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The aim of this study was to assess the validity of the predictive INTERSALT equation using spot urine samples to estimate 24-h urinary Na (24-hUNa) excretion and daily Na intake among the French adult population. Among 193 French adults ('validation sample'), we assessed the validity by comparing predicted 24-hUNa excretion from spot urine and measured 24-hUNa excretion from 24-h urine collections. Spearman correlation coefficients and Bland–Altman plots were used and we calculated calibration coefficients. In a nationally representative sample of 1720 French adults ('application sample'), the calibrated predictive equation was then applied to the spot urine Na values to estimate 24-hUNa excretion and daily Na intake. In that sample, predicted Na intake was compared with that estimated from 24-h dietary recalls. Results were adjusted and corrected using calibration coefficients. In the validation sample, the measured 24-hUNa excretion was on average 14 % higher than the predicted 24-hUNa (+13 % for men and +16 % for women). Correlation between measured and predicted 24-hUNa excretion was moderate (Spearman r 0·42), and the Bland–Altman plots showed underestimation at lower excretion level and overestimation at higher level. In the application study, estimated daily salt intake was 8·0 g/d using dietary recalls, 8·1 g/d using predicted INTERSALT equation and 9·3 g/d after applying calibration coefficients calculated in the validation study. Despite overall underestimation of 24-hUNa excretion by spot urinary Na, the use of predictive INTERSALT equation remains an acceptable alternative in monitoring global Na intake/excreted in the French population but its use is not advised at the individual level. [ABSTRACT FROM AUTHOR]

Despite some advantages over traditional methods, Web-based studies elicit concerns about generalizability. To address this issue, we compared dietary intakes between an electronic (e-) cohort study and a nationally representative survey. We studied 49,443 French volunteers aged 18-74 years recruited during 2009-2010 in the NutriNet-Santé Study, a general population-based e-cohort study. The Etude Nationale Nutrition Santé (ENNS; 2006-2007), a cross-sectional study with a nationally representative sample of 2,754 French adults aged 18-74 years, served as the reference data set. Reported dietary intakes from three 24-hour dietary records were weighted and compared between the two studies via Student t tests for mean location, using a >5% cutoff for establishing practically meaningful differences. We observed similar intakes as regards carbohydrates, total lipids, protein, and total energy. However, intakes of fruit and vegetables, fiber, vitamins B6, B9, C, D, and E, iron, and magnesium were higher in the e-cohort than in the ENNS, while intakes of alcohol and nonalcoholic beverages were lower in the e-cohort. Significant sex-specific differences were observed regarding vitamins A and B12, zinc, and potassium. True intake differences, mode effects, and volunteer bias might each contribute to explaining the findings. In the future, repeated use of the same tool in large e-cohorts with heterogeneous dietary exposures could serve research purposes and supplement group-level monitoring of dietary trends. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) is a key factor for facing the increasing prevalence of obesity and overweight, and should be part of every public health programs. In this context, a community-based public health program promoting PA was developed in a low-income neighborhood of the city of Saint-Denis (France).Methods: This work aimed at assessing the effectiveness of a 2-year PA promotion program. A quasi-experimental study was carried out using a pre/post design, with an assessment before (2013) and after (2015) the program. The interviewees were selected using a stratified random cluster sampling. The primary outcome was the proportion of participants practicing sufficient PA (WHO guidelines), and was measured using the RPAQ questionnaire. External interventions (on both neighborhood environment and inhabitants) were listed.Results: We collected 199 questionnaires at baseline and 217 in 2015. There was a majority of women in both samples: 64.3 % in 2013 and 58.2 % in 2015. The average age of participants was 38.1 years (+/-1.1) and 40.6 (+/-1.1) respectively. The proportion of people practicing sufficient PA was modified from 48.1 % in 2013 to 63.5 % in 2015 (p = 0.001). This was mainly driven by women whose level of PA, increased from 40.3 % to 60.3 % (p = 0.002), reaching the average national French estimation of PA level among adults (63.5 %).Conclusions: This work showed a significant increase of the proportion of people practicing PA in a disadvantaged neighborhood where a community-based program promoting PA was developed. Simultaneous external interventions contributed to the results, showing the necessity of synergic interventions to reach efficiency. [ABSTRACT FROM AUTHOR]

