Large Sample Of French Adults Research Articles

Halving food-related greenhouse gas emissions can be achieved by redistributing meat consumption: Progressive optimization results of the NutriNet-Santé cohort

BackgroundDiet-related greenhouse gas emissions (GHGe) mainly comes from animal-sourced foods. As progressive changes are more acceptable for a sustainable food transition, we aimed to identify nutritionally adequate and culturally acceptable optimized diets ensuring a gradual reduction in GHGe, using observed diet from a large sample of French adults, while considering the mode of food production (organic vs conventional farming) and the co-production link between milk and beef. Material and methodBased on the consumption of 257 organic and conventional foods among 29,413 participants (75% women, age: 53.5 ± 14.0y) of the NutriNet-Santé study, we modelled optimal diets according to GHGe reduction scenarios in 5% steps, from 0 to 50% with nutritional, acceptability, and coproduct constraints, for men, premenopausal and menopausal women separately. ResultsGradual GHGe decrease under these constraints led to optimal diets with an overall decrease in animal foods, with marked reductions in dairy products (up to −83%), together with a stable but largely redistributed meat consumption in favor of poultry (up to +182%) and pork (up to +46%) and at the expense of ruminant meat (down to −92%). Amounts of legumes increases dramatically (up to +238%). The greater the reduction in diet-related GHGe, the lower the cumulative energy demand (about −25%) and land use (about −43%). The proportion of organic food increased from ~30% in the observed diets to ~70% in the optimized diets. ConclusionOur results suggest that meeting both nutrient reference value and environmental objectives of up to 50% GHGe reduction requires the reduction of animal foods together with important substitutions between animal food groups, which result in drastic reductions in beef and dairy products. Further research is required to explore alignment with long-term health value and conflict with acceptability, in particular for even greater GHGe reductions.

Estimated dietary pesticide exposure from plant-based foods using NMF-derived profiles in a large sample of French adults.

This study, conducted in participants of the NutriNet-Santé cohort, aims to identify dietary pesticide exposure profiles (derived from Non-negative Matrix Factorization) from conventional and organic foods among a large sample of general population French adults. Organic and conventional dietary intakes were assessed using a self-administered semi-quantitative food frequency questionnaire. Exposure to 25 commonly used pesticides was evaluated using food contamination data from Chemisches und Veterinäruntersuchungsamt Stuttgart accounting for farming system (organic or conventional). Dietary pesticide exposure profiles were identified using Non-Negative Matrix factorization (NMF), especially adapted for non-negative data with excess zeros. The NMF scores were introduced in a hierarchical clustering process. Overall, the identified clusters (N = 34,193) seemed to be exposed to the same compounds with gradual intensity. Cluster 1 displayed the lowest energy intake and estimated dietary pesticide exposure, high organic food (OF) consumption (23.3%) and a higher proportion of male participants than other groups. Clusters 2 and 5 presented intermediate energy intake, lower OF consumption and intermediate estimated pesticide exposure. Cluster 3 showed high conventional fruits and vegetable (FV) intake, high estimated pesticide exposure, and fewer smokers. Cluster 4 estimated pesticide exposure varied more across compounds than for other clusters, with highest estimated exposures for acetamiprid, azadirachtin, cypermethrin, pyrethrins, spinosad. OF proportion in the diet was the highest (31.5%). Estimated dietary pesticide exposures appeared to vary across the clusters and to be related to OF proportion in the diet. Clinical Trial Registry: NCT03335644.

Optimizing the empirical assessment of orthorexia nervosa through EHQ and clarifying its relationship with BMI

Orthorexia nervosa (ON) is described as an obsession for healthy eating with potentially debilitating consequences but little of its psychopathology is empirically supported. Using suitable validation methodologies, we wanted to optimize the empirical assessment of ON symptoms and investigate their unclear relationship with BMI. Our objective was, therefore, twofold: (1) Validation of a robust measurement model of ON dimensions using the Eating Habits Questionnaire (EHQ); (2) Validation of a structural model describing a mechanism of relationships between ON dimensions and BMI. A self-report questionnaire assessing BMI and ON through a French translation of the 21-item EHQ was administered to a large sample of French adults (N = 2065). We used Exploratory and Confirmatory Factor Analysis for objective no. 1 and Structural Equation Modeling for objective no. 2. We validated a well-fitted (TLI = 0.98; RMSEA = 0.04) and conceptually consistent measurement model with 16 items for three ON dimensions: Rigid Eating Behavior (REB), Positive Feeling of Control (PFC) and Problems of Attention Control and Social Relationships (PACSR). We also validated a structural model (TLI = 0.96; RMSEA = 0.05) showing that: 1. REB strongly impacts both PFC and PACSR; 2. REB has a significant negative impact on BMI and BMI has a significant positive effect on PACSR but effect sizes are very small and globally ON dimensions are only marginally related to BMI. Our study achieved an improved assessment method of ON, a clarification of its links with BMI and implications for the descriptive psychopathology of ON. V, Descriptive cross-sectional study.

