To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
While food-based dietary guidelines have been widely disseminated for decades to improve nutritional knowledge in the population about healthy diets, more recent interventions such as front-of-pack labelling have made the differences between the two approaches apparent. While food-based dietary guidelines provide the overarching framework and benchmarks for a healthy diet, based on the current knowledge of the associations between various dietary components and health outcomes, front-of-pack labelling provides guidance to select a specific food, either within a food group or among similar foods belonging to various brands. Labelling foods as ‘healthy’ or ‘unhealthy’ raises multiple questions on the criteria used to define the terms and the implications of assigning an absolute healthiness value to an individual food in the context of complex diets. Gradual systems may provide more relative assessments and avoid dichotomisation. The present article presents the inherent differences and the complementarity of food-based dietary guidelines and food choice guidance in the context of food labelling.
The 2017 implementation in France of the front-of-package nutrition label known as Nutri-Score is a major public health strategy to help individuals make healthier food choices at the point of purchase and thus help reduce chronic disease risk on the population level. The algorithm behind the Nutri-Score is intended to reflect the overall nutritional quality of food and is based on the one developed by the British Food Standards Agency Nutrient Profiling System, following a slight modification (FSAm-NPS) in accordance with French dietary guidelines. Prior research has focused on its association with various physical health outcomes (weight gain, metabolic syndrome, cancer incidence, etc.), yet no studies have explored the link with oral health indicators. We analyzed the cross-sectional association of the FSAm-NPS with oral health in a population-based sample of 33,231 men and women enrolled in the NutriNet-Santé cohort. Oral health (main dependent variable) was assessed in 2016 with the General Oral Health Assessment Index (GOHAI). It consists of 12 items scored on a 5-point Likert scale (maximum score = 60) with lower scores corresponding to poorer oral health with a detrimental impact on quality of life. FSAm-NPS (main independent variable) was calculated on the basis of 3 non-consecutive 24-h dietary records, following established methodology (score range: -15 to + 40, with lower scores corresponding to higher nutritional quality). Age-specific associations (cutoff = 60 y) were explored via multivariable linear regression models. Mean GOHAI score in the sample was 53.8 ± 5.5 (range: 19 to 60) and mean FSAm-NPS was 6.0 ± 2.2 (range: -6.7 to + 15.5). The unadjusted and the age- and sex-adjusted models were significant only in the younger age group (18–59 y). The fully-adjusted model showed modest yet significant associations between overall nutritional quality and oral health in younger and older participants, with the strength of the model being more pronounced in the former compared with the latter age group (F value: 28.5 vs. 6.3, both p < 0.0001). Overall, consuming food with a higher FSAm-NPS score (corresponding to lower nutritional quality) was associated with higher risk of oral health problems. Future longitudinal studies are needed to confirm the observed associations. On the public health policy level, the findings support implementation of the Nutri-Score on pre-packaged food in order to steer consumer choice toward nutritional profiles that are favorable not only for chronic disease prevention but also for oral health.
A growing number of studies have explored overall health during ageing in a holistic manner by investigating multidimensional models of healthy ageing (HA). However, little attention has been given to the role of adherence to national nutrition guidelines in that context. This study aimed to investigate the prospective association between adherence to the French nutrition guidelines and HA. The authors analysed data from 21 407 participants of the NutriNet-Santé study with a median baseline age of 55·6 years (2009–2014) and initially free of major chronic diseases. HA was defined as not developing major chronic disease, no depressive symptoms, no function-limiting pain, independence in instrumental activities of daily living, good physical, cognitive and social functioning, as well as good self-perceived health. Adherence to guidelines of the French Nutrition and Health Programme (Programme National Nutrition Santé or PNNS) was measured via the PNNS Guideline Score (PNNS-GS), using baseline data from repeated 24-h dietary records and physical activity questionnaires. After a median follow-up of 5·7 years, 46·3 % of participants met our HA criteria. Robust-error-variance Poisson regression revealed that higher PNNS-GS scores, reflecting higher adherence to nutrition recommendations (including both diet and physical activity guidelines), were associated with a higher probability to age healthily (relative riskquartile 4 v. quartile 1 = 1·17 (95 % CI 1·12, 1·22)). Supplementary analyses revealed that this association may, to a small part, be mediated by weight status. The results suggest that high adherence to the French national nutrition recommendations may be linked to better overall health throughout ageing.
