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van Larebeke N, Colles A, Leermakers M, Den Hond E, Voorspoels S, Goderis L, Schoeters G. Organic food and internal exposure to pollutants among Flemish adolescents. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2024:1-22. [PMID: 39196262 DOI: 10.1080/19440049.2024.2386143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/06/2024] [Accepted: 07/21/2024] [Indexed: 08/29/2024]
Abstract
Contrary to the initial hypothesis, Flemish adolescents who reported consuming organic food at least 7.5 times per week did not exhibit reduced internal exposure to the tested recently used pesticides. After adjustment for gender, age, country of origin, socioeconomic status, body mass index, consumption of high-fat foods and foods linked to organic food consumption, and concerning organochlorine derivatives and lead, additional adjustment for the duration of breastfeeding expressed in weeks, they displayed slightly elevated internal exposure to organochlorine derivatives, lead, methyl arsenate, and toxic relevant arsenic. A comparison was also made between the correlation of internal exposure to pollutants with the frequency of organic food consumption on one hand and the total consumption of equivalent products from all sources on the other. Regarding potatoes, vegetables, and fruits, no clear trends were observed. Regarding eggs, there was a trend towards higher internal exposures with organic food consumption, significant for trans-nonachlor, PCB118, and 2,4-dichlorophenoxyacetic acid, and marginally significant for glyphosate. For dairy, there was a trend towards higher internal exposures with organic food consumption, significant for perfluorononanoic acid and marginally significant for PCB153. Regarding nuts and seeds, the higher internal exposure to dichlorophenoxyacetic acid and the lower exposure to 3-phenoxybenzoic acid were marginally significant, while there was also a trend towards higher internal exposure to other pollutants with organic food consumption, significant for PCB118, PCB153, and sum PCBs, and marginally significant for trans-nonachlor. Concerning breakfast cereals and muesli, no clear trends were observed.
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Affiliation(s)
- Nicolas van Larebeke
- Archeology, Environmental Changes and Geochemistry, Vrije Universiteit Brussel, Brussels, Belgium
- Ghent University Hospital, Study Centre for Carcinogenesis and Primary Prevention of Cancer, Ghent, Belgium
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Martine Leermakers
- Archeology, Environmental Changes and Geochemistry, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Stefan Voorspoels
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Lode Goderis
- Department Public Health and Primary Care, Centre for Environment and Health, Catholic University Leuven, Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
- Department of Biomedical Sciences, University of Antwerp, Wilrijk, Belgium
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Średnicka-Tober D, Góralska-Walczak R, Kopczyńska K, Kazimierczak R, Oczkowski M, Strassner C, Elsner F, Matthiessen LE, Bruun TSK, Philippi Rosane B, Zanasi C, Van Vliet M, Dragsted LO, Husain S, Damsgaard CT, Lairon D, Kesse-Guyot E, Baudry J, Leclercq C, Stefanovic L, Welch A, Bügel SG. Identifying Future Study Designs and Indicators for Somatic Health Associated with Diets of Cohorts Living in Eco-Regions: Findings from the INSUM Expert Workshop. Nutrients 2024; 16:2528. [PMID: 39125406 PMCID: PMC11314491 DOI: 10.3390/nu16152528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 07/26/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
Diets, but also overall food environments, comprise a variety of significant factors with direct and indirect impacts on human health. Eco-Regions are geographical areas with a territorial approach to rural development, utilizing organic food and farming practices, and principles and promoting sustainable communities and food systems. However, so far, little attention has been given to quantifying aspects of the health of citizens living in these sustainable transition territories. The project "Indicators for Assessment of Health Effects of Consumption of Sustainable, Organic School Meals in Eco-Regions" (INSUM) aims to identify and discuss research approaches and indicators that could be applied to effectively measure the somatic, mental, and social health dimensions of citizens in Eco-Regions, linked to the intake of organic foods in their diets. In this paper, we focus on the somatic (physical) health dimension. A two-day workshop was held to discuss suitable methodology with an interdisciplinary, international group of experts. The results showed the limitations of commonly used tools for measuring dietary intake (e.g., relying on the memory of participants), and nutritional biomarkers (e.g., variations in correlations with specific intakes) for research understanding dietary intake and the health effects of diets. To investigate the complexity of this issue, the most suitable approach seems to be the combination of traditional markers of physical and mental health alongside emerging indicators such as the microbiome, nutrigenomics, metabolomics, or inflammatory biomarkers. Using new, digital, non-invasive, and wearable technologies to monitor indicators could complement future research. We conclude that future studies should adopt systemic, multidisciplinary approaches by combining not only indicators of somatic and mental health and social wellbeing (MHSW) but also considering the potential benefits of organic diets for health as well as aspects of sustainability connected to food environments.
