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Relationship between sensory liking for fat, sweet or salt and cardiometabolic diseases: mediating effects of diet and weight status.
Lampuré, A, Adriouch, S, Castetbon, K, Deglaire, A, Schlich, P, Péneau, S, Fezeu, L, Hercberg, S, Méjean, C
European journal of nutrition. 2020;(1):249-261
Abstract
PURPOSE Previous works have been suggested that individual sensory liking is a predictor of dietary intake and weight status, and may consequently influence development of cardiometabolic diseases (CMDs). We investigated the association between sensory liking for fat-and-salt, fat-and-sweet, sweet or salt and the onset of hypertension, diabetes and cardiovascular diseases (CVDs) over 6 years in adults, and the mediating effects of dietary intake and body mass index (BMI). METHODS We examined the CMDs risk among 41,332 (for CVD and diabetes) and 37,936 (for hypertension) French adults (NutriNet-Santé cohort). Liking scores, individual characteristics, diet and anthropometry were assessed at baseline using questionnaires. Health events were collected during 6 years. Associations between sensory liking and CMDs risk, and the mediating effect of diet and BMI, were assessed using Cox proportional hazards models. RESULTS Sensory liking for fat-and-salt was associated with an increased risk of diabetes, hypertension and CVD [hazard ratios (HR) for 1-point increment of the sensory score: HR 1.30 (95% CI 1.18, 1.43), HR 1.08 (1.04, 1.13) and HR 1.10 (1.02, 1.19), respectively]. BMI and dietary intake both explained 93%, 98% and 70%, of the overall variation of liking for fat-and-salt liking in diabetes, hypertension and CVD, respectively. Liking for fat-and-sweet and liking for salt were also associated with an increased risk of diabetes [HR 1.09 (1.01, 1.17) and HR 1.09 (1.01, 1.18), respectively], whereas liking for sweet was associated with a decreased risk [HR 0.76 (0.69, 0.84)]. CONCLUSIONS Higher liking for fat-and-salt is significantly associated with CMDs risk, largely explained by dietary intake and BMI. Our findings may help to guide effective targeted measures in prevention.
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Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé).
Srour, B, Fezeu, LK, Kesse-Guyot, E, Allès, B, Méjean, C, Andrianasolo, RM, Chazelas, E, Deschasaux, M, Hercberg, S, Galan, P, et al
BMJ (Clinical research ed.). 2019;:l1451
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Abstract
OBJECTIVE To assess the prospective associations between consumption of ultra-processed foods and risk of cardiovascular diseases. DESIGN Population based cohort study. SETTING NutriNet-Santé cohort, France 2009-18. PARTICIPANTS 105 159 participants aged at least 18 years. Dietary intakes were collected using repeated 24 hour dietary records (5.7 for each participant on average), designed to register participants' usual consumption of 3300 food items. These foods were categorised using the NOVA classification according to degree of processing. MAIN OUTCOME MEASURES Associations between intake of ultra-processed food and overall risk of cardiovascular, coronary heart, and cerebrovascular diseases assessed by multivariable Cox proportional hazard models adjusted for known risk factors. RESULTS During a median follow-up of 5.2 years, intake of ultra-processed food was associated with a higher risk of overall cardiovascular disease (1409 cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet 1.12 (95% confidence interval 1.05 to 1.20); P<0.001, 518 208 person years, incidence rates in high consumers of ultra-processed foods (fourth quarter) 277 per 100 000 person years, and in low consumers (first quarter) 242 per 100 000 person years), coronary heart disease risk (665 cases; hazard ratio 1.13 (1.02 to 1.24); P=0.02, 520 319 person years, incidence rates 124 and 109 per 100 000 person years, in the high and low consumers, respectively), and cerebrovascular disease risk (829 cases; hazard ratio 1.11 (1.01 to 1.21); P=0.02, 520 023 person years, incidence rates 163 and 144 per 100 000 person years, in high and low consumers, respectively). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (saturated fatty acids, sodium and sugar intakes, dietary fibre, or a healthy dietary pattern derived by principal component analysis) and after a large range of sensitivity analyses. CONCLUSIONS In this large observational prospective study, higher consumption of ultra-processed foods was associated with higher risks of cardiovascular, coronary heart, and cerebrovascular diseases. These results need to be confirmed in other populations and settings, and causality remains to be established. Various factors in processing, such as nutritional composition of the final product, additives, contact materials, and neoformed contaminants might play a role in these associations, and further studies are needed to understand better the relative contributions. Meanwhile, public health authorities in several countries have recently started to promote unprocessed or minimally processed foods and to recommend limiting the consumption of ultra-processed foods. STUDY REGISTRATION ClinicalTrials.gov NCT03335644.
