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Open AccessArticle

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

1
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
2
INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France
3
Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France
4
School of Public Health, Faculty of Medicine, Université Paris-Sud, 94276 Kremlin-Bicêtre, France
5
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; https://doi.org/10.3390/nu10040515
Received: 2 April 2018 / Revised: 10 April 2018 / Accepted: 16 April 2018 / Published: 20 April 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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