Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France.
Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France.
Nutrition. 2021 Apr;84:111107. doi: 10.1016/j.nut.2020.111107. Epub 2020 Dec 5.
French food-based dietary guidelines (FBDG) were updated in 2017. The objective of this prospective study was to estimate the associations between the Programme National Nutrition Santé-guidelines score 2 (PNNS-GS2), reflecting the level of adherence to the 2017 FBDG, and the risk of type 2 diabetes (T2D).
A total of 79 205 French adult participants (mean age: 41.5 y [SD = 14.5]; 78.5% were women; 65% were postgraduate) from the NutriNet-Santé cohort (2009-2019) were included. Dietary intakes were collected using repeated 24-h dietary records. The PNNS-GS2 (theorical range: -∞ to 14.25), including six adequacy components and seven moderation components as well as a penalization on energy intake, was computed. The association between the PNNS-GS2 (as quintiles [Q]) and T2D risk was estimated using multivariable Cox proportional hazard models accounting for sociodemographic, anthropometric, and lifestyle and health-related factors.
During an average follow-up of 6.7 y (536 679 person-years), 676 T2D cases occurred. In the multiadjusted model, participants with the highest PNNS-GS2 (higher adherence to the 2017 FBDG), compared with those with the lowest (lower adherence to FBDG), exhibited a 49% reduction in risk of T2D (HR: 0.51, 95% CI: 0.37, 0.69). Body mass index accounted for up to 27% of the main association. The healthy profiles of the cohort's participants may have reduced statistical power.
In this large, prospective cohort study, a higher adherence to the French 2017 FBDG was strongly and inversely associated with the risk of developing T2D. Such analysis should be confirmed in other settings, but in terms of public health and nutritional policy, this study supports the relevance of the 2017 French FBDG.
法国的食物为基础的膳食指南（FBDG）于 2017 年进行了更新。本前瞻性研究的目的是评估反映对 2017 年 FBDG 遵循程度的国家营养健康计划指南得分 2（PNNS-GS2）与 2 型糖尿病（T2D）风险之间的关系。
本研究共纳入了来自 NutriNet-Santé 队列（2009-2019 年）的 79205 名法国成年参与者（平均年龄：41.5 岁[SD=14.5]；78.5%为女性；65%为研究生）。使用重复 24 小时膳食记录收集膳食摄入量。计算了包括六个适当性成分和七个适度性成分以及对能量摄入进行惩罚的 PNNS-GS2（理论范围：-∞至 14.25）。使用多变量 Cox 比例风险模型估计 PNNS-GS2（五分位数[Q]）与 T2D 风险之间的关联，该模型考虑了社会人口统计学、人体测量学、生活方式和与健康相关的因素。
在平均 6.7 年的随访期间（536679 人年），发生了 676 例 T2D 病例。在多调整模型中，与 PNNS-GS2 最低的参与者（对 FBDG 的遵循程度最低）相比，PNNS-GS2 最高的参与者（对 2017 年 FBDG 的遵循程度最高）患 T2D 的风险降低了 49%（HR：0.51，95%CI：0.37，0.69）。体重指数占主要关联的比例高达 27%。队列参与者的健康状况可能降低了统计能力。
在这项大型前瞻性队列研究中，对法国 2017 年 FBDG 的更高遵循度与 T2D 风险呈强烈负相关。在其他环境中应确认这种分析，但就公共卫生和营养政策而言，这项研究支持了 2017 年法国 FBDG 的相关性。
