According to France’s National Nutrition and Health Program (PNNS), a health-promoting diet means 5 servings of fruits and vegetables a day, legumes twice a week, whole-grain starches, and less salt, processed meat and sugary drinks. These guidelines help reduce the risk of cardiovascular disease and type 2 diabetes, with no diet required: the prevention check-up helps identify where to start.
What are the guidelines for a health-promoting diet in France?
The French guidelines are those of the National Nutrition and Health Program (Programme national nutrition santé, PNNS), updated on January 22, 2019 by Santé publique France, the French public health agency, together with Anses, the French food safety agency, and the French High Council for Public Health (HCSP), and published on mangerbouger.fr (Manger Bouger, “Eat, Move,” the program’s official public website). Their logic comes down to three verbs: increase, shift toward, reduce. Nothing is forbidden; there are frequencies and quantities, which apply to a healthy adult.
| PNNS guideline | Quantity or frequency (adults) | What it provides or helps avoid |
|---|---|---|
| Increase — fruits and vegetables | At least 5 per day (for example 3 vegetables and 2 fruits); one serving = 80 to 100 g; fruit juice does not count | Fiber, vitamins, minerals |
| Increase — legumes | At least twice a week (lentils, chickpeas, beans) | Fiber and plant protein |
| Increase — unsalted nuts | A small handful per day (walnuts, hazelnuts, almonds, pistachios) | Unsaturated fatty acids |
| Shift toward — whole-grain starches | At least one per day (whole-grain bread, whole-grain pasta, rice or semolina) | Fiber: only 8% of women and 17% of men reach 25 g per day |
| Shift toward — fish | Twice a week, including one oily fish (sardines, mackerel, herring, salmon) | Omega-3s |
| Shift toward — canola, walnut and olive oils | Every day, in small amounts, rather than butter and margarine | Unsaturated fatty acids, omega-3s |
| Shift toward — dairy products | 2 per day | Calcium and protein, without excess |
| Reduce — meat other than poultry (pork, beef, veal, mutton, lamb, organ meats) | No more than 500 g per week, or 3 or 4 steaks | Alternate with poultry, fish, eggs, legumes |
| Reduce — processed meats | No more than 150 g per week, or about 3 slices of ham | Salt and saturated fat |
| Reduce — salt and salty foods | Less than 5 g of salt per day; choose iodized salt | High blood pressure |
| Reduce — sugary drinks, juices, sodas (even diet ones) | No more than one glass per day | Free sugars |
| Reduce — ultra-processed foods, Nutri-Score D and E | Limit them; read the ingredient list | Fatty, sugary, salty, low in fiber |
| Reduce — alcohol | No more than 2 drinks per day, and not every day | See our alcohol guidelines |
These guidelines are in line with the WHO’s for adults: at least 400 g of fruits and vegetables per day, less than 5 g of salt, free sugars below 10% of energy intake (ideally 5%), total fat below 30%, with less than 10% saturated fat and less than 1% trans fatty acids. Two perspectives, one message: more plants and fiber, less salt, added sugar and industrially processed food.
Why does diet have such an impact on the heart and arteries?
Because three of the major cardiovascular risk factors are driven by what is on your plate: blood pressure, cholesterol and weight. The WHO ranks an unhealthy diet, with too much salt, sugar and fat, among the main behavioral risk factors for cardiovascular disease, alongside tobacco, physical inactivity and alcohol. These diseases caused 19.8 million deaths in 2022, about 32% of deaths worldwide, and most could be prevented by acting on these factors.
Salt first: excessive consumption promotes high blood pressure, which in turn causes strokes and heart attacks, as Manger Bouger points out. A large share of the salt we consume comes from processed foods (bread, processed meats, cheese, ready meals) rather than the salt shaker, hence the PNNS guideline on “salty foods and salt.” Fats next: saturated fats (processed meats, pastries, industrially prepared meals) raise LDL cholesterol, while unsaturated fats (canola, walnut and olive oils, oily fish, nuts) have the opposite effect; that is the point of the “shift toward” guidelines. Finally, fiber, which most adults do not get enough of, slows the absorption of sugars and fats and helps you feel full.
That is why, when we estimate 10-year cardiovascular risk with the SCORE2 score, two of the variables (systolic blood pressure and non-HDL cholesterol) depend partly on diet, while the third modifiable variable, smoking, is covered on our page about quitting smoking. Blood biomarkers then make it possible to track the effect of a dietary change on lipids and blood sugar, rather than relying on the scale alone.
Diet and type 2 diabetes: what is the link?
In France, more than 4.3 million people were being treated for diabetes in 2022, or 6.3% of the population, and 92% of them have type 2 diabetes, according to French National Health Insurance (Assurance Maladie). This form of diabetes sets in insidiously over ten to twenty years: the pancreas first compensates for insulin resistance, then becomes exhausted. Diagnosis is based on a fasting blood sugar of 1.26 g/l or higher on two successive tests.
The risk factors identified by French National Health Insurance are mostly lifestyle-related: a body mass index of 25 or more, a waist circumference of 94 cm or more in men and 80 cm or more in women, less than 30 minutes of physical activity per day, age over 45, a close family history, diabetes during pregnancy or a baby weighing more than 4 kg at birth, high blood pressure or a lipid abnormality. Since 2014, the French National Authority for Health (HAS) has recommended screening with a fasting blood sugar test for adults over 45 with at least one of these factors, repeated every one to three years depending on the result.
