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.

Body mass index growth trajectories associated with the different parameters of the metabolic syndrome at adulthood.

BACKGROUND: Growth trajectories have shown to be related to obesity and metabolic risks in later life, however body mass index (BMI) trajectories according to the presence or absence of metabolic syndrome (MS) and its parameters in adulthood are scarce in literature. OBJECTIVES: To investigate BMI trajectories during childhood in relation to MS and its parameters in adult age. METHODS: A total of 1919 subjects (43.4% male, 20-60 y) participated in this retrospective cohort study. Height, weight, waist circumference (WC), blood glucose, high-density lipoprotein cholesterol, triglycerides and blood pressure were measured at adulthood. Childhood weight and height were collected retrospectively from health booklets. Differences between BMI growth curves of subjects with and without MS were assessed using mixed models for correlated data. RESULTS: BMI trajectories differed according to the presence or not of MS at adulthood, from the age of 4 years forward (all P<0.05), to the presence or not of hypertriglyceridemia from 1.5 years forward (all P<0.05), and to WC>94 cm (men) / 80 cm (women) compared to lower WC, at all ages (all P<0.05). CONCLUSIONS: BMI growth curves differ according to the presence or not of MS at adulthood, but differences only appeared after the age of 4 years. Changes vary according to the MS parameters considered. Deviation of the MS-associated BMI curve from normal pattern could correspond to alteration in body composition. These differences in BMI trajectories during childhood support the theory of an early origin of the MS, justifying early prevention.

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.

Age at adiposity rebound: determinants and association with nutritional status and the metabolic syndrome at adulthood.

OBJECTIVE: Early-life growth characteristics and in particular age at adiposity rebound (AR), have been shown to impact nutritional status later in life but studies investigating the association with long-term health remain scarce. Our aims were to identify determinants of age at AR and its relationship with nutritional status and cardiometabolic risk factors at adulthood. DESIGN: A total of 1465 subjects aged 20-60 years participated in this retrospective cohort study. Height, weight, waist circumference, blood glucose, lipids and blood pressure were measured at adulthood. Childhood weight, height, gestational age, birth weight and early nutrition were collected retrospectively from health booklets and age at AR was assessed. Participants self-reported parental silhouettes. Associations were assessed using multiple linear and logistic regression. RESULTS: An earlier AR was associated with higher body mass index and waist circumference at adulthood in both men and women (P<0.0001). In addition, women with an earlier occurrence of AR had higher triglyceride (P=0.001), low-density lipoprotein-cholesterol (P=0.001), systolic (P=0.02) and diastolic blood pressure (P=0.04) at adulthood. Both men (odds ratio (OR) (95% confidence interval (CI)): 0.82 (0.70-0.95)) and women (OR (95% CI): 0.84 (0.73-0.96) with an AR occurring earlier were more likely to develop a metabolic syndrome. Larger parental silhouette was associated with an earlier AR. CONCLUSIONS: This long-term study showed that age at AR was associated with nutritional status and metabolic syndrome at adulthood. These results highlight the importance of monitoring childhood growth so as to help identify children at risk of developing an adverse cardiometabolic profile in adulthood. AR determinants for use in overweight surveillance were identified.

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.

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.

MC1R major variants are a risk factor of sleep lines in Caucasian women.

BACKGROUND: Sleep lines are caused by individual's sleeping positions and should be differentiated from expression wrinkles. OBJECTIVE: The aim of the study was to investigate possible risk factors for sleep lines on a sizeable sample of middle-aged Caucasian women. METHODS: This study involved a sample of 542 French middle-aged women (44 to 70 years old) from Paris area. Three standardized facial photographs (face and profiles) were examined independently by two dermatologists allowing the identification of sleep lines and the evaluation of the severity of several facial skin features. Possible impacts of MC1R gene polymorphisms were tested using logistic regression models. RESULTS: Sixty women (11%) had facial sleep lines and showed generally more than one sleep line. The sleep lines were often located on the forehead, along the nose, on the cheeks and under the eyes, and more rarely on the chin. As expected, the sleep lines were associated with age, and the women with sleep lines showed also more severe signs of skin ageing. After adjustment on possible confounders, the presence of two major diminished function variants of the MC1R gene was identified as a strong risk factor for sleep lines [adjusted odds ratios (AOR) (95% CI): 8.25 (2.62-25.97)]. DISCUSSION/CONCLUSION: The data in the literature are scarce and this study is the first to be conducted on a sizeable sample of women. Our results suggest that genetic variations of MC1R are important determinants of the development of sleep lines.

