Review: Quality of animal-source foods.

This article critically reviews the current state of knowledge on the quality of animal-source foods according to animal production and food processing conditions, including consumer expectations-behaviours and the effects of consumption of animal-source foods on human health. Quality has been defined through seven core attributes: safety, commercial, sensory, nutritional, technological, convenience, and image. Image covers ethical, cultural and environmental dimensions associated with the origin of the food and the way it is produced and processed. This framework enabled to highlight the priorities given to the different quality attributes. It also helped to identify potential antagonisms and synergies among quality attributes, between production and processing stages, and among stakeholders. Primacy is essentially given to commercial quality attributes, especially for standard commodity animal-source foods. This primacy has strongly influenced genetic selection and farming practices in all livestock commodity chains and enabled substantial quantitative gains, although at the expense of other quality traits. Focal issues are the destructuration of chicken muscle that compromises sensory, nutritional and image quality attributes, and the fate of males in the egg and dairy sectors, which have heavily specialised their animals. Quality can be gained but can also be lost throughout the farm-to-fork continuum. Our review highlights critical factors and periods throughout animal production and food processing routes, such as on-farm practices, notably animal feeding, preslaughter and slaughter phases, food processing techniques, and food formulation. It also reveals on-farm and processing factors that create antagonisms among quality attributes, such as the castration of male pigs, the substitution of marine-source feed by plant-based feed in fish, and the use of sodium nitrite in meat processing. These antagonisms require scientific data to identify trade-offs among quality attributes and/or solutions to help overcome these tensions. However, there are also food products that value synergies between quality attributes and between production and processing phases, particularly Geographical Indications, such as for cheese and dry-cured ham. Human epidemiological studies have found associations between consumption of animal-source foods and increased or decreased risk for chronic non-communicable diseases. These associations have informed public health recommendations. However, they have not yet considered animal production and food processing conditions. A concerted and collaborative effort is needed from scientists working in animal science, food process engineering, consumer science, human nutrition and epidemiology in order to address this research gap. Avenues for research and main options for policy action are discussed.

Influence of the urban context on the relationship between neighbourhood deprivation and obesity.

BACKGROUND: In middle- and high-income countries, obesity is positively associated with neighbourhood deprivation. However, the moderating effect of the broader urban residential context on this relationship remains poorly understood. METHODS: In this study, we have examined the nonlinear and geographically varying relationship between neighbourhood deprivation and the likelihood of being a person with overweight among participants of the French NutriNet-Santé adult cohort study (n = 68,698), adjusted for age, gender and educational level. Ten urban residential contexts (e.g., suburbs, peri-urban or rural areas) were defined. We used a multilevel generalised additive modelling framework for analyses. RESULTS: We found that the relationship between neighbourhood deprivation and overweight differed according to urban context, in terms of both linearity and intensity. Overall, the deprivation-overweight relationship was strongly positive (with a higher prevalence of overweight in deprived neighbourhoods) in suburban areas of Paris and of other large French cities, while weak or null in small towns and rural areas, and intermediate in inner cities. In addition, we observed in suburbs of Paris and in peri-urban belts of large cities that beyond a certain level of neighbourhood deprivation, the relationship with overweight plateaued. DISCUSSION: In a French population from a high-income country, suburbs, as well as moderately deprived neighbourhoods of peri-urban areas of large cities, are potential targets for public health and urban planning policies aiming at preventing obesity. Our results emphasize the value of local analyses to better capture the complexity and contextual variations of socioeconomic determinants of non-communicable diseases such as obesity.

High expression of CPT1b in skeletal muscle in metabolically healthy older subjects.

