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Sellem L, Srour B, Javaux G, Chazelas E, Chassaing B, Viennois E, Debras C, Druesne-Pecollo N, Esseddik Y, Szabo de Edelenyi F, Arnault N, Agaësse C, De Sa A, Lutchia R, Huybrechts I, Scalbert A, Pierre F, Coumoul X, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort. PLoS Med 2024; 21:e1004338. [PMID: 38349899 PMCID: PMC10863884 DOI: 10.1371/journal.pmed.1004338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 12/20/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Emulsifiers are widely used food additives in industrially processed foods to improve texture and enhance shelf-life. Experimental research suggests deleterious effects of emulsifiers on the intestinal microbiota and the metabolome, leading to chronic inflammation and increasing susceptibility to carcinogenesis. However, human epidemiological evidence investigating their association with cancer is nonexistent. This study aimed to assess associations between food additive emulsifiers and cancer risk in a large population-based prospective cohort. METHODS AND FINDINGS This study included 92,000 adults of the French NutriNet-Santé cohort without prevalent cancer at enrolment (44.5 y [SD: 14.5], 78.8% female, 2009 to 2021). They were followed for an average of 6.7 years [SD: 2.2]. Food additive emulsifier intakes were estimated for participants who provided at least 3 repeated 24-h dietary records linked to comprehensive, brand-specific food composition databases on food additives. Multivariable Cox regressions were conducted to estimate associations between emulsifiers and cancer incidence. Overall, 2,604 incident cancer cases were diagnosed during follow-up (including 750 breast, 322 prostate, and 207 colorectal cancers). Higher intakes of mono- and diglycerides of fatty acids (FAs) (E471) were associated with higher risks of overall cancer (HR high vs. low category = 1.15; 95% CI [1.04, 1.27], p-trend = 0.01), breast cancer (HR = 1.24; 95% CI [1.03, 1.51], p-trend = 0.04), and prostate cancer (HR = 1.46; 95% CI [1.09, 1.97], p-trend = 0.02). In addition, associations with breast cancer risk were observed for higher intakes of total carrageenans (E407 and E407a) (HR = 1.32; 95% CI [1.09, 1.60], p-trend = 0.009) and carrageenan (E407) (HR = 1.28; 95% CI [1.06, 1.56], p-trend = 0.01). No association was detected between any of the emulsifiers and colorectal cancer risk. Several associations with other emulsifiers were observed but were not robust throughout sensitivity analyses. Main limitations include possible exposure measurement errors in emulsifiers intake and potential residual confounding linked to the observational design. CONCLUSIONS In this large prospective cohort, we observed associations between higher intakes of carrageenans and mono- and diglycerides of fatty acids with overall, breast and prostate cancer risk. These results need replication in other populations. They provide new epidemiological evidence on the role of emulsifiers in cancer risk. TRIAL REGISTRATION ClinicalTrials.gov NCT03335644.
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Affiliation(s)
- Laury Sellem
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Bernard Srour
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Guillaume Javaux
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Eloi Chazelas
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Benoit Chassaing
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
- INSERM U1016, team “Mucosal microbiota in chronic inflammatory diseases”, CNRS UMR 8104, Université Paris Cité, Paris, France
| | - Emilie Viennois
- INSERM U1149, Center of Research on Inflammation, Université Paris Cité, Paris, France
| | - Charlotte Debras
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Nathalie Druesne-Pecollo
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Younes Esseddik
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Nathalie Arnault
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Cédric Agaësse
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Alexandre De Sa
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Rebecca Lutchia
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Augustin Scalbert
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Fabrice Pierre
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Xavier Coumoul
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
- INSERM UMR-S 1124, Université Paris Cité, Paris, France
| | - Chantal Julia
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Public Health Department, Groupe Hospitalier Paris-Seine-Saint-Denis, Assistance Publique-hôpitaux de Paris (AP-HP), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Benjamin Allès
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Pilar Galan
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Serge Hercberg
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
- Public Health Department, Groupe Hospitalier Paris-Seine-Saint-Denis, Assistance Publique-hôpitaux de Paris (AP-HP), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Mathilde Touvier
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
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2
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Vanhelst J, Srour B, Bourhis L, Charreire H, VerdotDeschasaux-Tanguy CM, Druesne-Pecollo N, de Edelenyi FS, Allègre J, Allès B, Deschamps V, Bellicha A, Fezeu LK, Galan P, Julia C, Kesse-Guyot E, Hercberg S, Bajos N, Severi G, Zins M, de Lamballerie X, Carrat F, Oppert JM, Touvier M. Association of SARS-CoV-2 infection with physical activity domains and types. Sci Rep 2023; 13:19187. [PMID: 37932323 PMCID: PMC10628273 DOI: 10.1038/s41598-023-46162-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023] Open
Abstract
Lockdown imposed in the early phase of the SARS-CoV-2 outbreak represented a specific setting where activity was restricted but still possible. The aim was to investigate the cross-sectional associations between physical activity (PA) and SARS-CoV-2 infection in a French population-based cohort. Participants completed a PA questionnaire. PA was classified into: (i) total PA; (ii) aerobic PA by intensity; (iii) strengthening PA; (iv) PA by domain and type; and (vii) by location. Sedentary time was also recorded. Seroprevalence of anti-SARS-CoV-2 antibodies was assessed. Multivariable logistic regression models controlling for sociodemographic, lifestyle, anthropometric data, health status, and adherence to recommended protective anti-SARS-CoV-2 behaviours were computed. From 22,165 participants included, 21,074 (95.1%) and 1091 (4.9%) had a negative and positive ELISA-S test result, respectively. Total PA, vigorous PA, leisure-time PA, household PA, outdoor PA and indoor PA were all associated with lower probability of SARS-CoV-2 infection. Observations made in such a setting shed light on PA possibilities in a context of restricted mobility, where the health benefits of PA should not be overlooked. Along with already well-established benefits of PA for non-communicable disease prevention, these findings provide additional evidence for policies promoting all types of PA as a lever for population health.
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Affiliation(s)
- Jérémy Vanhelst
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France.
| | - Bernard Srour
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Laurent Bourhis
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Hélène Charreire
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Charlotte Mélanie VerdotDeschasaux-Tanguy
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
- Santé Publique France, Nutritional Surveillance and Epidemiology Team (ESEN), Sorbonne Paris Nord University, Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Fabien Szabo de Edelenyi
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Julien Allègre
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Benjamin Allès
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Valérie Deschamps
- Santé Publique France, Nutritional Surveillance and Epidemiology Team (ESEN), Sorbonne Paris Nord University, Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Alice Bellicha
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Leopold K Fezeu
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Pilar Galan
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Chantal Julia
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
- Département de Santé Publique, APHP, Sorbonne Université, Paris, France
| | - Emmanuelle Kesse-Guyot
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Serge Hercberg
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Nathalie Bajos
- IRIS, UMR CNRS 8156, EHESS, Inserm U997, Aubervilliers, France
| | - Gianluca Severi
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, Villejuif, France
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Marie Zins
- Paris University, Paris, France
- Inserm UMS 11, Paris Saclay University, Villejuif, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents (UVE), Aix Marseille Univ, IRD 190, INSERM 1207, Marseille, France
| | - Fabrice Carrat
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Jean-Michel Oppert
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
- Department of Nutrition, Human Nutrition Research Center Ile-de-France (CRNH IdF), Pitié-Salpêtrière Hospital (AP-HP), Sorbonne University, Paris, France
| | - Mathilde Touvier
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
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3
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Reuzé A, Méjean C, Sirieix L, Baudry J, Kesse-Guyot E, Druesne-Pecollo N, Brunin J, Hercberg S, Touvier M, Péneau S, Allès B. Stages of Change toward Meat Reduction: Associations with Motives and Longitudinal Dietary Data on Animal-Based and Plant-Based Food Intakes in French Adults. J Nutr 2023; 153:3295-3307. [PMID: 37774842 DOI: 10.1016/j.tjnut.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Reducing meat consumption is advocated for healthier and more sustainable diets. However, behavioral studies are needed to better understand the mechanisms underlying meat-reducing dietary changes. OBJECTIVES The main aim of this study was to compare the motives associated with stages of change toward meat reduction in French adults, using the transtheoretical model (TTM). A second aim was to investigate the associations between stages of change and adherence to dietary patterns favoring a better balance of animal and plant food consumption over time. METHODS This longitudinal study included 25,143 non-vegetarian participants of the web-based NutriNet-Santé cohort with a mean follow-up of 6.2 (SD = 2.6) y. Dietary data were obtained from 24-h dietary records over the period 2009-2019. The contribution of meat to total energy intake and scores measuring the contribution of healthy and unhealthy plant-based foods to the diet were computed. A questionnaire completed in 2018 allowed us to identify the TTM stages of change related to meat reduction (precontemplation, contemplation, preparation, action, and maintenance), and recorded motives related to meat consumption. We used multivariate linear mixed models for repeated data to assess associations between food intake changes and stages, and logistic regression for motives, presented as adjusted frequencies. RESULTS Participants in later stages were characterized by a significantly higher decrease in meat intake over time, compared with the earliest stage (for example, βmaintenance ∗ time = -0.08, P < 0.0001), and a higher increase in the healthy plant-based food consumption score over time (for example, βmaintenance∗time = 0.11, P < 0.0001). Concerns about health, nutrition, and the environment were the most frequently cited motives for reducing meat consumption at all stages. CONCLUSIONS Individuals who had already initiated meat reduction adhered to healthier and more sustainable diets than meat continuers. Characterizing motives according to readiness to reduce meat consumption could support tailored public health campaigns. TRIAL REGISTRATION NUMBER The study protocol is registered at clinicaltrials.gov with Clinical Trial Registry number NCT03335644 available at https://clinicaltrials.gov/ct2/show/NCT03335644.
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Affiliation(s)
- Anouk Reuzé
- EREN, Université Sorbonne Paris Nord, CRESS, INSERM, INRAE, CNAM, Bobigny, France.
| | - Caroline Méjean
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Lucie Sirieix
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Julia Baudry
- EREN, Université Sorbonne Paris Nord, CRESS, INSERM, INRAE, CNAM, Bobigny, France
| | | | | | - Joséphine Brunin
- EREN, Université Sorbonne Paris Nord, CRESS, INSERM, INRAE, CNAM, Bobigny, France; Agence de l'Environnement et de la Maîtrise de l'Energie (ADEME), Angers, France
| | - Serge Hercberg
- EREN, Université Sorbonne Paris Nord, CRESS, INSERM, INRAE, CNAM, Bobigny, France
| | - Mathilde Touvier
- EREN, Université Sorbonne Paris Nord, CRESS, INSERM, INRAE, CNAM, Bobigny, France
| | - Sandrine Péneau
- EREN, Université Sorbonne Paris Nord, CRESS, INSERM, INRAE, CNAM, Bobigny, France
| | - Benjamin Allès
- EREN, Université Sorbonne Paris Nord, CRESS, INSERM, INRAE, CNAM, Bobigny, France
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4
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Sellem L, Srour B, Javaux G, Chazelas E, Chassaing B, Viennois E, Debras C, Salamé C, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Agaësse C, De Sa A, Lutchia R, Louveau E, Huybrechts I, Pierre F, Coumoul X, Fezeu LK, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Food additive emulsifiers and risk of cardiovascular disease in the NutriNet-Santé cohort: prospective cohort study. BMJ 2023; 382:e076058. [PMID: 37673430 PMCID: PMC10480690 DOI: 10.1136/bmj-2023-076058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE To assess the associations between exposure to food additive emulsifiers and risk of cardiovascular disease (CVD). DESIGN Prospective cohort study. SETTING French NutriNet-Santé study, 2009-21. PARTICIPANTS 95 442 adults (>18 years) without prevalent CVD who completed at least three 24 hour dietary records during the first two years of follow-up. MAIN OUTCOME MEASURES Associations between intake of food additive emulsifiers (continuous (mg/day)) and risk of CVD, coronary heart disease, and cerebrovascular disease characterised using multivariable proportional hazard Cox models to compute hazard ratios for each additional standard deviation (SD) of emulsifier intake, along with 95% confidence intervals. RESULTS Mean age was 43.1 (SD 14.5) years, and 79.0% (n=75 390) of participants were women. During follow-up (median 7.4 years), 1995 incident CVD, 1044 coronary heart disease, and 974 cerebrovascular disease events were diagnosed. Higher intake of celluloses (E460-E468) was found to be positively associated with higher risks of CVD (hazard ratio for an increase of 1 standard deviation 1.05, 95% confidence interval 1.02 to 1.09, P=0.003) and coronary heart disease (1.07, 1.02 to 1.12, P=0.004). Specifically, higher cellulose E460 intake was linked to higher risks of CVD (1.05, 1.01 to 1.09, P=0.007) and coronary heart disease (1.07, 1.02 to 1.12, P=0.005), and higher intake of carboxymethylcellulose (E466) was associated with higher risks of CVD (1.03, 1.01 to 1.05, P=0.004) and coronary heart disease (1.04, 1.02 to 1.06, P=0.001). Additionally, higher intakes of monoglycerides and diglycerides of fatty acids (E471 and E472) were associated with higher risks of all outcomes. Among these emulsifiers, lactic ester of monoglycerides and diglycerides of fatty acids (E472b) was associated with higher risks of CVD (1.06, 1.02 to 1.10, P=0.002) and cerebrovascular disease (1.11, 1.06 to 1.16, P<0.001), and citric acid ester of monoglycerides and diglycerides of fatty acids (E472c) was associated with higher risks of CVD (1.04, 1.02 to 1.07, P=0.004) and coronary heart disease (1.06, 1.03 to 1.09, P<0.001). High intake of trisodium phosphate (E339) was associated with an increased risk of coronary heart disease (1.06, 1.00 to 1.12, P=0.03). Sensitivity analyses showed consistent associations. CONCLUSION This study found positive associations between risk of CVD and intake of five individual and two groups of food additive emulsifiers widely used in industrial foods. TRIAL REGISTRATION ClinicalTrials.gov NCT03335644.
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Affiliation(s)
- Laury Sellem
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Bernard Srour
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Guillaume Javaux
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Eloi Chazelas
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Benoit Chassaing
- INSERM U1016, team "Mucosal microbiota in chronic inflammatory diseases," Université Paris Cité, Paris, France
| | - Emilie Viennois
- INSERM U1149, Centre for Research on Inflammation, Université de Paris, Paris, France
| | - Charlotte Debras
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Clara Salamé
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Younes Esseddik
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Cédric Agaësse
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Alexandre De Sa
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Rebecca Lutchia
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Erwan Louveau
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Fabrice Pierre
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | | | - Léopold K Fezeu
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Chantal Julia
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Public Health Department, Groupe Hospitalier Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Benjamin Allès
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Pilar Galan
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Serge Hercberg
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Public Health Department, Groupe Hospitalier Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Mathilde Touvier
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France
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5
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Debras C, Deschasaux-Tanguy M, Chazelas E, Sellem L, Druesne-Pecollo N, Esseddik Y, Szabo de Edelenyi F, Agaësse C, De Sa A, Lutchia R, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Huybrechts I, Cosson E, Tatulashvili S, Srour B, Touvier M. Artificial Sweeteners and Risk of Type 2 Diabetes in the Prospective NutriNet-Santé Cohort. Diabetes Care 2023; 46:1681-1690. [PMID: 37490630 PMCID: PMC10465821 DOI: 10.2337/dc23-0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/09/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE To study the relationships between artificial sweeteners, accounting for all dietary sources (total and by type of artificial sweetener) and risk of type 2 diabetes (T2D), in a large-scale prospective cohort. RESEARCH DESIGN AND METHODS The analyses included 105,588 participants from the web-based NutriNet-Santé study (France, 2009-2022; mean age 42.5 ± 14.6 years, 79.2% women). Repeated 24-h dietary records, including brands and commercial names of industrial products, merged with qualitative and quantitative food additive composition data, enabled artificial sweetener intakes to be accurately assessed from all dietary sources. Associations between artificial sweeteners (total, aspartame, acesulfame potassium [K], and sucralose) and T2D were investigated using Cox proportional hazard models adjusted for potential confounders, including weight variation during follow-up. RESULTS During a median follow-up of 9.1 years (946,650 person-years, 972 incident T2D), compared with nonconsumers, higher consumers of artificial sweeteners (i.e., above the sex-specific medians of 16.4 mg/day in men and 18.5 mg/day in women) had higher risks of developing T2D (hazard ratio [HR] 1.69; 95% CI 1.45-1.97; P-trend <0.001). Positive associations were also observed for individual artificial sweeteners: aspartame (HR 1.63 [95% CI 1.38-1.93], P-trend <0.001), acesulfame-K (HR 1.70 [1.42-2.04], P-trend <0.001), and sucralose (HR 1.34 [1.07-1.69], P-trend = 0.013). CONCLUSIONS Potential for reverse causality cannot be eliminated; however, many sensitivity analyses were computed to limit this and other potential biases. These findings of positive associations between artificial sweetener intakes and increased T2D risk strengthen the evidence that these additives may not be safe sugar alternatives. This study provides important insights in the context of on-going reevaluation of artificial sweeteners by health authorities worldwide.
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Affiliation(s)
- Charlotte Debras
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Eloi Chazelas
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Laury Sellem
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Younes Esseddik
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Cédric Agaësse
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Alexandre De Sa
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Rebecca Lutchia
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Benjamin Allès
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Emmanuel Cosson
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
- Diabetology, Endocrinology and Nutrition Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Sopio Tatulashvili
- Diabetology, Endocrinology and Nutrition Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Bernard Srour
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
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6
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Srour B, Hercberg S, Galan P, Monteiro CA, Szabo de Edelenyi F, Bourhis L, Fialon M, Sarda B, Druesne-Pecollo N, Esseddik Y, Deschasaux-Tanguy M, Julia C, Touvier M. Effect of a new graphically modified Nutri-Score on the objective understanding of foods' nutrient profile and ultraprocessing: a randomised controlled trial. BMJ Nutr Prev Health 2023; 6:108-118. [PMID: 37484539 PMCID: PMC10359533 DOI: 10.1136/bmjnph-2022-000599] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/18/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction When considering health-related impacts of foods, nutrient profile and (ultra)processing are two complementary dimensions. The Nutri-Score informs on the nutrient profile dimension. Recently, mounting evidence linked ultraprocessed food consumption to various adverse health outcomes, independently of their nutrient profile. To inform consumers about each of these health-related dimensions of food, we tested, in a randomised controlled trial, if a graphically modified version 'Nutri-Score V.2.0', including a black 'ultraprocessed' banner, would improve the capacity of consumers to rank products according to their nutrient profile and to detect those ultra-processed, compared with a no-label situation. Methods 21 159 participants included in the NutriNet-Santé web-cohort were randomly assigned to a control arm (no front-of-pack label) or an experimental arm (Nutri-Score 2.0) and were presented an online questionnaire with three sets of food products (cookies, breakfast cereals and ready-to-eat meals) to rank according to nutrient profile and to identify ultraprocessed foods. The primary outcome was objective understanding of nutrient profile and ultraprocessing, represented by a score of correct answers. Secondary outcomes were purchasing intentions and the healthiest-perceived product. Multinomial logistic regressions were performed. Results The Nutri-Score V.2.0 increased the objective understanding of both the nutrient profile dimension (OR highest vs lowest score category=29.0 (23.4-35.9), p<0.001) and the ultraprocessing dimension (OR=174.3 (151.4-200.5), p<0.001). Trends were similar for cookies, breakfast cereals and ready-to-eat meals. The Nutri-Score V.2.0 had a positive effect on purchasing intentions and on the products perceived as the healthiest. Conclusion This randomised controlled trial demonstrates the interest of a front-of-pack label combining the Nutri-Score (informing on the nutrient profile dimension) with an additional graphic mention, indicating when the food is ultraprocessed, compared with a no-label situation. Our results show that a combined label enabled participants to independently understand these two complementary dimensions of foods. Trial registration number NCT05610930.
