title: Compliance with French nutrition and health program recommendations is strongly associated with socioeconomic characteristics in the general adult population.
abstract: BACKGROUND
  In many countries, nutrition policies such as the Programme National Nutrition Santé (PNNS), implemented in France since 2001, have been developed to prevent and reduce the risk of chronic disease. However, the way in which such programs might benefit persons having different socioeconomic characteristics is unknown. The French nutrition and health survey (Etude Nationale Nutrition Santé [ENNS]) represented an opportunity to address this issue.
  
  
  OBJECTIVE
  To describe compliance with PNNS recommendations in the general population and to investigate the relationship between social, economic, and educational characteristics and poor compliance with French nutrition recommendations.
  
  
  METHODS
  A national cross-sectional multistage sampling survey. Food intake was estimated through three 24-hour recalls. Adherence to French nutrition recommendations was estimated using the PNNS guideline score (15 possible points).
  
  
  METHODS
  Two thousand five hundred seventy-seven adults aged 18 to 74 years living in France in 2006-2007 were included in these analyses.
  
  
  METHODS
  All analyses were carried out in men and women separately. Sex-specific quartiles of score were estimated. Multiple logistic models were used to identify socioeconomic characteristics (ie, age, marital status, occupational status, education level, and holiday trip in the past 12 months) associated with poor compliance with recommendations (first PNNS guideline score quartile vs three other quartiles), estimating odds ratios (ORs), and their 95% confidence intervals (CIs).
  
  
  RESULTS
  The mean PNNS guideline score was 7.67+/-0.17 in men and 8.55+/-0.12 in women. In both sex groups, a difference of approximately four attained recommendations (out of 13 maximum) was observed between the lowest and highest quartiles. In multivariate models, being in the first PNNS guideline score quartile was significantly associated with lower age and lower occupational status for both sexes. Moreover, women living without a partner were at higher risk of poor compliance with recommendations (adjusted OR 1.43; 95% CI 1.01 to 2.04, vs women living with a partner), as were men not having taken a holiday trip during the past 12 months (adjusted OR 1.78, 95% CI 1.05 to 3.02, vs at least one holiday trip).
  
  
  CONCLUSIONS
  Compliance with nutrition recommendations can be improved despite several years of public health interventions carried out by the PNNS. Identification of characteristics associated with poor compliance should help to target future public health measures.
authors.affiliation: Nutritional Surveillance and Epidemiology Unit, French Institute for Health Surveillance, Bobigny, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Malon
authors.forename: Valérie
authors.initials: V
authors.lastname: Deschamps
authors.forename: Benoit
authors.initials: B
authors.lastname: Salanave
authors.forename: Michel
authors.initials: M
authors.lastname: Vernay
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Szego
authors.forename: Carla
authors.initials: C
authors.lastname: Estaquio
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse-Guyot
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.forename: Katia
authors.initials: K
authors.lastname: Castetbon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000191:economics* / Q000592:standards*; D004522:Educational Status; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005602:France; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D011939:Mental Recall; D008875:Middle Aged; D018673:Nutrition Policy; D016017:Odds Ratio; D010349:Patient Compliance; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult