Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny93017, France.
Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France.
Br J Nutr. 2022 Feb 28;127(4):619-629. doi: 10.1017/S0007114521001367. Epub 2021 May 21.
Non-communicable diseases, such as cancers and CVD, represent a major public health concern, and diet is an important factor in their development. French dietary recommendations were updated in 2017, and an adherence score, the Programme National Nutrition Santé Guidelines Score (PNNS-GS2), has been developed and validated using a standardised procedure. The present study aimed to analyse the prospective association between PNNS-GS2 and the risk of death, cancer and CVD. Our sample consisted of French adults included in the prospective NutriNet-Santé cohort (n 67 748, 75 634 and 80 269 for the risk of death, cancer and CVD, respectively). PNNS-GS2 (range: -∞ to 14·25) was calculated from the 24-h dietary records of the first 2 years of monitoring. Association between PNNS-GS2 (in quintiles, Q) and the risk of death, cancer and CVD was studied using Cox models adjusted for the main confounding factors. The sample included 78 % of women, aged on average 44·4 years (sd 14·6) with on average 6·6 (sd 2·3) dietary records. Average PNNS-GS2 was 1·5 (sd 3·4) and median follow-up was 6·6 years for cancers and 6·2 years for CVD and deaths. PNNS-GS2 was significantly associated with the risk of death (hazard ratio (HR)Q5vsQ1: 0·77 (95 % CI 0·60, 1·00), 828 cases), cancer (HRQ5vsQ1 = 0·80 (95 % CI 0·69, 0·92), 2577 cases) and CVD (HRQ5vsQ1 0·64 (95 % CI 0·51, 0·81), 964 cases). More specifically, PNNS-GS2 was significantly associated with colorectal and breast cancer risks but not prostate cancer risk. Our results suggest that strong adherence to the 2017 French dietary recommendations is associated with a lower risk of death, cancer or CVD. This reinforces the validity of these new recommendations and will help to promote their dissemination.
非传染性疾病，如癌症和心血管疾病，是主要的公共卫生关注点，而饮食是其发展的一个重要因素。法国饮食建议已于 2017 年更新，并且已经使用标准化程序开发和验证了一个依从性评分，即国家营养与健康计划指南评分（PNNS-GS2）。本研究旨在分析 PNNS-GS2 与死亡、癌症和心血管疾病风险之间的前瞻性关联。我们的样本由参与前瞻性 NutriNet-Santé 队列的法国成年人组成（分别用于死亡、癌症和心血管疾病风险的研究，其人数为 67748、75634 和 80269）。PNNS-GS2（范围：-∞至 14.25）是根据前 2 年监测的 24 小时膳食记录计算得出的。使用 Cox 模型调整主要混杂因素后，研究了 PNNS-GS2（五分位数，Q）与死亡、癌症和心血管疾病风险之间的关系。样本中 78%为女性，平均年龄为 44.4 岁（标准差 14.6），平均有 6.6（标准差 2.3）份膳食记录。平均 PNNS-GS2 为 1.5（标准差 3.4），癌症和心血管疾病及死亡的中位随访时间分别为 6.6 年和 6.2 年。PNNS-GS2 与死亡风险显著相关（Q5 与 Q1 的风险比（HR）：0.77（95%CI0.60，1.00），828 例）、癌症（HRQ5 与 Q1=0.80（95%CI0.69，0.92），2577 例）和心血管疾病（HRQ5 与 Q1=0.64（95%CI0.51，0.81），964 例）。更具体地说，PNNS-GS2 与结直肠癌和乳腺癌风险显著相关，但与前列腺癌风险无关。我们的结果表明，强烈遵守 2017 年法国饮食建议与较低的死亡、癌症或心血管疾病风险相关。这进一步证实了这些新建议的有效性，并将有助于促进其传播。