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Affiliation(s)
- Bernard Srour
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
| | - Serge Hercberg
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
- Département de Santé Publique, Hôpital Avicenne, F-93017, Bobigny Cedex, France, Bobigny, France
| | - Pilar Galan
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
| | - Carlos Augusto Monteiro
- Department of Nutrition, School of Public Health, University of Sao Paulo, São Paulo, Brazil
| | - Fabien Szabo de Edelenyi
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
| | - Laurent Bourhis
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
| | - Morgane Fialon
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
| | - Barthélémy Sarda
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
| | - Nathalie Druesne-Pecollo
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
| | - Younes Esseddik
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
| | - Chantal Julia
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
- Département de Santé Publique, Hôpital Avicenne, F-93017, Bobigny Cedex, France, Bobigny, France
| | - Mathilde Touvier
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), F-93017 Bobigny, France
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7
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Deschasaux-Tanguy M, Szabo de Edelenyi F, Druesne-Pecollo N, Esseddik Y, Allègre J, Srour B, Galan P, Hercberg S, Severi G, Zins M, Wiernik E, de Lamballerie X, Carrat F, Touvier M. ABO blood types and SARS-CoV-2 infection assessed using seroprevalence data in a large population-based sample: the SAPRIS-SERO multi-cohort study. Sci Rep 2023; 13:4775. [PMID: 36959255 PMCID: PMC10034870 DOI: 10.1038/s41598-023-30714-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/28/2023] [Indexed: 03/25/2023] Open
Abstract
ABO blood type has been reported as a potential factor influencing SARS-CoV-2 infection, but so far mostly in studies that involved small samples, selected population and/or used PCR test results. In contrast our study aimed to assess the association between ABO blood types and SARS-CoV-2 infection using seroprevalence data (independent of whether or not individuals had symptoms or sought for testing) in a large population-based sample. Our study included 67,340 French participants to the SAPRIS-SERO multi-cohort project. Anti-SARS-CoV-2 antibodies were detected using ELISA (targeting the proteins spike (S) and nucleocapsid (NP)) and seroneutralisation (SN) tests on dried blood spots collected in May-November 2020. Non-O individuals (and especially types A and AB) were more likely to bear anti SARS-CoV-2 antibodies (ELISA-S, 2964 positive cases: ORnon-Ovs.O = 1.09[1.01-1.17], ORAvs.O = 1.08[1.00-1.17]; ELISA-S/ELISA-NP/SN, 678 triple positive cases: ORnon-Ovs.O = 1.19 [1.02-1.39], ORAvs.O = 1.19[1.01-1.41], ORABvs.O = 1.43[1.01-2.03]). Hence, our results provided additional insights into the dynamic of SARS-CoV-2 infection, highlighting a higher susceptibility of infection for individuals of blood types A and AB and a lesser risk for blood type O.
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Affiliation(s)
- Mélanie Deschasaux-Tanguy
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France.
| | - Fabien Szabo de Edelenyi
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
| | - Nathalie Druesne-Pecollo
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
| | - Younes Esseddik
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
| | - Julien Allègre
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
| | - Bernard Srour
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
| | - Pilar Galan
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
| | - Serge Hercberg
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
| | - Gianluca Severi
- UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP UMR1018, Paris-Saclay University, Villejuif, France
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Marie Zins
- Population-based Cohorts Unit, INSERM, UMS 011, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris Cité, Paris, France
| | - Emmanuel Wiernik
- Population-based Cohorts Unit, INSERM, UMS 011, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris Cité, Paris, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents (UVE), IRD 190, INSERM 1207, Aix Marseille Univ, Marseille, France
| | - Fabrice Carrat
- Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- Département de Santé Publique, APHP, Sorbonne Université, Paris, France
| | - Mathilde Touvier
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
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8
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Wendeu-Foyet G, Bellicha A, Chajès V, Huybrechts I, Bard JM, Debras C, Srour B, Sellem L, Fezeu LK, Julia C, Kesse-Guyot E, Agaësse C, Druesne-Pecollo N, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Different Types of Industry-Produced and Ruminant Trans Fatty Acid Intake and Risk of Type 2 Diabetes: Findings From the NutriNet-Santé Prospective Cohort. Diabetes Care 2023; 46:321-330. [PMID: 36542554 DOI: 10.2337/dc22-0900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The deleterious effects of trans fatty acids (TFAs) on cardiovascular health are well established; however, their impact on type 2 diabetes remains poorly understood. In particular, little is known about the impact of specific TFA types on type 2 diabetes etiology. We aimed to explore the associations between different types of TFAs (total, ruminant, industry produced [iTFAs], and corresponding specific isomers) and risk of type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 105,551 participants age >18 years from the French NutriNet-Santé cohort (2009-2021) were included (mean baseline age 42.7 years; SD 14.6 years); 79.2% were women. Dietary intake data, including usual TFA intake, were collected using repeated 24-h dietary records (n = 5.7; SD 3.1). Associations between sex-specific quartile of dietary TFAs and diabetes risk were assessed using multivariable Cox models. RESULTS Total TFA intake was associated with higher type 2 diabetes risk (hazard ratio [HR]quartile 4 vs. 1 1.38; 95% CI 1.11-1.73; Ptrend < 0.001; n = 969 incident cases). This association, specifically observed for iTFAs (HR 1.45; 95% CI 1.15-1.83; Ptrend < 0.001), was mainly driven by elaidic acid (HR 1.37; 95% CI 1.09-1.72; Ptrend < 0.001) and linolelaidic acid (HR 1.29; 95% CI 1.04-1.58; Ptrend = 0.07). In contrast, ruminant TFAs were not significantly associated with risk of type 2 diabetes. CONCLUSIONS In this large prospective cohort, higher intakes of total and iTFAs were associated with increased type 2 diabetes risk. These findings support the World Health Organization's recommendation to eliminate iTFAs from the food supply worldwide. Consumers should be advised to limit the consumption of food products containing partially hydrogenated oils (main vector of iTFAs). This may contribute to lowering the substantial global burden of type 2 diabetes.
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Affiliation(s)
- Gaëlle Wendeu-Foyet
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Alice Bellicha
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Véronique Chajès
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
- International Agency for Research on Cancer, Lyon, France
| | - Inge Huybrechts
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
- International Agency for Research on Cancer, Lyon, France
| | - Jean-Marie Bard
- EA 2160-IUML FR3473 CNRS, Laboratory of General and Applied Biochemistry, Nantes University, Nantes, France
- Cancer Institute, Saint-Herblain, France
| | - Charlotte Debras
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Bernard Srour
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Laury Sellem
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Léopold K Fezeu
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
| | - Chantal Julia
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Public Health Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Cédric Agaësse
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
| | - Nathalie Druesne-Pecollo
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Pilar Galan
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Serge Hercberg
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
- Public Health Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
| | - Mathilde Touvier
- INSERM U1153, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement U1125, Conservatoire National des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center-University Paris Cité, Sorbonne Paris Nord University, Bobigny, France
- Nutrition and Cancer Research Network, Jouy-en-Josas, France
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9
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Srour B, Chazelas E, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Agaësse C, De Sa A, Lutchia R, Debras C, Sellem L, Huybrechts I, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Pierre F, Deschasaux-Tanguy M, Touvier M. Dietary exposure to nitrites and nitrates in association with type 2 diabetes risk: Results from the NutriNet-Santé population-based cohort study. PLoS Med 2023; 20:e1004149. [PMID: 36649248 PMCID: PMC9844911 DOI: 10.1371/journal.pmed.1004149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/24/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Nitrites and nitrates occur naturally in water and soil and are commonly ingested from drinking water and dietary sources. They are also used as food additives, mainly in processed meats, to increase shelf life and to avoid bacterial growth. Experimental studies suggested both benefits and harmful effects of nitrites and nitrates exposure on type 2 diabetes (T2D) onset, but epidemiological and clinical data are lacking. We aimed to study these associations in a large population-based prospective cohort study, distinguishing foods and water-originated nitrites/nitrates from those from food additives. METHODS AND FINDINGS Overall, 104,168 adults from the French NutriNet-Santé cohort study (2009 to 2021, 79.1% female, mean age [SD] = 42.7 [14.5]) were included. Associations between self-reported exposure to nitrites and nitrates (evaluated using repeated 24-h dietary records, linked to a comprehensive food composition database and accounting for commercial names/brands details of industrial products) and risk of T2D were assessed using cause-specific multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). During a median follow-up duration of 7.3 years (interquartile range: [3.2; 10.1] years), 969 incident T2D cases were ascertained. Total nitrites and foods and water-originated nitrites were both positively associated with a higher T2D risk (HRtertile 3 vs.1 = 1.27 (95% CI 1.04 to 1.54), Ptrend = 0.009 and 1.26 (95% CI 1.03 to 1.54), Ptrend = 0.02, respectively). Participants with higher exposure to additives-originated nitrites (i.e., above the sex-specific median) and specifically those having higher exposure to sodium nitrite (e250) had a higher T2D risk compared with those who were not exposed to additives-originated nitrites (HR higher consumers vs. non-consumers = 1.53 (95% CI 1.24 to 1.88), Ptrend < 0.001 and 1.54 (95% CI 1.26 to 1.90), Ptrend < 0.001, respectively). There was no evidence for an association between total, foods and water-originated, or additives-originated nitrates and T2D risk (all Ptrend = 0.7). No causal link can be established from this observational study. Main limitations include possible exposure measurement errors and the lack of validation versus specific nitrites/nitrates biomarkers; potential selection bias linked to the healthier behaviors of the cohort's participants compared to the general population; potential residual confounding linked to the observational design, as well as a self-reported, yet cross-checked, case ascertainment. CONCLUSIONS The findings of this large prospective cohort did not support any potential benefits for dietary nitrites and nitrates. They suggested that a higher exposure to both foods and water-originated and additives-originated nitrites was associated with higher T2D risk in the NutriNet-Santé cohort. This study provides a new piece of evidence in the context of current debates about updating regulations to limit the use of nitrites as food additives. The results need to be replicated in other populations. TRIAL REGISTRATION ClinicalTrials.gov NCT03335644 (https://clinicaltrials.gov/ct2/show/NCT03335644).
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Affiliation(s)
- Bernard Srour
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Eloi Chazelas
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
| | - Cédric Agaësse
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
| | - Alexandre De Sa
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
| | - Rebecca Lutchia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
| | - Charlotte Debras
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Laury Sellem
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Inge Huybrechts
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Fabrice Pierre
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris-Cité (CRESS), Bobigny, France
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
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10
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Guillien A, Bédard A, Dumas O, Allegre J, Arnault N, Bochaton A, Druesne-Pecollo N, Dumay D, Fezeu LK, Hercberg S, Le Moual N, Pilkington H, Rican S, Sit G, de Edelenyi FS, Touvier M, Galan P, Feuillet T, Varraso R, Siroux V. Exposome Profiles and Asthma among French Adults. Am J Respir Crit Care Med 2022; 206:1208-1219. [PMID: 35816632 DOI: 10.1164/rccm.202205-0865oc] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022] Open
Abstract
Rationale: Although previous studies in environmental epidemiology focused on single or a few exposures, a holistic approach combining multiple preventable risk factors is needed to tackle the etiology of multifactorial diseases such as asthma. Objectives: To investigate the association between combined socioeconomic, external environment, early-life environment, and lifestyle-anthropometric factors and asthma phenotypes. Methods: A total of 20,833 adults from the French NutriNet-Santé cohort were included (mean age, 56.2 yr; SD, 13.2; 72% women). The validated asthma symptom score (continuous) and asthma control (never asthma, controlled asthma, and uncontrolled asthma) were considered. The exposome (n = 87 factors) covered four domains: socioeconomic, external environment, early-life environment, and lifestyle-anthropometric. Cluster-based analyses were performed within each exposome domain, and the identified profiles were studied in association to asthma outcomes in negative binomial (asthma symptom score) or multinomial logistic (asthma control) regression models. Measurements and Main Results: In total, 5,546 (27%) individuals had an asthma symptom score ⩾1, and 1,206 (6%) and 194 (1%) had controlled and uncontrolled asthma, respectively. Three early-life exposure profiles ("high passive smoking-own dogs," "poor birth parameters-daycare attendance-city center," or "⩾2 siblings-breastfed" compared with "farm-pet owner-molds-low passive smoking") and one lifestyle-anthropometric profile ("unhealthy diet-high smoking-overweight" compared with "healthy diet-nonsmoker-thin") were associated with more asthma symptoms and uncontrolled asthma. Conclusions: This large-scale exposome-based study revealed early-life and lifestyle exposure profiles that were at risk for asthma in adults. Our findings support the importance of multiinterventional programs for the primary and secondary prevention of asthma, including control of specific early-life risk factors and promotion of a healthy lifestyle in adulthood.
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Affiliation(s)
- Alicia Guillien
- University of Grenoble Alpes, French National Institute of Health and Medical Research, French National Center for Scientific Research, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Annabelle Bédard
- French National Institute of Health and Medical Research, Joint Research Unit 1018, Center for Research in Epidemiology and Population Health Integrative Respiratory Epidemiology Team, Villejuif, France
| | - Orianne Dumas
- French National Institute of Health and Medical Research, Joint Research Unit 1018, Center for Research in Epidemiology and Population Health Integrative Respiratory Epidemiology Team, Villejuif, France
| | - Julien Allegre
- Sorbonne Paris Nord University, French National Institute of Health and Medical Research U1153, National Research Institute for Agriculture, Food and Environment U1125, French National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Nathalie Arnault
- Sorbonne Paris Nord University, French National Institute of Health and Medical Research U1153, National Research Institute for Agriculture, Food and Environment U1125, French National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Audrey Bochaton
- Joint Research Unit French National Center for Scientific Research 7533 Social Dynamics and Recomposition of Spaces Laboratory, Department of Geography, University of Paris Nanterre, Nanterre, France; and
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, French National Institute of Health and Medical Research U1153, National Research Institute for Agriculture, Food and Environment U1125, French National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Dorothée Dumay
- Department of Geography, Joint Research Unit French National Center for Scientific Research 7533 Social Dynamics and Recomposition of Spaces Laboratory, University of Paris 8 Vincennes-Saint-Denis, Saint-Denis, France
| | - Léopold K Fezeu
- Sorbonne Paris Nord University, French National Institute of Health and Medical Research U1153, National Research Institute for Agriculture, Food and Environment U1125, French National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, French National Institute of Health and Medical Research U1153, National Research Institute for Agriculture, Food and Environment U1125, French National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Nicole Le Moual
- French National Institute of Health and Medical Research, Joint Research Unit 1018, Center for Research in Epidemiology and Population Health Integrative Respiratory Epidemiology Team, Villejuif, France
| | - Hugo Pilkington
- Department of Geography, Joint Research Unit French National Center for Scientific Research 7533 Social Dynamics and Recomposition of Spaces Laboratory, University of Paris 8 Vincennes-Saint-Denis, Saint-Denis, France
| | - Stéphane Rican
- Joint Research Unit French National Center for Scientific Research 7533 Social Dynamics and Recomposition of Spaces Laboratory, Department of Geography, University of Paris Nanterre, Nanterre, France; and
| | - Guillaume Sit
- French National Institute of Health and Medical Research, Joint Research Unit 1018, Center for Research in Epidemiology and Population Health Integrative Respiratory Epidemiology Team, Villejuif, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, French National Institute of Health and Medical Research U1153, National Research Institute for Agriculture, Food and Environment U1125, French National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, French National Institute of Health and Medical Research U1153, National Research Institute for Agriculture, Food and Environment U1125, French National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, French National Institute of Health and Medical Research U1153, National Research Institute for Agriculture, Food and Environment U1125, French National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Thierry Feuillet
- Sorbonne Paris Nord University, French National Institute of Health and Medical Research U1153, National Research Institute for Agriculture, Food and Environment U1125, French National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
- Department of Geography, Joint Research Unit French National Center for Scientific Research 7533 Social Dynamics and Recomposition of Spaces Laboratory, University of Paris 8 Vincennes-Saint-Denis, Saint-Denis, France
| | - Raphaëlle Varraso
- French National Institute of Health and Medical Research, Joint Research Unit 1018, Center for Research in Epidemiology and Population Health Integrative Respiratory Epidemiology Team, Villejuif, France
| | - Valérie Siroux
- University of Grenoble Alpes, French National Institute of Health and Medical Research, French National Center for Scientific Research, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
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11
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Robineau O, Zins M, Touvier M, Wiernik E, Lemogne C, de Lamballerie X, Blanché H, Deleuze JF, Saba Villarroel PM, Dorival C, Nicol J, Gomes-Rima R, Correia E, Coeuret-Pellicer M, Druesne-Pecollo N, Esseddik Y, Ribet C, Goldberg M, Severi G, Carrat F. Long-lasting Symptoms After an Acute COVID-19 Infection and Factors Associated With Their Resolution. JAMA Netw Open 2022; 5:e2240985. [PMID: 36350653 PMCID: PMC9647489 DOI: 10.1001/jamanetworkopen.2022.40985] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
IMPORTANCE Persistent symptoms after SARS-CoV-2 infection are an emerging public health problem. The duration of these symptoms remains poorly documented. OBJECTIVE To describe the temporal dynamics of persistent symptoms after SARS-CoV-2 infection and the factors associated with their resolution. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study involved 53 047 participants from 3 French adult population-based cohorts (CONSTANCES [Consultants des Centres d'Examens de Santé], E3N/E4N, and Nutrinet-Santé) who were included in a nationwide survey about SARS-CoV-2 infection. All participants were asked to complete self-administered questionnaires between April 1 and June 30, 2020. Variables included sociodemographic characteristics, comorbid conditions, COVID-19 diagnosis, and acute symptoms. Blood samples were obtained for serologic analysis between May 1 and November 30, 2020, from patients with SARS-CoV-2 infection defined as enzyme-linked immunosorbent assay immunoglobulin G antispike detection confirmed with a neutralization assay. A follow-up internet questionnaire was completed between June 1 and September 30, 2021, with details on persistent symptoms, their duration, and SARS-CoV-2 infection diagnosis by polymerase chain reaction. MAIN OUTCOMES AND MEASURES Persistent symptoms were defined as symptoms occurring during the acute infection and lasting 2 or more months. Survival models for interval-censored data were used to estimate symptom duration from the acute episode. Multivariable adjusted hazard ratios (HRs) were estimated for age, sex, and comorbid conditions. Factors associated with the resolution of symptoms were assessed. RESULTS A total of 3972 participants (2531 women [63.7%; 95% CI, 62.2%-65.2%]; mean [SD] age, 50.9 [12.7] years) had been infected with SARS-CoV-2. Of these 3972 participants, 2647 (66.6% [95% CI, 65.1%-68.1%]) reported at least 1 symptom during the acute phase. Of these 2647 participants, 861 (32.5% [95% CI, 30.8%-34.3%]) reported at least 1 persistent symptom lasting 2 or more months after the acute phase. After 1 year of follow-up, the estimated proportion of individuals with complete symptom resolution was 89.9% (95% CI, 88.7%-90.9%) with acute symptoms. Older age (>60 years; HR, 0.78; 95% CI, 0.68-0.90), female sex (HR, 0.64; 95% CI, 0.58-0.70), history of cancer (HR, 0.61; 95% CI, 0.47-0.79), history of tobacco consumption (HR, 0.80; 95% CI, 0.73-0.88), high body mass index (≥30: HR, 0.75; 95% CI, 0.63-0.89), and high number of symptoms during the acute phase (>4; HR, 0.43; 95% CI, 0.39-0.48) were associated with a slower resolution of symptoms. CONCLUSIONS AND RELEVANCE In this cross-sectional study, persistent symptoms were still present in 10.1% of infected individuals at 1 year after SARS-CoV-2 infection. Given the high level of cumulative incidence of COVID-19, the absolute prevalent number of people with persistent symptoms is a public health concern.
