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Background It has been suggested that a balanced nutritional intake may be useful in preventing or even reversing sarcopenia. Aim To describe cross-sectional associations between dietary nutrient intake and sarcopenia. Methods Subjects recruited from the SarcoPhAge study population completed a food frequency questionnaire. The micronutrient and macronutrient intake was evaluated in both sarcopenic and non-sarcopenic participants. The Nutritional Belgian Recommendations of 2016 were used, i.e., adequate intake and estimated average requirement (EAR). For micronutrients, the prevalence of insufficient intake was estimated as the proportion of subjects whose intake was below the EAR. Results A total of 331 subjects (mean age of 74.8 ± 5.9 years, 58.9% women) had complete data and were included in this study. Among them, 51 were diagnosed with sarcopenia (15.4%). In the fully adjusted model, analyses revealed that sarcopenic subjects consumed significantly lower amounts of two macronutrients (proteins, lipids) and five micronutrients (potassium, magnesium, phosphorus, iron, and vitamin K) than non-sarcopenic subjects (all p values < 0.005). A significantly increased prevalence of insufficiency was found for sarcopenic subjects compared to non-sarcopenic subjects for potassium, magnesium, iron, calcium and vitamins E and C (all p values < 0.005). The prevalence of sarcopenic subjects who were also below the Nutritional Belgian Recommendations for protein and lipids was significantly higher than that of non-sarcopenic subjects. Discussion and conclusions Sarcopenic subjects seem to consume significantly reduced amounts of many micronutrients and macronutrients compared to non-sarcopenic subjects. These results suggest that a poorly balanced diet may be associated with sarcopenia and poor musculoskeletal health, although prospective studies are needed to confirm these findings.

Daily eating/fasting cycles synchronise circadian peripheral clocks, involved in the regulation of the cardiovascular system. However, the associations of daily meal and fasting timing with cardiovascular disease (CVD) incidence remain unclear. We used data from 103,389 adults in the NutriNet-Santé study. Meal timing and number of eating occasions were estimated from repeated 24 h dietary records. We built multivariable Cox proportional-hazards models to examine their association with the risk of CVD, coronary heart disease and cerebrovascular disease. In this study, having a later first meal (later than 9AM compared to earlier than 8AM) and last meal of the day (later than 9PM compared to earlier than 8PM) was associated with a higher risk of cardiovascular outcomes, especially among women. Our results suggest a potential benefit of adopting earlier eating timing patterns, and coupling a longer nighttime fasting period with an early last meal, rather than breakfast skipping, in CVD prevention. The relation between daily meal and fasting timing with cardiovascular disease incidence remains unclear. Here, authors show that a later daily meal timing is associated with increased cardiovascular disease risk, especially in women. This study suggests that adopting earlier daily eating patterns may be beneficial for cardiovascular prevention.

Background: There is a growing trend for vegetarian and vegan diets in many Western countries. Epidemiological evidence suggesting that such diets may help in maintaining good health is rising. However, dietary and sociodemographic characteristics of vegetarians and vegans are not well known. The aim of this cross-sectional study was to describe sociodemographic and nutritional characteristics of self-reported, adult vegetarians and vegans, compared to meat-eaters, from the French NutriNet-Santé study. Methods: Participants were asked if they were following a specific diet. They were then classified into three self-reported diet groups: 90,664 meat-eaters, 2370 vegetarians, and 789 vegans. Dietary data were collected using three repeated 24-h dietary records. Multivariable polytomic logistic regression models were perfomed to assess the association between the sociodemographic characteristics and type of diet. The prevalence of nutrient intake inadequacy was estimated, by sex and age for micronutrients, as well as by type of self-reported diet. Results: Compared with meat-eaters, vegetarians were more likely to have a higher educational level, whereas vegans had a lower education level. Compared with meat-eaters, vegetarians were more likely to be women, younger individuals, and to be self-employed or never employed rather than managerial staff. Vegetarians and vegans substituted animal protein-dense products with a higher consumption of plant protein-dense products (e.g., soy-based products or legumes). Vegetarians had the most balanced diets in terms of macronutrients, but also had a better adherence to French dietary guidelines. Vegetarians exhibited a lower estimated prevalence of inadequacies for micronutrients such as antioxidant vitamins (e.g., for vitamin E, 28.9% for vegetarian women <55 years of age vs. 41.6% in meat-eaters) while vegans exhibited a higher estimated prevalence of inadequacies for some nutrients, in particular vitamin B12 (69.9% in men and 83.4% in women <55 years of age), compared to meat-eaters. Conclusions: Our study highlighted that, overall, self-reported vegetarians and vegans may meet nutritional recommendations.