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Affiliation(s)
- Dominika Średnicka-Tober
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (R.G.-W.); (K.K.); (R.K.)
| | - Rita Góralska-Walczak
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (R.G.-W.); (K.K.); (R.K.)
| | - Klaudia Kopczyńska
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (R.G.-W.); (K.K.); (R.K.)
| | - Renata Kazimierczak
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (R.G.-W.); (K.K.); (R.K.)
| | - Michał Oczkowski
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-776 Warsaw, Poland;
| | - Carola Strassner
- Department of Food—Nutrition—Facilities, FH Münster University of Applied Sciences, 48149 Münster, Germany; (C.S.); (F.E.); (S.H.)
| | - Friederike Elsner
- Department of Food—Nutrition—Facilities, FH Münster University of Applied Sciences, 48149 Münster, Germany; (C.S.); (F.E.); (S.H.)
| | - Lea Ellen Matthiessen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark; (L.E.M.); (B.P.R.); (L.O.D.); (C.T.D.); (S.G.B.)
| | - Thea Steenbuch Krabbe Bruun
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark; (L.E.M.); (B.P.R.); (L.O.D.); (C.T.D.); (S.G.B.)
| | - Beatriz Philippi Rosane
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark; (L.E.M.); (B.P.R.); (L.O.D.); (C.T.D.); (S.G.B.)
| | - Cesare Zanasi
- Department of Agricultural and Food Sciences, University of Bologna, 40127 Bologna, Italy;
| | - Marja Van Vliet
- Stichting Institute for Positive Health, 3521 AL Utrecht, The Netherlands;
| | - Lars Ove Dragsted
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark; (L.E.M.); (B.P.R.); (L.O.D.); (C.T.D.); (S.G.B.)
| | - Sarah Husain
- Department of Food—Nutrition—Facilities, FH Münster University of Applied Sciences, 48149 Münster, Germany; (C.S.); (F.E.); (S.H.)
| | - Camilla Trab Damsgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark; (L.E.M.); (B.P.R.); (L.O.D.); (C.T.D.); (S.G.B.)
| | - Denis Lairon
- Inserm, INRAE, C2VN, Aix Marseille Université, 13331 Marseille, France;
| | - Emmanuelle Kesse-Guyot
- Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—Paris Cité University (CRESS), Sorbonne Paris Nord University, 93000 Bobigny, France; (E.K.-G.); (J.B.)
| | - Julia Baudry
- Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—Paris Cité University (CRESS), Sorbonne Paris Nord University, 93000 Bobigny, France; (E.K.-G.); (J.B.)
| | - Catherine Leclercq
- Food and Nutrition Center, Council for Research in Agriculture and the Analysis of the Agriculture Economy (CREA), 00178 Rome, Italy
| | - Lilliana Stefanovic
- Section of Organic Food Quality, Faculty of Organic Agriculture Sciences, University of Kassel, 37213 Witzenhausen, Germany;
| | - Ailsa Welch
- Norwich Medical School, Centre for Population Health Research, Faculty of Health, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK;
| | - Susanne Gjedsted Bügel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark; (L.E.M.); (B.P.R.); (L.O.D.); (C.T.D.); (S.G.B.)