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Affiliation(s)
- Olivier Robineau
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Paris, France
- EA2694, Univ Lille, Centre Hospitalier de Tourcoing, Tourcoing, France
| | - Marie Zins
- Population-Based Epidemiological Cohorts, UMS 11, Paris-Saclay University, Versailles St Quentin University, Université de Paris, INSERM, Villejuif, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, Inrae U1125, Conservatoire National des Arts et Metiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center–University of Paris, Bobigny, France
| | - Emmanuel Wiernik
- Population-Based Epidemiological Cohorts, UMS 11, Paris-Saclay University, Versailles St Quentin University, Université de Paris, INSERM, Villejuif, France
| | - Cedric Lemogne
- Université de Paris, INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents, UVE: Aix Marseille University, IRD 190, INSERM 1207, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Hélène Blanché
- Fondation Jean Dausset–CEPH (Centre d’Etude du Polymorphisme Humain), Paris, France
| | | | - Paola Mariela Saba Villarroel
- Unité des Virus Emergents, UVE: Aix Marseille University, IRD 190, INSERM 1207, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Céline Dorival
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Jerome Nicol
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Roselyn Gomes-Rima
- Centre de recherche Epidémiologique en Santé des Populations UMR1018, Paris-Saclay University, Université de Versailles Saint-Quentin, INSERM, Gustave Roussy, Villejuif, France
| | - Emmanuelle Correia
- Centre de recherche Epidémiologique en Santé des Populations UMR1018, Paris-Saclay University, Université de Versailles Saint-Quentin, INSERM, Gustave Roussy, Villejuif, France
| | - Mireille Coeuret-Pellicer
- Population-Based Epidemiological Cohorts, UMS 11, Paris-Saclay University, Versailles St Quentin University, Université de Paris, INSERM, Villejuif, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, INSERM U1153, Inrae U1125, Conservatoire National des Arts et Metiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center–University of Paris, Bobigny, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, INSERM U1153, Inrae U1125, Conservatoire National des Arts et Metiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center–University of Paris, Bobigny, France
| | - Céline Ribet
- Population-Based Epidemiological Cohorts, UMS 11, Paris-Saclay University, Versailles St Quentin University, Université de Paris, INSERM, Villejuif, France
| | - Marcel Goldberg
- Population-Based Epidemiological Cohorts, UMS 11, Paris-Saclay University, Versailles St Quentin University, Université de Paris, INSERM, Villejuif, France
| | - Gianluca Severi
- Centre de recherche Epidémiologique en Santé des Populations UMR1018, Paris-Saclay University, Université de Versailles Saint-Quentin, INSERM, Gustave Roussy, Villejuif, France
- Department of Statistics, Computer Science, Applications “G. Parenti,” University of Florence, Florence, Italy
| | - Fabrice Carrat
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Paris, France
- Département de santé publique, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Paris, France
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12
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Srour B, Chazelas E, Debras C, Druesne-Pecollo N, Agaesse C, Szabo de Edelenyi F, Sellem L, Kesse-Guyot E, Deschasaux-Tanguy M, Touvier M. Nitrites and nitrates from additives and natural sources and risk of cardiovascular outcomes. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Nitrates and nitrites are used as food additives in processed meats. They are also commonly ingested from water and several foods. Evidence suggests a beneficial role of dietary nitrites and nitrates in lowering blood pressure. However, associations between exposure to nitrites and nitrates from natural sources and food additives, separately, and risks of hypertension and cardiovascular disease (CVD) have not been investigated. We aimed to study these associations in the French population based prospective cohort NutriNet-Santé. Overall, 104,817 adults were included. Associations between exposure to nitrites and nitrates (evaluated using repeated dietary records, linked to a food composition database accounting for commercial brands of industrial products) and risks of hypertension and cardiovascular disease were assessed using multivariable Cox proportional hazard models. During follow-up, 3810 incident cases of hypertension were ascertained, and 2075 cases of CVD, 1004 of cerebrovascular diseases and 1079 or coronary heart diseases were diagnosed. Participants with higher exposure to nitrites from food additives and specifically those highly exposed to sodium nitrite (e250) had a higher hypertension risk compared with those who are not exposed to nitrites from food additives (HR = 1.19 (95% CI 1.08-1.31), P = 0.002, and 1.19 (95% CI 1.07-1.31), P = 0.002, P < 0.001), respectively). There was no evidence for an association between total nitrites or nitrites from natural sources, or dietary nitrates with hypertension risk (all P-values>0.3). There was no evidence for associations between dietary nitrites, or nitrates with risks of cardiovascular, cerebrovascular or coronary heart diseases (all P-values>0.2). In conclusion, we found that higher exposure to nitrites from food additives was associated with higher risk of hypertension. Our results do not support a potential protective association between dietary nitrites or nitrates and cardiovascular outcomes.
Key messages
• These results provide additional evidence in the context of current discussions about updating regulations on the use of nitrites as food additives.
• Our findings do not support any protective impact of nitrites and nitrates on cardiovascular health.
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Affiliation(s)
- B Srour
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | - E Chazelas
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | - C Debras
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | | | - C Agaesse
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | | | - L Sellem
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | - E Kesse-Guyot
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | | | - M Touvier
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
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13
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Srour B, Chazelas E, Debras C, Druesne-Pecollo N, Agaesse C, Szabo de Edelenyi F, Sellem L, Kesse-Guyot E, Deschasaux-Tanguy M, Touvier M. Nitrites and nitrates dietary exposure from natural sources and additives and type-2 diabetes risk. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Nitrates and nitrites occur naturally in water and soil and are commonly ingested from drinking water and dietary sources. They are also used as food additives. The epidemiological evidence linking exposure to nitrites/nitrates with type-2 diabetes (T2D) risk is scarce. We aimed to study these associations in a large population based prospective cohort study. Overall, 104,168 adults from the French NutriNet-Santé cohort study (median follow-up time 6.7 years) were included. Associations between intakes of nitrites and nitrates (evaluated using repeated 24h dietary records, linked to a comprehensive food composition database and accounting for details of commercial names/brands of industrial products) and risk of T2D were assessed using cause-specific multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). During follow-up, 969 incident T2D cases were ascertained. Total nitrites and nitrites from natural sources were both positively associated with higher T2D risk (HRtertile 3 vs.1=1.29 (95% CI 1.06-1.56), Ptrend=0.004, and 1.27 (95% CI 1.05-1.54), Ptrend=0.01, respectively). Participants with higher exposure to nitrites from food additives (i.e. above the sex-specific median), and specifically those having higher exposure to sodium nitrite (e250) had a higher T2D risk compared with those who were not exposed to food additive nitrites (HRtertile 3 vs.1=1.58 (95% CI 1.28-1.94), Ptrend<0.001, and 1.59 (95% CI 1.30-1.96), Ptrend<0.001), respectively). There was no evidence for an association between nitrates of any source and T2D risk (all Ptrend>0.4). In this large prospective cohort, a higher dietary exposure to nitrites (from both natural sources and food additives) was associated with higher T2D risk. These results provide additional evidence in the context of current discussions about updating regulations on the use of nitrites as food additives.
Key messages
• A high exposure to dietary nitrites (from both natural and food additive sources) is associated with an increased risk of type-2 diabetes.
• These findings support further regulations concerning the use of nitrites as food additives in processed meats.
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Affiliation(s)
- B Srour
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | - E Chazelas
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | - C Debras
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | | | - C Agaesse
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | | | - L Sellem
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | - E Kesse-Guyot
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
| | | | - M Touvier
- EREN, Inserm, Inrae, Cnam, USPN, INSERM , Bobigny, France
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14
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Charreire H, Verdot C, Szabo de Edelenyi F, Deschasaux-Tanguy M, Srour B, Druesne-Pecollo N, Esseddik Y, Allès B, Baudry J, Deschamps V, Salanave B, Galan P, Hercberg S, Julia C, Kesse-Guyot E, Bellicha A, Touvier M, Oppert JM. Correlates of Changes in Physical Activity and Sedentary Behaviors during the COVID-19 Lockdown in France: The NutriNet-Santé Cohort Study. Int J Environ Res Public Health 2022; 19:ijerph191912370. [PMID: 36231670 PMCID: PMC9564572 DOI: 10.3390/ijerph191912370] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/17/2022] [Accepted: 09/24/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND COVID-19 lockdowns represent natural experiments where limitations of movement impact on lifestyle behaviors. The aim of this paper was to assess how lockdowns have influenced physical activity and sedentary behaviors among French adults. METHODS 32,409 adults from the NutriNet-Santé study filled out questionnaires in April 2020 (the first 2 weeks after the start of lockdown) and in May 2020 (2 weeks before the lockdown ended). Participants were asked about changes in physical activity level and sitting time, types of physical activity performed, and main reasons for change. RESULTS For decreased physical activity, similar rates were found at the beginning and end of the lockdown (58 and 55%-56 and 53%, in women and men, respectively). For increased physical activity, the figures were lower (20 and 14%-23 and 18%, in women and men, respectively). The participants with a decreasing physical activity evolution were older and more likely to be living in urban areas. The main reasons for (i) decreased physical activity were limitations of movement and not liking indoor exercise, (ii) increased physical activity were to stay physically fit and healthy. Physical activity changes were inversely associated with reported depressive symptoms. CONCLUSIONS Changes in physical activity and sedentary behaviors are heterogenous for both genders during the lockdown.
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Affiliation(s)
- Hélène Charreire
- Université Paris-Est Créteil, Lab’Urba, 94000 Créteil, France
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
- Institute Universitaire de France (IUF), 75005 Paris, France
- Correspondence:
| | - Charlotte Verdot
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Julia Baudry
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Valérie Deschamps
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Benoit Salanave
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, 93000 Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, 93000 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | | | - Alice Bellicha
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
| | - Jean-Michel Oppert
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University Paris Cité (CRESS), 93017 Bobigny, France
- Human Nutrition Research Center Ile-de-France (CRNH IdF), Pitié-Salpêtrière Hospital (AP-HP), Department of Nutrition, Sorbonne University, 75013 Paris, France
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15
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Debras C, Chazelas E, Sellem L, Porcher R, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Agaësse C, De Sa A, Lutchia R, Fezeu LK, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Deschasaux-Tanguy M, Huybrechts I, Srour B, Touvier M. Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort. BMJ 2022; 378:e071204. [PMID: 36638072 PMCID: PMC9449855 DOI: 10.1136/bmj-2022-071204] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To study the associations between artificial sweeteners from all dietary sources (beverages, but also table top sweeteners, dairy products, etc), overall and by molecule (aspartame, acesulfame potassium, and sucralose), and risk of cardiovascular diseases (overall, coronary heart disease, and cerebrovascular disease). DESIGN Population based prospective cohort study (2009-21). SETTING France, primary prevention research. PARTICIPANTS 103 388 participants of the web based NutriNet-Santé cohort (mean age 42.2±14.4, 79.8% female, 904 206 person years). Dietary intakes and consumption of artificial sweeteners were assessed by repeated 24 h dietary records, including brand names of industrial products. MAIN OUTCOMES MEASURES Associations between sweeteners (coded as a continuous variable, log10 transformed) and cardiovascular disease risk, assessed by multivariable adjusted Cox hazard models. RESULTS Total artificial sweetener intake was associated with increased risk of cardiovascular diseases (1502 events, hazard ratio 1.09, 95% confidence interval 1.01 to 1.18, P=0.03); absolute incidence rate in higher consumers (above the sex specific median) and non-consumers was 346 and 314 per 100 000 person years, respectively. Artificial sweeteners were more particularly associated with cerebrovascular disease risk (777 events, 1.18, 1.06 to 1.31, P=0.002; incidence rates 195 and 150 per 100 000 person years in higher and non-consumers, respectively). Aspartame intake was associated with increased risk of cerebrovascular events (1.17, 1.03 to 1.33, P=0.02; incidence rates 186 and 151 per 100 000 person years in higher and non-consumers, respectively), and acesulfame potassium and sucralose were associated with increased coronary heart disease risk (730 events; acesulfame potassium: 1.40, 1.06 to 1.84, P=0.02; incidence rates 167 and 164; sucralose: 1.31, 1.00 to 1.71, P=0.05; incidence rates 271 and 161). CONCLUSIONS The findings from this large scale prospective cohort study suggest a potential direct association between higher artificial sweetener consumption (especially aspartame, acesulfame potassium, and sucralose) and increased cardiovascular disease risk. Artificial sweeteners are present in thousands of food and beverage brands worldwide, however they remain a controversial topic and are currently being re-evaluated by the European Food Safety Authority, the World Health Organization, and other health agencies. TRIAL REGISTRATION ClinicalTrials.gov NCT03335644.
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Affiliation(s)
- Charlotte Debras
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Eloi Chazelas
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Laury Sellem
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Raphaël Porcher
- Université de Paris, CRESS UMR1153, INSERM, INRA, Paris, France
- Centre d'Épidémiologie Clinique, AP-HP, Hôtel-Dieu, Paris, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
| | - Cédric Agaësse
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
| | - Alexandre De Sa
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
| | - Rebecca Lutchia
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
| | - Léopold K Fezeu
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Chantal Julia
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Inge Huybrechts
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Bernard Srour
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre, University of Paris (CRESS), Bobigny, France
- French network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
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16
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Le Floch E, Cosentino T, Larsen CK, Beuschlein F, Reincke M, Amar L, Rossi GP, De Sousa K, Baron S, Chantalat S, Saintpierre B, Lenzini L, Frouin A, Giscos-Douriez I, Ferey M, Abdellatif AB, Meatchi T, Empana JP, Jouven X, Gieger C, Waldenberger M, Peters A, Cusi D, Salvi E, Meneton P, Touvier M, Deschasaux M, Druesne-Pecollo N, Boulkroun S, Fernandes-Rosa FL, Deleuze JF, Jeunemaitre X, Zennaro MC. Identification of risk loci for primary aldosteronism in genome-wide association studies. Nat Commun 2022; 13:5198. [PMID: 36057693 PMCID: PMC9440917 DOI: 10.1038/s41467-022-32896-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Primary aldosteronism affects up to 10% of hypertensive patients and is responsible for treatment resistance and increased cardiovascular risk. Here we perform a genome-wide association study in a discovery cohort of 562 cases and 950 controls and identify three main loci on chromosomes 1, 13 and X; associations on chromosome 1 and 13 are replicated in a second cohort and confirmed by a meta-analysis involving 1162 cases and 3296 controls. The association on chromosome 13 is specific to men and stronger in bilateral adrenal hyperplasia than aldosterone producing adenoma. Candidate genes located within the two loci, CASZ1 and RXFP2, are expressed in human and mouse adrenals in different cell clusters. Their overexpression in adrenocortical cells suppresses mineralocorticoid output under basal and stimulated conditions, without affecting cortisol biosynthesis. Our study identifies the first risk loci for primary aldosteronism and highlights new mechanisms for the development of aldosterone excess. Detection of primary aldosteronism, the most common form of secondary arterial hypertension, is essential for targeted management and prevention of cardiovascular complications. Here, the authors identify genetic loci associated with primary aldosteronism, suggesting new mechanisms of disease.
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Affiliation(s)
- Edith Le Floch
- Centre National de Recherche en Génomique Humaine, Institut de biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | | | - Casper K Larsen
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Felix Beuschlein
- Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, 80336, Munich, Germany.,Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich (USZ) und Universität Zürich (UZH), Zürich, Switzerland
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, 80336, Munich, Germany
| | - Laurence Amar
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Unité Hypertension artérielle, Paris, France
| | - Gian-Paolo Rossi
- DMCS 'G. Patrassi' University of Padova Medical School, University Hospital, 35126, Padova, Italy
| | - Kelly De Sousa
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Stéphanie Baron
- Université Paris Cité, F-75006, Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Physiologie, Paris, France
| | - Sophie Chantalat
- Centre National de Recherche en Génomique Humaine, Institut de biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Benjamin Saintpierre
- Université Paris Cité, Institut Cochin, Genom'IC platform, INSERM, CNRS, 75014, Paris, France
| | - Livia Lenzini
- DMCS 'G. Patrassi' University of Padova Medical School, University Hospital, 35126, Padova, Italy
| | - Arthur Frouin
- Centre National de Recherche en Génomique Humaine, Institut de biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | | | - Matthis Ferey
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | | | - Tchao Meatchi
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service d'Anatomie Pathologique, Paris, France
| | | | - Xavier Jouven
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Cardiologie, Paris, France
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Research Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany.,German Research Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Daniele Cusi
- Institute of Biomedical Technologies National Research Council of Italy, Milan, Italy.,Bio4Dreams-Business Nursery for Life Sciences, Milan, Italy
| | - Erika Salvi
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico 'Carlo Besta', Milan, Italy
| | - Pierre Meneton
- UMR_1142, INSERM, Sorbonne Université, Université Paris 13, Paris, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), 93017, Bobigny, France
| | - Mélanie Deschasaux
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), 93017, Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), 93017, Bobigny, France
| | | | | | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine, Institut de biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Xavier Jeunemaitre
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France
| | - Maria-Christina Zennaro
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France. .,Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France.
