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              <p>Introduction: Few studies have focused on the association between diet quality scores and the Metabolic Syndrome (MetS), a multi-component condition predictive of cardiovascular diseases (CVD) and death. The present study aims at investigating, in a cross-sectional design, the association between adherence to the French dietary guidelines through an a priori score - the French Nutrition and Health Program-Guideline Score (PNNS-GS) - and cardiovascular risk factors (CVRF) including the MetS and adiposity markers.  Methods: 7902 French adults participating in the NutriNet-Sante study (an on-going web-based cohort study) attended a clinical and biological examination between January 2011 and November 2012: a fasting blood sample was drawn, blood pressure and body composition (bio-impedance) were measured. Multivariate linear and logistic regression models were used to assess the association between PNNS-GS and CVRF or the MetS.  Results: An increase of PNNS-GS was significantly negatively associated with waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP) and serum triglycerides concentrations. From bottom to top quartile of PNNS-GS, SBP decreased from 129.9 to 128.8 mm Hg, DBP from 76.7 to 75.9 mm Hg, serum triglycerides concentrations from 110.8 to 104.6 mg/dL and WC from 94.8 to 90.1 cm for men and 81.3 to 78.9 cm for women. All adiposity markers (waist and hip circumference, % body fat, % trunk fat, % leg fat) were markedly reduced across quartiles of PNNS-GS and linearly. Individuals with a better PNNS-GS (quartile 4 vs quartile 1) were less likely to have the MetS (OR=0.71, 95% CI: 0.56-0.89).  Conclusion: The negative association between a higher adherence to the French dietary guidelines and a number of CVRF, the MetS prevalence and regional adiposity supports the importance of promoting the PNNS dietary guidelines in the population for the prevention of cardiometabolic abnormalities and hence, cardiovascular diseases.</p>
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