AIM: Ageing is often associated with metabolic abnormalities such as insulin resistance, although some people remain metabolically healthy throughout their lives. The aim of this study was to gain more insight into metabolic health with increasing age. METHODS: Two groups of robust and of frail subjects, respectively, were identified based on a composite ageing indicator and recruited from the French SU.VI.MAX 2 cohort of older disease-free subjects. In all, 14 men and 12 women, aged 67±4 years, with similar anthropometric and metabolic characteristics at baseline (BMI: 24.5±2.9kg.m-2) were included in the Compaliclamp study. Skeletal muscle biopsy was performed to assess expression of a set of metabolic and sirtuin (SIRT) genes. Also, whole-body substrate oxidation and insulin sensitivity were determined using the euglycaemic-hyperinsulinaemic clamp and indirect calorimetry techniques. RESULTS: Robust subjects were more insulin-sensitive, oxidized more lipid in a fasting state and stored more glucose during the euglycaemic - hyperinsulinaemic clamp than did frail subjects. At the gene-expression level in skeletal muscle, carnitine palmitoyltransferase 1b (CPT1b) messenger RNA (mRNA) levels were around four times higher in the robust compared with frail counterparts. Moreover, both SIRT2 and SIRT6 expression was lower in robust subjects and correlated with CPT1b expression. CONCLUSION: CPT1b overexpression could be helping to maintain metabolic health with increasing age. Thus, it is suggested that targeting CPT1b expression might be an interesting strategy to counteract frailty at an early stage. In addition, future studies should examine the role of sirtuin in CPT1b expression regulation.

A systematic literature review of observational studies of the bidirectional association between metabolic syndrome and migraine.

AIMS: To evaluate all epidemiological evidence in the literature linking the metabolic syndrome (MetS) and migraine in adults. METHODS: Database (Medline, Embase; published reports up to November 2017) and manual searches were performed. Information on data collection, sample characteristics, study design, MetS and migraine assessment, and results was extracted from each relevant publication. The methodological quality of each study was also assessed. RESULTS: A total of 15 observational epidemiological studies in adults, published between 2009 and 2017, were retrieved. Of these, one employed a prospective design, while the rest had a cross-sectional (13 studies) or case-control (one study) design. Five studies assessed the presence of migraine in individuals with MetS, whereas 10 studies assessed the presence or risk of MetS in migraineurs. Most participants were female hospital outpatients. The sole prospective cohort study reported 11-year MetS incidence of 21.8% in migraineurs with aura, 16.8% in migraineurs without aura and 14.5% in subjects without headaches. Most studies (60%) provided no statistical estimates of association. Methodological flaws included selection biases, lack of power analysis, unsuitable research plans and no multivariable analyses. Meta-analysis was not feasible with the available data. CONCLUSION: Our systematic review has identified major gaps in knowledge and weaknesses in research that should provide an impetus for future epidemiological investigations using more rigorous methodology, large general-population prospective cohorts, and substantial data on dietary behaviours and lifestyle.

Total and specific dietary polyphenol intakes and 6-year anthropometric changes in a middle-aged general population cohort.

BACKGROUND: Dietary polyphenols are suggested antiobesogenic agents. Prospective evidence in general population of an association between polyphenol intakes and anthropometry is lacking. OBJECTIVE: To assess the associations between dietary polyphenol intakes and changes in body mass index (BMI) and waist circumference (WC) over a 6-year period. METHODS: Individual intakes of 264 different polyphenols (mg day-1) were estimated using the Phenol-Explorer database and the mean of 6-17 24-h dietary records collected in 1994-1996. BMI in kg m-2 and WC in cm were measured in 1995-1996, 1998-1999 and 2001-2002. Linear mixed-effect models allowed for the assessment of longitudinal associations between energy-adjusted quartiles of total polyphenol intake as well as intake of 15 polyphenol classes and changes of these respective polyphenol classes in anthropometry over the 6 years of follow-up. Adjustment variables included sex, age, socio-economic status, lifestyle, dietary intakes and health status. RESULTS: Participants in the highest quartile of intake of flavanones (BMI change: -0.28 (-0.43; -0.13), P=0.009), flavones (BMI change: -0.29 (-0.44; -0.14), P=0.008) and lignans (BMI change: -0.28 (-1.63; -0.09), P=0.01) experienced a less notable increase in BMI over time compared with their counterparts in the bottom quartile of intake of the respective polyphenol classes. Participants in the highest quartile of intake of flavanones (WC change: -1.39 (-2.02; -0.92), P=0.001), flavones (WC change: -1.57 (-2.32; -0.92), P=0.001), hydroxycinnamic acids (WC change: -1.27 (-1.92; -0.63), P=0.01), lignans (WC change: -1.16 (-1.80; -0.51), P=0.006) and total polyphenol intake (WC change: -1.39 (-2.05; -0.74), P=0.001) experienced a less notable increase in WC over time compared with their counterparts in the bottom quartile of intake of the respective polyphenols. CONCLUSIONS: Dietary polyphenol intakes may help reduce weight gain over time in the general population. This could have important public health implications because moderate increases in BMI and WC over time have been shown to increase disease risk.