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17
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Reuzé A, Méjean C, Carrère M, Sirieix L, Druesne-Pecollo N, Péneau S, Touvier M, Hercberg S, Kesse-Guyot E, Allès B. Rebalancing meat and legume consumption: change-inducing food choice motives and associated individual characteristics in non-vegetarian adults. Int J Behav Nutr Phys Act 2022; 19:112. [PMID: 36050684 PMCID: PMC9438278 DOI: 10.1186/s12966-022-01317-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/13/2022] [Indexed: 11/26/2022] Open
Abstract
Background A shift toward more plant-based foods in diets is required to improve health and to reduce environmental impact. Little is known about food choice motives and associated characteristics of those individuals who have actually reduced their consumption of animal-based foods. The aim of this cross-sectional study was to identify change-inducing motives related to meat and legume consumptions among non-vegetarians. The association between change-inducing motives and individual characteristics was also studied. Methods This study included 25,393 non-vegetarian participants in the French NutriNet-Santé cohort (77.4% women, mean age 55.4 ± 13.9 y.). The motives related to the declared change in meat and legume consumptions (e.g., taste, environment, social pressure) were assessed by an online questionnaire in 2018. For each motive, respondents could be classified into three groups: no motive; motive, not change-inducing; change-inducing motive. Associations between change-inducing motives and individual characteristics were evaluated using multivariable polytomic logistic regressions. Characteristics of participants who rebalanced their meat and legume consumptions were also compared to those who reduced their meat but did not increase their legume consumption. Results Motives most strongly declared as having induced a change in meat or legume consumptions were health and nutrition (respectively 90.7 and 81.0% declared these motives as change-inducing for the meat reduction), physical environment (82.0% for meat reduction only) and taste preferences (77.7% for legume increase only). Other motives related to social influences, meat avoidance and meat dislike were reported by fewer individuals, but were declared as having induced changes in food consumption. Most motives that induced a meat reduction and a legume increase were more likely to be associated with specific individual characteristics, for example being a woman or highly educated for health motives. Conclusions Besides the motives reported as important, some motives less frequently felt important were declared as having induced changes in meat or legume consumptions. Change-inducing motives were reported by specific subpopulations. Public campaigns on health and sustainability could usefully develop new tools to reach populations less willing to change. Trial registrations The study was registered at ClinicalTrials.gov (NCT03335644). Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01317-w.
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Affiliation(s)
- Anouk Reuzé
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France. .,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France.
| | - Caroline Méjean
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Myriam Carrère
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Lucie Sirieix
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Nathalie Druesne-Pecollo
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Sandrine Péneau
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Mathilde Touvier
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Serge Hercberg
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France.,Department of Public Health, AP-HP Hôpital Avicenne, 93017, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Benjamin Allès
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
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18
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Chazelas E, Pierre F, Druesne-Pecollo N, Esseddik Y, Szabo de Edelenyi F, Agaesse C, De Sa A, Lutchia R, Gigandet S, Srour B, Debras C, Huybrechts I, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Nitrites and nitrates from food additives and natural sources and cancer risk: results from the NutriNet-Santé cohort. Int J Epidemiol 2022; 51:1106-1119. [PMID: 35303088 PMCID: PMC9365633 DOI: 10.1093/ije/dyac046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/16/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Nitrates and nitrites occur naturally in water and soil. They are also used as food additives (preservatives) in processed meats. They could play a role in the carcinogenicity of processed meat. The objective was to investigate the relationship between nitrate and nitrite intakes (natural food, water and food additive sources) and cancer risk in a large prospective cohort with detailed dietary assessment. METHODS Overall, 101 056 adults from the French NutriNet-Santé cohort (2009-ongoing, median follow-up 6.7 years) were included. Nitrites/nitrates exposure was evaluated using repeated 24-h dietary records, linked to a comprehensive composition database and accounting for commercial names/brands of industrial products. Associations with cancer risk were assessed using multi-adjusted Cox hazard models. RESULTS In total, 3311 incident cancer cases were diagnosed. Compared with non-consumers, high consumers of food additive nitrates had higher breast cancer risk [hazard ratio (HR) = 1.24 (95% CI 1.03-1.48), P = 0.02], more specifically for potassium nitrate. High consumers of food additive nitrites had higher prostate cancer risk [HR = 1.58 (1.14-2.18), P = 0.008], specifically for sodium nitrite. Although similar HRs were observed for colorectal cancer for additive nitrites [HR = 1.22 (0.85-1.75)] and nitrates [HR = 1.26 (0.90-1.76)], no association was detected, maybe due to limited statistical power for this cancer location. No association was observed for natural sources. CONCLUSION Food additive nitrates and nitrites were positively associated with breast and prostate cancer risks, respectively. Although these results need confirmation in other large-scale prospective studies, they provide new insights in a context of lively debate around the ban of these additives from the food industry.
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Affiliation(s)
- Eloi Chazelas
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Fabrice Pierre
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
| | - Cédric Agaesse
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
| | - Alexandre De Sa
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
| | - Rebecca Lutchia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
| | | | - Bernard Srour
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Charlotte Debras
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Inge Huybrechts
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France
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19
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Debras C, Chazelas E, Srour B, Druesne-Pecollo N, Esseddik Y, Szabo de Edelenyi F, Agaësse C, De Sa A, Lutchia R, Gigandet S, Huybrechts I, Julia C, Kesse-Guyot E, Allès B, Andreeva VA, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study. PLoS Med 2022; 19:e1003950. [PMID: 35324894 PMCID: PMC8946744 DOI: 10.1371/journal.pmed.1003950] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/23/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The food industry uses artificial sweeteners in a wide range of foods and beverages as alternatives to added sugars, for which deleterious effects on several chronic diseases are now well established. The safety of these food additives is debated, with conflicting findings regarding their role in the aetiology of various diseases. In particular, their carcinogenicity has been suggested by several experimental studies, but robust epidemiological evidence is lacking. Thus, our objective was to investigate the associations between artificial sweetener intakes (total from all dietary sources, and most frequently consumed ones: aspartame [E951], acesulfame-K [E950], and sucralose [E955]) and cancer risk (overall and by site). METHODS AND FINDINGS Overall, 102,865 adults from the French population-based cohort NutriNet-Santé (2009-2021) were included (median follow-up time = 7.8 years). Dietary intakes and consumption of sweeteners were obtained by repeated 24-hour dietary records including brand names of industrial products. Associations between sweeteners and cancer incidence were assessed by Cox proportional hazards models, adjusted for age, sex, education, physical activity, smoking, body mass index, height, weight gain during follow-up, diabetes, family history of cancer, number of 24-hour dietary records, and baseline intakes of energy, alcohol, sodium, saturated fatty acids, fibre, sugar, fruit and vegetables, whole-grain foods, and dairy products. Compared to non-consumers, higher consumers of total artificial sweeteners (i.e., above the median exposure in consumers) had higher risk of overall cancer (n = 3,358 cases, hazard ratio [HR] = 1.13 [95% CI 1.03 to 1.25], P-trend = 0.002). In particular, aspartame (HR = 1.15 [95% CI 1.03 to 1.28], P = 0.002) and acesulfame-K (HR = 1.13 [95% CI 1.01 to 1.26], P = 0.007) were associated with increased cancer risk. Higher risks were also observed for breast cancer (n = 979 cases, HR = 1.22 [95% CI 1.01 to 1.48], P = 0.036, for aspartame) and obesity-related cancers (n = 2,023 cases, HR = 1.13 [95% CI 1.00 to 1.28], P = 0.036, for total artificial sweeteners, and HR = 1.15 [95% CI 1.01 to 1.32], P = 0.026, for aspartame). Limitations of this study include potential selection bias, residual confounding, and reverse causality, though sensitivity analyses were performed to address these concerns. CONCLUSIONS In this large cohort study, artificial sweeteners (especially aspartame and acesulfame-K), which are used in many food and beverage brands worldwide, were associated with increased cancer risk. These findings provide important and novel insights for the ongoing re-evaluation of food additive sweeteners by the European Food Safety Authority and other health agencies globally. TRIAL REGISTRATION ClinicalTrials.gov NCT03335644.
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Affiliation(s)
- Charlotte Debras
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Eloi Chazelas
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Bernard Srour
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Cédric Agaësse
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Alexandre De Sa
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Rebecca Lutchia
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | | | - Inge Huybrechts
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Chantal Julia
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Assistance Publique–Hôpitaux de Paris, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Valentina A. Andreeva
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
- Public Health Department, Avicenne Hospital, Assistance Publique–Hôpitaux de Paris, Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
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20
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Chazelas E, Pierre F, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Agaesse C, De Sa A, Lutchia R, Gigandet S, Srour B, Debras C, Huybrechts I, Julia C, Kesse-Guyot E, Allès B, Zelek L, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Abstract P1-09-01: Breast and prostate cancer risk associated with nitrites and nitrates from food additives: Results from the NutriNet-Santé cohort. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p1-09-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Nitrates and nitrites occur naturally in water and soil and are commonly ingested from drinking water and dietary sources. They are also used as food additives in processed meats to increase shelf life and to avoid bacterial growth. These compounds could have a role in the carcinogenicity of processed meat. Objective To investigate the relationship between nitrate and nitrite intakes (distinguishing between natural food, water and food additive sources) and the risk of cancer in a large prospective cohort with detailed and up to date dietary assessment. Design Population based prospective cohort study. Setting Overall, 101,056 adults from the French NutriNet-Santé cohort study (2009-ongoing) were included. Consumption of nitrites and nitrates was evaluated using repeated 24h dietary records, linked to a comprehensive food composition database and accounting for details of commercial names/brands of industrial products. Main outcome measures Associations between nitrite and nitrate exposures and the risk of cancer (overall and by main cancer sites) were assessed by Cox hazard models adjusted for known risk factors. Results During follow-up, 3311 first incident cancer cases were diagnosed (among which 966 breast and 400 prostate cancers). Compared with non-consumers, higher consumers of nitrates from food additives had higher risk of breast cancer (HR=1.24 (1.03-1.48), P=0.02); this was more specifically observed for potassium nitrate (e252, HR=1.25 (1.04-1.50), P=0.01). Higher consumers of nitrites from food additives had higher risk of prostate cancer (HR=1.58 (1.14-2.18), P=0.008), specifically for sodium nitrite (e250, HR=1.62 (1.17-2.25), P=0.004). No significant association was observed for nitrates and nitrites from natural sources. Conclusions In this large prospective cohort, food additive nitrates were positively associated with breast cancer risk and food additive nitrites were positively associated with prostate cancer risk. While these results need confirmation in other large-scale prospective studies, they provide new insights in a context of lively debate around the ban of nitrite additives in the food industry. Study registration The NutriNet-Santé cohort is registered at clinicaltrials.gov (NCT03335644).
Citation Format: Eloi Chazelas, Fabrice Pierre, Nathalie Druesne-Pecollo, Younes Esseddik, Fabien Szabo de Edelenyi, Cédric Agaesse, Alexandre De Sa, Rebecca Lutchia, Stéphane Gigandet, Bernard Srour, Charlotte Debras, Inge Huybrechts, Chantal Julia, Emmanuelle Kesse-Guyot, Benjamin Allès, Laurent Zelek, Pilar Galan, Serge Hercberg, Mélanie Deschasaux-Tanguy, Mathilde Touvier. Breast and prostate cancer risk associated with nitrites and nitrates from food additives: Results from the NutriNet-Santé cohort [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-09-01.
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Affiliation(s)
- Eloi Chazelas
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Fabrice Pierre
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France, Toulouse, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Cédric Agaesse
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Alexandre De Sa
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Rebecca Lutchia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | | | - Bernard Srour
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Charlotte Debras
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Laurent Zelek
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
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Wendeu-Foyet G, Chajes V, Huybrechts I, Bard JM, Debras C, Chazelas E, Srour B, Zelek L, Julia C, Kesse-Guyot E, Agaësse C, Druesne-Pecollo N, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Abstract P3-12-35: Industrial and ruminant trans fatty acid intakes and cancer risk: Results from the NutriNet-Santé cohort. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p3-12-35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Dietary trans fatty acids (TFAs) are either natural (from ruminant sources) or generated through industrial processes by partial hydrogenation of vegetable oils. Extended evidence demonstrated their role as cardiovascular risk factors. In contrast, their involvement in cancer etiology is suspected, but epidemiological evidence remains limited. Objectives Our objective was to investigate associations between TFA intake of different types (total, rumninant [rTFAs], industrial [iTFAs], and corresponding specific isomers) and the risk of cancer (overall and main cancer sites) in the NutriNet-Santé prospective cohort (2009-2020). Methods Overall, 104,909 participants were included. Usual TFA intake was estimated from validated repeated 24-h dietary records matched with detailed composition table. Associations between sex-specific quartiles of TFA intake and cancer risk were assessed using multi-adjusted Cox proportional hazard models. Results A total of 3,374 incident cancer cases occured during follow-up (among which 982 breast and 405 prostate cancers). Dietary intake of total TFAs was associated with higher prostate cancer risk (HRfor quartile 4 versus 1: 1.27, 1.11-1.77 Ptrend=0.005). rTFAs were associated with increased overall cancer risk (1.16, 1.02-1.32 Ptrend=0.07), in particular the conjugated linoleic acid isomers (CLA) (1.19, 1.04-1.36 Ptrend=0.04). These associations were specifically observed for breast cancer (rTFAs: 1.35, 1.06-1.72 Ptrend=0.01; CLA: 1.29, 1.00-1.66 Ptrend=0.048), in particular before menopause (rTFAs: 1.68, 1.06-2.67 Ptrend=0.02; CLA: 2.013, 1.25-3.23 Ptrend=0.003). Several iTFAs were associated with overall (1.18, 1.06-1.31 Ptrend=0.02 for transdocosenoic acid), breast (isomer 18:2t: 1.30, 1.06-1.58 Ptrend=0.01; hexadecenoic acid: 1.28, 1.05-1.56 Ptrend=0.02) and prostate (transdocosenoic acid: 1.52, 1.09-2.12 Ptrend=0.07) cancer risks. Conclusion In this large prospective study, several types of TFAs were associated with increased overall, breast and prostate cancer risks. Although further studies are needed to better understand underlying mechanisms, these results support the WHO's goal of achieving industrially produced TFAs elimination from food supplies. Meanwhile, the consumption of food products containing partially-hydrogenated oils should be avoided.
Citation Format: Gaëlle Wendeu-Foyet, Véronique Chajes, Inge Huybrechts, Jean-Marie Bard, Charlotte Debras, Eloi Chazelas, Bernard Srour, Laurent Zelek, Chantal Julia, Emmanuelle Kesse-Guyot, Cédric Agaësse, Nathalie Druesne-Pecollo, Pilar Galan, Serge Hercberg, Mélanie Deschasaux-Tanguy, Mathilde Touvier. Industrial and ruminant trans fatty acid intakes and cancer risk: Results from the NutriNet-Santé cohort [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-12-35.
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Affiliation(s)
- Gaëlle Wendeu-Foyet
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Véronique Chajes
- Nutrition and Metabolism Branch- International Agency for Research on Cancer, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Branch- International Agency for Research on Cancer, Lyon, France
| | - Jean-Marie Bard
- Laboratoire de Biochimie Générale et Appliquée- UFR de Pharmacie- MMS-EA 2160-Mer Molécules Santé- IUML-Institut Universitaire Mer et Littoral-FR3473 CNRS, Nantes, France
| | - Charlotte Debras
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Eloi Chazelas
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Laurent Zelek
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Cédric Agaësse
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University- INSERM U1153- INRAe U1125- CNAM- Nutritional Epidemiology Research Team (EREN)- Epidemiology and Statistics Research Center – University of Paris (CRESS), Bobigny, France
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Debras C, Chazelas E, Srour B, Druesne-Pecollo N, Essedik Y, de Edelenyi FS, Agaësse C, De Sa A, Lutchia R, Gigandet S, Huybrechts I, Julia C, Kesse-Guyot E, Zelek L, Allès B, Andreeva VA, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Abstract P1-09-02: Risk of breast and other cancers associated with the consumption of artificial sweeteners: Results from the prospective NutriNet-Santé cohort. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p1-09-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Added sugars’ deleterious effects have been established for several chronic diseases, leading food industries to use artificial sweeteners as alternatives in a wide range of foods and beverages. Their safety is debated and findings remain contrasted regarding their role in the etiology of various diseases. In particular, their carcinogenicity has been suggested by several experimental studies but robust epidemiological evidence is lacking. Objective: The objective was to investigate the associations between sweetener intakes (total from all dietary sources, and most frequently consumed ones: aspartame e951, acesulfame-K e950 and sucralose e955) and cancer risk (overall and by sites: breast, prostate and obesity-related cancers). Design: Population based prospective cohort study. Setting and Participants: Overall, 102,046 adults from the French NutriNet-Santé prospective cohort (2009-2021) were included. Consumption of sweeteners was obtained by repeated 24h-dietary records including brands and commercial names of industrial products. Associations between sweeteners and cancer incidence were assessed by multi-adjusted Cox hazard models. Main outcome measures: Association between sweetener intakes and cancer risk were assessed by Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). Results: Compared to non-consumers, higher consumers of total sweeteners (i.e. above the median exposure in consumers) had higher risk of overall cancer (n=2,527 cases, hazard ratio=1.12, 95% confidence interval=1.00-1.25, P-trend=0.005). In particular, aspartame (HR=1.20 [1.05-1.38] P=0.001) and acesulfame-K (HR=1.18 [1.04-1.34] P=0.003) were associated with increased cancer risk. Similarly, higher risks were observed for breast (n=723 cases, HR=1.25 [1.02-1.53] P=0.01 for total sweeteners, HR=1.33 [1.05-1.69] P=0.007 for aspartame and HR=1.39 [1.11-1.74] P=0.003, for acesulfame-K) and obesity-related cancers. (n=1,509 cases, HR=1.16 [1.00-1.33] P=0.02 for total sweeteners, HR=1.22 [1.02-1.45] P=0.01 for aspartame and HR=1.23 [1.04-1.45] P=0.01, for acesulfame-K). Conclusion: In this large prospective cohort, artificial sweeteners (especially aspartame and acesulfame-K), which are found in >10,000 foods and beverage references worldwide, were associated with increased cancer risk. These findings provide important and novel insights for the ongoing re-evaluation of food additive sweeteners by the European Food Safety Authority and other health agencies globally.
Citation Format: Charlotte Debras, Eloi Chazelas, Bernard Srour, Nathalie Druesne-Pecollo, Younes Essedik, Fabien Szabo de Edelenyi, Cédric Agaësse, Alexandre De Sa, Rebecca Lutchia, Stéphane Gigandet, Inge Huybrechts, Chantal Julia, Emmanuelle Kesse-Guyot, Laurent Zelek, Benjamin Allès, Valentina A. Andreeva, Pilar Galan, Serge Hercberg, Mélanie Deschasaux-Tanguy, Mathilde Touvier. Risk of breast and other cancers associated with the consumption of artificial sweeteners: Results from the prospective NutriNet-Santé cohort [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-09-02.