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Bozkurt O, Kocaadam‐Bozkurt B. Evaluation of factors related to organic food consumption and orthorexia nervosa tendencies. Food Sci Nutr 2024; 12:3585-3592. [PMID: 38726398 PMCID: PMC11077188 DOI: 10.1002/fsn3.4029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 05/12/2024] Open
Abstract
The relationship between organic food consumption, awareness of reducing ecological footprint, and orthorexia nervosa (ON) tendencies has yet to be explored in detail. This study aimed to determine factors related to organic food consumption and ON tendencies in young adults. Also, the relationship between organic food consumption, awareness of reducing ecological footprint, and ON tendencies was investigated. This study was conducted with 887 young adults (58.4% female, 41.6% male, aged 18-25 years, mean age 20.8 ± 2.55 years). Study data were obtained with a web-based questionnaire. The questionnaire included socio-demographic characteristics, anthropometric measurements, the Organic Food Consumption Scale (OFC), ORTO-11, and the Awareness Scale for Reducing Ecological Footprint (ASREF). While 17.2% were overweight or obese, 74.9% had a normal body weight. There were no differences by sex in terms of ORTO-11, OFC, and ASREF total scores (p > .05). Significant positive correlations were found between ASREF and OFC (p < .001), while negative correlations were found for ORTO-11 and OFC (p < .001). A higher ASREF and increased ON tendencies predicted increased organic food consumption (p < .05). Furthermore, higher organic food consumption behaviors and awareness of reducing ecological footprint predicted increased ON tendencies (p < .05). Findings from this study will contribute to a deeper understanding of the factors associated with organic food consumption and ON tendencies among individuals. By shedding light on the interplay between ecological awareness, organic food consumption, and orthorexic tendencies, policymakers and health professionals can develop targeted interventions to promote sustainable and healthy food consumption.
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Affiliation(s)
- Osman Bozkurt
- Department of Nutrition and Dietetics, Faculty of Health SciencesErzurum Technical UniversityErzurumTurkey
| | - Betul Kocaadam‐Bozkurt
- Department of Nutrition and Dietetics, Faculty of Health SciencesErzurum Technical UniversityErzurumTurkey
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Dobrowolski H, Szumigaj B, Włodarek D, Kazimierczak R, Obidzińska J, Rembiałkowska E. Dietary intake of polish organic and conventional fruit growers and their life partners - a pilot study. Front Public Health 2024; 12:1345402. [PMID: 38686036 PMCID: PMC11056513 DOI: 10.3389/fpubh.2024.1345402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/28/2024] [Indexed: 05/02/2024] Open
Abstract
Diet is one of the elements that contribute to health and quality of life. There are significant discrepancies between the diets of people living in different regions, with different beliefs, or with different approaches to sustainability and ecology. There is a lack of research on dietary intake among organic and conventional fruit growers. The aim of our study was to examine the diets of orchardists and their immediate life partners in terms of meeting energy requirements, nutrient intake and fulfillment of dietary recommendations in this group. Fifty-three participants (28 in the organic group and 25 in the conventional group) took part in the study. Dietary data were obtained using the 3-day dietary record. Body mass and height were measured and BMI was calculated. Physical activity was estimated using a questionnaire method. The study group was aged 44 ± 8 years, with a body weight of 84 ± 16 kg and a height of 172 ± 9 cm. The mean BMI was 28 ± 4 kg/m2. Mean energy intake with diet was 2170 ± 606 kcal/day with needs of 3002 (1991-5144) kcal/day. A significant proportion of the study group did not fulfill their calcium and vitamin D requirements. In addition, a significant proportion of the conventional fruit growers did not cover their needs for potassium, magnesium and vitamins: E, C, and folate. Both groups had too high an intake of cholesterol and saturated fatty acids, and too low an intake of polyunsaturated fatty acids. In conclusion, the orchardists' diets mostly provided adequate amounts of nutrients, with inadequate intakes of calcium, vitamin D, cholesterol, and fatty acids. The diets of organic fruit growers were significantly richer in selected nutrients.
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Affiliation(s)
- Hubert Dobrowolski
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), Warsaw, Poland
| | - Bartosz Szumigaj
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), Warsaw, Poland
| | - Dariusz Włodarek
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), Warsaw, Poland
| | - Renata Kazimierczak
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), Warsaw, Poland
| | - Justyna Obidzińska
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), Warsaw, Poland
| | - Ewa Rembiałkowska
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), Warsaw, Poland
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Rahman A, Baharlouei P, Koh EHY, Pirvu DG, Rehmani R, Arcos M, Puri S. A Comprehensive Analysis of Organic Food: Evaluating Nutritional Value and Impact on Human Health. Foods 2024; 13:208. [PMID: 38254509 PMCID: PMC10814746 DOI: 10.3390/foods13020208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
In recent years, organic agriculture has gained more popularity, yet its approach to food production and its potential impact on consumers' health and various environmental aspects remain to be fully discovered. The goal of organic farming practices is to maintain soil health, sustain ecological systems, maintain fairness in its relationship with the environment and protect the environment in its entirety. Various health benefits have been associated with higher consumption of organic foods. This review identified some of these health benefits, including a reduction in obesity and body mass index (BMI), improvements in blood nutrient composition as well as reductions in maternal obesity and pregnancy-associated preeclampsia risks. Furthermore, organic food consumption can reduce the development of non-Hodgkin lymphoma (NHL) and colorectal cancers. Upon reviewing the existing literature regarding the nutritional value of organic foods, it was found that organic food contained higher levels of iron, magnesium and vitamin C. However, the evidence available to draw definitive causations remains limited due to study biases, short study durations and confounding variables; thus, it cannot be concluded that the organic diet provides any related health benefits. In this review, we provided essential insights and statistical analysis from the evidence available and consider study limitations to evaluate the potential of organic food consumption in positively impacting human health.