Gender differences in the association between socioeconomic status and hypertension in France: A cross-sectional analysis of the CONSTANCES cohort.

BackgroundHypertension prevalence increases when socioeconomic status decreases but gender differences in the relationship between socioeconomic status and hypertension have been less studied. This work aimed to explore the pattern of associations between three indicators of socioeconomic status at individual, household, and municipal levels with hypertension across genders in a large sample of French adults from the CONSTANCES cohort.MethodsUsing data at inclusion from 59 805 participants (52% women) aged 25–69 years and recruited between 2012 and 2015, multilevel log-Poisson regressions with robust variance estimates were used to assess the associations of Relative Index of Inequality in education, monthly income per consumption unit and residential deprivation with hypertension. Modifying effects of gender and age in those associations were tested.ResultsHypertension prevalence was higher in men than in women. Steep socioeconomic gradients of hypertension were observed for the three socioeconomic indicators in both genders and from the youngest to the oldest age class. Socioeconomic inequalities, especially educational inequalities, were larger among women than men: Relative Index of Inequality for highest versus lowest education among the 25–34 years were 0.43 [95%-confidence interval = 0.28–0.67] in women and 0.70 [95%-confidence interval = 0.53–0.92] in men. With increasing age, socioeconomic gradients of hypertension eased in men and even more in women so that gender differences decreased.ConclusionsIn this cross-sectional analysis of a large sample of adults, prevalence of hypertension was higher in men than in women. Moreover, socioeconomic status and especially education displayed a stronger association with hypertension prevalence in women compared to men. Reducing inequalities in hypertension may require gender-specific approaches.

Greenhouse gas emissions, energy demand and land use associated with omnivorous, pesco-vegetarian, vegetarian, and vegan diets accounting for farming practices

In the present context of environmental damages, food systems constitute one of the key burdens on the environment and resources. Dietary patterns emerge as a main leverage to preserve a healthy environment.The aim is to compare the environmental impacts of different diets with different levels of animal product consumption, while accounting for the type of farming systems (organic or conventional) of the food consumed.Dietary environmental impacts of the diet of 29,210 NutriNet-Santé participants were estimated using databases developed within the BioNutriNet project. Four diets, differing from their animal-based food proportion, were studied: omnivorous, pesco-vegetarian, vegetarian, and vegan. Three individual environmental indicators were assessed (greenhouse gas emissions, cumulative energy demand and land occupation) and combined in one aggregated partial score (pReCiPe, partial ReCiPe). Means of these indicators adjusted for energy intake were estimated across diet groups using covariance analysis.About 95% of the study sample was omnivorous. Organic consumption was much higher among non–omnivorous than other groups. The pReCiPe were 64%, 61%, and 69% lower for diet of pesco-vegetarians, vegetarians and vegans respectively, in comparison to the omnivorous diet. Regarding the three individual environmental indicators included in the pReCiPe index, the same trend was observed but trade-offs exist in organic with cumulative energy lowered and land occupation augmented.A positive link between animal-sourced food consumption and total environmental impact was observed in this large sample of French adults. By far, omnivorous had the highest-level of greenhouse gas emissions, cumulative energy demand and land occupation while vegan diets had the lowest. Further research on environmental indicators distinguishing farming practices is needed to allow a more comprehensive evaluation of the impact.

Education and hypertension in the CONSTANCES cohort: which factors mediate this association?