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Affiliation(s)
- Charlotte Debras
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Eloi Chazelas
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Bernard Srour
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Younes Essedik
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Cédric Agaësse
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Alexandre De Sa
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Rebecca Lutchia
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | | | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Chantal Julia
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Laurent Zelek
- Oncology Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Benjamin Allès
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Valentina A. Andreeva
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Pilar Galan
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Serge Hercberg
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | | | - Mathilde Touvier
- Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
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Chazelas E, Pierre F, Druesne-Pecollo N, Esseddik Y, Szabo De Edelenyi F, Agaesse C, De Sa A, Lutchia R, Gigandet S, Srour B, Debras C, Huybrechts I, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Deschasaux M, Touvier M. Nitrites et nitrates provenant d’additifs alimentaires et de sources naturelles et risque de cancer : résultats de la cohorte NutriNet-Santé. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Robert M, Deschasaux-Tanguy M, Shankland R, Druesne-Pecollo N, Esseddik Y, Szabo de Edelenyi F, Baudry J, Galan P, Hercberg S, Touvier M, Péneau S. Les traits psychologiques positifs sont associés aux changements de comportement alimentaire liés au confinement du COVID-19 dans la cohorte NutriNet-Santé. NUTR CLIN METAB 2022. [PMCID: PMC8900969 DOI: 10.1016/j.nupar.2021.12.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction et but de l’étude La propagation du coronavirus (COVID-19) a eue pour conséquence la mise en place de mesures strictes de confinement, ayant entraîné des changements dans les comportements alimentaires. Les traits psychologiques sont des déterminants bien connus du comportement alimentaire. L’objectif de cette étude était donc d’étudier les associations entre les traits psychologiques positifs et les changements dans le grignotage et la consommation de groupes alimentaires pendant la période du confinement. Méthodes En 2016, les niveaux d’optimisme, de résilience, d’estime de soi, de satisfaction de la vie, de pleine conscience et de maîtrise ont été mesurés chez 33 766 adultes de la cohorte NutriNet-Santé. Le grignotage et la consommation de groupes d’aliments ont été évalués en avril–mai 2020. L’association entre les traits psychologiques et les changements dans le grignotage et la consommation de groupes alimentaires a été évaluée à l’aide de régressions logistiques, ajustées sur les caractéristiques sociodémographiques et le mode de vie, l’anxiété et la symptomatologie dépressive. Résultats Les participants présentant des niveaux plus élevés d’optimisme, de résilience, d’estime de soi, de satisfaction de la vie, de pleine conscience ou de maîtrise étaient moins susceptibles d’avoir des changements dans leur comportement de grignotage et leur consommation de divers groupes alimentaires. Conclusion Les personnes présentant des niveaux de traits psychologiques plus élevés ont été moins affectées par le confinement en termes de comportement alimentaire, alors que les personnes ayant des niveaux plus faibles ont montré des changements favorables et défavorables dans leur comportement alimentaire global.
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Debras C, Chazelas E, Julia C, Schneider E, Kesse-Guyot E, Agaësse C, Druesne-Pecollo N, Andreeva V, Wendeu-Foyet G, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. FODMAPs et risque de cancer dans la cohorte NutriNet-Santé. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Robert M, Deschasaux-Tanguy M, Shankland R, Druesne-Pecollo N, Esseddik Y, Szabo de Edelenyi F, Baudry J, Galan P, Hercberg S, Touvier M. Association between positive psychological traits and changes in dietary behaviour related to first COVID-19 lockdown: A general population-based study. Appetite 2021; 171:105885. [PMID: 34958832 PMCID: PMC8704735 DOI: 10.1016/j.appet.2021.105885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 11/17/2022]
Abstract
Background The spread of the coronavirus disease (COVID-19) led many countries to implement lockdown measures, which resulted in changes in dietary behaviours that could persist over the long term and have associated health consequences. Psychological traits may impact these changes given their known association with dietary behaviours. We aimed to investigate in a population-based study, whether positive psychological traits were associated with changes of snacking behaviour and food consumption observed during the first COVID-19 lockdown period. Design In 2016, levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness and mastery were assessed in 33,766 adults of the French NutriNet-Santé cohort. Snacking and food group consumption were assessed in April–May 2020. Association between psychological traits and changes (no change, increase, decrease) in snacking and food group consumption were assessed using logistic regressions. Multiple correspondence analysis followed by ascending hierarchical classification were used to derive clusters of dietary behaviours. Covariance analyses were used to compare mean scores of psychological traits between clusters. Analyses were adjusted for sociodemographic and lifestyle characteristics, anxiety and depressive symptomatology. Results Participants with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less likely to change their snacking behaviour and food group consumption of various food groups. Individuals with lower levels were more likely to make changes, with either unhealthy (e.g., less fruits and vegetables, more processed meat) or healthy (e.g., more pasta/rice (whole-grain)) changes. Overall, individuals showed higher levels of positive psychological traits in the “no change” cluster, followed by the “healthy” and the “unhealthy” cluster (all P < 0.05). Conclusions Individuals with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less impacted by the lockdown in terms of dietary behaviours.
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Affiliation(s)
- Margaux Robert
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France.
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Rebecca Shankland
- DIPHE Laboratory (Development, Individual, Personality, Handicap, Education), University Lumière Lyon 2, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Julia Baudry
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
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Deschasaux-Tanguy M, Srour B, Bourhis L, Arnault N, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Allègre J, Allès B, Andreeva VA, Baudry J, Fezeu LK, Galan P, Julia C, Kesse-Guyot E, Péneau S, Hercberg S, Bajos N, Severi G, Zins M, de Lamballerie X, Carrat F, Touvier M. Nutritional risk factors for SARS-CoV-2 infection: a prospective study within the NutriNet-Santé cohort. BMC Med 2021; 19:290. [PMID: 34844606 PMCID: PMC8629697 DOI: 10.1186/s12916-021-02168-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Nutritional factors are essential for the functioning of the immune system and could therefore play a role in COVID-19 but evidence is needed. Our objective was to study the associations between diet and the risk of SARS-CoV-2 infection in a large population-based sample. METHODS Our analyses were conducted in the French prospective NutriNet-Santé cohort study (2009-2020). Seroprevalence of anti-SARS-CoV-2 antibodies was assessed by ELISA on dried blood spots. Dietary intakes were derived from repeated 24 h dietary records (at least 6) in the two years preceding the start of the COVID-19 pandemic in France (February 2020). Multi-adjusted logistic regression models were computed. RESULTS A total of 7766 adults (70.3% women, mean age: 60.3 years) were included, among which 311 were positive for anti-SARS-CoV-2 antibodies. Dietary intakes of vitamin C (OR for 1 SD=0.86 (0.75-0.98), P=0.02), vitamin B9 (OR=0.84 (0.72-0.98), P=0.02), vitamin K (OR=0.86 (0.74-0.99), P=0.04), fibers (OR=0.84 (0.72-0.98), P=0.02), and fruit and vegetables (OR=0.85 (0.74-0.97), P=0.02) were associated to a decreased probability of SARS-CoV-2 infection while dietary intakes of calcium (OR=1.16 (1.01-1.35), P=0.04) and dairy products (OR=1.19 (1.06-1.33), P=0.002) associated to increased odds. No association was detected with other food groups or nutrients or with the overall diet quality. CONCLUSIONS Higher dietary intakes of fruit and vegetables and, consistently, of vitamin C, folate, vitamin K and fibers were associated with a lower susceptibility to SARS-CoV-2 infection. Beyond its established role in the prevention of non-communicable diseases, diet could therefore also contribute to prevent some infectious diseases such as COVID-19.
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Affiliation(s)
- Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France.
| | - Laurent Bourhis
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Nathalie Arnault
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Julien Allègre
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Julia Baudry
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Leopold K Fezeu
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Nathalie Bajos
- IRIS, UMR CNRS 8156, EHESS, Inserm U997, Aubervilliers, France
| | - Gianluca Severi
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP UMR1018, Villejuif, France
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Marie Zins
- Paris University, Paris, France
- Inserm UMS 11, Paris Saclay University, Villejuif, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents (UVE), Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection, Marseille, France
| | - Fabrice Carrat
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France
- Département de Santé Publique, APHP, Sorbonne Université, Paris, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
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Carrat F, de Lamballerie X, Rahib D, Blanché H, Lapidus N, Artaud F, Kab S, Renuy A, Szabo de Edelenyi F, Meyer L, Lydié N, Charles MA, Ancel PY, Jusot F, Rouquette A, Priet S, Saba Villarroel PM, Fourié T, Lusivika-Nzinga C, Nicol J, Legot S, Druesne-Pecollo N, Esseddik Y, Lai C, Gagliolo JM, Deleuze JF, Bajos N, Severi G, Touvier M, Zins M. Antibody status and cumulative incidence of SARS-CoV-2 infection among adults in three regions of France following the first lockdown and associated risk factors: a multicohort study. Int J Epidemiol 2021; 50:1458-1472. [PMID: 34293141 PMCID: PMC8344948 DOI: 10.1093/ije/dyab110] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND We aimed to estimate the seropositivity to anti-SARS-CoV-2 antibodies in May-June 2020 after the first lockdown period in adults living in three regions in France and to identify the associated risk factors. METHODS Between 4 May 2020 and 23 June 2020, 16 000 participants in a survey on COVID-19 from an existing consortium of three general adult population cohorts living in the Ile-de-France (IDF) or Grand Est (GE) (two regions with high rate of COVID-19) or in the Nouvelle-Aquitaine (NA) (with a low rate) were randomly selected to take a dried-blood spot for anti-SARS-CoV-2 antibodies assessment with three different serological methods (ClinicalTrial Identifier #NCT04392388). The primary outcome was a positive anti-SARS-CoV-2 ELISA IgG result against the spike protein of the virus (ELISA-S). Estimates were adjusted using sampling weights and post-stratification methods. Multiple imputation was used to infer the cumulative incidence of SARS-CoV-2 infection with adjustments for imperfect tests accuracies. RESULTS The analysis included 14 628 participants, 983 with a positive ELISA-S. The weighted estimates of seropositivity and cumulative incidence were 10.0% [95% confidence interval (CI): 9.1%, 10.9%] and 11.4% (95% CI: 10.1%, 12.8%) in IDF, 9.0% (95% CI: 7.7%, 10.2%) and 9.8% (95% CI: 8.1%, 11.8%) in GE and 3.1% (95% CI: 2.4%, 3.7%) and 2.9% (95% CI: 2.1%, 3.8%) in NA, respectively. Seropositivity was higher in younger participants [odds ratio (OR) = 1.84 (95% CI: 1.79, 6.09) in <40 vs 50-60 years old and OR = 0.56 (95% CI: 0.42, 0.74) in ≥70 vs 50-60 years old)] and when at least one child or adolescent lived in the same household [OR = 1.30 (95% CI: 1.11, 1.53)] and was lower in smokers compared with non-smokers [OR = 0.71 (95% CI: 0.57, 0.89)]. CONCLUSIONS Seropositivity to anti-SARS-CoV-2 antibodies in the French adult population was ≤10% after the first wave. Modifiable and non-modifiable risk factors were identified.
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Affiliation(s)
- Fabrice Carrat
- Sorbonne Université, Inserm, Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Paris, France
- Département de Santé Publique, APHP.Sorbonne Université, Paris, France
| | - Xavier de Lamballerie
- Unité des Virus Émergents, UVE: Aix Marseille Univ, IRD 190, Inserm 1207, IHU Méditerranée Infection, Marseille, France
| | | | - Hélène Blanché
- Fondation Jean Dausset-CEPH (Centre d’Etude du Polymorphisme Humain), CEPH-Biobank, Paris, France
| | - Nathanael Lapidus
- Sorbonne Université, Inserm, Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Paris, France
- Département de Santé Publique, APHP.Sorbonne Université, Paris, France
| | - Fanny Artaud
- CESP UMR1018, Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Villejuif, France
| | - Sofiane Kab
- Paris University, Paris, France
- Paris-Saclay University, Inserm UMS 11, Villejuif, France
| | - Adeline Renuy
- Paris University, Paris, France
- Paris-Saclay University, Inserm UMS 11, Villejuif, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Laurence Meyer
- Université Paris-Saclay, Inserm, CESP U1018, Le Kremlin Bicêtre, France
- Service de Santé Publique, APHP.Paris Saclay, Le Kremlin Bicêtre, France
| | | | | | - Pierre-Yves Ancel
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Statistics Sorbonne Paris Cité, Inserm U1153, Paris Descartes University, Paris, France
- Clinical Research Unit, Center for Clinical Investigation P1419, Cochin Broca Hôtel-Dieu Hospital, Paris, France
| | - Florence Jusot
- Université Paris-Dauphine, PSL-Research University, LEDa, Paris, France
| | - Alexandra Rouquette
- Université Paris-Saclay, Inserm, CESP U1018, Le Kremlin Bicêtre, France
- Service de Santé Publique, APHP.Paris Saclay, Le Kremlin Bicêtre, France
| | - Stéphane Priet
- Unité des Virus Émergents, UVE: Aix Marseille Univ, IRD 190, Inserm 1207, IHU Méditerranée Infection, Marseille, France
| | - Paola Mariela Saba Villarroel
- Unité des Virus Émergents, UVE: Aix Marseille Univ, IRD 190, Inserm 1207, IHU Méditerranée Infection, Marseille, France
| | - Toscane Fourié
- Unité des Virus Émergents, UVE: Aix Marseille Univ, IRD 190, Inserm 1207, IHU Méditerranée Infection, Marseille, France
| | - Clovis Lusivika-Nzinga
- Sorbonne Université, Inserm, Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Jérôme Nicol
- Sorbonne Université, Inserm, Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Stephane Legot
- Paris University, Paris, France
- Paris-Saclay University, Inserm UMS 11, Villejuif, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Cindy Lai
- Institut de Santé Publique, Pôle Recherche Clinique, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | | | - Jean-François Deleuze
- Fondation Jean Dausset-CEPH (Centre d’Etude du Polymorphisme Humain), CEPH-Biobank, Paris, France
| | | | - Gianluca Severi
- CESP UMR1018, Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Villejuif, France
- Department of Statistics, Computer Science and Applications, University of Florence, Florence, Italy
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Marie Zins
- Paris University, Paris, France
- Paris-Saclay University, Inserm UMS 11, Villejuif, France
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Carrat F, de Lamballerie X, Rahib D, Blanché H, Lapidus N, Artaud F, Kab S, Renuy A, Szabo de Edelenyi F, Meyer L, Lydié N, Charles MA, Ancel PY, Jusot F, Rouquette A, Priet S, Saba Villarroel PM, Fourié T, Lusivika-Nzinga C, Nicol J, Legot S, Druesne-Pecollo N, Esseddik Y, Lai C, Gagliolo JM, Deleuze JF, Bajos N, Severi G, Touvier M, Zins M. Corrigendum to: Antibody status and cumulative incidence of SARS-CoV-2 infection among adults in three regions of France following the first lockdown and associated risk factors: a multicohort study. Int J Epidemiol 2021; 50:1755. [PMID: 34453524 PMCID: PMC8787412 DOI: 10.1093/ije/dyab173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Debras C, Chazelas E, Srour B, Julia C, Schneider É, Kesse-Guyot E, Agaësse C, Druesne-Pecollo N, Andreeva VA, Wendeu-Foyet G, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAPs) and cancer risk in the prospective NutriNet-Santé cohort. J Nutr 2021; 152:1059-1069. [PMID: 36967163 DOI: 10.1093/jn/nxab379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/02/2021] [Accepted: 10/25/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Fermentable Oligosaccharides, Disaccharides and Monosaccharides And Polyols (FODMAPs) have been shown to be involved in gastrointestinal disorders. In view of their pro-inflammatory potential and their interactions with the gut microbiota, their contribution to the etiology of other chronic diseases such as cancer has been postulated. However, no epidemiological study has investigated this hypothesis so far. OBJECTIVE Our objective was to investigate the associations between FODMAP intake (total and by type) and cancer risk (overall, breast, prostate and colorectal) in a large prospective cohort. DESIGN The study was based on the NutriNet-Santé cohort (2009-2020); 104,909 adult participants without cancer at baseline were included in our analyses (median follow-up time = 7.7y, 78.7% women, mean age at baseline 42.1y (SD = 14.5)). Baseline dietary intakes were obtained from repeated 24h-dietary records linked to a detailed food composition table. Associations between FODMAP intake (expressed in quintiles, Q) and cancer risks were assessed by Cox proportional hazard models adjusted for a large range of lifestyle, sociodemographic and anthropometric variables. RESULTS Total FODMAP intake was associated with increased overall cancer risk (n = 3374 incident cases, HR for sex-specific Quintile 5 versus Quintile 1: 1.21; 95%CI: 1.02, 1.44; P-trend = 0.04). In particular, oligosaccharides were associated with cancer risk: a trend was observed for overall cancer (HR Q5 vs. Q1: 1.10; 95%CI: 0.97, 1.25; P-trend = 0.04) and colorectal cancer (n = 272, HR Q5 vs. Q1: 1.78; 95%CI: 1.13-2.79; P-trend = 0.02). CONCLUSION Results from this large population-based study on French adults from the NutriNet-Santé cohort show a significant association between FODMAP intake and the risk of cancer development. Further epidemiological and experimental studies are needed to confirm these results and provide data on the potential underlying mechanisms.
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Affiliation(s)
- Charlotte Debras
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France.
| | - Eloi Chazelas
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Bernard Srour
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Chantal Julia
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Élodie Schneider
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Cédric Agaësse
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Gaëlle Wendeu-Foyet
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Pilar Galan
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France; Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France; French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France
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Debras C, Chazelas E, Srour B, Julia C, Schneider É, Agaësse C, Druesne-Pecollo N, Hercberg S, Deschasaux-Tanguy M, Touvier M. Fermentable Oligo-, Di-, Monosaccharides and Polyols and cancer risk in the NutriNet-Santé cohort. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Fermentable Oligosaccharides, Disaccharides and Monosaccharides And Polyols (FODMAPs), which are found in a variety of foods (dairy products, fruit, legumes, refined grains, sugary beverages, etc.) have been involved in risk for gastrointestinal disorders. In view of their pro-inflammatory potential and their interactions with the gut microbiota, their contribution to the etiology of other chronic diseases such as cancer has been postulated. However, no epidemiological study has investigated this hypothesis so far. Our objective was to investigate the associations between FODMAP intake (total and by type) and cancer risk (overall, breast, prostate and colorectal).
Methods
104,909 French adults from the NutriNet-Santé prospective cohort (2009-2020) were included (median follow-up time=7.7y). FODMAP intakes were obtained from repeated 24h-dietary records linked to a detailed food composition table. Associations between FODMAPs and cancer risks were assessed by Cox proportional hazard models adjusted for a large range of lifestyle, sociodemographic and anthropometric variables.
Results
Total FODMAP intake was associated with increased overall cancer risk (n = 3,374 incident cases, Hazard Ratio for quintile 5 vs quintile 1=1.21, 95% confidence interval 1.02-1.44, P-trend=0.04). Oligosaccharides seemed to be the FODMAP type particularly associated with cancer risk: a trend was observed for overall cancer (HR = 1.10 (0.97-1.25) P-trend=0.04) and colorectal cancer (n = 272, HR = 1.78 (1.13-2.79) P-trend=0.02). Associations remained stable across a series of sensitivity analyses.
Conclusions
Our findings suggest a potential role of FODMAPs in cancer onset. Further epidemiological and experimental studies are needed to confirm these results and provide data on the potential underlying mechanisms.
Key messages
In this large-scale prospective cohort of French adults, FODMAP intake was associated with increased cancer risk. These associations need to be studied in other prospective cohorts, in order to clarify FODMAPs role in cancer development.
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Affiliation(s)
- C Debras
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
| | - E Chazelas
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
| | - B Srour
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
| | - C Julia
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - É Schneider
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
| | - C Agaësse
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
| | - N Druesne-Pecollo
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
| | - S Hercberg
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - M Deschasaux-Tanguy
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
| | - M Touvier
- Nutritional Epidemiology Research Team, Sorbonne Paris Nord University, Bobigny, France
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Deschasaux-Tanguy M, Bourhis L, Druesne-Pecollo N, Esseddik Y, Galan P, Hercberg S, de Lamballerie X, Carrat F, Touvier M. Nutritional risk factors for SARS-CoV-2 infection: prospective study from the NutriNet-Santé cohort. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Many hypotheses were raised regarding a role of nutrition in COVID-19 (susceptibility to infection, disease severity) based on the importance of macronutrients, vitamins or minerals for a proper functioning of the immune system. Our objective was to study the associations between dietary intakes and the seroprevalence SARS-CoV-2 infection in a large population-based sample.
Methods
Our analyses included 7766 adults from the French NutriNet-Santé cohort who provided at least 6 valid 24h dietary records in the two years preceding the start of the COVID-19 pandemic in France (February 2020). An ELISA assay was used to detect anti-SARS-CoV-2 antibodies: 311 participants were positive and 7455, negative. Associations between dietary intakes and the seroprevalence of anti-SARS-CoV-2 antibodies were investigated using multi-adjusted logistic regressions.
Results
A lower seroprevalence of SARS-CoV-2 infection was associated to higher intakes of vitamin B9 (HR = 0.84 (0.72-0.98)), vitamin C (HR = 0.85 (0.75-0.97)), vitamin K (HR = 0.86 (0.74-0.99)), dietary fibres (HR = 0.84 (0.72-0.97)), and fruit and vegetables (HR = 0.84 (0.74-0.97)). Higher intakes of calcium (HR = 1.17 (1.01-1.35)) and dairy products (HR = 1.19 (1.06-1.33)) associated to a higher seroprevalence of SARS-CoV-2 infection. No association was observed with other food groups or nutrients or with the overall diet.
Conclusions
Based on exhaustive seroprevalence data in a large population-based sample, our results suggested that higher intakes of vitamin C, folates, vitamin K, dietary fibres and fruit and vegetables were associated with a lower susceptibility to SARS-CoV-2 infection.
Key messages
Higher intakes of vitamin C, folates, vitamin K, dietary fibres and fruit and vegetables were associated to a lower susceptibility to SARS-CoV-2 infection, assessed with exhaustive seroprevalence data. Beyond its established role in the prevention of non-communicable diseases, nutrition could also contribute to prevent some infectious diseases such as COVID-19.
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Affiliation(s)
- M Deschasaux-Tanguy
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 - Sorbonne Paris Nord University, Bobigny, France
| | - L Bourhis
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 - Sorbonne Paris Nord University, Bobigny, France
| | - N Druesne-Pecollo
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 - Sorbonne Paris Nord University, Bobigny, France
| | - Y Esseddik
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 - Sorbonne Paris Nord University, Bobigny, France
| | - P Galan
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 - Sorbonne Paris Nord University, Bobigny, France
| | - S Hercberg
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 - Sorbonne Paris Nord University, Bobigny, France
| | - X de Lamballerie
- Unité des Virus Emergents, Aix Marseille University, IRD 190, INSERM 1207, IHU Méditerranée Infection, Marseille, France
| | - F Carrat
- Sorbonne Université, Inserm, Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Paris, France
- Département de Santé Publique, APHP, Sorbonne Université, Paris, France
| | - M Touvier
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 - Sorbonne Paris Nord University, Bobigny, France
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Deschasaux-Tanguy M, Druesne-Pecollo N, Esseddik Y, Szabo de Edelenyi F, Charreire H, Oppert JM, Hercberg S, Touvier M. Diet and physical activity during the first COVID-19 lockdown in France (March-May 2020). Eur J Public Health 2021. [PMCID: PMC8574777 DOI: 10.1093/eurpub/ckab165.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background To counter the spread of COVID-19 and avoid overwhelmed health-care systems and numerous deaths, strict lockdown measures were adopted by many countries, causing an unprecedented disruption of daily life. Our objective was to explore the changes in dietary intakes, physical activity, body weight, and food supply occurring during the first lockdown in France (March-May 2020), in light of individual characteristics. Methods 37,252 adults from the French web-based NutriNet-Santé cohort completed lockdown-specific questionnaires. Nutrition-related changes and their sociodemographic and lifestyle correlates were investigated using multi-adjusted logistic regressions. Clusters of participants were defined combining multiple correspondence analyses and an ascending hierarchical classification. Results During the lockdown, trends of unfavorable changes were observed: decreased physical activity (53% of the participants), increased sedentary time (63%), increased snacking, decreased consumption of fresh food (especially fruit and fish), and increased consumption of sweets, cookies, and cakes. Yet, the opposite trends were also observed: increased home cooking (40%) and increased physical activity (19%). Additionally, 35% of the participants gained weight (mean weight gain in these individuals:1.8kg (SD:1.3) and 23% lost weight (2kg (SD:1.4)). All of these trends displayed associations with sociodemographic and lifestyle characteristics. Conclusions These results suggest that nutrition-related changes occurred during the lockdown in both unfavorable and favorable directions, and differed according to individual characteristics. Key messages COVID-19-related lockdown in France led to nutritional changes in both unfavorable and favorable directions, linked to sociodemographic and lifestyle inequalities. Unfavorable changes should be considered to inform future lockdown decisions and monitored to prevent a future increase in the nutrition-related burden of disease.
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Affiliation(s)
- M Deschasaux-Tanguy
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 -Sorbonne Paris Nord University, Bobigny, France
| | - N Druesne-Pecollo
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 -Sorbonne Paris Nord University, Bobigny, France
| | - Y Esseddik
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 -Sorbonne Paris Nord University, Bobigny, France
| | - F Szabo de Edelenyi
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 -Sorbonne Paris Nord University, Bobigny, France
| | - H Charreire
- Lab'Urba, Université Paris-Est Créteil, Créteil, France
| | - JM Oppert
- Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France
| | - S Hercberg
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 -Sorbonne Paris Nord University, Bobigny, France
- Department of Public Health, Paris Seine-Saint-Denis University Hospital System, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - M Touvier
- Nutritional Epidemiology Research Team, Inserm U1153, Inrae U1125, Cnam, Paris 13 -Sorbonne Paris Nord University, Bobigny, France
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Wendeu-Foyet G, Chajes V, Huybrechts I, Debras C, Chazelas E, Srour B, Agaësse C, Druesne-Pecollo N, Deschasaux-Tanguy M, Touvier M. Dietary trans fatty acid intakes and cancer risk: results from the NutriNet-Santé cohort. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Dietary trans fatty acids (TFAs) are either natural (ruminant sources) or industrially generated by partial hydrogenation of vegetable oils. Increasing evidence demonstrated their role as cardiovascular risk factors. Their involvement in cancer etiology is suspected, but epidemiological evidence is limited so far. We aimed to investigate the associations between different types of TFAs (total, ruminant [rTFAs], industrial [iTFAs] and corresponding specific isomers) and the risk of cancer in the NutriNet-Santé prospective cohort (2009-2020). Overall, 104,909 participants were included. Usual TFA intake was estimated from validated repeated 24-h dietary records. Associations between sex-specific quartiles of dietary intake of TFA and cancer risk were assessed using multi-adjusted Cox proportional hazard models. A total of 3,374 incident cancer cases occured during follow-up (including 982 breast and 405 prostate cancers). Total TFAs was associated with higher prostate cancer risk (1.34[1.25;1.87] Ptrend=0.005). rTFAs were associated with increased overall cancer risk (HRfor quartile 4 versus 1: 1.21[1.06;1.39] Ptrend=0.03), in particular the conjugated linoleic acid isomer (CLA) (1.19[1.04;1.36] Ptrend=0.04). These associations were specifically observed for breast cancer, in particular before menopause (rTFAs: 1.78[1.11;2.87] Ptrend=0.006; CLA: 2.013[1.25;3.23] Ptrend=0.003). Several iTFAs were associated with overall (1.18[1.06;1.31] Ptrend=0.02 for transdocosenoic acid), breast (isomer 18:2t: 1.30[1.06;1.58] Ptrend=0.01; hexadecenoic acid: 1.28[1.05-1.56] Ptrend=0.02) and prostate (transdocosenoic acid: 1.52[1.09;2.12] Ptrend=0.07) cancer risks. In this large prospective study, several types of TFAs were associated with increased overall, breast and prostate cancer risks. Although further studies are needed to better understand underlying mechanisms, these results support the WHO's goal of achieving industrially produced TFAs elimination from food supplies.
Key messages
Higher intake of dietary trans fatty acids is associated with an increased risk of various cancers. Our findings support WHO’s global recommendation of eliminating industrially produced TFAs by 2023.
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Affiliation(s)
- G Wendeu-Foyet
- Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center – University of Paris Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Bobigny, France
| | - V Chajes
- Nutrition and Metabolism Branch, IARC, Lyon, France
| | - I Huybrechts
- Nutrition and Metabolism Branch, IARC, Lyon, France
| | - C Debras
- Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center – University of Paris Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Bobigny, France
| | - E Chazelas
- Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center – University of Paris Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Bobigny, France
| | - B Srour
- Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center – University of Paris Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Bobigny, France
| | - C Agaësse
- Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center – University of Paris Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Bobigny, France
| | - N Druesne-Pecollo
- Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center – University of Paris Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Bobigny, France
| | - M Deschasaux-Tanguy
- Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center – University of Paris Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Bobigny, France
| | - M Touvier
- Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center – University of Paris Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Bobigny, France
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Chazelas E, Pierre F, Druesne-Pecollo N, Gigandet S, Srour B, Huybrechts I, Julia C, Kesse-Guyot E, Deschasaux-Tanguy M, Touvier M. Nitrites and nitrates from food additives and cancer risk: results from the NutriNet-Santé cohort. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Nitrates and nitrites occur naturally in water and soil and are commonly ingested from water and dietary sources. They are also frequently used as food additives mainly in processed meats. Experimental data consistently suggest their involvement in carcinogenesis but human data is still limited. The aim was to investigate the relationship between nitrate and nitrite intakes and the risk of cancer in a large prospective cohort with detailed and up-to-date dietary assessment. Overall, 101,056 adults from the French NutriNet-Santé cohort study (2009-ongoing) were included. Consumption of nitrites and nitrates was evaluated using repeated 24h dietary records, linked to a comprehensive food composition database which includes details of commercial names/brands of industrial products. Prospective associations between nitrite and nitrate exposures and the risk of cancer were assessed by multivariable Cox hazard models. During follow-up, 3311 first incident cancer cases were diagnosed. Compared with non-consumers, higher consumers of nitrates as food additives had higher risk of breast cancer (HR = 1.24 (1.03-1.48), P = 0.02); this was more specifically observed for potassium nitrate e252, P = 0.01). Higher consumers of nitrites as food additives, and specifically for sodium nitrite (e250), had a higher risk of prostate cancer (HR = 1.58 (1.14-2.18), P = 0.008 and HR = 1.62 (1.17-2.25), P = 0.004, respectively). No significant association was observed for nitrates and nitrites from natural sources. In this large prospective cohort, nitrates as food additives were positively associated with breast cancer risk and nitrites as food additives were positively associated with prostate cancer risk. While these results need confirmation in other large-scale prospective studies, they provide new insights in a context of lively debate around the ban of nitrite additives in food products.
Key messages
Nitrates as food additives were positively associated with breast cancer risk. Nitrites as food additives were positively associated with prostate cancer risk.
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Affiliation(s)
- E Chazelas
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
- French Network for Nutrition and Cancer Research, NACRe network, Jouy-en-Josas, France
| | - F Pierre
- French Network for Nutrition and Cancer Research, NACRe network, Jouy-en-Josas, France
- Toxalim, Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | - N Druesne-Pecollo
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
- French Network for Nutrition and Cancer Research, NACRe network, Jouy-en-Josas, France
| | - S Gigandet
- Open Food Facts, Saint-Maur-des-Fossés, France
| | - B Srour
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
- French Network for Nutrition and Cancer Research, NACRe network, Jouy-en-Josas, France
| | - I Huybrechts
- French Network for Nutrition and Cancer Research, NACRe network, Jouy-en-Josas, France
- International Agency for Research on Cancer, WHO, Lyon, France
| | - C Julia
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - E Kesse-Guyot
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
- French Network for Nutrition and Cancer Research, NACRe network, Jouy-en-Josas, France
| | - M Deschasaux-Tanguy
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
- French Network for Nutrition and Cancer Research, NACRe network, Jouy-en-Josas, France
| | - M Touvier
- Nutritional Epidemiology Research Team, Bobigny Cedex, France
- French Network for Nutrition and Cancer Research, NACRe network, Jouy-en-Josas, France
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Chazelas E, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Agaesse C, De Sa A, Lutchia R, Rebouillat P, Srour B, Debras C, Wendeu-Foyet G, Huybrechts I, Pierre F, Coumoul X, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Exposure to food additive mixtures in 106,000 French adults from the NutriNet-Santé cohort. Sci Rep 2021; 11:19680. [PMID: 34608173 PMCID: PMC8490357 DOI: 10.1038/s41598-021-98496-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/28/2021] [Indexed: 11/11/2022] Open
Abstract
Food additives (e.g. artificial sweeteners, emulsifiers, dyes, etc.) are ingested by billions of individuals daily. Some concerning results, mainly derived from animal and/or cell-based experimental studies, have recently emerged suggesting potential detrimental effects of several widely consumed additives. Profiles of additive exposure as well as the potential long-term impact of multiple exposure on human health are poorly documented. This work aimed to estimate the usual intake of food additives among participants of the French NutriNet-Santé cohort and to identify and describe profiles of exposure (single substances and mixtures). Overall, 106,489 adults from the French NutriNet-Santé cohort study (2009-ongoing) were included. Consumption of 90 main food additives was evaluated using repeated 24 h dietary records including information on brands of commercial products. Qualitative information (as presence/absence) of each additive in food products was determined using 3 large-scale composition databases (OQALI, Open Food Facts, GNPD), accounting for the date of consumption of the product. Quantitative ingested doses were estimated using a combination of laboratory assays on food matrixes (n = 2677) and data from EFSA and JECFA. Exposure was estimated in mg per kg of body weight per day. Profiles of exposure to food additive mixtures were extracted using Non-negative Matrix Factorization (NMF) followed by k-means clustering as well as Graphical Lasso. Sociodemographic and dietary comparison of clusters of participants was performed by Chi-square tests or linear regressions. Data were weighted according to the national census. Forty-eight additives were consumed by more than 10% of the participants, with modified starches and citric acid consumed by more than 90%. The top 50 also included several food additives for which potential adverse health effects have been suggested by recent experimental studies: lecithins (86.6% consumers), mono- and diglycerides of fatty acids (78.1%), carrageenan (77.5%), sodium nitrite (73.9%), di-, tri- and polyphosphates (70.1%), potassium sorbate (65.8%), potassium metabisulphite (44.8%), acesulfame K (34.0%), cochineal (33.9%), potassium nitrate (31.6%), sulfite ammonia caramel (28.8%), bixin (19.5%), monosodium glutamate (15.1%) and sucralose (13.5%). We identified and described five clusters of participants more specifically exposed to five distinct additive mixtures and one additional cluster gathering participants with overall low additive exposure. Food additives, including several for which health concerns are currently debated, were widely consumed in this population-based study. Furthermore, main mixtures of additives were identified. Their health impact and potential cocktail effects should be explored in future epidemiological and experimental studies.
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Affiliation(s)
- Eloi Chazelas
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France.
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France.
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
| | - Cédric Agaesse
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
| | - Alexandre De Sa
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
| | - Rebecca Lutchia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
| | - Pauline Rebouillat
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Charlotte Debras
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Gaëlle Wendeu-Foyet
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Inge Huybrechts
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
- International Agency for Research On Cancer, World Health Organization, Lyon, France
| | - Fabrice Pierre
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Xavier Coumoul
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
- UMR-S1124, Institut national de la santé et de la recherché médicale (Inserm), T3S, Toxicologie Environnementale, Cibles thérapeutiques, Signalisation cellulaire et Biomarqueurs, Paris, France
- Université de Paris, Paris, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH, Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, Cedex, France
- French Network for Nutrition And Cancer Research (NACRe Network), Jouy-en-Josas, France
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Debras C, Chazelas E, Srour B, Julia C, Kesse-Guyot E, Zelek L, Agaësse C, Druesne-Pecollo N, Andreeva VA, Galan P, Hercberg S, Latino-Martel P, Deschasaux-Tanguy M, Touvier M. Glycaemic index, glycaemic load and cancer risk: results from the prospective NutriNet-Santé cohort. Int J Epidemiol 2021; 51:250-264. [PMID: 34491326 DOI: 10.1093/ije/dyab169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 07/30/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Evidence is accumulating that high dietary glycaemic index (GI) and glycaemic load (GL) are potential risk factors for several metabolic disorders (e.g. type-2 diabetes, cardiovascular diseases), but remains limited concerning cancer risk. Although, mechanistic data suggest that consuming high-GI foods may contribute to carcinogenesis through elevated blood glucose levels, insulin resistance or obesity-related mechanisms. Our objective was to study the associations between dietary GI/GL and cancer. METHODS In total, 103 020 French adults (median age = 40.2 years) from the NutriNet-Santé cohort (2009-2020) with no cancer or diabetes at baseline were included (705 137 person-years, median follow-up time = 7.7 years). Repeated 24-h dietary records linked with a detailed food-composition table (>3500 food/beverage items). We computed the average dietary GI and GL at the individual level. Associations between GI, GL, contribution of low- and medium/high-GI foods to energy and carbohydrate intake and cancer risk (overall, breast, prostate and colorectal) were assessed using multivariable Cox proportional-hazard models. RESULTS Higher dietary GL was associated with higher overall cancer risk [n = 3131 cases, hazard ratios (HRs) for sex-specific quintile 5 vs 1 = 1.25, 95% confidence interval (CI) = 1.03-1.52; Ptrend = 0.008] and specifically postmenopausal breast cancer (n = 924, HRQ5vs.Q1 = 1.64, 95% CI = 1.06-2.55; Ptrend = 0.03). A higher contribution of low-GI food/beverages to energy intake was associated with lower cancer risk whereas a higher contribution of medium/high-GI items to energy intake was positively associated with higher risk of overall, breast and postmenopausal breast cancers (Ptrend ≤ 0.02). CONCLUSIONS These results support a possible impact of GI/GL on cancer risk. If confirmed in other populations and settings, dietary GI/GL could be considered as modifiable risk factors for primary cancer prevention. TRIAL REGISTRATION https://clinicaltrials.gov/ct2/show/NCT03335644.