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Affiliation(s)
- Azizur Rahman
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Parnian Baharlouei
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- Physiology and Human Biology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Eleanor Hui Yan Koh
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Diana Gabby Pirvu
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Rameesha Rehmani
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Mateo Arcos
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Simron Puri
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
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de Lima DP, Dos Santos Pinto Júnior E, de Menezes AV, de Souza DA, de São José VPB, da Silva BP, de Almeida AQ, de Carvalho IMM. Chemical composition, minerals concentration, total phenolic compounds, flavonoids content and antioxidant capacity in organic and conventional vegetables. Food Res Int 2024; 175:113684. [PMID: 38129028 DOI: 10.1016/j.foodres.2023.113684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/28/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023]
Abstract
The demand for organic vegetables is increasing worldwide, which has led to the growth of organic agriculture. However, information on chemical composition and antioxidant activity in vegetables grown organically under controlled conditions remains uncertain. For this study, 3 vegetables widely consumed in Brazil were cultivated in controlled organic and conventional cultivation systems: lettuce, coriander and tomato. Their chemical composition, mineral concentration, phenolic compound content, flavonoids and antioxidant activity (AA) were evaluated. The analyses of chemical and mineral composition revealed differences between the cultivation systems. Organic lettuce presented higher content of ashes, calcium and potassium. A higher content of phenolic compounds and flavonoids was observed in most organic vegetables. Using the 2,2'-diphenyl-1-picrylhydrazyl (DPPH) assay, the organic tomato exhibited higher AA compared to conventional, while the ferric-reducing antioxidant power (FRAP) method showed higher AA for organic coriander and tomato than theirs conventional version. The correlation between bioactive compounds and AA was positive, higher and stronger for organic vegetables, considering phenolic compounds (including flavonoids) and DPPH or FRAP antioxidant activity. Principal Component Analysis (PCA) disclosed that organic lettuce and coriander were grouped according bioactive components. In general, organic vegetables showed better results for bioactive compounds and antioxidant activity.
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Affiliation(s)
- Daniele Pinto de Lima
- Post-Graduate Program in Nutrition Science, Federal University of Sergipe (UFS), São Cristóvão, Brazil
| | | | - Anely Vieira de Menezes
- Post-Graduate Program in Nutrition Science, Federal University of Sergipe (UFS), São Cristóvão, Brazil
| | - Daniel Alves de Souza
- Post-Graduate Program in Nutrition Science, Federal University of Sergipe (UFS), São Cristóvão, Brazil
| | | | | | - André Quintão de Almeida
- Department of Agricultural Engineering, Federal University of Sergipe (UFS), São Cristóvão, Brazil
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Iwatani S, Honda H, Otaki Y, Ueda K. Effect of asking questions and providing knowledge on attitudes toward organic foods among Japanese consumers. Front Psychol 2023; 14:1274446. [PMID: 38204889 PMCID: PMC10779989 DOI: 10.3389/fpsyg.2023.1274446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/30/2023] [Indexed: 01/12/2024] Open
Abstract
Some people overestimate the benefits of certain kinds of foods, such as organic foods, while others underestimate it. Previous studies have found that reducing people's self-assessed knowledge successfully moderated these extreme attitudes. In this study, we investigated interventions to reduce people's self-assessed knowledge and to moderate attitude extremity. We examined extreme attitudes toward organic foods and investigated the effects of implementing two intervention methods to moderate their attitude: (1) providing knowledge on organic food after asking them some questions and (2) simply providing them with knowledge. We conducted a two-factor mixed-design experiment with 653 college-educated Japanese women. In the first condition, before knowledge provision, participants were asked to answer questions about organic foods and were then informed of the correct answer and whether their answer was correct (Q&A Intervention). This step was based on an intervention conducted in a previous study to reduce their self-assessed factual knowledge. In the second condition, participants were simply provided with knowledge without being asked to answer any questions (Simple Intervention). The results showed that both intervention methods, on average, decreased the participants' self-assessed knowledge and attitude extremity. Therefore, simply providing knowledge may be effective in reducing their self-assessed factual knowledge and moderating their extreme attitudes toward organic foods.