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Adherence to the French Eating Model is inversely associated with overweight and obesity: results from a large sample of French adults.
Ducrot, P, Méjean, C, Bellisle, F, Allès, B, Hercberg, S, Péneau, S
The British journal of nutrition. 2018;(2):231-239
Abstract
The 'French Eating Model' characterised by structured meals and conviviality has received little attention, although it has been suggested as a potential explanation of the French paradox. This study aims at assessing the adherence to this model in French adults and whether it is associated with weight status. Eating behaviour and, in particular, number of meals per day, snacking frequency, meal time, meal duration, number of courses, position (standing, sitting), presence of others and pleasure experienced was assessed in 2014, in 47 219 participants of the NutriNet-Santé study. A global score of adherence to the French Eating Model was computed on the basis of eating behaviour components. Prevalence of the model was assessed on a sample weighted according to Census data. Associations between adherence to the model (and its components) and overweight and obesity were assessed using logistic regression analyses adjusted for individual characteristics. Most individuals followed the French Eating Model: three meals a day, at set times, sitting at a table with other people and considering meals as a moment of pleasure. Individuals who exhibited higher adherence to the model were less likely to be overweight (OR=0·89; 95 % CI 0·87, 0·92 or obese (0·76; 95 % CI 0·74, 0·79). Similar trends were found for the following components: number of meals per day, snacking frequency, meal time, meal duration and pleasure experience, whereas an opposite trend was observed for the eating with others component. Although prospective studies are needed to conclude on a causal relationship, these results suggested the potential role of the French Eating Model, which is still prevailing in France, in obesity prevention.
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Are self-reported unhealthy food choices associated with an increased risk of breast cancer? Prospective cohort study using the British Food Standards Agency nutrient profiling system.
Deschasaux, M, Julia, C, Kesse-Guyot, E, Lécuyer, L, Adriouch, S, Méjean, C, Ducrot, P, Péneau, S, Latino-Martel, P, Fezeu, LK, et al
BMJ open. 2017;(6):e013718
Abstract
OBJECTIVES French authorities are considering the implementation of a simplified nutrition labelling system on food products to help consumers make healthier food choices. One of the most documented candidates (Five-Colour Nutrition Label/Nutri-score) is based on the British Food Standards Agency Nutrient Profiling System (FSA-NPS), a score calculated for each food/beverage using the 100 g amount of energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits and vegetables. To assess its potential public health relevance, studies were conducted on the association between the nutritional quality of the diet, measured at the individual level by an energy-weighted mean of all FSA-NPS scores of foods usually consumed (FSA-NPS dietary index (FSA-NPS DI)), and the risk of chronic diseases. The present study aimed at investigating the relationship between the FSA-NPS DI and breast cancer risk. DESIGN Prospective study. SETTING Population based, NutriNet-Santé cohort, France. PARTICIPANTS 46 864 women aged ≥35 years who completed ≥3 24-hour dietary records during their first 2 year of follow-up. PRIMARY OUTCOME MEASURE Associations between FSA-NPS DI and breast cancer risk (555 incident breast cancers diagnosed between 2009 and 2015) were characterised by multivariable-adjusted Cox proportional hazard models. RESULTS A higher FSA-NPS DI (lower nutritional quality of the diet) was associated with an increased breast cancer risk (HR1-point increment=1.06 (1.02-1.11), p=0.005; HRQ5vs.Q1=1.52 (1.11-2.08), p trend=0.002). Similar trends were observed in premenopausal and postmenopausal women (HR1-point increment=1.09 (1.01-1.18) and 1.05 (1.00-1.11), respectively).This study was based on an observational cohort using self-reported dietary data, thus residual confounding cannot be entirely ruled out. Finally, this holistic approach does not allow investigating which factors in the diet most specifically influence breast cancer risk. CONCLUSIONS These results suggested that unhealthy food choices, as characterised by the FSA-NPS, may be associated with an increase in breast cancer risk, supporting the potential public health relevance of using this profiling system in the framework of public health nutritional measures.
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Relative Influence of Socioeconomic, Psychological and Sensory Characteristics, Physical Activity and Diet on 5-Year Weight Gain in French Adults.
Lampuré, A, Castetbon, K, Hanafi, M, Deglaire, A, Schlich, P, Péneau, S, Hercberg, S, Méjean, C
Nutrients. 2017;(11)
Abstract
Individual characteristics, dietary intake and physical activity influence weight status; however, the contribution of each factor to weight change has not been studied. The objective was to confirm a conceptual framework by simultaneously assessing the relative influence of socioeconomic, psychological and sensory characteristics, physical activity, and dietary intake on five-year weight gain in French adults. Individual characteristics, physical activity, and dietary data were assessed at baseline in 8014 participants in the NutriNet-Santé cohort. Self-reported anthropometric data were collected at baseline and five years later. Structural equation models, stratified by baseline body mass index (BMI), were used to perform analyses. Dietary restraint was a direct predictor of weight gain, with a stronger effect than age or intake of energy-dense foods, both in non-overweight and overweight participants. In non-overweight individuals only, intake of nutrient-dense foods and physical activity were inversely associated with weight gain. Regarding dietary intake, fat liking was the most important predictor of nutrient-dense food intake and was also related to energy-dense food intake. In these models, dietary restraint appears to be a direct predictor of weight gain and fat liking is a strong determinant of dietary intake. The influence of dietary restraint on weight gain, not explained by diet, warrants further investigation.
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Food Choice Motives When Purchasing in Organic and Conventional Consumer Clusters: Focus on Sustainable Concerns (The NutriNet-Santé Cohort Study).
Baudry, J, Péneau, S, Allès, B, Touvier, M, Hercberg, S, Galan, P, Amiot, MJ, Lairon, D, Méjean, C, Kesse-Guyot, E
Nutrients. 2017;(2)
Abstract
The purpose of this study was to examine food choice motives associated with various organic and conventional dietary patterns among 22,366 participants of the NutriNet-Santé study. Dietary intakes were estimated using a food frequency questionnaire. Food choice motives were assessed using a validated 63-item-questionnaire gathered into nine food choice motive dimension scores: "absence of contaminants", "avoidance for environmental reasons", "ethics and environment", "taste", "innovation", "local and traditional production", "price", "health" and "convenience". Five consumers' clusters were identified: "standard conventional food small eaters", "unhealthy conventional food big eaters", "standard organic food small eaters", "green organic food eaters" and "hedonist moderate organic food eaters". Relationships between food choice motive dimension scores and consumers' clusters were assessed using analysis of covariance (ANCOVA) models adjusted for sociodemographic factors. "Green organic food eaters" had the highest mean score for the "health" dimension, while "unhealthy conventional food big eaters" obtained the lowest mean score for the "absence of contaminants" dimension. "Standard organic food small eaters", "green organic food eaters" and "hedonist moderate organic food eaters" had comparable scores for the "taste" dimension. "Unhealthy conventional food big eaters" had the highest mean score for the "price" dimension while "green organic food eaters" had the lowest mean scores for the "innovation" and "convenience" dimensions. These results provide new insights into the food choice motives of diverse consumers' profiles including "green" and "hedonist" eaters.
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Association between Motives for Dish Choices during Home Meal Preparation and Weight Status in the NutriNet-Santé Study.
Ducrot, P, Fassier, P, Méjean, C, Allès, B, Hercberg, S, Péneau, S
Nutrients. 2016;(7)
Abstract
Although home cooking has been associated with a lower body mass index in a few studies, no data exists on the motives behind food dish choices during home meal preparation and on their association with overweight. This study aimed to evaluate this association in 50,003 participants from the NutriNet-Santé cohort. Dimensions underlying the importance of 27 criteria possibly influencing dish choices were determined using an exploratory factor analysis. The association between dish choice motives and overweight (including obesity) was estimated using logistic regression models adjusted for sociodemographic and lifestyle characteristics. Five dimensions of dishes choice motives emerged: healthy diet (e.g., "nutritional balance of the dish"), constraints (e.g., "my cooking skills"), pleasure (e.g., "originality of the dish"), specific diets (e.g., "my health status"), and organization (e.g., "what I planned to eat"). A negative association was observed between the healthy diet factor and being overweight (OR = 0.65 (95% CI (confidence interval): 0.62-0.67)), whereas a positive association appeared for factors regarding pleasure (OR = 1.14 (95% CI: 1.10-1.19)) and specific diets (OR = 1.19 (95% CI: 1.17-1.22)). No significant associations were observed for constraints and organization. The significant associations between dish choice motives and overweight suggested the interest of focusing on these motives in order to promote healthier food choices during home cooking.
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Prospective association between a dietary quality index based on a nutrient profiling system and cardiovascular disease risk.
Adriouch, S, Julia, C, Kesse-Guyot, E, Méjean, C, Ducrot, P, Péneau, S, Donnenfeld, M, Deschasaux, M, Menai, M, Hercberg, S, et al
European journal of preventive cardiology. 2016;(15):1669-76
Abstract
BACKGROUND Public health strategies are essential to guide consumers' choices and produce a substantial population impact on cardiovascular disease risk prevention through nutrition. Our aim was to investigate the prospective association between the Food Standards Agency nutrient profiling system dietary index (FSA-NPS DI) and cardiovascular disease risk. The FSA-NPS has been proposed to serve as a basis for a five-colour nutrition label suggested in France to be put on the front of pack of food products. METHODS AND RESULTS A total of 6515 participants to the SU.VI.MAX cohort (1994-2007), who completed at least six 24-hour dietary records during the first two years of the study, were followed for a median of 12.4 years (25th-75th percentiles: 11.0-12.6). Multivariable Cox proportional hazards models were used to characterise the associations between FSA-NPS DI (continuous and sex-specific quartiles) and the incidence of cardiovascular diseases. Interactions with individual characteristics were tested; 181 major cardiovascular events were reported (59 myocardial infarctions, 43 strokes, 79 anginas). A higher FSA-NPS DI, characterising poorer food choices, was associated with an overall increase in cardiovascular disease risk (HRfor a 1-point increment = 1.14 (1.03-1.27); HRQ4vs.Q1 = 1.61 (1.05-2.47), Ptrend Q4-Q1 = 0.03). This association tended to be stronger in smokers (HRfor a 1-point increment = 1.39 (1.11-1.73); Pinteraction = 0.01) and those less physically active (HRfor a 1-point increment = 1.26 (1.08-1.46); Pinteraction = 0.04). CONCLUSIONS Our results suggest that poorer food choices, as reflected by a higher FSA-NPS DI, may be associated with a significant increase in cardiovascular risk, especially in at-risk individuals (smokers and physically inactive persons). This score could be a useful tool for public health prevention strategies. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT00272428.
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Associations between liking for fat, sweet or salt and obesity risk in French adults: a prospective cohort study.
