European Journal of Nutrition

, Volume 55, Issue 5, pp 1901–1910 | Cite as

Validation of the FSA nutrient profiling system dietary index in French adults—findings from SUVIMAX study

  • Chantal JuliaEmail author
  • Caroline Méjean
  • Mathilde Touvier
  • Sandrine Péneau
  • Camille Lassale
  • Pauline Ducrot
  • Serge Hercberg
  • Emmanuelle Kesse-Guyot
Original Contribution



Population-wide nutritional recommendations give guidance on food groups’ consumption, though a wide variability in nutritional quality within groups may subsist. Nutrient profiling systems may help capturing such variability. We aimed to apply and validate a dietary index based on the British Food Standards Agency nutrient profiling system (FSA-NPS DI) in French middle-aged adults.


Dietary data were collected through repeated 24-h dietary records in participants of the Supplémentation en Vitamines et Minéraux Antioxydants study (N = 5882). An aggregated dietary index at the individual level was computed using the FSA-NPS for each food consumed as well as compliance to the French nutritional guidelines using the Programme National Nutrition Santé-Guideline Score (PNNS-GS). Cross-sectional associations between FSA-NPS DI and nutrient intake, PNNS-GS, socio-demographic factors, lifestyle and nutritional biomarkers were computed using ANOVAs.


The FSA-NPS DI was able to characterize the quality of the diets at the individual level in terms of nutrient intake and of adherence to nutritional recommendations: +37.6 % in beta-carotene intakes between subjects with a healthier diet versus subjects with a poorer diet, +42.8 % in vitamin C intakes; +17 % in PNNS-GS, all P < 0.001. FSA-NPS-DI was also associated with nutritional status at the biological level: +21.4 % in beta-carotene levels between subjects with a healthier diet versus subjects with a poorer diet, +12.8 % in vitamin C levels, all P < 0.001.


The FSA-NPS DI is a useful and validated tool to discriminate individuals according to the quality of the diet, accounting for nutritional quality within food groups. Taking into account nutritional quality of individual foods allows monitoring change in dietary patterns beyond food groups.


Dietary index Nutrient profiling Biomarkers Nutritional recommendations 


Author contributions

C.J. and E.K.-G. carried out data checking and analyses and were responsible for drafting the manuscript. C.M., M.T., S.P., C.L., P.D., S.H. and P.G. were involved in interpreting results and editing the manuscript. All authors read and approved the final version of the manuscript.

Compliance with ethical standards

Conflict of interest

None of the authors has any competing interests and all are independent of the funding bodies.

Supplementary material

394_2015_1006_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 16 kb)
394_2015_1006_MOESM2_ESM.docx (18 kb)
Supplementary material 2 (DOCX 18 kb)