Reassessment of the putative role of BLK-p.A71T loss-of-function mutation in MODY and type 2 diabetes.

AIMS/HYPOTHESIS: MODY is believed to be caused by at least 13 different genes. Five rare mutations at the BLK locus, including only one non-synonymous p.A71T variant, were reported to segregate with diabetes in three MODY families. The p.A71T mutation was shown to abolish the enhancing effect of BLK on insulin content and secretion from pancreatic beta cell lines. Here, we reassessed the contribution of BLK to MODY and tested the effect of BLK-p.A71T on type 2 diabetes risk and variations in related traits. METHODS: BLK was sequenced in 64 unelucidated MODY samples. The BLK-p.A71T variant was genotyped in a French type 2 diabetes case-control study including 4,901 cases and 4,280 controls, and in the DESIR (Data from an Epidemiological Study on the Insulin Resistance Syndrome) and SUVIMAX (Supplementation en Vitamines et Mineraux Antioxydants) population-based cohorts (n = 6,905). The variant effects were assessed by logistic and linear regression models. RESULTS: No rare non-synonymous BLK mutations were found in the MODY patients. The BLK p.A71T mutation was present in 52 normoglycaemic individuals, making it very unlikely that this loss-of-function mutation causes highly penetrant MODY. We found a nominal association between this variant and increased type 2 diabetes risk, with an enrichment of the mutation in the obese diabetic patients, although no significant association with BMI was identified. CONCLUSIONS/INTERPRETATION: No mutation in BLK was found in our MODY cohort. From our findings, the BLK-p.A71T mutation may weakly influence type 2 diabetes risk in the context of obesity; however, this will require further validation.

Association of nutrition in early life with body fat and serum leptin at adult age.

BACKGROUND: There is overwhelming evidence that experiences during early life could have long-term health consequences. However, the role of early nutrition in programming obesity and leptin resistance is still poorly understood. OBJECTIVE: We aimed at determining whether nutritional intakes in early life are associated with body composition and hormonal status at 20 years. SUBJECTS: Healthy infants participating in the two-decade-long prospective ELANCE (Etude Longitudinale Alimentation Nutrition Croissance des Enfants) study were examined at 10 months and 2 years. At 20 years, weight, height, subscapular and triceps skinfold thicknesses, fat mass (FM) and fat-free mass (FFM) assessed via bioelectrical impedance analysis, and serum leptin concentration were recorded in 73 subjects still participating in the follow-up. RESULTS: In adjusted linear regression models, an increase by 100 kcal in energy intake at 2 years was associated with higher subscapular skinfold thickness (ß=6.4% SF, 95% confidence interval 2.53-10.30, P=0.002) and higher FFM (0.50 kg, 0.06-0.95, P=0.03) at 20 years. An increase by 1% energy from fat at 2 years was associated with lower subscapular skinfold thickness (-2.3% SF, -4.41 to -0.18, P=0.03), lower FM (-0.31 kg, -0.60 to -0.01, P=0.04) and lower serum leptin concentration (-0.21 µg l(-1), -0.39 to -0.03, P=0.02) at 20 years. CONCLUSIONS: Low-fat intake in early life was negatively associated with body fat (particularly at the trunk site) and serum leptin concentration at 20 years, suggesting that early low-fat intake could increase the susceptibility to develop overweight and leptin resistance at later ages. These findings substantiate current recommendations against restricting fat intake in early life and open new directions for investigating the origin of obesity.