Although nutrition has been advocated as a major determinant of healthy ageing (HA), studies investigating the link between dietary quality and HA are scarce. We investigated the association between adherence to French food-based and nutrient-based guidelines at midlife, as assessed by three dietary scores, and HA. HA was assessed in 2007–2009, among 2329 participants of the SUpplémentation en Vitamines et Minéraux AntioXydants study aged 45–60 years at baseline (1994–1995) and initially free of diabetes, CVD and cancer. HA was defined as not developing any major chronic disease, good physical and cognitive functioning, no limitations in instrumental activities of daily living, no depressive symptoms, no health-related limitations in social life, good overall self-perceived health and no function-limiting pain. Data from repeated 24-h dietary records provided at baseline permitted the computation of the modified French Programme National Nutrition Santé-Guideline Score (mPNNS-GS), the Probability of Adequate Nutrient Intake Dietary Score (PANDiet) and the Diet Quality Index-International (DQI-I). Associations of these scores with HA were assessed by logistic regression. In 2007–2009, 42 % of men and 36 % of women met our criteria of HA. After adjustment for potential confounders, higher scores of the mPNNS-GS (ORquartile 4 v. quartile 1 1·44; 95 % CI 1·10, 1·87; Ptrend=0·006) and the PANDiet (1·28; 95 % CI 1·00, 1·64; Ptrend=0·03) were associated with higher odds of HA. We observed no association between DQI-I and HA. In conclusion, this study suggests a beneficial long-term role of high adherence to both food-based and nutrient-based French dietary guidelines for a HA process.
The Internet has become a major source of health and nutrition information. Little is known about the type of consulted websites (institutional v. non-institutional) and the tendency to discuss with a healthcare professional (HCP) the information found on the Internet. The aim of this cross-sectional study was to investigate health- and nutrition-related Internet use in a large French population-based study. Data were collected in 2013 using self-administered, web-based questionnaires from 42 113 participants of the NutriNet-Santé study (mean age=51·2 years, 76 % women). Unconditional multivariate logistic regression analyses and χ2 tests were used for comparisons. In total, 85·1 % of the subjects used the Internet to search for health and/or nutrition information, and 23·6 % used the Internet to read or post messages on health/nutrition forums. Only 16·0 % discussed with a HCP the information found online. This proportion was lower in subjects with lower educational level (OR 0·77; 95 % CI 0·72, 0·82) and lower computer skills (OR 0·70; 95 % CI 0·65, 0·76). In total, 8038 health/nutrition websites were cited, with institutional websites representing only 12·9 % of that number. Only one institutional website was present in the top 10. Older subjects (OR 1·49; 95 % CI 1·28–1·74), those with lower educational level (OR 2·08; 95 % CI 1·75, 2·50) and lower nutritional knowledge (OR 1·33; 1·12, 1·59) were more likely to cite non-institutional websites. This large population-based study showed that institutional websites were infrequently accessed and that a few participants discussed the information found online with their HCP. This particular trend was especially visible among individuals who were more vulnerable regarding misleading information. This supports the need to increase awareness of high-quality websites providing reliable health/nutrition information.
25-Hydroxyvitamin D (25(OH)D) insufficiency is very common in many countries. Yet, the extent to which 25(OH)D status affects cognitive performance remains unclear. The objective of the present study was to evaluate the cross-time association between midlife plasma 25(OH)D concentrations and subsequent cognitive performance, using a subsample from the French ‘SUpplémentation en Vitamines et Minéraux AntioXydants’ randomised trial (SU.VI.MAX, 1994–2002) and the SU.VI.MAX 2 observational follow-up study (2007–9). 25(OH)D concentrations were measured in plasma samples drawn in 1994–5, using an electrochemoluminescent immunoassay. Cognitive performance was evaluated in 2007–9 with a neuropsychological battery including phonemic and semantic fluency tasks, the RI-48 (rappel indicé-48 items) cued recall test, the Trail Making Test and the forward and backward digit span. Cognitive factors were extracted via principal component analysis (PCA). Data from 1009 individuals, aged 45–60 years at baseline, with available 25(OH)D and cognitive measurements were analysed by multivariable linear regression models and ANCOVA, stratified by educational level. PCA yielded two factors, designated as ‘verbal memory’ (strongly correlated with the RI-48 and phonemic/semantic fluency tasks) and ‘short-term/working memory’ (strongly correlated with the digit span tasks). In the fully adjusted regression model, among individuals with low education, there was a positive association between 25(OH)D concentrations and the ‘short-term/working memory’ factor (P= 0·02), mainly driven by the backward digit span (P= 0·004). No association with either cognitive factor was found among better educated participants. In conclusion, higher midlife 25(OH)D concentrations were linked to better outcomes concerning short-term and working memory. However, these results were specific to subjects with low education, suggesting a modifying effect of cognitive reserve.