  1. 1.
    WHO (2009) Global health risks. WHO Technical Report, GenevaGoogle Scholar
  2. 2.
    WHO-FAO Expert Consultation (2003) Diet, nutrition and the prevention of chronic diseases. WHO Technical Report, GenevaGoogle Scholar
  3. 3.
    Hughes R (2004) Competencies for effective public health nutrition practice: a developing consensus. Public Health Nutr 7:683–691Google Scholar
  4. 4.
    Lachat C, Van Camp J, De Henauw S, Matthys C, Larondelle Y, Remaut-De Winter AM, Kolsteren P (2005) A concise overview of national nutrition action plans in the European Union Member States. Public Health Nutr 8:266–274CrossRefGoogle Scholar
  5. 5.
    Serra-Majem L (2009) Moving forward in public health nutrition—the I World Congress of public health nutrition—introduction. Nutr Rev 67:S2–S6CrossRefGoogle Scholar
  6. 6.
    Hercberg S, Chat-Yung S, Chauliac M (2008) The French national nutrition and health program: 2001–2006–2010. Int J Public Health 53:68–77CrossRefGoogle Scholar
  7. 7.
    Waijers PM, Feskens EJ, Ocke MC (2007) A critical review of predefined diet quality scores. Br J Nutr 97:219–231CrossRefGoogle Scholar
  8. 8.
    Wirt A, Collins CE (2009) Diet quality—what is it and does it matter? Public Health Nutr 12:2473–2492. doi: 10.1017/S136898000900531X CrossRefGoogle Scholar
  9. 9.
    Arambepola C, Scarborough P, Rayner M (2008) Validating a nutrient profile model. Public Health Nutr 11:371–378CrossRefGoogle Scholar
  10. 10.
    Azais-Braesco V, Goffi C, Labouze E (2006) Nutrient profiling: comparison and critical analysis of existing systems. Public Health Nutr 9:613–622CrossRefGoogle Scholar
  11. 11.
    Garsetti M, de Vries J, Smith M, Amosse A, Rolf-Pedersen N (2007) Nutrient profiling schemes: overview and comparative analysis. Eur J Nutr 46:15–28CrossRefGoogle Scholar
  12. 12.
    Tetens I, Oberdoerfer R, Madsen C, de Vries J (2007) Nutritional characterisation of foods: science-based approach to nutrient profiling—summary report of an ILSI Europe workshop held in April 2006. Eur J Nutr 46:4–14CrossRefGoogle Scholar
  13. 13.
    Lobstein T, Davies S (2009) Defining and labelling ‘healthy’ and ‘unhealthy’ food. Public Health Nutr 12:331–340CrossRefGoogle Scholar
  14. 14.
    Verhagen H, van den Berg H (2008) A simple visual model to compare existing nutrient profiling schemes. Food Nutr Res. doi: 10.3402/fnr.v52i0.1649 Google Scholar
  15. 15.
    Townsend MS (2010) Where is the science? What will it take to show that nutrient profiling systems work? Am J Clin Nutr 91:1109S–1115SCrossRefGoogle Scholar
  16. 16.
    Asp NG, Bryngelsson S (2007) Health claims in the labelling and marketing of food products: the Swedish food sector’s code of practice in a European perspective. Food Nutr Res 51(3):2007Google Scholar
  17. 17.
    Choices International Foundation (2011) Product criteria v2.2, Brussels, Belgium.
  18. 18.
    Rayner M, Scarborough P, Stockley L, Boxer A (2005) Nutrient profiles: development of final model. Final report. Food Standards Agency, London.
  19. 19.
    Rayner M, Scarborough P, Lobstein T (2009) The UK Ofcom nutrient profiling model—defining ‘healthy’ and ‘unhealthy’ food and drinks for TV advertising to children. Food Standards Agency, London.
  20. 20.
    Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, Roussel AM, Favier A, Briancon S (2004) The SU.VI.MAX study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med 164:2335–2342CrossRefGoogle Scholar
  21. 21.
    Hercberg S, Preziosi P, Briancon S, Galan P, Triol I, Malvy D, Roussel AM, Favier A (1998) A primary prevention trial using nutritional doses of antioxidant vitamins and minerals in cardiovascular diseases and cancers in a general population: the SU.VI.MAX study-design, methods, and participant characteristics. Supplementation en Vitamines et Mineraux Antioxydants. Control Clin Trials 19:336–351CrossRefGoogle Scholar
  22. 22.
    Le Moullec N, Deheeger M, Preziosi P, Montero P, Valeix P, Rolland-Cachera MF, Potier de Courcy G, Christides JP, Galan P, Hercberg S (1996) Validation du manuel photos utilisé pour l’enquête alimentaire de l’étude SU.VI.MAX. Cahier de Nutrition et de Diététique 31:158–164Google Scholar
  23. 23.
    Lasfargues G, Vol S, Le Clesiau H, Bedouet M, Hagel L, Constans T, Tichet J (1990) Validity of a short self-administered dietary questionnaire compared with a dietetic interview. Presse Med 19:953–957Google Scholar
  24. 24.
    Estaquio C, Kesse-Guyot E, Deschamps V, Bertrais S, Dauchet L, Galan P, Hercberg S, Castetbon K (2009) Adherence to the French Programme National Nutrition Sante guideline score is associated with better nutrient intake and nutritional status. J Am Diet Assoc 109:1031–1041CrossRefGoogle Scholar
  25. 25.
    Schofield WN (1985) Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 39(Suppl. 1):5–41Google Scholar
  26. 26.
    Willett W, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124:17–27Google Scholar
  27. 27.
    Chiuve SE, Sampson L, Willett WC (2011) The association between a nutritional quality index and risk of chronic disease. Am J Prev Med 40:505–513CrossRefGoogle Scholar
  28. 28.
    Stanner SA, Hughes J, Kelly CNM, Buttriss J (2004) A review of the epidemiological evidence for the ‘antioxidant hypothesis’. Public Health Nutr 7:407–422CrossRefGoogle Scholar
  29. 29.
