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Diet Quality Measures and Cardiovascular Risk Factors in France: Applying the Healthy Eating Index to the SU.VI.MAX Study

Objective: To examine associations between diet quality measures, lifestyle variables, and cardiovascular risk factors in a large cohort of French adults. Methods: Participants were 5,081 French men and women aged 35-61 y, voluntarily enrolled in a long-term clinical trial of cancer and CVD prevention (SU.VI.MAX study). Participants provided 12 days of dietary recalls. Data on heights, weights, blood pressure, and lipid profiles were obtained from clinic visits. Statistical Analysis: Healthy Eating Index (HEI) scores were calculated for each participant. The association between dietary and lifestyle variables and health was tested using analyses of variance and regression models in a cross sectional design. Results: Mean age was 51.7 y for men and 47.0 y for women. Mean body mass index (BMI) values were 24.9 for men and 22.6 for women. Obesity rate was 4% and cardiovascular risk factors were low. Mean percent energy from fat was 37% (saturated fat 16%) and very few respondents met US dietary guidelines for fat, saturated fat, and cholesterol. Higher diet quality, as indexed by HEI scores, was associated with being older, married, better educated, physically active, and having never smoked. For men only, higher HEI scores were weakly associated with lower BMI and lower blood pressure. HEI was not associated with plasma lipid measures. Conclusions: In this sample of adult men and women in France, higher HEI scores were associated with healthier lifestyles and higher socioeconomic status. However, HEI scores were only weakly linked to health parameters or to body weight. Linking diet quality to health outcomes is a continuing challenge.