Carotenoids may help to prevent the ageing of the brain. Previous findings regarding β-carotene alone are not consistent. In the present study, we evaluated the cross-time association between a carotenoid-rich dietary pattern (CDP) and subsequent cognitive performance using a sample of 2983 middle-aged adults participating in the SU.VI.MAX (Supplémentation en Vitamines et Minéraux Antioxydants) study. Cognitive performance was assessed in 2007–9 using six neuropsychological tests, and a composite cognitive score was computed. The cognitive data were related to dietary data obtained by repeated 24 h dietary records (1994–6) and to measurements of baseline plasma concentrations of carotenoids (lutein, zeaxanthin, β-cryptoxanthin, lycopene, α-carotene, trans-β-carotene and cis-β-carotene). DP were extracted using the reduced rank regression method for 381 participants and then extrapolated to the whole sample using plasma carotenoid concentrations as response variables. Associations between a CDP and cognitive function measured 13 years later were estimated with ANCOVA providing mean difference values and 95 % CI across the tertiles of CDP. A correlation between CDP and consumption of orange- and green-coloured fruits and vegetables, vegetable oils and soup was observed. CDP was found to be associated with a higher composite cognitive score (mean difference 1·04, 95 % CI 0·20, 1·87, P for trend 0·02), after adjustment for sociodemographic, lifestyle and health factors. Similar findings were obtained for scores obtained in the cued recall task, backward digit span task, trail making test and semantic fluency task (all P for trend < 0·05). Further studies ought to confirm whether a diet providing sufficient quantity and variety of coloured fruits and vegetables may contribute to the preservation of cognitive function during ageing.
Information on the determinants of dietary supplement (DS) use in France is largely lacking, especially in population subgroups such as smokers. Also, little is known about the role of health professionals in DS purchases. The aim of the present study was to describe DS use along with its sociodemographic, lifestyle and dietary correlates in a large sample of French adults (age 18+years) participating in the NutriNet-Santé cohort study. Data were collected by self-administered Internet questionnaires. Food intakes were assessed by 24 h dietary records. Data on DS use were available for 79 786 participants. Supplement users were compared with non-users by logistic regression. Current DS use at least three times/week was reported by 14·6 % of men and 28·1 % of women. Mg, and vitamins B6 and C were the most frequently consumed nutrients. DS were prescribed or recommended by a physician in 54·9 % of the cases. DS use was positively associated with knowledge of nutritional recommendations and organic product consumption, following a healthier diet and lifestyle (non-smoker, moderate leisure-time physical activity). Current smokers used less DS than did non-smokers, but their DS consumption was substantial (19·0 %) and they were more likely to self-medicate. The present study provides updated and detailed information on DS use determinants in a large French cohort, including a focus on smokers, for whom the long-term effects of DS use are poorly documented and could represent a risk. These findings pave the way for future aetiological studies.
Only a few studies have investigated the impact of nutrients and food groups on hearing level (HL) with a population-based approach. We examined the 13-year association between intake of specific nutrients and food groups and HL in a sample of French adults. A total of 1823 subjects, aged 45–60 years at baseline, participating in the Supplementation with Antioxidant Vitamins and Minerals 2 cohort were selected. Nutrient and food intake was estimated at baseline among participants who had completed at least six 24 h dietary records. HL was assessed 13 years after baseline and was defined as the pure-tone air conduction of the worse ear at the following thresholds: 0·5, 1, 2 and 4 kHz. The relationship between quartiles of energy-adjusted nutrient and food intake and HL was assessed by multivariate linear regression analyses, in men and women separately. Intakes of retinol (P-trend = 0·058) and vitamin B12 (P-trend = 0·068) tended to be associated with better HL in women. Intakes of meat as a whole (P-trend = 0·030), red meat (P-trend = 0·014) and organ meat (P-trend = 0·017) were associated with better HL in women. Higher intake of seafood as a whole (P-trend = 0·07) and of shellfish (P-trend = 0·097) tended to be associated with better HL in men. Consumption of meat is therefore associated with a better HL in women. Further research is required to better elucidate the mechanisms behind the associations between diet and hearing.
Oily fish and other sources of long-chain n-3 polyunsaturated fatty acids (n-3 LCPs) have been proposed as protective against dementia and age related cognitive impairment. The basic mechanisms underlying these proposed benefits have been postulated and experimental studies supporting the plausibility of the putative effects have been published. Observational epidemiological and case control studies also largely support a protective role of fish consumption on cognitive function with advancing age, albeit with important unexplained heterogeneity in findings. In this review we report the findings of the latest Cochrane review on the benefits of n-3 LCP supplementation on cognitive function among cognitively healthy older people and expand the review by including trials conducted with individuals with prevalent poor cognitive function or dementia. We identified seven relevant trials, four among cognitively healthy older people, and three among individuals with pre-existing cognitive decline or dementia, and overall conclude that there is no evidence to support the routine use of n-3 LCPs supplements for the prevention, or amelioration, of cognitive decline in later life. We identified several challenges in the design of intervention studies for the prevention of dementia and cognitive decline in older people that require careful consideration especially in recruitment and retention in long-term trials. Whether the lack of agreement in findings from mechanistic and observational data and from intervention studies reflects a real absence of benefit on cognitive function from n-3 LCP supplementation, or whether it reflects intrinsic limitations in the design of published studies remains open to question.
Email your librarian or administrator to recommend adding this to your organisation's collection.