    Albanes D, Heinonen OP, Huttunen JK, Taylor PR, Virtamo J, Edwards BK, Haapakoski J, Rautalahti M, Hartman AM, Palmgren J, Greenwald P (1995) Effects of alpha-tocopherol and beta-carotene supplements on cancer incidence in the alpha-tocopherol beta-carotene cancer prevention study. Am J Clin Nutr 62:S1427–S1430Google Scholar
  30. 30.
    Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C (2007) Mortality in randomized trials of antioxidant supplements for primary and secondary prevention—systematic review and meta-analysis. JAMA 297:842–857CrossRefGoogle Scholar
  31. 31.
    Collins R, Armitage J, Parish S, Sleight P, Peto R (2002) MRC/BHF heart protection study of antioxidant vitamin supplementation in 20536 high-risk individuals: a randomised placebo-controlled trial. Lancet 360:23–33CrossRefGoogle Scholar
  32. 32.
    Hennekens CH, Buring JE, Manson JE, Stampfer M, Rosner B, Cook NR, Belanger C, LaMotte F, Gaziano JM, Ridker PM, Willett W, Peto R (1996) Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 334:1145–1149CrossRefGoogle Scholar
  33. 33.
    Lee IM, Cook NR, Manson JE, Buring JE, Hennekens CH (1999) Beta-carotene supplementation and incidence of cancer and cardiovascular disease: the Women’s Health Study. J Natl Cancer Inst 91:2102–2106CrossRefGoogle Scholar
  34. 34.
    Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, Keogh JP, Meyskens FL, Valanis B, Williams JH, Barnhart S, Hammar S (1996) Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 334:1150–1155CrossRefGoogle Scholar
  35. 35.
    Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C (2012) Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev 3:CD007176. doi: 10.1002/14651858.CD007176.pub2 Google Scholar
  36. 36.
    Hercberg S, Czernichow S, Galan P (2009) Tell me what your blood beta-carotene level is, I will tell you what your health risk is! The viewpoint of the SUVIMAX researchers. Ann Nutr Metab 54:310–312CrossRefGoogle Scholar
  37. 37.
    Howell WH, McNamara DJ, Tosca MA, Smith BT, Gaines JA (1997) Plasma lipid and lipoprotein responses to dietary fat and cholesterol: a meta-analysis. Am J Clin Nutr 65:1747–1764Google Scholar
  38. 38.
    Siri-Tarino PW, Sun Q, Hu FB, Krauss RM (2010) Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr 91:502–509. doi: 10.3945/ajcn.2008.26285 CrossRefGoogle Scholar
  39. 39.
    Naska A, Fouskakis D, Oikonomou E, Almeida MD, Berg MA, Gedrich K, Moreiras O, Nelson M, Trygg K, Turrini A, Remaut AM, Volatier JL, Trichopoulou A (2006) Dietary patterns and their socio-demographic determinants in 10 European countries: data from the DAFNE databank. Eur J Clin Nutr 60:181–190. doi: 10.1038/sj.ejcn.1602284 CrossRefGoogle Scholar
  40. 40.
    Fogli-Cawley JJ, Dwyer JT, Saltzman E, McCullough ML, Troy LM, Jacques PF (2006) The 2005 dietary guidelines for Americans adherence index: development and application. J Nutr 136:2908–2915Google Scholar
  41. 41.
    Julia C, Vernay M, Salanave B, Deschamps V, Malon A, Oleko A, Hercberg S, Castetbon K (2010) Nutrition patterns and metabolic syndrome A need for action in young adults (French Nutrition and Health Survey—ENNS, 2006–2007). Prev Med 51:488–493CrossRefGoogle Scholar
  42. 42.
    Kennedy ET, Ohls J, Carlson S, Fleming K (1995) The healthy eating index: design and applications. J Am Diet Assoc 95:1103–1108. doi: 10.1016/S0002-8223(95)00300-2 CrossRefGoogle Scholar
  43. 43.
    Kesse-Guyot E, Bertrais S, Peneau S, Estaquio C, Dauchet L, Vergnaud AC, Czernichow S, Galan P, Hercberg S, Bellisle F (2009) Dietary patterns and their sociodemographic and behavioural correlates in French middle-aged adults from the SU.VI.MAX cohort. Eur J Clin Nutr 63:521–528CrossRefGoogle Scholar
  44. 44.
    McNaughton SA, Ball K, Crawford D, Mishra GD (2008) An index of diet and eating patterns is a valid measure of diet quality in an Australian population. J Nutr 138:86–93Google Scholar
  45. 45.
    Chiolero A, Wietlisbach V, Ruffieux C, Paccaud F, Cornuz J (2006) Clustering of risk behaviors with cigarette consumption: a population-based survey. Prev Med 42:348–353CrossRefGoogle Scholar
  46. 46.
    Dallongeville J, Marecaux N, Fruchart JC, Amouyel P (1998) Cigarette smoking is associated with unhealthy patterns of nutrient intake: a meta-analysis. J Nutr 128:1450–1457Google Scholar
  47. 47.
    Clerfeuille E, Vieux F, Lluch A, Darmon N, Rolf-Pedersen N (2013) Assessing the construct validity of five nutrient profiling systems using diet modeling with linear programming. Eur J Clin Nutr 67:1003–1005CrossRefGoogle Scholar
  48. 48.
    Malon A, Deschamps V, Salanave B, Vernay M, Szego E, Estaquio C, Kesse-Guyot E, Hercberg S, Castetbon K (2010) Compliance with French nutrition and health program recommendations is strongly associated with socioeconomic characteristics in the general adult population. J Am Diet Assoc 110:848–856CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Chantal Julia
    • 1
    • 2
    Email author
  • Caroline Méjean
    • 1
  • Mathilde Touvier
    • 1
  • Sandrine Péneau
    • 1
  • Camille Lassale
    • 1
  • Pauline Ducrot
    • 1
  • Serge Hercberg
    • 1
    • 2
  • Emmanuelle Kesse-Guyot
    • 1
  1. 1.Université Paris 13, Sorbonne Paris Cité, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Biostatistiques, Inserm U1153, Inra U1125, Cnam, COMUEParis 5 University, Paris 7 UniversityBobigny CedexFrance
  2. 2.Département de Santé PubliqueHôpital Avicenne (AP-HP)BobignyFrance

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