Dyslipidemia as a Potential Moderator of the Association between Hearing Loss and Depressive Symptoms.

OBJECTIVES: Knowledge about moderation of the association between hearing loss and depression is scant. We investigated dyslipidemia as a potential moderator of the association between hearing/hearing loss and depressive symptoms. DESIGN: Cross-sectional study. SETTING: General population-based cohort in France (SU.VI.MAX 2; 2007-2009). PARTICIPANTS: N= 4,307 adults (mean age = 61.5 ± 6.1 y; 59.6% women). MEASUREMENTS: A score ≥ 16 on the Center for Epidemiologic Studies Depression Scale defined presence of depressive symptoms. Mean hearing level for each ear was defined as the pure-tone average of the following thresholds: 0.5, 1.0, 2.0 and 4.0 kHz; the value for the better hearing ear was retained for analysis. Hearing loss was defined as inability to hear at thresholds ≥ 25 dB in both ears. A subjective measure of perceived hearing loss was also used. Serum triglyceride, total-, LDL- and HDL-cholesterol concentrations were assessed in fasting blood samples and established cutoffs were used in multivariable logistic regression models. The interaction between hearing/hearing loss (independent variables) and each of the four lipid parameters was tested. RESULTS: Even though the interaction tests regarding LDL-, HDL- cholesterol, and triglyceride status were statistically significant, the subgroup analyses revealed few significant and somewhat unexpected findings. In fact, among individuals with low LDL-cholesterol, unlike their counterparts with high LDL-cholesterol, there was an inverse association between hearing level in the better hearing ear and depressive symptoms (OR= 0.94; 95% CI: 0.89-0.99). Regarding the subjective measure of hearing, a few of the dyslipidemia-moderated associations were statistically significant, albeit not all in the predicted direction. CONCLUSIONS: The findings provide some support for moderation of the association between hearing/hearing loss and depressive symptoms by dyslipidemia, with important lipid-specific and hearing measure-specific differences. The results could serve as impetus for future investigations in order to identify and target population subgroups with increased vulnerability to depression in the context of both sensory disability and aging.

Food choice motives including sustainability during purchasing are associated with a healthy dietary pattern in French adults.

BACKGROUND: Sustainability has become a greater concern among consumers that may influence their dietary intake. Only a few studies investigated the relationship between sustainable food choice motives and diet and they focused on specific food groups. OBJECTIVE: This cross-sectional study aimed to assess the associations between food choice motives during purchasing, with a focus on sustainability, and dietary patterns in a large sample of French adults. DESIGN: Food choice motives were collected in 31,842 adults from the NutriNet-Santé study, using a validated 63 items questionnaire gathered into 9 dimension scores: ethics and environment, traditional and local production, taste, price, environmental limitation (i.e. not buying a food for environmental concerns), health, convenience, innovation and absence of contaminants. Dietary intake was assessed using at least three web-based 24-h food records. Three dietary patterns were obtained through factor analysis using principal component analysis. The associations between food choice motive dimension scores and dietary patterns were assessed using linear regression models, stratifying by sex. RESULTS: Individuals were more likely to have a "healthy diet" when they were more concerned by not buying a food for environmental concerns (only for 3rd tertile versus 1st tertile ßwomen=0.18, 95% CI=0.15-0.20, ßmen=0.20 95% CI=(0.15-0.25)), ethics and environment (women only, ß=0.05, 95% CI=0.02-0.08), absence of contaminants (women only, ß=0.05, 95% CI=0.01-0.07), local production (women only, ß=0.08, 95% CI=0.04-0.11), health (women only) and innovation (men only), and when they were less concerned by price. Individuals were also less likely to have traditional or western diets when they gave importance to food choice motive dimensions related to sustainability. CONCLUSION: Individuals, especially women, having higher concerns about food sustainability dimensions such as ethics and environment and local production, appear to have a healthier diet. Further longitudinal studies are required to better understand how sustainable concerns may influence long-term nutritional quality of the diet.