Abstract Background Individual socioeconomic characteristics and in particular education have been shown to be strongly associated with hypertension (HTN). Few studies have examined the mechanisms involved in such associations and understanding them would help to reduce the burden of social inequalities. We aimed to investigate whether specific risk factors of HTN intervene as mediators in the association between individual education and HTN in a large sample of French adults. Methods In this cross-sectional analysis, participants are adults aged between 18 and 69 years old recruited to the CONSTANCES cohort over the period 2012-2015. We included behavioral (poor diet, physical inactivity, alcohol consumption), anthropometric (body mass index) and socioeconomic risk factors (income and longest occupation) as potential mediators. Analyses were stratified by sex. Natural direct and indirect effects of education on HTN were estimated using weighted Poisson regression models with inverse odds weighting. Results A total of 62,247 individuals (53% women, mean age 48±13 years) were included. Prevalence of HTN was 37.3% [95%-Confidence Interval (95%-CI) =36.6-38.0] in men and 23.2% [95%-CI=22.7-23.8] in women. We found a steep educational gradient of HTN in both sexes, larger among young adults in relative terms. Low education was strongly associated with HTN: RRTotal Effect=1.16 [95%-CI=1.12-1.21] in men and 1.26 [95%-CI=1.21-1.32] in women. Behavioral, anthropometric and socioeconomic risk factors accounted for 49% and 32% of the total effect in men and women respectively. Conclusions This study underlines the importance of education in inequalities in HTN and suggests that behavioral, anthropometric and socioeconomic risk factors substantially mediate the association between education and HTN. Future research using longitudinal data should be done to help understand the causal pathway linking education and HTN. Key messages A strong gradient of decreased prevalence of hypertension with higher individual education is observed in both sexes and in early adulthood, suggesting that prevention should start early. Behavioral, anthropometric and socioeconomic characteristics at adulthood substantially mediate the association between education and hypertension.

Individual and neighbourhood socioeconomic disparities and high blood pressure in France: Results from a cross-sectional analysis of the CONSTANCES cohort

Introduction The influence of socioeconomic status (SES) on cardiovascular outcomes has already been well-established. Lower income, lower education or manual occupation are associated with a higher prevalence of cardiovascular risk factors such as high blood pressure (HBP) as well as with cardiovascular mortality. Neighborhood factors, such as the affluence of the area of residence have also been associated with cardiovascular diseases. However, few studies have been able to analyze jointly the influence of individual and neighborhood SES on the prevalence of HBP. We aimed to do so using a large sample of French adults. Methods Participants are randomly selected adults aged 18 to 69 recruited to the CONSTANCES cohort between 2012 and 2015. Information on lifestyle was collected by a self-administered questionnaire. Blood pressure (BP) was measured in 16 recruitment centers using a standardized protocol. HBP has been defined as BP over 140/90 mmHg and/or taking antihypertensive medication as indicated by matched records from the national database or reimbursements from the French health insurance. SES has been defined at an individual-level using education and at a neighborhood-level through an indicator of socioeconomic deprivation of the area of residence (FDep), divided in quintiles in this study. Analyses were stratified by gender. We first calculated prevalence of HBP according to individual and neighborhood variables separately. We then performed three-level logistic regressions (recruitment center, neighborhood, individual) to analyze jointly the influence of individual and neighborhood SES on the prevalence of HBP, taking into account the specific structure of the data. Results A total of 63,627 individuals (53% women) recruited between 2012 and 2015 were included in the analyses. Mean age in men and women was 48.8 ± 13.3 years and 47.2 ± 13.5 years, respectively. In this sample, 19,383 individuals were classified hypertensive, so the crude prevalence of HBP was 30.5%. Using 2016 French population as reference, standardized prevalence of HBP was 27.5% [95% CI: 27.1–27.8], higher among men (33.8% [95% CI: 33.2–34.5%]) than women (21.3% [95% CI: 20.8–21.8%]). Prevalence increased with age, from 9.5% in 18–34 years to 63.5% in people aged 65 years and more. Prevalence of HBP strongly differed according to the education level in all age groups in both gender. For instance in women with no diploma, prevalence of HBP increased from 10% among 18–34 years to 65% among 65–70 years compared with 4% to 46% in women with highest diploma. The corresponding age-adjusted odds ratios (OR) for prevalence of HBP comparing the lowest versus highest level of education were 2.22 [95% CI: 2.00–2.50] in women and 1.82 [95% CI: 1.67–2.00] in men. Regarding neighborhood, living in more deprived areas was associated with a higher prevalence of HBP in women and men. Age-adjusted ORs for prevalence of HBP comparing the most versus least deprived quintile of areas of residence were 1.61 [95% CI: 1.47–1.75] in women and 1.69 [95% CI: 1.56–1.85] in men. In models including both individual and neighborhood indicators, OR comparing the lowest versus highest level of education were 2.09 [95% CI: 1.87–2.34] in women and 1.70 [95% CI: 1.53–1.88] in men. OR for prevalence of HBP comparing the most versus least deprived quintile of areas of residence were 1.25 [95% CI: 1.11–1.41] in women and 1.15 [95% CI: 1.03–1.30] in men. Conclusions In this cross-sectional analysis of a large sample of adults, we found marked socioeconomic gradients of HBP in all age groups and among both men and women. Individual and contextual indicators of SES were independently associated with the prevalence of HBP.