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Affiliation(s)
- Shuma Iwatani
- Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Hidehito Honda
- Faculty of Psychology, Otemon Gakuin University, Osaka, Japan
| | - Yurina Otaki
- Graduate School of Social Sciences, Hitotsubashi University, Tokyo, Japan
| | - Kazuhiro Ueda
- Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
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Åkesson A, Donat-Vargas C, Hallström E, Sonesson U, Widenfalk A, Wolk A. Associations between dietary pesticide residue mixture exposure and mortality in a population-based prospective cohort of men and women. ENVIRONMENT INTERNATIONAL 2023; 182:108346. [PMID: 38008011 DOI: 10.1016/j.envint.2023.108346] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 10/31/2023] [Accepted: 11/21/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND There is a concern that pesticide residues, regularly detected in foods, might pose a health risk to the consumer, but epidemiological evidence is limited. We assessed the associations between dietary exposure to a mixture of pesticide residues and mortality. METHODS Food consumption was assessed in 68,844 participants from the Swedish Mammography Cohort and the Cohort of Swedish Men, 45-83 years at baseline (1997). Concentrations of pesticide residues detected in foods on the Swedish market (1996-1998), mainly fruits and vegetables, were obtained via monitoring programs. To assess mixture effects, we summed per food item the ratios of each single pesticide mean residue concentration divided by its acceptable daily intake to create for each participant a Dietary Pesticide Hazard Index (adjusted for energy intake and expressed per kilogram of body weight). Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 %CI). RESULTS During 15 years of follow-up (1998-2014), a total of 16,527 deaths occurred, of which 6,238 were caused by cardiovascular disease (CVD) and 5,364 by cancer. Comparing extreme quintiles of Dietary Pesticide Hazard Index, the highest category was inversely associated with CVD mortality HR, 0.82 (95 % CI, 0.75-0.90) and with cancer mortality HR 0.82 (95 % CI 0.75-0.91). In analyses stratified by high/low Dietary Pesticide Hazard Index, similar inverse associations were observed by increasing fruit and vegetable consumption. CONCLUSIONS We observed no indications that dietary exposure to pesticide residue mixtures was associated with increased mortality, nor any clear indications that the benefits of fruit and vegetable consumption on mortality was compromised. Yet, our results need to be interpreted with caution.
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Affiliation(s)
- Agneta Åkesson
- Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
| | - Carolina Donat-Vargas
- Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden; ISGlobal, Campus Mar, Barcelona, Spain; Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Elinor Hallström
- RISE - Research Institutes of Sweden, Dep of Agriculture and Food, Box 5401, SE-402 29 Gothenburg, Sweden
| | - Ulf Sonesson
- RISE - Research Institutes of Sweden, Dep of Agriculture and Food, Box 5401, SE-402 29 Gothenburg, Sweden
| | | | - Alicja Wolk
- Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
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Baudry J, Allès B, Langevin B, Reuzé A, Brunin J, Touvier M, Hercberg S, Lairon D, Péneau S, Pointereau P, Kesse-Guyot E. Associations between measures of socio-economic position and sustainable dietary patterns in the NutriNet-Santé study. Public Health Nutr 2023; 26:965-975. [PMID: 36213945 PMCID: PMC10346073 DOI: 10.1017/s1368980022002208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/04/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We aimed to explore the relationship between socio-economic characteristics and sustainable dietary patterns. DESIGN Dietary data were derived from a web-based FFQ. Diet sustainability was evaluated using a modified Sustainable Diet Index, comprising nutritional, environmental and cultural components (higher scores expressing higher sustainability). The socio-economic position markers were education, household income and occupation status. Multi-adjusted linear and Poisson regression models were used to assess the cross-sectional association of the markers of socio-economic status with a sustainable diet and sustainability subcomponents, respectively. SETTING France. PARTICIPANTS 29 119 NutriNet-Santé participants. RESULTS Individuals with a more sustainable diet had slightly higher diet monetary cost, lower total energy intake and consumed less animal-based foods than their counterparts. Lower education level was associated with lower overall diet sustainability (βprimary v. postgraduate = -0·62, 95 % CI (-0·72, -0·51)) and nutrition, socio-cultural and environmental subscores. Manual workers and employees had a lower modified Sustainable Diet Index than intermediate professionals (βmanual workers v. intermediate professionals = -0·43, 95 % CI (-0·52, -0·33) and βemployees v. intermediate professionals = -0·56, 95 % CI (-0·64, -0·48)). Participants with the lowest v. highest incomes had a higher environmental subscore but a lower socio-cultural subscore, whereas the results were less marked for occupational status. CONCLUSIONS Overall, our results documented associations between socio-economic status and the level of diet sustainability, arguing for the implementation of appropriate food policies to promote sustainable diets at lower cost.