On the plate, three levers are well established: cutting back on sugary drinks and ultra-processed foods, which provide rapidly absorbed sugars; increasing fiber (vegetables, legumes, whole-grain starches), which slows glucose absorption; and reaching a stable weight, since excess abdominal weight is a major, modifiable risk factor. No single food “cures” diabetes or prevents it on its own; what matters is the overall pattern, together with physical activity, the other half of prevention.
What does the prevention check-up identify about diet?
The prevention check-up is a 30- to 45-minute consultation, fully covered (100%) by French National Health Insurance, at ages 18–25, 45–50, 60–65 and 70–75. Diet is one of its official themes, and the self-assessment questionnaire asks how often you eat fruits and vegetables, drink sugary beverages, skip meals and snack, as well as about your weight. It is not a dietitian consultation: nothing is weighed, and no menu is prescribed. The general framework of the program is described on our page about the prevention check-up.
What the check-up identifies is a profile. Few vegetables and lots of processed food in a young adult living alone. Gradual weight gain and a widening waistline between 45 and 50, just as blood pressure starts to rise, as we explain in the prevention check-up at ages 45–50. Conversely, after 70, loss of appetite and weight loss that raise concerns about undernutrition: nutritional needs do not decrease with age, and some even increase, as Manger Bouger points out. The same guideline does not read the same way at 25 and at 72.
What comes out of it: in the Personalized Prevention Plan, one or two concrete actions chosen with you (“soup or salad at dinner five evenings a week,” “replace the lunchtime soda with water”) and, if necessary, a referral to your regular doctor (médecin traitant) for a fasting blood sugar test or a lipid panel, or to a dietitian. The plan is sent to your regular doctor unless you object.
Nutri-Score and ultra-processed foods: how do you make sense of them?
The Nutri-Score is a five-color, five-letter logo, from dark green (A) to dark orange (E), displayed on the front of packaging to summarize the nutritional quality of a processed product per 100 g or 100 ml. It counts the components to limit (energy, saturated fat, sugars, salt) and those to favor (fiber, protein, fruits, vegetables, legumes). Launched in France in 2017, it remains voluntary for manufacturers; its revised algorithm came into force in France on March 16, 2025, and seven European countries take part in its governance.
How to use it well: compare two products from the same aisle (two breakfast cereals, two ready meals), not an A product from one aisle with a C product from another. The PNNS recommends limiting products rated D and E. Its limitation: it says nothing about additives or the degree of processing. For that, a second simple habit: the shorter the ingredient list, the better; additives can be spotted by the letter E followed by three digits, and Manger Bouger advises choosing products with no additives or with the shortest list.
Where to start, without dieting?
We do not prescribe diets at the prevention check-up, and we are wary of miracle diets: they lead to weight loss for a few months and the weight often comes back afterward. What we suggest are lasting substitutions, one at a time, chosen from the list above according to your profile.
- One action per month, not ten. The first is often what you drink: replacing soda or juice with water at meals.
- Add before you remove: one more vegetable at dinner, a legume dish on Tuesdays, a handful of nuts as an afternoon snack. Adding creates less frustration than depriving yourself, and it is filling.
- Cook a little more often, even simply: it is the surest way to reduce salt, sugar and additives. Manger Bouger actually lists “homemade” among the habits to increase.
- Read two labels per shopping trip: the Nutri-Score, then the ingredient list.
- Move at the same time: thirty minutes of brisk activity per day, as our physical activity recommendations point out.
Situations that call for individual advice from your regular doctor or a dietitian: known diabetes or prediabetes, kidney disease, pregnancy, unintentional weight loss, a history of eating disorders, or a treatment that interacts with diet. In these cases, general guidelines are not enough, and this is precisely what the prevention check-up helps identify so you can be referred appropriately.
Key takeaways
- PNNS guidelines (Santé publique France, 2019): at least 5 fruits and vegetables per day, legumes twice a week, a handful of nuts, one whole-grain starch per day, fish twice a week, 2 dairy products per day.
- To reduce: meat other than poultry (500 g per week at most), processed meats (150 g), salt (less than 5 g per day), sugary drinks (one glass at most), ultra-processed foods and Nutri-Score D or E, alcohol.
- Salt, saturated fat and lack of fiber directly affect blood pressure, cholesterol and weight, three cardiovascular risk factors.
- Type 2 diabetes accounts for 92% of the 4.3 million people treated for diabetes in France (2022); it is prevented through the same guidelines and 30 minutes of activity per day.
- The prevention check-up does not prescribe a diet: it identifies a profile and sets one or two lasting actions, which are sent to your regular doctor.
What Sokrate lets you do
Sokrate lets you prepare your prevention check-up online: an adaptive questionnaire covering nine dimensions of health, including diet, physical activity, weight and cardiovascular risk, followed by a personalized plan written and signed by a doctor and sent to your regular doctor, unless you object. A care coordination nurse provides long-term follow-up, for as long as it takes for one habit to replace another. The check-up remains fully covered (100%) by French National Health Insurance when carried out by an authorized professional. To be notified when the service opens in your region, join the waitlist.