Adherence to the French Eating Model is inversely associated with overweight and obesity: results from a large sample of French adults.

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.

Socio-economic and demographic factors associated with snacking behavior in a large sample of French adults

BackgroundFew studies have specifically focused on demographic and socio-economic characteristics associated with snacking in adults, whereas their identification could be useful for defining effective public health measures. The aim of our study was to assess the associations of these factors with daily snacking behavior and its dietary quality.MethodsThis cross-sectional study included 84,692 women and 23,491 men from the NutriNet-Santé cohort study. Occurrence of snacking, energy intake from snacks, snack nutrient, and energy densities were assessed using 24-h dietary records of weekdays at baseline. Associations between socio-economic and demographic factors (age, presence of children in the household, education, income, occupation), and snacking behavior were examined using multivariable logistic regression and analysis of covariance, stratified by sex and adjusted for total daily energy intake.ResultsOlder individuals were more likely to snack during the day in both sexes while individuals with primary education (OR = 0.79 (0.71;0.87) in women; OR = 0.71 (0.60;0.83) in men), female employees (OR = 0.94 (0.89;0.99), and self-employed women were less likely to snack during the day. Older individuals, in particular middle-aged subjects, had higher snack nutrient density, and lower energy intake and density from snacks compared with younger adults. Presence of a child in the household was associated with higher energy density, lower nutrient density (in women), and lower energy intake from snacks (in men), compared with those who lived without a child in household. In low income individuals and manual workers, snacks had lower nutrient density and higher energy content than in higher socioeconomic categories. At last, energy intake from daily snacking occasions was higher in women with low education level.ConclusionsAlthough snacking was less prevalent in low socioeconomic categories and young adults, their snacks had higher energy content and were of poorer nutrient density. Such findings provide useful information on mechanisms of social disparities in dietary behavior.Trial registrationThis study was conducted according to the guidelines laid down in the Declaration of Helsinki. All procedures were approved by the Institutional Review Board of the French Institute for Health and Medical Research (IRB Inserm No0000388FWA00005831) and the French Data Protection Authority (Commission Nationale Informatique et Libertés No.908450 and No.909216). Clinical Trial no. NCT03335644

Meal planning is associated with food variety, diet quality and body weight status in a large sample of French adults

BackgroundMeal planning could be a potential tool to offset time scarcity and therefore encourage home meal preparation, which has been linked with an improved diet quality. However, to date, meal planning has received little attention in the scientific literature. The aim of our cross-sectional study was to investigate the association between meal planning and diet quality, including adherence to nutritional guidelines and food variety, as well as weight status.MethodsMeal planning, i.e. planning ahead the foods that will be eaten for the next few days, was assessed in 40,554 participants of the web-based observational NutriNet-Santé study. Dietary measurements included intakes of energy, nutrients, food groups, and adherence to the French nutritional guidelines (mPNNS-GS) estimated through repeated 24-h dietary records. A food variety score was also calculated using Food Frequency Questionnaire. Weight and height were self-reported. Association between meal planning and dietary intakes were assessed using ANCOVAs, while associations with quartiles of mPNNS-GS scores, quartiles of food variety score and weight status categories (overweight, obesity) were evaluated using logistic regression models.ResultsA total of 57% of the participants declared to plan meals at least occasionally. Meal planners were more likely to have a higher mPNNS-GS (OR quartile 4 vs. 1 = 1.13, 95% CI: [1.07–1.20]), higher overall food variety (OR quartile 4 vs. 1 = 1.25, 95% CI: [1.18–1.32]). In women, meal planning was associated with lower odds of being overweight (OR = 0.92 [0.87–0.98]) and obese (OR = 0.79 [0.73–0.86]). In men, the association was significant for obesity only (OR = 0.81 [0.69–0.94]).ConclusionsMeal planning was associated with a healthier diet and less obesity. Although no causality can be inferred from the reported associations, these data suggest that meal planning could potentially be relevant for obesity prevention.