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Affiliation(s)
- Julia Baudry
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, Université Paris Cité (CRESS), UFR SMBH 74, Rue Marcel Cachin, Bobigny93017, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, Université Paris Cité (CRESS), UFR SMBH 74, Rue Marcel Cachin, Bobigny93017, France
| | | | - Anouk Reuzé
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, Université Paris Cité (CRESS), UFR SMBH 74, Rue Marcel Cachin, Bobigny93017, France
| | - Joséphine Brunin
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, Université Paris Cité (CRESS), UFR SMBH 74, Rue Marcel Cachin, Bobigny93017, France
- ADEME (Agence de l’Environnement et de la Maîtrise de l’Energie), Angers, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, Université Paris Cité (CRESS), UFR SMBH 74, Rue Marcel Cachin, Bobigny93017, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, Université Paris Cité (CRESS), UFR SMBH 74, Rue Marcel Cachin, Bobigny93017, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Denis Lairon
- Aix Marseille University, Inserm, INRAE, C2VN, Marseille, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, Université Paris Cité (CRESS), UFR SMBH 74, Rue Marcel Cachin, Bobigny93017, France
| | | | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, Université Paris Cité (CRESS), UFR SMBH 74, Rue Marcel Cachin, Bobigny93017, France
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10
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Ropero AB, Borrás F, Rodríguez M, Beltrá M. Nutritional Description of Organic and Conventional Food Products in Spain: The BADALI Project. Nutrients 2023; 15:nu15081876. [PMID: 37111095 PMCID: PMC10144859 DOI: 10.3390/nu15081876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Organic food and drink is undoubtedly a growing market. Consumers perceive organic food as healthy, and nutrition claims (NCs) and fortification may add to this perception. Whether this is true is still a matter of controversy, particularly for organic food products. We present here the first comprehensive study of large samples of six specific organic food types, analysing the nutritional quality (nutrient composition and "healthiness") as well as the use of NCs and fortification. In parallel, a comparison with conventional food is also carried out. For this purpose, the Food Database of products in the Spanish market, BADALI, was used. Four cereal-based and two dairy-substitute food types were analysed. Our results show that as many as 81% of organic foods are considered "less healthy" by the Pan American Health Organization Nutrient Profile Model (PAHO-NPM). Organic foods present a slightly improved nutrient profile compared to conventional foods. However, many of the differences, though statistically significant, are nutritionally irrelevant. Organic foods use NCs very frequently, more than conventional foods, with very little micronutrient fortification. The main conclusion of this work is that consumers' perception that organic food products are healthy is unfounded from a nutritional point of view.