Lampuré, A, Castetbon, K, Deglaire, A, Schlich, P, Péneau, S, Hercberg, S, Méjean, C
The international journal of behavioral nutrition and physical activity. 2016;:74
Abstract
BACKGROUND Individual sensory liking appears to be an important determinant of dietary intake and may consequently influence weight status. Cross-sectional studies have shown positive association between fat liking and weight status and equivocal results regarding salt and sweet liking. Moreover, the contribution of dietary intake to explain this relationship has not been studied yet. We investigated the prospective association between sensory liking for fat, sweet or salt and the onset of obesity over 5 years in adults, and the mediating effect of dietary intake. METHODS We prospectively examine the risk of obesity among 24,776 French adults participating in the NutriNet-Santé cohort study. Liking scores and dietary data were assessed at baseline using a validated web-based questionnaire and 24 h records, respectively. Self-reported anthropometric data were collected using web-based questionnaire, each year during 5 years. Associations between quartiles of liking for fat, sweet or salt and obesity risk, and the mediating effect of diet were assessed by multivariate Cox proportional hazards models stratified by gender, adjusted for sociodemographic and lifestyle factors. RESULTS In both genders, sensory liking for fat was associated with an increased risk of obesity (hazard ratios for quartile 4 compared to quartile 1, men: HR(Q4vs.Q1) = 2.39 (95% CI 1.39,4.11) P-trend = 0.0005, women: HR(Q4vs.Q1) = 2.02 (1.51,2.71) P-trend = <0.0001). Dietary intake explained 32% in men and 52% in women of the overall variation of liking for fat in obesity. Sensory liking for sweet was associated with a decreased risk of obesity (men: HR(Q4vs.Q1) = 0.51 (0.31,0.83) P-trend = 0.01, women: HR(Q4vs.Q1) = 0.72 (0.54,0.96) P-trend = 0.035). No significant association between salt liking and the risk of obesity was found. CONCLUSIONS Unlike sweet and salt liking, higher liking for fat appears to be a major risk factor of obesity, largely explained by dietary intake. Our findings emphasize the need to centrally position sensory liking in obesity prevention.
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Prospective association between cancer risk and an individual dietary index based on the British Food Standards Agency Nutrient Profiling System.
Donnenfeld, M, Julia, C, Kesse-Guyot, E, Méjean, C, Ducrot, P, Péneau, S, Deschasaux, M, Latino-Martel, P, Fezeu, L, Hercberg, S, et al
The British journal of nutrition. 2015;(10):1702-10
Abstract
The Food Standards Agency Nutrient Profiling System (FSA-NPS) constitutes the basis for the Five-Colour Nutrition Label suggested in France to be put on the front-of-pack of food products. At the individual level, a dietary index (FSA-NPS DI) has been derived and validated and corresponds to a weighted mean of all FSA-NPS scores of foods usually consumed by the individual, reflecting the nutritional quality of his/her diet. Our aim was to investigate the association between the FSA-NPS DI and cancer risk in a large cohort. This prospective study included 6435 participants to the SUpplémentation en VItamines et Minéraux AntioXydants cohort (1994-2007) who completed at least six 24 h dietary records during the first 2 years of follow-up. FSA-NPS DI was computed for each subject (higher values representing lower nutritional quality of the diet). After a median follow-up of 12·6 years, 453 incident cancers were diagnosed. Associations were characterised by multivariate Cox proportional hazards models. The FSA-NPS DI was directly associated with overall cancer risk (hazard ratio (HR)for a 1-point increment=1·08 (95 % CI 1·01, 1·15), P trend=0·02; HRQ5 v. Q1=1·34 (95 % CI 1·00, 1·81), P trend=0·03). This association tended to be more specifically observed in subjects with moderate energy intake (≤median, HRfor a 1-point increment=1·10 (95 % CI 1·01-1·20), P trend=0·03). No association was observed in subjects with higher energy intake (P trend=0·3). Results were not statistically significant for breast and prostate cancer risks. For the first time, this study investigated the prospective association between the FSA-NPS individual score and cancer risk. The results suggest that unhealthy food choices may be associated with a 34 % increase in overall cancer risk, supporting the public health relevance of developing front-of-pack nutrition labels based on this score.