Characteristics of Beverage Consumption Habits among a Large Sample of French Adults: Associations with Total Water and Energy Intakes.

Background: Adequate hydration is a key factor for correct functioning of both cognitive and physical processes. In France, public health recommendations about adequate total water intake (TWI) only state that fluid intake should be sufficient, with particular attention paid to hydration for seniors, especially during heatwave periods. The objective of this study was to calculate the total amount of water coming from food and beverages and to analyse characteristics of consumption in participants from a large French national cohort. Methods: TWI, as well as contribution of food and beverages to TWI was assessed among 94,939 adult participants in the Nutrinet-Santé cohort (78% women, mean age 42.9 (SE 0.04)) using three 24-h dietary records at baseline. Statistical differences in water intakes across age groups, seasons and day of the week were assessed. Results: The mean TWI was 2.3 L (Standard Error SE 4.7) for men and 2.1 L (SE 2.4) for women. A majority of the sample did comply with the European Food Safety Authority (EFSA) adequate intake recommendation, especially women. Mean total energy intake (EI) was 1884 kcal/day (SE 1.5) (2250 kcal/day (SE 3.6) for men and 1783 kcal/day (SE 1.5) for women). The contribution to the total EI from beverages was 8.3%. Water was the most consumed beverage, followed by hot beverages. The variety score, defined as the number of different categories of beverages consumed during the three 24-h records out of a maximum of 8, was positively correlated with TWI (r = 0.4); and with EI (r = 0.2), suggesting that beverage variety is an indicator of higher consumption of food and drinks. We found differences in beverage consumptions and water intakes according to age and seasonality. Conclusions: The present study gives an overview of the water intake characteristics in a large population of French adults. TWI was found to be globally in line with public health recommendations.

Contribution of Organic Food to the Diet in a Large Sample of French Adults (the NutriNet-Santé Cohort Study).

In developed countries, the demand for organic products continues to substantially increase each year. However, little information is available regarding the level of consumption of organic food and its relative share of the whole diet. Our aim was to provide, using individual consumption data, a detailed description of organic food consumption among French adults. Conventional and organic intakes were assessed using an organic food frequency questionnaire administered to 28,245 French adults participating in the NutriNet-Santé study. P values of Student t-test or Chi-square for the difference between genders were reported. Less than 12% of the respondents reported never consuming organic food in the past year. Women consumed on average 20% organic food in their whole diet per day while men consumed an average of 18%. The proportion of vegetables consumed that came from organic sources was 31% among women and 28% among men. Overall, the estimate of the contribution of organic food from products of plant origin was higher than that from products of animal origin. Our study provides a framework for the exploration of organic consumption and its correlates and can serve as a basis for future studies investigating relationships between the level of organic food consumption and health outcomes.

Determinants of Vitamin D Status in Caucasian Adults: Influence of Sun Exposure, Dietary Intake, Sociodemographic, Lifestyle, Anthropometric, and Genetic Factors

Very few studies have investigated the determinants of serum vitamin D levels using a set of variables that include simultaneously sun exposure, phototype, dietary intake, sociodemographics, anthropometric, lifestyle data, and genetic polymorphisms. Our objective was to investigate the associations between all these parameters and vitamin D status in a large sample of French adults. This cross-sectional survey was based on 1,828 middle-aged Caucasian adults from the SU.VI.MAX (SUpplémentation en VItamines et Minéraux AntioXydants) study. Plasma 25-hydroxyvitamin D (25OHD) concentration was lower among women (P<0.0001), older subjects (P=0.04), obese/underweight (P<0.0001), those living at higher latitudes (P<0.0001), those whose blood draw occurred in early spring (P<0.0001), less physically active (P<0.0001), with low sun exposure (P<0.0001), and with no-to-low alcohol intake (P=0.0001). Mutant GC rs4588 and rs7041 single nucleotide polymorphisms were associated with lower and higher 25OHD concentrations, respectively (P<0.0001). Dietary intake was not a major determinant of vitamin D status (P=0.7). This study provides an overall picture of determinants of vitamin D status. Several modifiable factors were identified, such as daily-life moderate sun exposure, physical activity, and normal-weight maintenance, which should be targeted by public health policies in order to improve vitamin D status in the general population, while avoiding active/intensive sun exposure, in line with recommendations for skin cancer prevention.

