions of a food or beverage within the same food group resulted in the greatest improvement in the PANDiet score (Δ = +31.8 ± 0.2) but with an increase in energy intake (Δ = +204 ± 9 kcal/d). In this third scenario, the improvement in nutrient adequacy was largely due to substitutions of fish for meat and processed meat (∼30% of the increase in the PANDiet score). This study shows that a strategy based on simple substitutions within food subgroups is effective in rapidly improving the nutritional adequacy of the diet of French adults and could be used in public health nutrition actions.
确定具有最大改善饮食质量潜力的饮食变化对于设计高效的营养传播活动至关重要。我们的目标是模拟不同类型的饮食替代，以改善个体层面的饮食质量。从参与国家法国营养与健康调查（Etude Nationale Nutrition Santé）的 1330 名成年人的观察性饮食开始，我们在逐步的饮食咨询模型中模拟了 3 种不同类型的食品和饮料替代的效果，根据改善 PANDiet 指数的程度，该指数根据营养素充足性来衡量饮食质量。在情景 1 中，用“更轻”的版本替代一种食品或饮料会适度提高 PANDiet 评分（Δ=+3.3±0.1）并降低能量摄入（Δ=-114±2kcal/d）。在情景 2 中，在同一食物亚组内替代一种食品或饮料会显著提高 PANDiet 评分（Δ=+26.4±0.2），而能量摄入没有显著变化。在这种第二种情况下，营养素充足性的改善是由于许多亚组中的替代，没有任何一个亚组对 PANDiet 评分的增加贡献超过 8%。在情景 3 中，在同一食物组内替代一种食品或饮料会最大程度地提高 PANDiet 评分（Δ=+31.8±0.2），但会增加能量摄入（Δ=+204±9kcal/d）。在这种第三种情况下，营养素充足性的改善主要归因于鱼类对肉类和加工肉类的替代（约占 PANDiet 评分增加的 30%）。本研究表明，基于食物亚组内简单替代的策略可有效快速提高法国成年人饮食的营养充足性，并可用于公共卫生营养行动。