Exposure to contaminants and nutritional intakes in a French vegetarian population.

The NutriNet Santé study collected, on a voluntary basis, the dietary consumption of French vegetarian populations (N = 1766, including 188 vegan individuals) from 18 to 81 years (18-77 years for the vegan). Taking advantage of the availability of contamination data generated in the context of the second French total diet study, dietary exposures of French vegetarian populations to several contaminants were estimated. Results showed that exposures to persistent organic pollutants (PCBs, PCDD/Fs for instance) was dramatically lower than those of the general French population due to the non consumption of food of animal origins. On the other hand, exposures to phytoestrogens, some mycotoxins (T2 and HT2 toxins) and some trace elements (Cd, Al, Sn, Ni) were higher in the vegetarian population compared to those of the general population. Despite some limitations of this approach (both the consumption study and the total diet study were not aimed to estimate dietary exposure of the vegetarian populations), this study showed that dietary habits can dramatically influence the exposure of some contaminants.

Consumption of Dairy Products and Cognitive Functioning: Findings from the SU.VI.MAX 2 Study.

OBJECTIVES: Research concerning the link between dairy product intake and cognition is scant while experimental studies suggest links through various biological mechanisms. This study's objective was to examine the cross-time associations of total and specific dairy product consumption with cognitive performance in aging adults. We also explored compliance with dairy intake recommendations in France. DESIGN: The study was based on the «Supplémentation en Vitamines et Minéraux Antioxydants¼ randomized trial (SU.VI.MAX, 1994-2002) and the SU.VI.MAX 2 observational follow-up study (2007-2009). SETTING: A general-population cohort in France. PARTICIPANTS: N=3,076 participants included in both the SU.VI.MAX and SU.VI.MAX 2 studies. MEASUREMENTS: Dairy product consumption was estimated using repeated 24h records (1994-1996; mean=10 records, SD=3). Cognitive performance was assessed by neuropsychologists after an average of 13 years post-baseline via a battery of six validated tests. Mean age at the time of the cognitive function evaluation was 65.5 (SD=4.6) years. Principal component analysis revealed factors for verbal memory and working memory. Associations of energy-adjusted dairy product consumption and compliance with the respective dietary guidelines with subsequent cognitive impairment were examined using ANCOVA, providing mean differences (95% confidence intervals, CI) according to tertiles (T), adjusted for confounders including overall dietary patterns. RESULTS: Total dairy product consumption was not associated with cognitive function. However, milk intake was negatively associated with verbal memory performance: mean difference T3 versus T1= -0.99 (-1.83, -0.15). Among women, consuming more than the recommended amount of dairy was negatively associated with working memory performance: excess versus adequate = -1.52 (-2.93, -0.11). CONCLUSION: Our results indicate that dairy products consumption and especially compliance with dietary guidelines regarding dairy product intake are differentially associated with performance in specific cognitive domains after a comprehensive adjustment for lifestyle factors, health status markers and dietary patterns. Further longitudinal research is needed given the limited data available.

Determining the association between types of sedentary behaviours and cardiometabolic risk factors: A 6-year longitudinal study of French adults.

