Adherence to the French Programme National Nutrition Santé Guideline Score Is Associated with Better Nutrient Intake and Nutritional Status

Background: The Nutrition and Health Program (Programme National Nutrition Santé), which has been carried out in France since 2001, includes diet and physical activity recommendations that are being widely disseminated to the general population. Objectives: To develop a score based on adherence to these recommendations and retrospectively estimated its association with demographic and behavior factors, nutrient intake, and serum biomarkers. The Programme National Nutrition Santé Guideline Score (PNNS-GS) includes 13 components. Scoring and cut-off values were determined using information provided by national guidelines. At least one point was attributed when the behavior reported was in accordance with the recommendation. Design/subjects: Adults participating in the SU.VI.MAX study with a minimum of three 24-hour dietary records were included in our analysis (n=5,500). Statistical analysis: Data were analyzed by sex, and sex-specific quartiles of scores were estimated. Multiple logistic regression models adjusted for social and demographic variables were used to estimate the odds ratios for having a relatively high score (quartile 4 vs others). Multivariate linear regression models were used to examine associations of nutrient intake or biomarkers with PNNS-GS quartiles. When applicable, we included a linear contrast to test for trend. Results: The authors found statistical associations between the top PNNS-GS quartile and older age, higher occupational categories, nonsmoking status, and normal body mass (P<=0.05). Higher PNNS-GS was also associated with lower intake of energy, cholesterol, and added simple sugars, and higher intake of various protective micronutrients. In addition, higher levels of serum beta-carotene and vitamin C were positively associated with increasing quartiles of PNNS-GS. Conclusions: This score is a useful tool for monitoring compliance with the French recommendations.