Programme National Nutrition Sante - guidelines score 2 (PNNS-GS2): development and validation of a diet quality score reflecting the 2017 French dietary guidelines

Following the revision of the French dietary guidelines in 2017, the Programme National Nutrition Sante - guidelines score (PNNS-GS), built upon previous recommendations released in 2001, needed to be updated. This cross-sectional study thus aimed to develop and validate the PNNS-GS2, a predefined food-based dietary index based on the 2017-revised French nutritional guidelines. A total of 80 965 participants recruited among French adults (>= 18 years old) in the NutriNet-Sante web-based prospective cohort were included. Collected data included repeated 24 h-dietary records over a 2-year period, sociodemographic and, for 16 938 subjects, clinical and biological data. Weighting and cut-offs of the PNNS-GS2 components were collegially arbitrated by nutrition experts who participated in the 2017 revision of the guidelines. Sociodemographic, nutritional and clinical and biological factors were investigated according to quintiles (Q) of PNNS-GS2 (theoretical ranging -17 to +13 center dot 5). Mean PNNS-GS2 was 2 center dot 1 (sd 3 center dot 1) in women and -0 center dot 3 (sd 3 center dot 6) in men. Higher PNNS-GS2 (higher adherence to 2017 dietary guidelines) was positively associated with (mean difference between Q5 and Q1 in women/men) age (+8 center dot 4/+4 center dot 7 years), education (+3 center dot 9/+7 center dot 4 % of university level), physical activity (+13 center dot 3/+3 center dot 5 % of >= 60 min/d) and non-smoking (+9 center dot 7/+13 center dot 7 %), and was negatively associated with mean blood pressure (-3 center dot 0/-2 center dot 8 mmHg), plasma LDL-cholesterol (-0 center dot 07/-0 center dot 06 g/l) and TAG (-0 center dot 10/-0 center dot 16 g/l) concentrations. Higher PNNS-GS2 was also associated with higher intake of favourable nutrients, e.g. n-3 PUFA (+0 center dot 2/+0 center dot 2 % of energy intake), fibres (+8 center dot 7/+10 center dot 7 g) and vitamin C (+36 center dot 6/+43 center dot 8 mg). Associations between PNNS-GS2 and sociodemographic and nutritional factors arguing for its validation are coherent. Further studies are needed to evaluate its association with mortality and morbidity.