Background A recurring concern in traditional and in Web-based studies pertains to non-representativeness due to volunteer bias. We investigated this issue in an ongoing, large population-based e-cohort. Methods The sample included 122 912 individuals enrolled in the Internet-based, nutrition-focused NutriNet-Santé study between May 2009 and March 2014, with complete baseline data. Participants were recruited via recurrent multimedia campaigns and other traditional and online strategies. Individuals aged 18+ years, residing in France and having Internet access, were eligible for enrolment. Their sociodemographic characteristics were compared with the corresponding 2009 Census data via χ2 goodness-of-fit tests. The effectiveness of statistical weighting of the e-cohort data was also explored. Results The sample exhibited marked geographical and sociodemographic diversity, including volunteers belonging to typically under-represented subgroups in traditional surveys (unemployed, immigrants, the elderly). Nonetheless, the proportions of women, relatively welleducated individuals and those who are married or cohabiting, were notably larger compared with the corresponding national figures (women: 78.0% vs 52.4%; postsecondary education: 61.5% vs 24.9%; married or cohabiting: 70.8% vs 62.0%, respectively; all p<0.0001). Conclusions There were notable sociodemographic differences between the general French population and this general population-based e-cohort, some of which were corrected by statistical weighting. The findings bear on the potential generalisability of future investigations in the context of e-epidemiology. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate the relationship between adherence to French diet and physical activity recommendations and metabolic syndrome (MetS) risk. Methods: 18–74-year-old subjects who underwent dietary assessment and health examination in the 2006–2007 French Nutrition and Health Survey (Etude Nationale Nutrition Santé, ENNS 2006–2007) were included in the analyses (n=1608). Quintiles of PNNS-GS, the score measuring adherence to French recommendations, were generated. The prevalence of overall MetS risk and separate components across quintiles of PNNS-GS was estimated by adjusted logistic regressions. Interactions were searched for between PNNS-GS and sex, age and currently used medication. Results: The PNNS-GS was inversely associated with overall MetS risk in subjects not taking antidiabetic, antihypertensive or lipid-lowering medication (12.8% in the lowest quintile vs. 4.6% in the highest PNNS-GS quintile; P<0.01). This was true in 18–49-year-old subjects (10.0% vs. 1.7%, P<0.01), but not in 50–74-year-olds (23.8% vs. 11.2%; P=0.15). In 18–49-year-old adults, including those taking such medication, the HDL component was associated with PNNS-GS (22.1% vs. 7.9%; P<0.01). Conclusion: Improvement in diet and physical activity in line with recommendations could be effective in young adults for MetS prevention so as to decrease the risk of cardiovascular disease in France. [Copyright &y& Elsevier]

Aim: Metabolic risk factors are poorly documented for the first generation of young adults who have lived with HIV since childhood. We compared their metabolic profile with that of adults of same age from the general population., Methods: We conducted a cross-sectional analysis of data from two populations: (1) COVERTE (ANRS-CO19), a French national cohort of 18 to 30-year-old patients HIV-infected since childhood, and (2) ENNS, a national cross-sectional population-based household survey on nutrition. Body mass index (BMI), blood pressure, waist circumference, fasting glucose, triglycerides, and HDL-, LDL- and total cholesterol were measured in both studies. Direct standardization on overweight and education level and logistic regression were used to compare the prevalence of metabolic abnormalities between the two populations., Results: Data from 268 patients from COVERTE and 245 subjects from ENNS were analyzed. Tobacco use was similar in both groups. HIV-infected patients had increased mean waist-to-hip ratio and triglycerides to HDL-cholesterol ratio and decreased mean HDL-cholesterol as compared to their counterparts from the general population in both genders. In HIV-infected patients, metabolic syndrome was identified in 13.2% of men (95% confidence interval [CI]: 7.1-19.2) and 10.4% (95% CI: 5.4-15.3) of women versus 10.6% (95%CI: 1.5-19.7) and 1.7% (95%CI: 0-4.1) in subjects from the general population, respectively., Conclusion: Young adults infected with HIV since childhood had a higher prevalence of dyslipidemia and metabolically detrimental fat distribution than adults of same age of the general population, supporting close monitoring for cardiometabolic diseases., Competing Interests: The authors have declared that no competing interests exist.

Objective: Dietary recommendations to reduce blood pressure (BP) have been widely disseminated. We investigated associations between dietary intake and BP in a national sample of adults living in France., Methods: The survey included 1968 18-74-year-old participants in the French Nutrition and Health Survey (Etude Nationale Nutrition Santé), a cross-sectional national multistage sampling study. Dietary intake and SBP and DBP were assessed using three 24-h recalls and three measurements, respectively. Mean dietary intake was compared across BP categories: previously diagnosed hypertensive and among undiagnosed optimal (SBP <120  mmHg and DBP <80  mmHg), intermediate and high (SBP ≥140  mmHg and/or DBP ≥90  mmHg) BP participants. After exclusion of previously diagnosed hypertensive participants, linear regressions were also carried out between dietary intake and SBP and DBP., Results: Eating habits of previously diagnosed hypertensive participants were not different from those of undiagnosed high BP participants, except higher milk consumption (P = 0.03) and lower seafood and alcohol intake (P < 0.03 and P = 0.002, respectively) in previously diagnosed hypertensive. After exclusion of them, dairy products (milk especially), fruit and vegetables, fiber and whole-grain food consumption were inversely and linearly associated with SBP (P < 0.04), whereas alcohol intake was positively associated with SBP (P < 10) and DBP (P = 0.005). Modification effect of sex was observed for saturated fatty acids intake (positive association with DPB in women) and calcium (negative association with SBP in men)., Conclusion: Adherence to nutritional recommendations still needs to be improved in hypertensive adults even if they are aware of their condition. In the rest of the population, proper habits regarding milk, fruit and vegetables, fiber and alcohol should decrease the risk of hypertension onset.

Epidemiologic data on end-stage renal disease (ESRD) treated with renal dialysis remain sparse and incomplete in France because there is no national registry of dialysis patients. The aim of this study was to determine the characteristics (age, gender, comorbidities, associated handicap) of patients treated with renal dialysis and to compare the dialysis regional practices. We performed a cross-sectional descriptive study from June 2 to June 8, 2003 in all renal dialysis units by enrolling all the patients residing in France with ESRD who were dialysed during that week, irrespective of the treatment they received or where they were being treated. In 2003, the type of dialysis units available and the technique they employ were quite different from one region to another, varying from 41.1 to 70.2% for highly specialized unit, 9.4 to 48.4% for self-care hemodialysis, and 2.9 to 26.5% for peritoneal dialysis.