AIM: This study identified the longitudinal associations between leisure-time sedentary behaviours [television (TV) viewing, computer use and reading (h/week)] and cardiometabolic risk factors, including the metabolic syndrome. METHODS: A total of 2517 participants (mean±SD age: 55.5±4.9 years) were assessed in 2001 and in 2007 for physical activity and leisure-time sedentary behaviours, anthropometry, body composition, blood pressure, fasting blood glucose and lipids, using standardized methods. Multivariate generalized linear (beta, 95% CI and P values) and logistic (OR and 95% CI) regression models were used to assess cross-sectional associations between sedentary behaviours and cardiometabolic risk factors, while a 6-year longitudinal study explored these associations as well as the odds of developing the metabolic syndrome, as defined by the NCEP ATPIII. RESULTS: Increased TV viewing time over the follow-up period was positively associated with increases in body mass index (BMI; P<0.01) and percent body fat (P<0.001), and marginally with waist circumference (P=0.06). Reverse associations were also found, with changes in BMI, percent fat mass and waist circumference positively associated with TV viewing and computer use. Associations between reading and cardiometabolic risk factors were less consistent. Each 1-h/week increase in baseline TV viewing and in reading was associated with an increase in the chances of developing the metabolic syndrome (OR=1.031, 95% CI: 0.998-1.060, P=0.07; and OR=1.032, 95% CI: 1.002-1.065, P=0.02; respectively). CONCLUSION: The present study data emphasizes the notion of differential associations of specific sedentary behaviours with cardiometabolic risk factors. They are also evidence that different longitudinal associations should be taken into account when designing public health objectives of interventions aimed at improving cardiometabolic health.

Prospective association between the dietary inflammatory index and metabolic syndrome: findings from the SU.VI.MAX study.

BACKGROUND AND AIMS: The prevention of the metabolic syndrome (MetS) is of major concern and nutrition has been shown to modulate at least partly MetS risk. Our objective was to investigate whether a pro-inflammatory diet was associated with a higher risk of MetS and its components in a large cohort of French adults. METHODS AND RESULTS: A total of 3726 participants from the Supplémentation en Vitamines et Minéraux AntioXydants (SU.VI.MAX) cohort were included in this study. The MetS status was identified at baseline and after 13 years of follow-up using self-reported medication, data from clinical investigations and biological measurements. The dietary inflammatory index (DII) was computed using repeated 24 h-dietary records (n = 10.1 ± 3.1). Logistic and linear regression analyses were conducted to assess the prospective association of the DII (as Q, quartiles) with the incidence of MetS and with the traits contributing to the MetS-definition (blood pressure, glycaemia, triglycerides, HDL-cholesterol, waist circumference). A diet with pro-inflammatory properties, as expressed by higher DII scores, was significantly associated with a higher risk of developing the MetS (OR comparing Q4 to Q1: 1.39, 95% confidence interval 1.01-1.92, P = 0.047). Moreover, higher DII scores were associated with higher systolic and diastolic blood pressure (Ptrend across quartiles = 0.03 and 0.05, respectively) and triglycerides (Ptrend = 0.01), and with lower HDL-cholesterol (Ptrend = 0.03). CONCLUSION: A higher DII score was prospectively associated with a higher risk of MetS, with associations with blood pressure, triglycerides and HDL-cholesterol. Promotion of a healthy diet exhibiting anti-inflammatory properties may contribute to prevent cardio-metabolic disorders.

Operational Definition of Active and Healthy Ageing (AHA): A Conceptual Framework.

Health is a multi-dimensional concept, capturing how people feel and function. The broad concept of Active and Healthy Ageing was proposed by the World Health Organisation (WHO) as the process of optimizing opportunities for health to enhance quality of life as people age. It applies to both individuals and population groups. A universal Active and Healthy Ageing definition is not available and it may differ depending on the purpose of the definition and/or the questions raised. While the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has had a major impact, a definition of Active and Healthy Ageing is urgently needed. A meeting was organised in Montpellier, France, October 20-21, 2014 as the annual conference of the EIP on AHA Reference Site MACVIA-LR (Contre les Maladies Chroniques pour un Vieillissement Actif en Languedoc Roussillon) to propose an operational definition of Active and Healthy Ageing including tools that may be used for this. The current paper describes the rationale and the process by which the aims of the meeting will be reached.

Overall and abdominal adiposity in midlife and subsequent cognitive function.