Eating behaviour in obese patients with melanocortin-4 receptor mutations: a literature review.

Melanocortin-4 receptor (MC4R) mutations are the most common known cause of monogenic obesity and an important contributor to polygenic obesity. MC4R mutations with partial or total loss of function, as well as the variant rs17782313 mapped near MC4R, are positively associated with obesity. MC4R is involved in the leptin-melanocortin signalling system, located in hypothalamic nuclei, that controls food intake via both anorexigenic or orexigenic signals. Impairment in this receptor might affect eating behaviours. Thus, in the case of MC4R mutation carriers, obesity could be related, at least partly, to inadequate control over eating behaviours. Many published studies address eating behaviours in MC4R mutation carriers. Most studies focus on binge eating disorder, whereas others examine various aspects of intake and motivation. Up to now, no evaluation of this literature has been performed. In this review, we examine the available literature on eating behaviours in carriers of MC4R mutations and variant rs17782313 near MC4R gene. We address binge eating disorder, bulimia nervosa, mealtime hyperphagia, snacking, psychological factors, satiety responsiveness and intake of energy and macro/micronutrient. In a small number of studies, MC4R mutations seem to impair eating behaviours or motivation, but no clear causal effects can be found in the balance of the evidence presented. Improvements in methodologies will be necessary to clarify the behavioural effects of MC4R mutations.

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.

Freckles and solar lentigines have different risk factors in Caucasian women.

BACKGROUND: To date, few epidemiological data on the relationships between solar lentigines, freckles and behavioural and constitutional risk factors in Caucasian populations exist. OBJECTIVES: To investigate the potential impact of behavioural and phenotypic variables, as well as the MC1R genetic background, on the history of facial freckles and the severity of solar lentigines in Caucasian women. METHODS: The severity of solar lentigines was graded from facial digital images of 523 French middle-aged women by a dermatologist and summarized by a score afterwards. The history of facial freckles was assessed and the sun-exposure behaviour was characterized using a six-category typology. Risk factors including MC1R polymorphism were evaluated using logistic regression models. RESULTS: Two constitutive host factors were found to be independently associated with a history of facial freckles: frequent sunburns and the presence of diminished function variants of the MC1R gene. In addition to age, five factors were independently associated with solar lentigines: constitutive host factors (dark skin colour and tanning capacity), a history of freckles, sun-exposure behaviour and current intake of oral contraceptive or progestogen treatments. CONCLUSION: These results strengthen the hypothesis that solar lentigines are markers of photoaging, whereas freckles are mainly determined by genetic factors. The finding that hormonal treatment is associated with a higher risk for solar lentigines merits further investigations.

Consumer acceptability and understanding of front-of-pack nutrition labels.

BACKGROUND: Front-of-pack (FOP) nutrition labelling has been proposed as a tool for helping consumers make healthy choices. Before determining its effects on consumer behaviour, factors involved in its use must be elucidated, i.e. understanding and acceptability on the part of the consumer. Among five FOP labels, we sought to determine which formats were most easily understood and accepted by a large sample of adults. METHODS: Among 39 370 adults who participated in the French Nutrinet-Santé cohort study, understanding and indicators of acceptability (attitude, liking, visual attractiveness and perceived cognitive workload) were measured for five FOP labels: The currently used 'multiple traffic lights' (MTL) and 'simple traffic lights' (STL), and the 'colour range' logo (CR), the 'green tick' and the PNNS logo. We investigated the contribution of the different elements to consumer perception of FOP labels using multiple correspondence analyses. RESULTS: Over half of the sample population showed a high level of understanding and perceived no discomfort in terms of the different logos. Label formats were positioned along an acceptability gradient ranging from acceptance to rejection, consisting of 'liking', 'attractiveness' and indicators of perceived cognitive workload. MTL was significantly more often liked and was viewed as reliable and informative. MTL, STL and the green tick performed better than the CR and PNNS logos in terms of ease of identification and comprehension. CR was clearly the least appreciated and it had the most complex format. CONCLUSIONS: Consumers prefer FOP labels which give complete, reliable and simplified information on the nutrient quality of foods.