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Affiliation(s)
- Ana B Ropero
- Institute of Bioengineering, Miguel Hernández University, 03202 Elche, Spain
| | - Fernando Borrás
- Department of Statistics, Mathematics and Informatics, Miguel Hernández University, 03202 Elche, Spain
| | - Marta Rodríguez
- Polytechnic School of Orihuela, Miguel Hernández University, 03202 Elche, Spain
| | - Marta Beltrá
- Institute of Bioengineering, Miguel Hernández University, 03202 Elche, Spain
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11
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Les fruits et légumes « Biologiques » sont-ils de qualité supérieure et meilleurs pour notre santé ? CAHIERS DE NUTRITION ET DE DIÉTÉTIQUE 2023. [DOI: 10.1016/j.cnd.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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12
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Elsner F, Matthiessen LE, Średnicka-Tober D, Marx W, O’Neil A, Welch AA, Hayhoe RP, Higgs S, van Vliet M, Morphew-Lu E, Kazimierczak R, Góralska-Walczak R, Kopczyńska K, Steenbuch Krabbe Bruun T, Rosane BP, Gjedsted Bügel S, Strassner C. Identifying Future Study Designs for Mental Health and Social Wellbeing Associated with Diets of a Cohort Living in Eco-Regions: Findings from the INSUM Expert Workshop. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:669. [PMID: 36612999 PMCID: PMC9819394 DOI: 10.3390/ijerph20010669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/13/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Diets influence our mental health and social wellbeing (MHSW) in multiple ways. A rising community concept, Eco-Regions, has gained interest. The research project "Indicators for assessment of health effects of consumption of sustainable, organic school meals in Ecoregions" (INSUM) aims to develop future-oriented research approaches to measure the potential health effects of more sustainable and healthy diets. This first part of the project focuses on MHSW with the goal to identify suitable study designs and indicators. The methodology is based on a 2-day workshop with an interdisciplinary group of experts. This paper describes commonly applied research methods on the nexus between diet and MHSW as presented by the experts and summarises key points from the discussions. The results show that the dominating tool to investigate MSHW is questionnaires. Questionnaires vary largely depending on the research design, such as participants or distribution channels. Cohort studies addressing families and including in-depth interventional and/or experimental studies may be suitable for an Eco-Region investigation. Those MHSW studies can be conducted and combined with measurements of somatic health effects. We conclude that indicators should be seen as complementary rather than independent. Explorative research designs are required to investigate complex Eco-Regions.
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Affiliation(s)
- Friederike Elsner
- Department of Food, Nutrition, Facilities, FH Münster University of Applied Sciences, 48149 Muenster, Germany
| | - Lea Ellen Matthiessen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark
| | - Dominika Średnicka-Tober
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-776 Warsaw, Poland
| | - Wolfgang Marx
- Food & Mood Centre, IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC 3220, Australia
| | - Adrienne O’Neil
- Food & Mood Centre, IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC 3220, Australia
| | - Ailsa A. Welch
- Norwich Medical School, University of East Anglia, Norfolk NR4 7TJ, UK
| | - Richard Peter Hayhoe
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford CM1 1SQ, UK
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
| | - Marja van Vliet
- Institute for Positive Health, 3521 AL Utrecht, The Netherlands
| | | | - Renata Kazimierczak
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-776 Warsaw, Poland
| | - Rita Góralska-Walczak
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-776 Warsaw, Poland
| | - Klaudia Kopczyńska
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-776 Warsaw, Poland
| | | | - Beatriz Philippi Rosane
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark
| | - Susanne Gjedsted Bügel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark
| | - Carola Strassner
- Department of Food, Nutrition, Facilities, FH Münster University of Applied Sciences, 48149 Muenster, Germany
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13
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Woś K, Dobrowolski H, Gajewska D, Rembiałkowska E. Organic Food Consumption and Perception among Polish Mothers of Children under 6 Years Old. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15196. [PMID: 36429913 PMCID: PMC9690996 DOI: 10.3390/ijerph192215196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Pro-environmental attitudes, including organic food consumption, can reduce negative impact on the environment. The consumption of organic food in Poland is rather low, but the ecological awareness of Poles is steadily increasing. The aim of the study was to assess the frequency and factors influencing the consumption of organic products and to analyze the perception of such food by mothers of children under 6 years of age (n = 667). The survey was conducted between March 2020 and May 2021 in three voivodships in Eastern Poland. The results of the survey indicate that the majority of respondents are occasional consumers of organic food (51%). The most commonly consumed organic products are eggs, vegetables and fruits, whereas the least consumed are alcoholic beverages, coffees and ready-to-eat meals. The responders' main characteristics of organic food are as follows: no genetic modification/GMO-free, no synthetic additives and having organic certification. Statistically significant correlations were found between the frequency of organic food consumption and education, financial situation as well as familiarity with the logo of the organic certificate and verifying that it is present on the packaging. The most common reasons for consuming organic food were health issues, while the high price was declared as the main barrier.