OBJECTIVES: The scientific literature supports a link between midlife adiposity and cognitive function or decline but most studies to-date have investigated only overall adiposity, often omitting important confounders from the analyses. We investigated in a cross-time design the relationships between two different midlife adiposity markers and subsequent cognitive function, testing midlife dietary patterns as a potential confounder of the associations. DESIGN: The study was based on the «Supplémentation en Vitamines et Minéraux Antioxydants¼ randomized trial (SU.VI.MAX, 1994-2002) and the SU.VI.MAX 2 observational follow-up study (2007-2009). SETTING: A general-population cohort in France. PARTICIPANTS: N=2,817 individuals (1,493 men and 1,324 women) included in both the SU.VI.MAX and SU.VI.MAX 2 studies. MEASUREMENTS: The cognitive performance of 2,817 middle-aged adults participating in the SU.VI.MAX (Supplémentation en Vitamines et Minéraux Antioxydant) study was assessed in 2007-2009 using 6 neuropsychological tests. Principal component analysis was used to derive specific cognitive scores. A composite cognitive score was also computed. Body mass index (BMI) and waist circumference (WC) were measured 13 years earlier (1994). Associations between midlife adiposity and cognitive functioning were estimated through covariance analyses. RESULTS: After adjustment for obesity-related cardio-metabolic parameters, higher BMI and larger WC at midlife predicted lower executive function. For example, the adjusted mean difference (95% confidence interval) for 1 SD increase in WC was -0.48 (-0.97, 0.00). Obese participants in midlife showed an adjusted mean difference (95% confidence interval) of -1.68 (-3.15, -0.22) compared with non-obese. Further adjustment for midlife dietary patterns slightly attenuated these associations. No relationships were observed with verbal memory or global cognitive function. CONCLUSION: Midlife overall and abdominal adiposity were similarly associated with lower executive functioning scores. Dietary patterns may partly explain such a relationship, arguing for the importance of controlling for lifestyle confounders in future studies.

Associations between weight status and liking scores for sweet, salt and fat according to the gender in adults (The Nutrinet-Santé study).

BACKGROUND/OBJECTIVES: As taste preferences may be associated with obesity, the present study investigated whether obese subjects presented heightened liking for the sensations of sweet, salt and fat. SUBJECTS/METHODS: Liking scores were determined by a questionnaire including 83 items on liking for sweet or fatty foods, and the preferred extent of seasoning with salt, sweet or fat. Data from 46909 adults included in the French web-based observational cohort of the Nutrinet-Santé study were collected and weighted according to the national population census. Relationships between liking scores and body mass index (BMI) as categorical or linear explanatory variable were assessed separately by gender using covariance and linear regression analyses, adjusted for age, education level, living area, smoking and alcohol. RESULTS: Overall liking scores for salt and fat were linearly positively linked to BMI in men and women (P≤0.001) and were higher in obese than in normal-weight individuals. The score difference between BMI categories was greater in women for fat liking only. For sweet liking, results differed between gender and compounding factors. Liking for added sugar and sweet foods was positively linked to BMI in women unlike in men; liking for natural sweetness was negatively linked to BMI in both genders. CONCLUSIONS: This study demonstrates that the relationship between liking and BMI differs according to the gender in its magnitude for fat and in its nature for sweet, unlike that for salt. Liking for sweet and fat may be linked to overconsumption of the corresponding foods, especially in women. This warrants further investigation.

Association between melanocortin-4 receptor mutations and eating behaviors in obese patients: a case--control study.

Melanocortin-4 receptor (MC4R) gene mutations are involved in the leptin-melanocortin pathways that control food intake. The effect of these mutations on eating behavior phenotypes is still debated. To determine the association between functional MC4R mutations and eating behaviors, dietary intake and physical activity, we sequenced the MC4R gene in 4653 obese adults. Among them, 19 adults carriers of functional MC4R mutation were matched on age, sex and body mass index with two randomly-paired controls without MC4R mutation (n=57). We found that eating behaviors and physical activity did not differ between groups. In particular, cases were not at increased risk of binge eating disorders. Subjects carriers of MC4R mutation reported a higher proportion of dietary carbohydrates intakes (43.2±7.1 and 39.2±8.1% of total energy intake, respectively, P=0.048) and a lower proportion of dietary lipids (34.3±6.7 and 38.5±6.7% of total energy intake, respectively, P=0.018). In conclusion, mutation carriers differ from controls by a higher consumption of carbohydrates counterbalanced by a lower consumption of lipids expressed as percentage of total energy intake. However, functional MC4R mutations do not have a higher risk of compulsive eating contrary to what was previously suggested.