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.

Correlates of sedentary behavior in 7 to 9-year-old French children are dependent on maternal weight status.

OBJECTIVE: Sedentary behavior accounts for overweight and obesity, independently of physical activity. Correlates of sedentary behavior have not been extensively reported in the literature. Our objective was to determine factors associated with such behavior in 7 to 9-year-old French children in 2007, and to assess interactions between the identified correlates. DESIGN: A nationally representative sample of 2525 children participated in the study. Television viewing, video/computer duration and characteristics of the children and their parents were assessed using a questionnaire completed by the parents. Correlates of television viewing (<2 h per day versus ≥ 2 h per day) as a proxy for sedentary behavior were estimated using multivariate logistic regression. RESULTS: On an average, children spent more than 2 h per day in front of a screen (television: 1 h 32 min (s.e.m.: ± 0 h 02 min); video/computer: 0 h 40 min (± 0 h 02 min)). Television viewing duration was associated with sociodemographic (child's age, weight status, socio-economic characteristics of the family) and behavioral factors (physical and lifestyle activities). In children of non-overweight mothers, risk of spending ≥ 2 h per day in front of a television was significantly higher in those over 9 (versus 7 years: odds ratio (OR): 2.07; 95% confidence intervals (CI): 1.04-4.11), living in an educational priority zone (OR: 1.62; 95% CI: 1.08-2.44), who were not members of a sports team (OR: 2.24; 95% CI: 1.47-3.41), nor declared active by parents (OR: 1.92; 95% CI: 1.13-3.25), and whose parents' education level was lower than high school (OR: 1.84; 95% CI: 1.24-2.72). In contrast, in children of overweight mothers, only the criteria of ≥ 4 children in the family (versus 2-3 children: OR: 1.87; 95% CI: 1.05-3.35) and no reported parental occupation (versus manager or white collar: OR: 0.29; 95% CI: 0.11-0.76) were associated with watching television ≥ 2 h per day. CONCLUSIONS: Correlates of sedentary behavior in 7 to 9-year-old children vary according to maternal overweight. Maternal body mass index must therefore be taken into account when developing strategies to prevent a sedentary lifestyle in children.

Sociodemographic and economic characteristics associated with dairy intake vary across genders.

BACKGROUND: Recommendations promote a diversified and optimal but not excessive consumption of dairy products. Their efficiency may depend on sociodemographic and economic factors, for which little information is available. Links between these factors and dairy intake were investigated in a large sample of French adults. METHODS: Dietary intakes were assessed using at least six 24-h dietary records collected during a 2-year period from 4574 adults aged 45-60 years. The cost of each food item was estimated from national data. Sociodemographic and economic characteristics were assessed by self-administered questionnaires. Compliance with the current dairy recommendation, distribution of the dairy budget and calcium inadequacy were compared by logistic regression and covariance analyses. RESULTS: Thirty-five percent of subjects complied with the three-per-day dairy recommendation, with more men than women exceeding this (36.2% versus 26.5%, P < 0.0001). The proportion of the dairy budget spent on milk increased with age in men (P = 0.002); in women, it was inversely associated with occupational category (P = 0.009) and residence in an urban area (P = 0.0001). The proportion of this budget spent on cheese increased with education level in women (P = 0.04) and decreased with age in men (P = 0.03). In men, the consumption of cream desserts decreased with age (P = 0.006) and education level (P = 0.002). Dietary calcium inadequacy was more prevalent in women than in men (32.7% versus 14.2%, P < 0.0001). Among women, this prevalence was higher in older subjects (P < 0.0001) and those who lived alone (P = 0.005). CONCLUSIONS: Although compliance with dairy recommendation needs to be improved, sociodemographic and economic factors should be taken into account to improve the efficiency of targeted public health messages.