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Affiliation(s)
- Charlotte Debras
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Eloi Chazelas
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Laurent Zelek
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Oncology Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Cédric Agaësse
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Paule Latino-Martel
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
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Deschasaux-Tanguy M, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Allès B, Andreeva VA, Baudry J, Charreire H, Deschamps V, Egnell M, Fezeu LK, Galan P, Julia C, Kesse-Guyot E, Latino-Martel P, Oppert JM, Péneau S, Verdot C, Hercberg S, Touvier M. Diet and physical activity during the coronavirus disease 2019 (COVID-19) lockdown (March-May 2020): results from the French NutriNet-Santé cohort study. Am J Clin Nutr 2021; 113:924-938. [PMID: 33675635 PMCID: PMC7989637 DOI: 10.1093/ajcn/nqaa336] [Citation(s) in RCA: 221] [Impact Index Per Article: 73.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/22/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Since December 2019, coronavirus disease 2019 (COVID-19) has been spreading steadily, resulting in overwhelmed health-care systems and numerous deaths worldwide. To counter these outcomes, many countries, including France, put in place strict lockdown measures, requiring the temporary closure of all but essential places and causing an unprecedented disruption of daily life. OBJECTIVES Our objective was to explore potential changes in dietary intake, physical activity, body weight, and food supply during the COVID-19 lockdown and how these differed according to individual characteristics. METHODS The analyses included 37,252 adults from the French web-based NutriNet-Santé cohort who completed lockdown-specific questionnaires in April-May 2020. Nutrition-related changes and their sociodemographic, lifestyle, and health-status correlates were investigated using multivariable logistic regression models. Clusters of participants were defined using an ascending hierarchical classification of change profiles derived from multiple correspondence analyses. RESULTS During the lockdown, trends of unfavorable changes were observed: decreased physical activity (reported by 53% of the participants), increased sedentary time (reported by 63%), increased snacking, decreased consumption of fresh food (especially fruit and fish), and increased consumption of sweets, cookies, and cakes. Yet, the opposite trends were also observed: increased home cooking (reported by 40%) and increased physical activity (reported by 19%). Additionally, 35% of the participants gained weight (mean weight gain in these individuals, 1.8 kg ± SD 1.3 kg) and 23% lost weight (2 kg ± SD 1.4 kg weight loss). All of these trends displayed associations with various individual characteristics. CONCLUSIONS These results suggest that nutrition-related changes occurred during the lockdown in both unfavorable and favorable directions. The observed unfavorable changes should be considered in the event of a future lockdown, and should also be monitored to prevent an increase in the nutrition-related burden of disease, should these diet/physical activity changes be maintained in the long run. Understanding the favorable changes may help extend them on a broader scale. This trial was registered at clinicaltrials.gov as NCT03335644.
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Affiliation(s)
- Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Julia Baudry
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Hélène Charreire
- Paris-Est University, Lab'Urba, Université Paris-Est Créteil (UPEC), Créteil, France
| | - Valérie Deschamps
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Sorbonne Paris Nord University, Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Manon Egnell
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Leopold K Fezeu
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Department of Public Health, Paris Seine-Saint-Denis University Hospital System, Assistance Publique - Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Paule Latino-Martel
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Jean-Michel Oppert
- Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Charlotte Verdot
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Sorbonne Paris Nord University, Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Department of Public Health, Paris Seine-Saint-Denis University Hospital System, Assistance Publique - Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
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Philippe C, Szabo de Edelenyi F, Naudon L, Druesne-Pecollo N, Hercberg S, Kesse-Guyot E, Latino-Martel P, Galan P, Rabot S. Relation between Mood and the Host-Microbiome Co-Metabolite 3-Indoxylsulfate: Results from the Observational Prospective NutriNet-Santé Study. Microorganisms 2021; 9:microorganisms9040716. [PMID: 33807160 PMCID: PMC8065611 DOI: 10.3390/microorganisms9040716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 11/29/2022] Open
Abstract
Gut microbiota metabolizes tryptophan into indole, which can influence brain and behavior. Indeed, some oxidized derivatives of indole, formed in the liver, have neuroactive properties, and indole overproduction by the gut microbiota induces an anxio-depressive phenotype in rodents. The aim of this study was to investigate in humans whether there was a relationship between recurrent depressive symptoms and indole production by the gut microbiota. A case-control study was conducted in 45–65-year-old women, who were participants in the observational prospective NutriNet-Santé Study. Cases were defined as having two Center for Epidemiological Studies-Depression Scales (CES-D) scores ≥ 23 at a two-year interval (recurrent depressive symptoms, n = 87). Each case was matched with two controls (two CES-D <23; n = 174). Urinary excretion of 3-indoxylsulfate, the major final metabolite of indole, was used as a biomarker of indole production by the gut microbiota. Conditional logistic regression models for paired data showed a positive association between urinary 3-indoxylsulfate concentrations, grouped in tertiles, and recurrent depressive symptoms (odds ratio = 2.46, p for trend = 0.0264 in the final model adjusted for confounding factors). This association suggested that indole production by the gut microbiota may play a role in the onset of mood disorders in humans.
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Affiliation(s)
- Catherine Philippe
- Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France
- Correspondence: (C.P.); (F.S.d.E.); (P.G.); (S.R.)
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord, Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 93017 Bobigny, France; (N.D.-P.); (S.H.); (E.K.-G.); (P.L.-M.)
- Correspondence: (C.P.); (F.S.d.E.); (P.G.); (S.R.)
| | - Laurent Naudon
- INRAE, AgroParisTech, CNRS, Micalis Institute, Université Paris-Saclay, 78350 Jouy-en-Josas, France;
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord, Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 93017 Bobigny, France; (N.D.-P.); (S.H.); (E.K.-G.); (P.L.-M.)
| | - Serge Hercberg
- Sorbonne Paris Nord, Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 93017 Bobigny, France; (N.D.-P.); (S.H.); (E.K.-G.); (P.L.-M.)
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord, Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 93017 Bobigny, France; (N.D.-P.); (S.H.); (E.K.-G.); (P.L.-M.)
| | - Paule Latino-Martel
- Sorbonne Paris Nord, Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 93017 Bobigny, France; (N.D.-P.); (S.H.); (E.K.-G.); (P.L.-M.)
| | - Pilar Galan
- Sorbonne Paris Nord, Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 93017 Bobigny, France; (N.D.-P.); (S.H.); (E.K.-G.); (P.L.-M.)
- Correspondence: (C.P.); (F.S.d.E.); (P.G.); (S.R.)
| | - Sylvie Rabot
- Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France
- Correspondence: (C.P.); (F.S.d.E.); (P.G.); (S.R.)
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Lécuyer L, Victor Bala A, Demidem A, Rossary A, Bouchemal N, Triba MN, Galan P, Hercberg S, Partula V, Srour B, Latino-Martel P, Kesse-Guyot E, Druesne-Pecollo N, Vasson MP, Deschasaux-Tanguy M, Savarin P, Touvier M. NMR metabolomic profiles associated with long-term risk of prostate cancer. Metabolomics 2021; 17:32. [PMID: 33704614 DOI: 10.1007/s11306-021-01780-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 02/24/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Prostate cancer is a multifactorial disease whose aetiology is still not fully understood. Metabolomics, by measuring several hundred metabolites simultaneously, could enhance knowledge on the metabolic changes involved and the potential impact of external factors. OBJECTIVES The aim of the present study was to investigate whether pre-diagnostic plasma metabolomic profiles were associated with the risk of developing a prostate cancer within the following decade. METHODS A prospective nested case-control study was set up among the 5141 men participant of the SU.VI.MAX cohort, including 171 prostate cancer cases, diagnosed between 1994 and 2007, and 171 matched controls. Nuclear magnetic resonance (NMR) metabolomic profiles were established from baseline plasma samples using NOESY1D and CPMG sequences. Multivariable conditional logistic regression models were computed for each individual NMR signal and for metabolomic patterns derived using principal component analysis. RESULTS Men with higher fasting plasma levels of valine (odds ratio (OR) = 1.37 [1.07-1.76], p = .01), glutamine (OR = 1.30 [1.00-1.70], p = .047), creatine (OR = 1.37 [1.04-1.80], p = .02), albumin lysyl (OR = 1.48 [1.12-1.95], p = .006 and OR = 1.51 [1.13-2.02], p = .005), tyrosine (OR = 1.40 [1.06-1.85], p = .02), phenylalanine (OR = 1.39 [1.08-1.79], p = .01), histidine (OR = 1.46 [1.12-1.88], p = .004), 3-methylhistidine (OR = 1.37 [1.05-1.80], p = .02) and lower plasma level of urea (OR = .70 [.54-.92], p = .009) had a higher risk of developing a prostate cancer during the 13 years of follow-up. CONCLUSIONS This exploratory study highlighted associations between baseline plasma metabolomic profiles and long-term risk of developing prostate cancer. If replicated in independent cohort studies, such signatures may improve the identification of men at risk for prostate cancer well before diagnosis and the understanding of this disease.
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Affiliation(s)
- Lucie Lécuyer
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Agnès Victor Bala
- Chemistry Structures Properties of Biomaterials and Therapeutic Agents (CSPBAT), Nanomédecine Biomarqueurs Détection (NBD), The National Center for Scientific Research (CNRS) 7244, Sorbonne Paris Nord University, 93017, Bobigny Cedex, France
| | - Aicha Demidem
- INRAE, UMR 1019, Human Nutrition Unit (UNH), Cellular Micro-Environment, Immunomodulation and Nutrition (ECREIN), Clermont Auvergne University, CRNH Auvergne, 63000, Clermont-Ferrand, France
| | - Adrien Rossary
- INRAE, UMR 1019, Human Nutrition Unit (UNH), Cellular Micro-Environment, Immunomodulation and Nutrition (ECREIN), Clermont Auvergne University, CRNH Auvergne, 63000, Clermont-Ferrand, France
| | - Nadia Bouchemal
- Chemistry Structures Properties of Biomaterials and Therapeutic Agents (CSPBAT), Nanomédecine Biomarqueurs Détection (NBD), The National Center for Scientific Research (CNRS) 7244, Sorbonne Paris Nord University, 93017, Bobigny Cedex, France
| | - Mohamed Nawfal Triba
- Chemistry Structures Properties of Biomaterials and Therapeutic Agents (CSPBAT), Nanomédecine Biomarqueurs Détection (NBD), The National Center for Scientific Research (CNRS) 7244, Sorbonne Paris Nord University, 93017, Bobigny Cedex, France
| | - Pilar Galan
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Serge Hercberg
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
- Public Health Department, Avicenne Hospital, 93000, Bobigny, France
| | - Valentin Partula
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Bernard Srour
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Paule Latino-Martel
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Emmanuelle Kesse-Guyot
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Nathalie Druesne-Pecollo
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Marie-Paule Vasson
- INRAE, UMR 1019, Human Nutrition Unit (UNH), Cellular Micro-Environment, Immunomodulation and Nutrition (ECREIN), Clermont Auvergne University, CRNH Auvergne, 63000, Clermont-Ferrand, France
- Anticancer Center Jean-Perrin, CHU Clermont-Ferrand, 63011, Clermont-Ferrand Cedex, France
| | - Mélanie Deschasaux-Tanguy
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France.
| | - Philippe Savarin
- Chemistry Structures Properties of Biomaterials and Therapeutic Agents (CSPBAT), Nanomédecine Biomarqueurs Détection (NBD), The National Center for Scientific Research (CNRS) 7244, Sorbonne Paris Nord University, 93017, Bobigny Cedex, France
| | - Mathilde Touvier
- Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Sorbonne Paris Nord University, SMBH Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
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Kesse-Guyot E, Chaltiel D, Fezeu LK, Baudry J, Druesne-Pecollo N, Galan P, Deschamps V, Touvier M, Julia C, Hercberg S. Association between adherence to the French dietary guidelines and the risk of type 2 diabetes. Nutrition 2020; 84:111107. [PMID: 33454528 DOI: 10.1016/j.nut.2020.111107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/10/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE French food-based dietary guidelines (FBDG) were updated in 2017. The objective of this prospective study was to estimate the associations between the Programme National Nutrition Santé-guidelines score 2 (PNNS-GS2), reflecting the level of adherence to the 2017 FBDG, and the risk of type 2 diabetes (T2D). METHODS A total of 79 205 French adult participants (mean age: 41.5 y [SD = 14.5]; 78.5% were women; 65% were postgraduate) from the NutriNet-Santé cohort (2009-2019) were included. Dietary intakes were collected using repeated 24-h dietary records. The PNNS-GS2 (theorical range: -∞ to 14.25), including six adequacy components and seven moderation components as well as a penalization on energy intake, was computed. The association between the PNNS-GS2 (as quintiles [Q]) and T2D risk was estimated using multivariable Cox proportional hazard models accounting for sociodemographic, anthropometric, and lifestyle and health-related factors. RESULTS During an average follow-up of 6.7 y (536 679 person-years), 676 T2D cases occurred. In the multiadjusted model, participants with the highest PNNS-GS2 (higher adherence to the 2017 FBDG), compared with those with the lowest (lower adherence to FBDG), exhibited a 49% reduction in risk of T2D (HRQ5 versus Q1: 0.51, 95% CI: 0.37, 0.69). Body mass index accounted for up to 27% of the main association. The healthy profiles of the cohort's participants may have reduced statistical power. CONCLUSIONS In this large, prospective cohort study, a higher adherence to the French 2017 FBDG was strongly and inversely associated with the risk of developing T2D. Such analysis should be confirmed in other settings, but in terms of public health and nutritional policy, this study supports the relevance of the 2017 French FBDG.
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Affiliation(s)
- Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France.
| | - Dan Chaltiel
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France
| | - Léopold K Fezeu
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France
| | - Julia Baudry
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France
| | - Valérie Deschamps
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Sorbonne Paris Nord University, Epidemiology and Statistics Research Center, University of Paris, Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France; Public Health Department, Avicenne Hospital, Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris Bobigny, France; Public Health Department, Avicenne Hospital, Bobigny, France
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42
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Debras C, Chazelas E, Srour B, Kesse-Guyot E, Julia C, Zelek L, Agaësse C, Druesne-Pecollo N, Galan P, Hercberg S, Latino-Martel P, Deschasaux M, Touvier M. Total and added sugar intakes, sugar types, and cancer risk: results from the prospective NutriNet-Santé cohort. Am J Clin Nutr 2020; 112:1267-1279. [PMID: 32936868 DOI: 10.1093/ajcn/nqaa246] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/04/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Excessive sugar intake is now recognized as a key risk factor for obesity, type 2 diabetes, and cardiovascular diseases. In contrast, evidence on the sugar-cancer link is less consistent. Experimental data suggest that sugars could play a role in cancer etiology through obesity but also through inflammatory and oxidative mechanisms and insulin resistance, even in the absence of weight gain. OBJECTIVE The objective was to study the associations between total and added sugar intake and cancer risk (overall, breast, and prostate), taking into account sugar types and sources. METHODS In total, 101,279 participants aged >18 y (median age, 40.8 y) from the French NutriNet-Santé prospective cohort study (2009-2019) were included (median follow-up time, 5.9 y). Sugar intake was assessed using repeated and validated 24-h dietary records, designed to register participants' usual consumption for >3500 food and beverage items. Associations between sugar intake and cancer risk were assessed by Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). RESULTS Total sugar intake was associated with higher overall cancer risk (n = 2503 cases; HR for quartile 4 compared with quartile 1: 1.17; 95% CI: 1.00, 1.37; Ptrend = 0.02). Breast cancer risks were increased (n = 783 cases; HRQ4vs.Q1 = 1.51; 95% CI: 1.14, 2.00; Ptrend = 0.0007). Results remained significant when weight gain during follow-up was adjusted for. In addition, significant associations with cancer risk were also observed for added sugars, free sugars, sucrose, sugars from milk-based desserts, dairy products, and sugary drinks (Ptrend ≤ 0.01). CONCLUSIONS These results suggest that sugars may represent a modifiable risk factor for cancer prevention (breast in particular), contributing to the current debate on the implementation of sugar taxation, marketing regulation, and other sugar-related policies. This trial was registered at clinicaltrials.gov as NCT03335644.
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Affiliation(s)
- Charlotte Debras
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Eloi Chazelas
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Laurent Zelek
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Oncology Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Cédric Agaësse
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Paule Latino-Martel
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Mélanie Deschasaux
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
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43
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Kesse-Guyot E, Rebouillat P, Payrastre L, Allès B, Fezeu LK, Druesne-Pecollo N, Srour B, Bao W, Touvier M, Galan P, Hercberg S, Lairon D, Baudry J. Prospective association between organic food consumption and the risk of type 2 diabetes: findings from the NutriNet-Santé cohort study. Int J Behav Nutr Phys Act 2020; 17:136. [PMID: 33167995 PMCID: PMC7653706 DOI: 10.1186/s12966-020-01038-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/16/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Organic food (OF) consumption has substantially increased in high income countries, mostly driven by environmental concerns and health beliefs. Lower exposure to synthetic pesticides has been systematically documented among consumers of organic products compared to non-consumers. While experimental studies suggest that pesticides currently used in food production may be associated with type 2 diabetes (T2D), no well-conducted prospective studies have investigated the potential association between consumption of organic products and the risk of T2D, controlling for potential confounding factors. The objective of this prospective study was to estimate the association between OF consumption and the risk of T2D. METHODS A total of 33,256 participants (76% women, mean (SD) age: 53 years (14)) of the French NutriNet-Santé prospective cohort study who completed the organic food frequency questionnaire were included (2014-2019). The proportion of OF in the diet (as weight without drinking water) was computed. The associations between the proportion of OF in the diet (as 5% increment and as quintiles) and the risk of T2D were estimated using multivariable Hazard Ratio (HR) and 95% confidence interval (95% CI) derived from proportional hazards models adjusted for confounders (sociodemographic, anthropometric, lifestyle, medical and nutritional factors). RESULTS During follow-up (mean = 4.05 y, SD = 1.03 y, 134,990 person-years), 293 incident cases of T2D were identified. After adjustment for confounders including lifestyle (physical activity, smoking status, alcohol consumption) and nutritional quality of the diet assessed by the adherence to the French food-based dietary guidelines, OF consumption was associated with a lower risk of T2D. Participants with the highest quintile of OF consumption, compared with those with the lowest quintile, had 35% lower risk of T2D (95% CI = 0.43-0.97). Each increment of 5% in the proportion of OF in the diet was associated with 3% lower risk of T2D (HR 0.97, 95% CI = 0.95-0.99). CONCLUSIONS In this large prospective cohort study, OF consumption was inversely associated with the risk of T2D. Further experimental and prospective studies should be conducted to confirm these observations. CLINICAL TRIAL REGISTRY The study was registered at ClinicalTrials.gov ( NCT03335644 ).
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Affiliation(s)
- Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France.
| | - Pauline Rebouillat
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France
| | - Laurence Payrastre
- Toxalim (Research Center in Food Toxicology), University of Toulouse, INRA, ENVT, INP-Purpan, UPS, 31027, Toulouse, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France
| | - Léopold K Fezeu
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, 52246, USA
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France
- Département de Santé Publique, Hôpital Avicenne, F-93017, Bobigny, France
| | - Denis Lairon
- Aix Marseille Université, INSERM, INRA, C2VN, Marseille, France
| | - Julia Baudry
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), F- 93017, Bobigny, France
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44
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Chazelas E, Deschasaux M, Srour B, Druesne-Pecollo N, Hercberg S, Esseddik Y, Szabo F, Slamich P, Gigandet S, Touvier M. Food additives: distribution and co-occurrence in 126 000 food products of the French market. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
More than 330 food additives (e.g. artificial sweeteners, emulsifiers, dyes) are authorized in Europe, with a great variability of use across food products. The objective of this study was to investigate the distribution and co-occurrence of food additives in a large-scale database of foods and beverages available on the French market.
