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 Sante (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 Supple mentation en Vitamines et Mineraux 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. European Journal of Clinical Nutrition (2011) 65, 887-894; doi:10.1038/ejcn.2011.61; published online 11 May 2011