PurposeWhile intensive modern food systems have significant unfavourable impacts on health and the environment, new sustainable food consumption trends have been emerging in recent years. This study identified recent dietary trends over a 4-year period in terms of overall dietary patterns and organic foods consumption and associated socio-demographic determinants.MethodsFood intakes were assessed among 18,108 participants of the NutriNet-Santé cohort in 2014 and 2018. A food frequency questionnaire was used to estimate organic and conventional food consumption. Change in food consumption, quality of the diet (assessed by the adherence to the French national guidelines), plant-based diet using published scores, organic food intake were evaluated in regard with various socio-demographic factors. The paired student t test to compare dietary intake and the Kruskal–Walllis test to consider socio-demographic characteristics were used.ResultsConsumption of meat and processed meat decreased respectively by 5.09 g/day (SD 51.15) and 1.12 g/day (SD 26.05). The average total consumption of organic products increased by 12% (+ 93 g/day) while consumption of organic fish and seafood (− 1.4 g/day), poultry (− 1 g/day), processed meat (− 0.3 g/day) and meat (− 3.3 g/day) decreased. The dietary towards healthier diets was more pronounced in certain population subgroups. For example, females, young individuals and postgraduate participants were more likely to increase their consumption of healthful plant and animal-based foods, organic foods and to improve the overall nutritional quality of their diets during the follow-up period than their counterparts.ConclusionOur results indicate a slight inflexion towards healthier and plant-based diets over a 4-year period at least in some segments of the population. A decrease in the consumption of animal products and an increase in the consumption of healthful plant-based foods and organic foods suggests a potential trend towards more sustainable diets among certain subgroups. The environmental impacts of these changes need to be assessed in further works as well as the way to sustain and improve them, in particular those who do not initiate sustainable transition.

Background The Nutri-Score summary graded front-of-pack nutrition label has been identified as an efficient tool to increase the nutritional quality of pre-packed food purchases. However, no study has been conducted to investigate the effect of the Nutri-Score on the shopping cart composition, considering the type of foods. The present paper aims to investigate the effect of the Nutri-Score on the type of food purchases, in terms of the relative contribution of unpacked and pre-packed foods, or the processing degree of foods. Methods Between September 2016 and April 2017, three consecutive randomized controlled trials were conducted in three specific populations – students ( N  = 1866), low-income individuals ( N  = 336) and subjects suffering from cardiometabolic diseases ( N  = 1180) – to investigate the effect of the Nutri-Score on purchasing intentions compared to the Reference Intakes and no label. Using these combined data, the proportion of unpacked products in the shopping carts, as well as the distribution of products across food categories taking into account the degree of processing (NOVA classification) were assessed by trials arm. Results The shopping carts of participants simulating purchases with the Nutri-Score affixed on pre-packed foods contained higher proportion of unpacked products – especially raw fruits and meats, i.e. with no FoPL –, compared to participants purchasing with no label (difference of 5.93 percentage points [3.88–7.99], p -value< 0.0001) or with the Reference Intakes (difference of 5.27[3.25–7.29], p-value< 0.0001). This higher proportion was partly explained by fewer purchases of pre-packed processed and ultra-processed products overall in the Nutri-Score group. Conclusions These findings provide new insights on the positive effect of the Nutri-Score, which appears to decrease purchases in processed products resulting in higher proportions of unprocessed and unpacked foods, in line with public health recommendations.

Evidence on the impact of ultra-processed food (UPF) intake on diet quality among cancer survivors remains limited. This study examined UPF consumption and nutrient intake adequacy among cancer survivors in Lebanon. In this cross-sectional study, adult cancer survivors in remission for at least three months were recruited from two medical centers. Dietary intake was assessed using a validated food frequency questionnaire (FFQ), and food items were categorized according to the NOVA classification. Nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR) were calculated. Participant characteristics, nutrient adequacy, and macronutrient intakes were compared across UPF quartiles using Chi-square tests, and ANOVA. Logistic regression was performed to identify predictors of nutrient inadequacy. The study included 268 participants (mean age: 59 years; 83% female). UPF accounted for 8 ± 7% of total food weight and 17.5 ± 11% of energy intake. Most participants did not meet requirements for potassium (95%), vitamin A (87%), and vitamin D (99%) with mean intakes of 2,527 ± 1236 mg, 350 ± 175 Retinol Activity Equivalents, and 0.8 ± 1.2 µg, respectively. Higher UPF intake was significantly associated with higher energy ( p  < 0.001), carbohydrate ( p  < 0.001), protein ( p  = 0.017), fat ( p  < 0.001), and saturated fat intake ( p  < 0.001), and with lower vitamin C adequacy ( p  = 0.02). In multivariable analysis, higher education predicted lower odds of nutrient inadequacy (AOR = 0.26, 95% CI: 0.1–0.65, p  = 0.004), while UPF intake did not. Despite the relatively low UPF contribution, significant micronutrient inadequacies were observed among cancer survivors. These findings underscore the importance of integrating dietary counseling into cancer care to address nutrient gaps and promote healthier food choices.

