Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France.
Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Paris-13 University, Centre de recherche en épidémiologie et statistiques, COMUE Sorbonne Paris Cité, Bobigny, France.
Br J Nutr. 2019 Aug 14;122(3):331-342. doi: 10.1017/S0007114519001181. Epub 2019 Jul 25.
Following the revision of the French dietary guidelines in 2017, the Programme National Nutrition Santé - guidelines score (PNNS-GS), built upon previous recommendations released in 2001, needed to be updated. This cross-sectional study thus aimed to develop and validate the PNNS-GS2, a predefined food-based dietary index based on the 2017-revised French nutritional guidelines. A total of 80 965 participants recruited among French adults (≥18 years old) in the NutriNet-Santé web-based prospective cohort were included. Collected data included repeated 24 h-dietary records over a 2-year period, sociodemographic and, for 16 938 subjects, clinical and biological data. Weighting and cut-offs of the PNNS-GS2 components were collegially arbitrated by nutrition experts who participated in the 2017 revision of the guidelines. Sociodemographic, nutritional and clinical and biological factors were investigated according to quintiles (Q) of PNNS-GS2 (theoretical ranging -17 to +13·5). Mean PNNS-GS2 was 2·1 (sd 3·1) in women and -0·3 (sd 3·6) in men. Higher PNNS-GS2 (higher adherence to 2017 dietary guidelines) was positively associated with (mean difference between Q5 and Q1 in women/men) age (+8·4/+4·7 years), education (+3·9/+7·4 % of university level), physical activity (+13·3/+3·5 % of ≥60 min/d) and non-smoking (+9·7/+13·7 %), and was negatively associated with mean blood pressure (-3·0/-2·8 mmHg), plasma LDL-cholesterol (-0·07/-0·06 g/l) and TAG (-0·10/-0·16 g/l) concentrations. Higher PNNS-GS2 was also associated with higher intake of favourable nutrients, e.g. n-3 PUFA (+0·2/+0·2 % of energy intake), fibres (+8·7/+10·7 g) and vitamin C (+36·6/+43·8 mg). Associations between PNNS-GS2 and sociodemographic and nutritional factors arguing for its validation are coherent. Further studies are needed to evaluate its association with mortality and morbidity.
在 2017 年修订法国饮食指南后，需要更新基于 2001 年发布的先前建议的国家营养健康计划指南评分（PNNS-GS）。因此，这项横断面研究旨在开发和验证 PNNS-GS2，这是一个基于 2017 年修订的法国营养指南的预先设定的基于食物的饮食指数。共有 80965 名法国成年人（≥18 岁）参加了 NutriNet-Santé 网络前瞻性队列研究，其中包括参与者的 2 年重复 24 小时饮食记录、社会人口统计学数据，以及 16938 名参与者的临床和生物学数据。营养专家通过集体协商确定了 PNNS-GS2 成分的权重和切点，这些专家参与了 2017 年指南的修订。根据 PNNS-GS2 的五分位数（Q）（理论范围为-17 至+13.5），调查了社会人口统计学、营养和临床及生物学因素。女性的平均 PNNS-GS2 为 2.1（标准差 3.1），男性为-0.3（标准差 3.6）。更高的 PNNS-GS2（更符合 2017 年饮食指南）与（女性/男性中 Q5 和 Q1 之间的平均差异）年龄（+8.4/+4.7 岁）、教育（+3.9/+7.4%的大学水平）、体力活动（+13.3/+3.5%的≥60 分钟/天）和不吸烟（+9.7/+13.7%）呈正相关，与平均血压（-3.0/-2.8mmHg）、血浆 LDL 胆固醇（-0.07/-0.06g/L）和 TAG（-0.10/-0.16g/L）浓度呈负相关。更高的 PNNS-GS2 也与更有利的营养素摄入有关，例如 n-3PUFA（+0.2/+0.2%的能量摄入）、纤维（+8.7/+10.7g）和维生素 C（+36.6/+43.8mg）。PNNS-GS2 与社会人口统计学和营养因素之间的关联证明了其有效性。需要进一步的研究来评估其与死亡率和发病率的关系。