Adherence to Mediterranean diet reduces the risk of metabolic syndrome: a 6-year prospective study.

BACKGROUND AND AIMS: Benefits of Mediterranean diet on MetS risk have been suggested, but overall prospective evidence in the general population is limited. For the first time, the prospective association of adherence to Mediterranean diet with the 6-y risk of MetS and its components was evaluated in a large cohort in Europe. METHODS AND RESULTS: Subjects included were participants from the Supplémentation en Vitamines et Minéraux AntioXydants (SU.VI.MAX) study. Adherence to Mediterranean diet was assessed using traditional Mediterranean diet score (MDS), an updated Mediterranean score (MED) and Mediterranean style-dietary pattern score (MSDPS) calculated from at least three 24-h records. In 3232 subjects, the association between Mediterranean diet scores and 6-y risk of MetS was evaluated. The association between Mediterranean scores and MetS components was also estimated. A lower risk of MetS was observed with increasing MED score (P-trend = 0.001) and MDS (P-trend = 0.03) in multivariate models. The adjusted odds ratios (95% Confidence Interval) for MetS risk were 0.47 (0.32-0.69) and 0.50 (0.32-0.77) in subjects in the highest versus lowest tertile of MED score and MDS, respectively. The MED score was inversely associated with waist circumference, systolic blood pressure and triglycerides, and directly associated with HDL-cholesterol. The MDS was negatively associated with waist circumference and triglycerides, and MSDPS was positively associated with HDL-cholesterol. CONCLUSIONS: All Mediterranean diet scores were associated in a potentially beneficial direction with components of MetS or MetS incidence. Our findings support that individuals should be encouraged to follow a Mediterranean dietary pattern for reduction of MetS risk.

Dietary patterns, inflammation and the metabolic syndrome.

AIM: The study of dietary patterns offers a comprehensive, real-life approach towards examining the complex diet and disease relationship. The simultaneous association of dietary patterns with inflammation and the metabolic syndrome (MetS) has not been extensively reviewed. This report reviews the association of dietary patterns with inflammation in the context of the MetS. METHODS: Original English-language research studies with humans were identified via MEDLINE, using inflammation, MetS, whole diets and dietary patterns as keywords. The findings were carefully examined and synthesized along consistent axes. RESULTS: Many observational and a few prospective studies, as well as some randomized controlled trials (RCTs), support an inverse association between a Mediterranean dietary pattern and markers of inflammation. The link is generally independent of traditional cardiovascular disease (CVD) risk factors and weight loss. The few studies that have examined the association between following a healthy dietary pattern, evaluated using various diet quality scores, and inflammation report an inverse association; however, this association was attenuated upon adjusting for CVD risk factors. A Mediterranean dietary pattern has also been associated with a reduced risk of the MetS in several cross-sectional studies and a few prospective studies conducted with healthy people. Few RCTs (lasting 1-2years) have confirmed the benefits of following a Mediterranean diet on MetS risk in obese individuals, in those with the MetS or in those at CVD risk. The evidence, albeit limited, for a link between healthy diets based on other diet quality scores and the MetS supports a similar inverse association for the primary and secondary prevention of the MetS. CONCLUSION: Adhering to healthy diets such as the Mediterranean diet and/or national dietary guidelines can reduce inflammation and the MetS.

Association between dietary scores and 13-year weight change and obesity risk in a French prospective cohort.