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Affiliation(s)
- Karolina Woś
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), 02-776 Warsaw, Poland
| | - Hubert Dobrowolski
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), 02-776 Warsaw, Poland
| | - Danuta Gajewska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), 02-776 Warsaw, Poland
| | - Ewa Rembiałkowska
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), 02-776 Warsaw, Poland
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14
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Han S, Lee Y. Analysis of the impacts of social class and lifestyle on consumption of organic foods in South Korea. Heliyon 2022; 8:e10998. [PMID: 36254277 PMCID: PMC9568844 DOI: 10.1016/j.heliyon.2022.e10998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/17/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022] Open
Abstract
The purpose of this study is to analyze the impact of social class and lifestyle on the consumption of organic foods in South Korea. Consumer behavior regarding organic foods is influenced by lifestyle, as well as income-level and education. This study provides a new perspective on the socio-economic structure of organic food consumption patterns in urban areas by extracting information from big data. The organic food consumption patterns are then analyzed through visualization of the geographical distribution of organic food stores. In addition, this study estimates the effects of social class and lifestyle variables on the consumption of organic foods based on survey data. This study finds that social class characteristics are factors that influence the consumption of organic foods. However, individual lifestyle plays a more important role in actual buying behavior.
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Affiliation(s)
- Seungwoo Han
- Division of Global Affairs, Rutgers University, NJ, USA
| | - Yookyung Lee
- Hyundai Research Institute, Seoul, South Korea,Corresponding author.
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15
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Garutti M, Nevola G, Mazzeo R, Cucciniello L, Totaro F, Bertuzzi CA, Caccialanza R, Pedrazzoli P, Puglisi F. The Impact of Cereal Grain Composition on the Health and Disease Outcomes. Front Nutr 2022; 9:888974. [PMID: 35711559 PMCID: PMC9196906 DOI: 10.3389/fnut.2022.888974] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/26/2022] [Indexed: 12/21/2022] Open
Abstract
Whole grains are a pivotal food category for the human diet and represent an invaluable source of carbohydrates, proteins, fibers, phytocompunds, minerals, and vitamins. Many studies have shown that the consumption of whole grains is linked to a reduced risk of cancer, cardiovascular diseases, and type 2 diabetes and other chronic diseases. However, several of their positive health effects seem to disappear when grains are consumed in the refined form. Herein we review the available literature on whole grains with a focus on molecular composition and health benefits on many chronic diseases with the aim to offer an updated and pragmatic reference for physicians and nutrition professionals.
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Affiliation(s)
- Mattia Garutti
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Gerardo Nevola
- Department of Anaesthesia and Intensive Care - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Roberta Mazzeo
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Linda Cucciniello
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Fabiana Totaro
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Carlos Alejandro Bertuzzi
- Department of Anaesthesia and Intensive Care - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fabio Puglisi
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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16
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DeClercq V, Nearing JT, Sweeney E. Plant-Based Diets and Cancer Risk: What is the Evidence? Curr Nutr Rep 2022; 11:354-369. [PMID: 35334103 DOI: 10.1007/s13668-022-00409-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 01/23/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the recent (past 5 years) available evidence regarding the association between plant-based diets on cancer risk from clinical trials and observational studies. Biological mechanisms and gaps in the current literature will also be discussed. RECENT FINDINGS There is a lack of intervention studies but there are abundant observational studies assessing the association between plant-based diets and cancer risk, including multiple longitudinal cohort studies and similar data from case-control studies that demonstrate a decreased overall cancer risk with plant-based diets. Case-control studies support a decreased risk of colorectal and breast cancers with plant-based diets, but results for specific cancers remain inconsistent in cohort studies. Current evidence from observational studies indicates an inverse association between plant-based diets and overall cancer risk. Future research should include intervention studies, address inconsistencies in dietary assessment methods and provide greater detail on underrepresented groups.
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Affiliation(s)
- Vanessa DeClercq
- Department of Pharmacology, Dalhousie University, Room 5-D Tupper Medical Building, 5850 College Street, Halifax, NS, B3H 4R2, Canada. .,Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
| | - Jacob T Nearing
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - Ellen Sweeney
- Atlantic Partnership for Tomorrow's Health (PATH), Dalhousie University, Halifax, NS, Canada
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17
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Curl CL. How much pesticide residue is in your diet? It depends on what you eat-and how it's grown. Am J Clin Nutr 2022; 115:325-326. [PMID: 34914836 PMCID: PMC8827071 DOI: 10.1093/ajcn/nqab362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Cynthia L Curl
- Department of Public Health and Population Science, Boise State University, Boise, ID, USA
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