Dietary behaviour and nutritional status in underprivileged people using food aid (ABENA study, 2004-2005).

BACKGROUND: Although initiatives are setting up to improve the nutritional status of deprived people, few studies have described the food aid user profile and evaluated their nutritional needs. The contributions of food aid to the food supply, dietary behaviour and nutritional status of food aid users were evaluated in the ABENA study. METHODS: A cross-sectional study was conducted among food aid users in four urban French zones (n = 1664, age ≥18 years). Sociodemographic and economic characteristics, food insufficiency, food supply and diet behaviours were assessed using standardised questionnaires. A subsample of participants underwent clinical and biochemical examinations. Descriptive and comparative analyses were performed taking into account sample weights. RESULTS: Over 70% of participants used food aid as the only source of supply among numerous food groups, and one-quarter of them (27.2%) were using food aid for 3 years or more. The mean food budget was €70.0 per person per month, and 46.0% of subjects were classified as 'food-insufficient'. Half of the subjects fulfilled the French recommendations for starchy foods (48.7%) and 'meat, fish and eggs' (49.4%); 27.3% met the requirements for seafood. Only a very small proportion of participants met the recommendations for fruits and vegetables (1.2%) and dairy products (9.2%). In addition, 16.7% of subjects were obese, 29.4% had high blood pressure, 14.8% were anaemic, 67.9% were at risk of folate deficiency and 85.6% had vitamin D deficiency. CONCLUSIONS: These results provide evidence of an unhealthy diet and poor health profiles in severely disadvantaged persons and highlight the importance of food aid in this population. Thus, this study points to the necessity of improving the nutritional quality of currently distributed food aid.

[MC1R polymorphisms and facial photoaging]. / Polymorphismes du MC1R et photovieillissement du visage.

BACKGROUND: The objective of this study was to assess the association between melanocortin-1 receptor (MC1R) variants and the severity of facial skin photoaging. METHODS: The study population comprised 530 French middle-aged women between 44 and 70 years. A trained dermatologist graded the severity of facial skin photoaging from photographs using Larnier's global scale. Logistic regressions were performed to assess the influence of MC1R polymorphism on severe photoaging (grades 1-3 vs. 4-6), with adjustment for possible confounders (demographic and phenotypic data, and sun exposure intensity). RESULTS: Overall, 35% of the women were wild-type homozygotes, 49% had one variant, 15% had two variants, and 1% had at least one rare variant. After adjustment for possible confounders, the presence of two major diminished function variants was found to be a risk factor for photoaging (adjusted odds ratio=5.61; 95% confidence interval [1.43-21.96]). DISCUSSION: Our results suggest that genetic variations of MC1R are important determinants for severe photoaging.

Physical activity does not influence the effect of antioxidant supplementation at nutritional doses on the incidence of impaired fasting glucose: a 7.5 year post-hoc analysis from the SU.VI.MAX study.

Supplementation with high doses of antioxidant vitamins prevents the insulin-sensitizing effects of physical exercise. However, little is known whether antioxidant supplementation affects the incidence of impaired fasting glucose (IFG). Data from 8938 subjects included in a randomized controlled trial on supplementation with antioxidants vitamins and trace elements at nutritional doses (SU.VI.MAX) were used to examine the effects of antioxidants on incident IFG after 7.5 years of follow-up, with and without stratification for daily physical exercise. The odds-ratio (95% CI) for developing an IFG among study participants receiving antioxidant supplementation was 1.34 (0.90-1.97) (p=0.33), in comparison to placebo. This risk did not vary significantly according to physical activity level (p for homogeneity=0.10). Supplementation with trace elements and antioxidants at nutritional doses apparently does not affect the incidence of IFG irrespective of self-reported physical exercise habits.

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.