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The Mediating Role of Overweight and Obesity in the Prospective Association between Overall Dietary Quality and Healthy Aging

Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, Paris 13 University, COMUE Sorbonne Paris Cité, 93017 Bobigny, France
INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France
Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France
School of Public Health, Faculty of Medicine, Université Paris-Sud, 94276 Kremlin-Bicêtre, France
Public Health Department, Avicenne Hospital, 93017 Bobigny, France
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Nutrients 2018, 10(4), 515;
Received: 2 April 2018 / Revised: 10 April 2018 / Accepted: 16 April 2018 / Published: 20 April 2018
PDF [1147 KB, uploaded 3 May 2018]


Background: Our objective was to quantify to what extent the association between adherence to the French nutritional recommendations at midlife, measured by the Programme National Nutrition Santé-Guideline Score (PNNS-GS), and healthy aging (HA) is mediated by body mass index (BMI) status. Methods: We analyzed data from 2249 participants of the French ‘Supplementation with Vitamins and Mineral Antioxidants’ (SU.VI.MAX-‘SUpplémentation en VItamines et Minéraux AntioXydants’) cohort. At baseline (1994–1995), data on BMI status (<25 vs. ≥25 and <30 vs. ≥30) and diet were collected. At follow-up (2007–2009), HA status (yes/no) was evaluated via a multidimensional concept focusing on chronic disease incidence, physical and cognitive functioning, mental and social health, pain, and perceived health. Relative risks (RR) were estimated by extensively adjusted robust-error-variance Poisson regression, and counterfactual-based mediation analysis was performed. Results: Our HA criteria were met by 39% of participants. We identified a positive direct relation of a greater adherence to the French nutritional recommendations, with the probability of HA (RRQuartile 4 vs. quartile 1 = 1.31 (95% confidence interval (CI) = 1.13, 1.53)), and an indirect relation mediated by BMI status (1.01 (95% CI: 1.01, 1.02)), accounting for 5% of the total relation. Conclusion: These results indicate that high dietary quality may contribute to the preservation of overall health during aging, partly via obesity prevention and partly via other mechanisms. View Full-Text
Keywords: aging; diet; nutrition; body mass index (BMI); overweight obesity; prevention aging; diet; nutrition; body mass index (BMI); overweight obesity; prevention

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Assmann, K.E.; Ruhunuhewa, I.; Adjibade, M.; Li, Z.; Varraso, R.; Hercberg, S.; Galan, P.; Kesse-Guyot, E. The Mediating Role of Overweight and Obesity in the Prospective Association between Overall Dietary Quality and Healthy Aging. Nutrients 2018, 10, 515.

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