Profiles of Organic Food Consumers in a Large Sample of French Adults: Results from the Nutrinet-Santé Cohort Study

BackgroundLifestyle, dietary patterns and nutritional status of organic food consumers have rarely been described, while interest for a sustainable diet is markedly increasing.MethodsConsumer attitude and frequency of use of 18 organic products were assessed in 54,311 adult participants in the Nutrinet-Santé cohort. Cluster analysis was performed to identify behaviors associated with organic product consumption. Socio-demographic characteristics, food consumption and nutrient intake across clusters are provided. Cross-sectional association with overweight/obesity was estimated using polytomous logistic regression.ResultsFive clusters were identified: 3 clusters of non-consumers whose reasons differed, occasional (OCOP, 51%) and regular (RCOP, 14%) organic product consumers. RCOP were more highly educated and physically active than other clusters. They also exhibited dietary patterns that included more plant foods and less sweet and alcoholic beverages, processed meat or milk. Their nutrient intake profiles (fatty acids, most minerals and vitamins, fibers) were healthier and they more closely adhered to dietary guidelines. In multivariate models (after accounting for confounders, including level of adherence to nutritional guidelines), compared to those not interested in organic products, RCOP participants showed a markedly lower probability of overweight (excluding obesity) (25≤body mass index<30) and obesity (body mass index ≥30): −36% and −62% in men and −42% and −48% in women, respectively (P<0.0001). OCOP participants (%) generally showed intermediate figures.ConclusionsRegular consumers of organic products, a sizeable group in our sample, exhibit specific socio-demographic characteristics, and an overall healthy profile which should be accounted for in further studies analyzing organic food intake and health markers.

Sociodemographic, lifestyle and dietary correlates of dietary supplement use in a large sample of French adults: results from the NutriNet-Santé cohort study

Information on the determinants of dietary supplement (DS) use in France is largely lacking, especially in population subgroups such as smokers. Also, little is known about the role of health professionals in DS purchases. The aim of the present study was to describe DS use along with its sociodemographic, lifestyle and dietary correlates in a large sample of French adults (age 18+years) participating in the NutriNet-Santé cohort study. Data were collected by self-administered Internet questionnaires. Food intakes were assessed by 24 h dietary records. Data on DS use were available for 79,786 participants. Supplement users were compared with non-users by logistic regression. Current DS use at least three times/week was reported by 14·6% of men and 28·1% of women. Mg, and vitamins B6 and C were the most frequently consumed nutrients. DS were prescribed or recommended by a physician in 54·9% of the cases. DS use was positively associated with knowledge of nutritional recommendations and organic product consumption, following a healthier diet and lifestyle (non-smoker, moderate leisure-time physical activity). Current smokers used less DS than did non-smokers, but their DS consumption was substantial (19·0%) and they were more likely to self-medicate. The present study provides updated and detailed information on DS use determinants in a large French cohort, including a focus on smokers, for whom the long-term effects of DS use are poorly documented and could represent a risk. These findings pave the way for future aetiological studies.

Sociodemographic and economic characteristics associated with dairy intake vary across genders

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. 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. 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). 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.

Relationship between serum, red cell, urinary and dietary magnesium in a middle-aged French adult population.

Magnesium (Mg) is the second most common intracellular electrolyte; in the body. Few data are available in general population studies on the assessment of Mg status and its relationship to dietary intake. We explored the relationship between several biological Mg surrogates (serum, red cell, and urinary), Mg intake, age, alcohol intake, and mean energy intake in a large sample of French adults issued from the SUVIMAX study. Serum Mg was positively correlated with red cell Mg in men and women (r = 0.17; p < 0.001) whereas no association was found between urinary Mg and red cell Mg nor between urinary Mg and serum Mg. Age was positively correlated with serum and red cell Mg in women (p < 0.001) and negatively correlated with urinary Mg in both genders (p < 0.001). Finally, a negative correlation was found between dietary intake and red cell Mg in women (r = -0.06; p < 0.05). Among the biological Mg surrogates, an association was found between serum Mg and red cell Mg. Further investigations should be conducted in order to determine the role played by dietary Mg intake in the relationship between health status and several biological Mg measurements.