Background To improve nutritional status and prevent chronic nutrition-related diseases, international organizations have recommended the use of multiple strategies, including front-of-package nutrition labelling (FOPL). In France, the Nutri-Score has been selected by health authorities in March 2017. However, to be effective in purchasing situations, the label needs to be well understood, which may be influenced by label format and sociodemographic characteristics. This study aimed at investigating the objective understanding of the Nutri-Score compared to other label formats, and more particularly among specific at-risk populations. Methods The objective understanding of four FOPLs-namely Nutri-Score, Multiple Traffic Lights (MTL), the simplified nutrition labelling system (SENS), and modified Reference Intakes (mRls)-was investigated in a sample from the NutriNet-Sante French cohort (n = 3,751). Logistic regression mixed models were computed to assess the association of the four FOPLs, compared to a \"no label\" situation, on the consumers' ability to rank products according to their overall nutritional quality. Objective understanding was also investigated according to sociodemographic and lifestyle characteristics. Results Compared to a \"no label\" situation, all FOPLs were significantly associated to an increase in consumers' ability to classify the products correctly, with wide disparities in results according to formats. The best performance was observed for the Nutri-Score (OR = 20.33(17.68-23.37)), followed by SENS (OR = 9.57(8.50-10.77)), MTL (OR = 3.55(3.20-3.93)) and mRls (OR = 1.53(1.39-1.69)). This ranking was similar among all sub-populations and the ORs associated to the Nutri-Score were over 10, whichever the sub-group considered. Women, younger people, non-smokers, individuals with higher educational level and those with children had a higher capacity to identify healthier products (all P <= 0.05). Conclusion Nutri-Score, with a summarized graded and color-coded format, using semantic colours, is associated to a higher objective understanding than monochrome and nutrient-specific labels. Furthermore, though objective understanding may differ according to individual characteristics of subjects, the magnitude of effect of the Nutri-Score largely outweighed this effect, even in the at-risk populations.

Despite the urgent need for plant-based dietary shifts, few studies have examined current diet trajectories using longitudinal data. This study analyzed dietary transitions of French adults over 8 years (2014-2022), assessing diet quality and the role of various socio-economic factors. Consumption data from 17 187 NutriNet-Santé cohort participants, weighted for the French Census, were collected via FFQ in 2014, 2018 and 2022. Adopting a gender-specific approach, consumption changes in twenty-three food groups were assessed over time. Diet quality was evaluated using the Comprehensive Diet Quality Index score, categorising foods into ‘healthy’ and ‘unhealthy’. Socio-economic analysis targeted four food groups (red meat (including fresh beef, pork, offal and lamb), processed meat (e.g. sausages, ham and bacon), legumes and whole-grain products), strongly linked to mortality risk and recognised as significant markers of the sustainable diet transition. All analyses were conducted using multi-adjusted mixed-effects models. Consumption of some healthy plant-based foods (nuts +59 %, legumes +22 %, whole-grain products +7 %) significantly increased over time, while consumption of some unhealthy foods (red meat −19 %, refined cereals −18 %, sweetened drinks −15 %) decreased. Conversely, consumption of prepared and mixed dishes (+16 %) and processed meat (+35 %) increased. These changes differed in magnitude between genders and translated into an improved diet quality score (Comprehensive Diet Quality Index). Occupational status was linked to longitudinal changes in food consumption, showing increased consumption of plant-based foods among students and higher socio-professional categories. Our findings provide accurate data on trends and factors for targeted initiatives, guiding strategic interventions for a sustainable dietary transition.

AbstractObjectiveTo investigate the association between intake of food additive preservatives and cancer incidence in a large prospective cohort.DesignProspective cohort.SettingFrench NutriNet-Santé cohort, 2009-23.Participants105 260 participants (≥15 years) without prevalent cancer who completed at least two 24 hour dietary records at baseline.Main outcome measuresCumulative time dependent intake of preservatives, including those in industrial food brands, assessed using repeated 24 hour dietary records and evaluated through multiple composition databases and ad hoc laboratory assays in food products for the most frequently consumed additive-food pairs. Associations between intake of three categories of preservatives (defined as sex specific thirds if preservative was consumed by at least a third of participants, otherwise defined as non-consumers and lower or higher consumers separated by the sex specific median) and cancer incidence were characterised using multivariable proportional hazards Cox models adjusted for potential confounders.ResultsMean age of participants was 42.0 years (standard deviation (SD 14.5) years), and 78.7% were women. 4226 participants received a diagnosis of incident cancer (mean follow-up 7.57 (SD 4.56) years), comprising 1208 breast, 508 prostate, 352 colorectal, and 2158 other cancers). Higher intakes of several preservatives were associated with higher cancer incidence: total non-antioxidants with overall cancer (hazard ratio for higher v non-consumers or lower consumers 1.16 (95% confidence interval (CI) 1.07 to 1.26); absolute risk of cancer at age 60 years, respectively, 13.3%, 12.1%) and breast cancer (1.22 (1.05 to 1.41); 5.7%, 4.8%); total sorbates, specifically potassium sorbate, with overall cancer (1.14 (1.04 to 1.24); 13.4%, 11.8%) and breast cancer (1.26 (1.07 to 1.49); 5.7%, 4.6%); total sulfites with overall cancer (1.12 (1.02 to 1.24); 13.4%, 11.9%); potassium metabisulfite with overall cancer (1.11 (1.03 to 1.20); 13.5%, 12.0%) and breast cancer (1.20 (1.04 to 1.38); 5.7%, 4.9%); sodium nitrite with prostate cancer (1.32 (1.02 to 1.70); 4.2%, 3.4%); potassium nitrate with overall cancer (1.13 (1.05 to 1.23); 14.0%, 12.0%) and breast cancer (1.22 (1.05 to 1.41); 5.9%, 4.8%); total acetates with overall cancer (1.15 (1.06 to 1.25); 14.3%, 12.2%) and breast cancer (1.25 (1.07 to 1.45); 6.1%, 4.9%); acetic acid with overall cancer (1.12 (1.01 to 1.25); 14.4%, 12.4%); and sodium erythorbate with overall cancer (1.12 (1.04 to 1.22); 13.5%, 11.9%) and breast cancer (1.21 (1.04 to 1.41); 5.7%, 4.8%). 11 of the 17 individually studied preservatives were not associated with cancer incidence.ConclusionMultiple positive associations between intake of preservatives widely used in industrial foods and higher cancer incidence (overall, breast, and prostate) were observed in this large prospective cohort. Epidemiology based on health effect biomarkers and experimental research are needed to gain insight into outcome pathways. If confirmed, these new data call for the re-evaluation of regulations governing the food industry’s use of these additives, to improve consumer protection. In the meantime, the findings support recommendations for consumers to favour freshly made, minimally processed foods.Trial registrationClinicalTrials.gov NCT03335644.

Two independent cross-sectional dietary surveys (the Individual and National Food Consumption Surveys, INCA), performed in 1998–99 (INCA1) and in 2006–07 (INCA2) on nationally representative samples of French people, were used to analyse trends in the dietary habits and nutritional intake of French adults. Food consumption was recorded through 7-d dietary records, and nutritional intakes were assessed using the French food composition database. After exclusion of under-reporters, analyses were performed on 3267 adults, aged 18–79 years: 1345 from INCA1 and 1922 from INCA2. The trends highlighted over the 8-year period showed a decrease in consumption of dairy products, meat, bread, potatoes, pastries/croissant-like pastries/cakes/biscuits and sugar/confectionery. In contrast, the consumption of fruits and vegetables, rice, ice cream and chocolate increased. Other food groups, like fish and snacking foods, remained stable. Food choices were mostly age specific. These age differences remained consistent over the years and underlined two opposite dietary trends: a ‘traditional’ one mainly followed by the elderly, and a ‘snacking and convenience’ one mainly adopted by young adults. The overall trends in food consumption did not influence the mean energy intake, but did slightly modify the contribution of each macronutrient to energy intake. These repeated surveys highlighted the fact that trends in French food habits have moved towards an average European diet at the crossroads between Mediterranean and Northern diets, and that food consumption changes impacted, to a lesser extent, nutritional intake.