BACKGROUND/OBJECTIVES: The relationship between diet quality and development of obesity is complex and unresolved. The aim of this study was to assess and compare the predictive value of six different dietary scores on both relative weight change and the risk of obesity after 13 years of follow-up in adults aged 45 years and older. SUBJECTS/METHODS: Six scores reflecting adherence to different nutritional recommendations (the French Programme National Nutrition Santé-Guideline Score (PNNS-GS), the Dietary Guidelines for Americans Index (DGAI), the Diet Quality Index-International (DQI-I), the Mediterranean Diet Scale (MDS), the relative Mediterranean Diet Score (rMED) and the Mediterranean Style Dietary Pattern Score (MSDPS)) were estimated in 3151 participants in the French SU.VI.MAX (SUpplémentation en VItamines et Minéraux AntioXydants) study. Associations of dietary scores with 13-year weight change were assessed through multivariate linear regression models, and obesity risk was analyzed with logistic regression, providing odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Except for the MSDPS, higher scores, that is, better adherence to nutritional guidelines or to a Mediterranean diet, were associated with lower weight gain in men (all P-value for trend <0.05). In addition, among men, ORs for becoming obese after 13 years associated with a 1 s.d. increase in dietary scores ranged from 0.63, 95% CI: 0.51, 0.78 for DGAI to 0.72, 95% CI: 0.59, 0.88 for MDS. These associations were weaker or not statistically significant in women. CONCLUSION: Overall, the six dietary scores predicted obesity risk equally well. Among French adults, strong adherence to dietary guidelines appears to be protective with regard to weight gain and obesity, especially in men.

Higher adherence to French dietary guidelines and chronic diseases in the prospective SU.VI.MAX cohort.

BACKGROUND/OBJECTIVES: Nutritional recommendations are widely disseminated, but assessment of their predictive value for risk of chronic diseases and mortality is essential for ensuring their validity. We evaluated, in a large population-based study, the association between the French Programme National Nutrition Santé (PNNS) Guideline Score (GS) (maximum score of 15 points), an a priori-based score, and the incidences of cancer, cardiovascular disease (CVD) and overall mortality. SUBJECTS/METHODS: Subjects included in this analysis (n=5823) were participants in the Supplémentation en Vitamines et Minéraux AntioXydants study, with available data for estimating the PNNS-GS. Hazards ratios (HRs) and 95% confidence intervals (95% CIs) for outcomes (cancer, CVD and death) were estimated across quartiles of PNNS-GS using Cox proportional hazards models. RESULTS: A total of 734 major events were recorded during an average 11.6-year follow-up (maximum 13 years): 423 cancers, 193 ischemic diseases and 118 deaths. In the fully adjusted model, a significant reduction in CVD risk between the first and fourth PNNS-GS quartiles (HR=0.65, 95% CI=0.41, 1.00, P for trend=0.04) was observed. No significant overall association with risk of cancer or death was detected. CONCLUSIONS: These observations support the role of nutritional guidelines in prevention of CVD.

Thirteen-year prospective study between fish consumption, long-chain n-3 fatty acids intakes and cognitive function.

OBJECTIVES: Because of their structural, anti-inflammatory and antithrombic properties, long-chain n-3 fatty acids may be key factors in the aging process. We sought to elucidate the association between intake of long-chain n-3 fatty acids and/or fish and cognitive function evaluated 13 years after dietary assessment. DESIGN: Prospective population-based study. PARTICIPANTS/SETTING: 3,294 adults from the SU.VI.MAX study (Supplementation with Antioxidant Vitamins and Minerals study). MEASUREMENTS/STATISTICAL ANALYSIS: Subjects underwent a standardized clinical examination which included cognitive tests and self-reported cognitive difficulties scale (2007-2009). Poor scores were defined using percentiles as cut-off. Dietary data were assessed through repeated 24-h dietary records. Odd ratio (OR), comparing the fourth (Q4) to the first quartile (Q1), of having a poor score were calculated using adjusted logistic regression. RESULTS: Self-reported cognitive difficulties were less frequent among subjects with higher intakes of total n-3 long chain fatty acids (OR = 0.72, CI 95%=0.56-0.92) and eicosapentaenoic acid (OR Q4 versus Q1 = 0.74, CI 95%=0.58-0.95), even after adjustment for depressive symptoms. A borderline significant association was also found with high fish consumption (OR Q4 versus Q1 = 0.80, CI 95%=0.63-1.01). CONCLUSION: Cognitive complaints, which may be an early indicator of cognitive decline, are less frequent among the elderly who have a high long-chain n-3 acids intake, as assessed 13 years earlier.