The Perceptions and Needs of French Parents and Pediatricians Concerning Information on Complementary Feeding.

Appropriate complementary feeding (CoF) is the key to preventing childhood obesity and promoting long-term health. Parents must be properly informed through the CoF process. Pediatricians have opportunities to interact with parents during the CoF transition and influence parental feeding decisions. They can convey public health nutrition messages to parents. With the release of new CoF recommendations in France in 2019, and from the perspective of their conversion into official public health communication material, the aim of this study was to explore parents' and pediatricians' perceptions and needs regarding information on CoF. Two online surveys were disseminated to gather information on CoF communication and guidance: one for parents (n = 1001, January 2020); one for pediatricians (n = 301, October 2019). The results showed that the importance of CoF for children's healthy growth was well recognized by both parents and pediatricians. Parents acknowledged pediatricians as the most influential source of advice; and pediatricians were aware of their responsibility in counselling parents on CoF. However, pediatricians neglected the fact that parents gave high trust to their personal network when looking for advice. The Internet was a well-recognized source of information according to all. Diverging from what pediatricians considered useful, parents were interested in practical advice for implementing CoF. This study highlights common expectations and points of divergence between parents' needs and pediatricians' perceptions of those needs with regard to CoF information.

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.

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.

Validation of the FSA nutrient profiling system dietary index in French adults-findings from SUVIMAX study.

PURPOSE: Population-wide nutritional recommendations give guidance on food groups' consumption, though a wide variability in nutritional quality within groups may subsist. Nutrient profiling systems may help capturing such variability. We aimed to apply and validate a dietary index based on the British Food Standards Agency nutrient profiling system (FSA-NPS DI) in French middle-aged adults. METHODS: Dietary data were collected through repeated 24-h dietary records in participants of the Supplémentation en Vitamines et Minéraux Antioxydants study (N = 5882). An aggregated dietary index at the individual level was computed using the FSA-NPS for each food consumed as well as compliance to the French nutritional guidelines using the Programme National Nutrition Santé-Guideline Score (PNNS-GS). Cross-sectional associations between FSA-NPS DI and nutrient intake, PNNS-GS, socio-demographic factors, lifestyle and nutritional biomarkers were computed using ANOVAs. RESULTS: The FSA-NPS DI was able to characterize the quality of the diets at the individual level in terms of nutrient intake and of adherence to nutritional recommendations: +37.6 % in beta-carotene intakes between subjects with a healthier diet versus subjects with a poorer diet, +42.8 % in vitamin C intakes; +17 % in PNNS-GS, all P < 0.001. FSA-NPS-DI was also associated with nutritional status at the biological level: +21.4 % in beta-carotene levels between subjects with a healthier diet versus subjects with a poorer diet, +12.8 % in vitamin C levels, all P < 0.001. CONCLUSIONS: The FSA-NPS DI is a useful and validated tool to discriminate individuals according to the quality of the diet, accounting for nutritional quality within food groups. Taking into account nutritional quality of individual foods allows monitoring change in dietary patterns beyond food groups.

Prospective association between cancer risk and an individual dietary index based on the British Food Standards Agency Nutrient Profiling System.

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.

The Nutrient Profile of Foods Consumed Using the British Food Standards Agency Nutrient Profiling System Is Associated with Metabolic Syndrome in the SU.VI.MAX Cohort.

BACKGROUND: Metabolic syndrome (MetS), comprising high waist circumference, blood pressure, glycemia, and triglycerides, and lower HDL cholesterol could in part be prevented by adequate nutrition. Nutrient profiling systems could be useful public health tools to help consumers make healthier food choices. An individual dietary index (DI) based on nutrient profiling of foods consumed could characterize dietary patterns in relation to the onset of MetS. OBJECTIVE: The objective of this study was to prospectively investigate the association between the Food Standards Agency (FSA) Nutrient Profiling System (NPS) DI and the onset of MetS in a middle-aged French cohort. METHODS: Participants from the SUpplémentation en VItamines et Minéraux AntioXydants cohort (SU.VI.MAX, n = 3741) were included in the present study. The FSA NPS DI was computed by using dietary data from 24 h records at inclusion. MetS was identified at baseline and at year 13 of follow-up with the use of self-reported medication, data from clinical investigations, and biological measurements. A prospective association between the FSA NPS DI (in quartiles and continuous) and the onset of MetS was investigated by using logistic regression. RESULTS: Poorer diets identified with the use of the FSA NPS DI were significantly associated with a higher risk of developing MetS (OR for poorer vs. healthier FSA NPS DI: 1.43; 95% CI: 1.08, 1.89; P-trend across quartiles = 0.02). The FSA NPS DI was significantly associated with the systolic blood pressure (SBP) and diastolic blood pressure (DBP) components of MetS (difference between healthier vs. poorer FSA NPS DI: 2.16 mm Hg for SBP and 1.5 mm Hg for DBP, P-trend across quartiles = 0.02). CONCLUSION: The FSA NPS DI was prospectively associated with the onset of MetS in a middle-aged French population. The application of NPSs in public health initiatives may help the population make healthier food choices, which might reduce the risk of developing MetS.