Methods
The open access Open Food Facts database was used to retrieve the composition of food and beverage products commonly marketed on the French market (n = 126 556), based on the ingredients list. Clustering of food additive variables was used in order to determine groups of additives frequently co-occurring in food products. The clusters were confirmed by network analysis, using the eLasso method.
Results
53.8% of food products contained at least 1 food additive and 11.3% at least 5. Food categories most likely to contain food additives (in more than 85% of food items) were artificially sweetened beverages, ice creams, industrial sandwiches, biscuits and cakes. The most frequently used food additives were citric acid, lecithins and modified starches (>10,000 products each). Some food additives with suspected health effects also pertained to the top 50: sodium nitrite, potassium nitrate, carrageenan, monosodium glutamate, sulfite ammonia caramel, acesulfame K, sucralose, (di/tri/poly) phosphates, mono- and diglycerides of fatty acids, potassium sorbate, cochineal, potassium metabisulphite, sodium alginate, and bixin (>800 food products each). We identified 6 clusters of food additives frequently co-occurring in food products.
Conclusions
Food additives are widespread in industrial French products and some clusters of additives frequently co-occurring in food products were identified. These results pave the way to future etiological studies merging composition data to food consumption data to investigate their association with chronic disease risk, in particular potential 'cocktail effects'.
Key messages
Food additives are widespread in industrial French products and some clusters of additives frequently co-occurring in food products were identified. These results pave the way to future etiological studies to investigate their association with chronic disease risk, in particular potential ‘cocktail effects’.
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Affiliation(s)
- E Chazelas
- Nutritional Epidemiology Research Team, Bobigny, France
| | - M Deschasaux
- Nutritional Epidemiology Research Team, Bobigny, France
| | - B Srour
- Nutritional Epidemiology Research Team, Bobigny, France
| | | | - S Hercberg
- Nutritional Epidemiology Research Team, Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Y Esseddik
- Nutritional Epidemiology Research Team, Bobigny, France
| | - F Szabo
- Nutritional Epidemiology Research Team, Bobigny, France
| | - P Slamich
- Open Food Facts, Saint-Maur-des-Fossés, France
| | - S Gigandet
- Open Food Facts, Saint-Maur-des-Fossés, France
| | - M Touvier
- Nutritional Epidemiology Research Team, Bobigny, France
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45
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Partula V, Deschasaux M, Druesne-Pecollo N, Latino-Martel P, Desmetz E, Chazelas E, Kesse-Guyot E, Julia C, Fezeu LK, Galan P, Hercberg S, Mondot S, Lantz O, Quintana-Murci L, Albert ML, Duffy D, Srour B, Touvier M. Associations between consumption of dietary fibers and the risk of cardiovascular diseases, cancers, type 2 diabetes, and mortality in the prospective NutriNet-Santé cohort. Am J Clin Nutr 2020; 112:195-207. [PMID: 32369545 DOI: 10.1093/ajcn/nqaa063] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 03/06/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Mounting evidence, yet with varying levels of proof, suggests that dietary fibers (DFs) may exert a protective role against various chronic diseases, but this might depend on the DF type and source. OBJECTIVES Our objectives were to assess the associations between the intake of DFs of different types [total (TDF), soluble (SF), insoluble (IF)] and from different sources (fruits, vegetables, whole grains, legumes, potatoes and tubers) and the risk of cardiovascular diseases (CVDs), cancer, type 2 diabetes (T2D), and mortality in the large-scale NutriNet-Santé prospective cohort (2009-2019). METHODS Overall, 107,377 participants were included. Usual DF intake was estimated from validated repeated 24-h dietary records over the first 2 y following inclusion in the cohort. Associations between sex-specific quintiles of DF intake and the risk of chronic diseases and mortality were assessed using multiadjusted Cox proportional hazards models. RESULTS T2D risk was inversely associated with TDFs [HR for quintile 5 compared with quintile 1: 0.59 (95% CI: 0.42, 0.82), P-trend <0.001], SFs [HR: 0.77 (0.56, 1.08); P-trend = 0.02], and IFs [HR: 0.69 (0.50, 0.96); P-trend = 0.004]. SFs were associated with a decreased risk of CVD [HR: 0.80 (0.66, 0.98); P-trend = 0.01] and colorectal cancer [HR: 0.41 (0.21, 0.79); P-trend = 0.01]. IFs were inversely associated with mortality from cancer or CVDs [HR: 0.65 (0.45, 0.94); P-trend = 0.02]. TDF intake was associated with a decreased risk of breast cancer [HR:: 0.79 (0.54, 1.13); P-trend = 0.04]. DF intake from fruit was associated with the risk of several chronic diseases. CONCLUSIONS Our results suggest that DF intake, especially SFs and DFs from fruits, was inversely associated with the risk of several chronic diseases and with mortality. Further studies are needed, involving different types and sources of fiber. Meanwhile, more emphasis should be put on DFs in public health nutrition policies, as DF intake remains below the recommended levels in many countries. This trial was registered at clinicaltrials.gov as NCT03335644.
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Affiliation(s)
- Valentin Partula
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France.,Université de Paris, Université Paris-VII Denis Diderot, Paris, France
| | - Mélanie Deschasaux
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Paule Latino-Martel
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Elisa Desmetz
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Eloi Chazelas
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France.,Department of Public Health, Hôpital Avicenne (Hôpitaux Universitaires 93/AP-HP), Bobigny, France
| | - Léopold K Fezeu
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France.,Department of Public Health, Hôpital Avicenne (Hôpitaux Universitaires 93/AP-HP), Bobigny, France
| | - Stanislas Mondot
- MICALIS (INRAE/Université Paris-Saclay-AgroParisTech), Jouy-en-Josas, France
| | - Olivier Lantz
- Curie Institute, PSL University, INSERM U932, Paris, France.,Clinical Investigation Center CIC-BT1428 (Institut Gustave Roussy/Institut Curie), INSERM, Paris, France
| | - Lluis Quintana-Murci
- Human Evolutionary Genetics laboratory (CNRS URA3012/Institut Pasteur), Paris, France
| | - Matthew L Albert
- Department of Immunology and Infectious Diseases, Insitro, San Fransisco, CA, USA
| | - Darragh Duffy
- Immunobiology of Dendritic Cells laboratory (INSERM U1223/Institut Pasteur), Paris, France
| | | | - Bernard Srour
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
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46
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Szabo de Edelenyi F, Philippe C, Druesne-Pecollo N, Naudon L, Rabot S, Hercberg S, Latino-Martel P, Kesse-Guyot E, Galan P. Depressive symptoms, fruit and vegetables consumption and urinary 3-indoxylsulfate concentration: a nested case-control study in the French Nutrinet-Sante cohort. Eur J Nutr 2020; 60:1059-1069. [PMID: 32588216 DOI: 10.1007/s00394-020-02306-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 06/15/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Previous epidemiologic studies have provided some evidence of an inverse association between fruit and vegetables consumption and risk of developing recurrent depressive symptoms. This association could possibly be explained by the role of such dietary factors on the gut microbiota. Especially, indole, a metabolite of tryptophan produced by gut bacteria, may be associated with the development of mood disorders. Thus, the purpose of this study was to investigate relationships between fruit and vegetables intake, recurrent depressive symptoms and indole, using measurement of its main urinary excretion form, i.e., 3-indoxylsulfate, as a biomarker. METHODS A nested case-control study was conducted in 891 women (aged 45-65) participating to the web-based NutriNet-Santé cohort with available dietary data and biological samples. Cases (individuals with recurrent depressive symptoms, n = 297) were defined as having two Center for Epidemiologic Studies-Depression Scale (CES-D) scores ≥ 16 during the follow-up and were matched with 2 controls having two CES-D scores < 16. Urinary 3-indoxylsulfate concentration was measured as a biomarker of indole production by the gut microbiota. Multivariable conditional logistic regression models were used to test the association of both fruit and vegetables consumption and urine 3-indoxylsulfate measurements with recurrent depressive symptoms. We also tested the association between fruit and vegetables consumption and urinary 3-indoxylsulfate levels using multivariate analysis of variance models. RESULTS We found a significant inverse association between fruit and vegetables consumption and the risk of having recurrent depressive symptoms over a 2-year period. Fruit and vegetables consumption was inversely associated to urinary 3-indoxylsulfate concentration. However, no significant association was observed between urinary 3-indoxylsulfate levels and recurrent depressive symptoms within this sample. CONCLUSIONS Our results confirm that low fruit and vegetables consumption could be associated with recurrent depressive symptoms. We also found an inverse association between fruit and vegetable intake and urinary levels of 3-indoxylsulfate. However, it is not possible to conclude to a possible mediation role of the indole produced by the gut microbiota from tryptophan, since there was no relationship between 3-indoxylsulfate and recurrent depressive symptoms.
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Affiliation(s)
- Fabien Szabo de Edelenyi
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 74 rue Marcel Cachin, 93017, Bobigny, France.
| | - Catherine Philippe
- INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, INRAE, 78350, Jouy-en-Josas, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 74 rue Marcel Cachin, 93017, Bobigny, France
| | - Laurent Naudon
- INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, INRAE, 78350, Jouy-en-Josas, France
| | - Sylvie Rabot
- INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, INRAE, 78350, Jouy-en-Josas, France
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 74 rue Marcel Cachin, 93017, Bobigny, France
| | - Paule Latino-Martel
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 74 rue Marcel Cachin, 93017, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 74 rue Marcel Cachin, 93017, Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, INRAE U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 74 rue Marcel Cachin, 93017, Bobigny, France
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Chaltiel D, Julia C, Chaltiel R, Baudry J, Touvier M, Fezeu L, Druesne-Pecollo N, Galan P, Hercberg S, Kesse-Guyot E. Association entre la qualité de l’alimentation selon les recommandations alimentaires françaises de 2017 et le risque de décès, de maladies cardiovasculaires et de cancer. NUTR CLIN METAB 2020. [DOI: 10.1016/j.nupar.2020.02.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chazelas E, Deschasaux M, Srour B, Kesse-Guyot E, Julia C, Alles B, Druesne-Pecollo N, Galan P, Hercberg S, Latino-Martel P, Esseddik Y, Szabo F, Slamich P, Gigandet S, Touvier M. Food additives: distribution and co-occurrence in 126,000 food products of the French market. Sci Rep 2020; 10:3980. [PMID: 32132606 PMCID: PMC7055242 DOI: 10.1038/s41598-020-60948-w] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/13/2020] [Indexed: 01/03/2023] Open
Abstract
Background. More than 330 food additives (e.g. artificial sweeteners, emulsifiers, dyes) are authorized in Europe, with a great variability of use across food products. Objective. The objective of this study was to investigate the distribution and co-occurrence of food additives in a large-scale database of foods and beverages available on the French market. Design. The open access crowdsourced Open Food Facts database (https://world.openfoodfacts.org/) was used to retrieve the composition of food and beverage products commonly marketed on the French market (n = 126,556), based on the ingredients list. Clustering of food additive variables was used in order to determine groups of additives frequently co-occurring in food products. The clusters were confirmed by network analysis, using the eLasso method. Results. Fifty-three-point eight percent of food products contained at least 1 food additive and 11.3% at least 5. Food categories most likely to contain food additives (in more than 85% of food items) were artificially sweetened beverages, ice creams, industrial sandwiches, biscuits and cakes. The most frequently used food additives were citric acid, lecithins and modified starches (>10,000 products each). Some food additives with suspected health effects also pertained to the top 50: sodium nitrite, potassium nitrate, carrageenan, monosodium glutamate, sulfite ammonia caramel, acesulfame K, sucralose, (di/tri/poly) phosphates, mono- and diglycerides of fatty acids, potassium sorbate, cochineal, potassium metabisulphite, sodium alginate, and bixin (>800 food products each). We identified 6 clusters of food additives frequently co-occurring in food products. Conclusions. Food additives are widespread in industrial French products and some clusters of additives frequently co-occurring in food products were identified. These results pave the way to future etiological studies merging composition data to food consumption data to investigate their association with chronic disease risk, in particular potential ‘cocktail effects’.
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Affiliation(s)
- Eloi Chazelas
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France.
| | - Mélanie Deschasaux
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Benjamin Alles
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Paule Latino-Martel
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Younes Esseddik
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Fabien Szabo
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | | | | | - Mathilde Touvier
- Sorbonne Paris Nord - Paris 13 University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
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Debras C, Chazelas E, Srour B, Zelek L, Kesse-Guyot E, Julia C, Druesne-Pecollo N, Galan P, Hercberg S, Latino-Martel P, Deschasaux M, Touvier M. Abstract P5-08-09: Sugar consumption and breast cancer risk: Results from NutriNet-Santé prospective cohort. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-08-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The impact of sugar consumption on diabetes and cardiovascular disease risks is well established. In contrast, the level of evidence regarding the role of sugar in cancer onset is still very limited. However, simple sugars could have a deleterious effect on cancer risk via different mechanisms, such as weight gain, but also through inflammation or insulin resistance. We recently showed that an increased consumption of sugary drinks was associated with cancer incidence, in particular, with breast cancer in the NutriNet-Santé cohort (Chazelas BMJ 2019).
Objective: Our objective was to expand this research to all sugary products and to prospectively investigate the association between the consumption of sugar (simple sugar, added sugar, sugar from different food sources) and risk of breast cancer (overall, premenopausal and postmenopausal) in a large cohort of French adults.
Design: Population based prospective cohort study.
Setting and participants: 79,742 female participants aged ≥ 18y (mean age: 41.0±14.0y) from the French NutriNet-Santé cohort (2009- 2019) were included. Consumption of sugar were assessed using repeated 24h-dietary records, designed to register participants’ usual consumption for more than 3,500 different food and beverages items.
Main outcome measures: Prospective associations between sugar consumption and risk of breast (premenopausal, postmenopausal and both) cancer were assessed by multivariable Cox proportional hazard models adjusted for known risk factors.
Results: The consumption of sugar was significantly associated with higher breast cancer risk (n=783 cases, HRfor a 10g/d increase=1.05, 95% confidence interval 1.01 to 1.09, P for trend=0.02), so was the consumption of added sugar (n=783 cases, HRfor a 10g/d increase=1.07, 95% confidence interval 1.02 to 1.12, P for trend=0.01) and more specifically with postmenopausal breast cancer (n=459 cases, HRfor a 10g/d increase=1.08, 95% confidence interval 1.01 to 1.16, P for trend=0.02). The consumption of sugar from sugary drinks was significantly associated with breast cancer (n=783 cases, HRfor a 10g/d increase=1.09, 95% confidence interval 1.01 to 1.17, P for trend=0.03). The overall consumption of sugar from sugary food and beverages (excluding fruits) was significantly associated with breast cancer risk (n=783 cases, HRfor a 10g/d increase=1.07, 95% confidence interval 1.02 to 1.11, P for trend=0.003).
Conclusion In this large prospective study, a greater consumption of sugar, added sugars, sugary food and beverages was associated with an increased risk of breast cancer, especially after menopause. These results need replication in other large-scale prospective studies. They suggest that sugar and sugary foods, whose consumption is increasing in Western countries, may potentially represent a modifiable risk factor for breast cancer prevention.
Citation Format: Charlotte Debras, Eloi Chazelas, Bernard Srour, Laurent Zelek, Emmanuelle Kesse-Guyot, Chantal Julia, Nathalie Druesne-Pecollo, Pilar Galan, Serge Hercberg, Paule Latino-Martel, Mélanie Deschasaux, Mathilde Touvier. Sugar consumption and breast cancer risk: Results from NutriNet-Santé prospective cohort [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-08-09.
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Affiliation(s)
- Charlotte Debras
- 1Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Eloi Chazelas
- 1Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Bernard Srour
- 1Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Laurent Zelek
- 2Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University) Oncology Department, Avicenne Hospital,, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- 1Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Chantal Julia
- 3Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Public Health Department, Avicenne Hospital, Bobigny, France
| | - Nathalie Druesne-Pecollo
- 1Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Pilar Galan
- 1Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Serge Hercberg
- 3Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Public Health Department, Avicenne Hospital, Bobigny, France
| | - Paule Latino-Martel
- 1Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Mélanie Deschasaux
- 1Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
| | - Mathilde Touvier
- 1Nutritional epidemiology Research Team (Inserm, Inra, Cnam, Paris 13 University), Bobigny, France
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Srour B, Fezeu LK, Kesse-Guyot E, Allès B, Debras C, Druesne-Pecollo N, Chazelas E, Deschasaux M, Hercberg S, Galan P, Monteiro CA, Julia C, Touvier M. Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort. JAMA Intern Med 2020; 180:283-291. [PMID: 31841598 PMCID: PMC6990737 DOI: 10.1001/jamainternmed.2019.5942] [Citation(s) in RCA: 222] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/10/2019] [Indexed: 12/11/2022]
Abstract
Importance Ultraprocessed foods (UPF) are widespread in Western diets. Their consumption has been associated in recent prospective studies with increased risks of all-cause mortality and chronic diseases such as cancer, cardiovascular diseases, hypertension, and dyslipidemia; however, data regarding diabetes are lacking. Objective To assess the associations between consumption of UPF and risk of type 2 diabetes (T2D). Design, Setting, and Participants In this population-based prospective cohort study, 104 707 participants aged 18 years or older from the French NutriNet-Santé cohort (2009-2019) were included. Dietary intake data were collected using repeated 24-hour dietary records (5.7 per participant on average), designed to register participants' usual consumption for more than 3500 different food items. These were categorized according to their degree of processing by the NOVA classification system. Main Outcomes and Measures Associations between UPF consumption and risk of T2D were assessed using cause-specific multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). Results A total of 104 707 participants (21 800 [20.8%] men and 82 907 [79.2%] women) were included. Mean (SD) baseline age of participants was 42.7 (14.5) years. Absolute T2D rates in the lowest and highest UPF consumers were 113 and 166 per 100 000 person-years, respectively. Consumption of UPF was associated with a higher risk of T2D (multi-adjusted hazard ratio [HR] for an absolute increment of 10 in the percentage of UPF in the diet, 1.15; 95% CI, 1.06-1.25; median follow-up, 6.0 years; 582 252 person-years; 821 incident cases). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet, for other metabolic comorbidities (HR, 1.13; 95% CI, 1.03-1.23), and for weight change (HR, 1.13; 95% CI, 1.01-1.27). The absolute amount of UPF consumption (grams per day) was consistently associated with T2D risk, even when adjusting for unprocessed or minimally processed food intake (HR for a 100 g/d increase, 1.05; 95% CI, 1.02-1.08). Conclusions and Relevance In this large observational prospective study, a higher proportion of UPF in the diet was associated with a higher risk of T2D. Even though these results need to be confirmed in other populations and settings, they provide evidence to support efforts by public health authorities to recommend limiting UPF consumption. Trial Registration ClinicalTrials.gov Identifier: NCT03335644.
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Affiliation(s)
- Bernard Srour
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Léopold K. Fezeu
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Benjamin Allès
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Charlotte Debras
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Nathalie Druesne-Pecollo
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Eloi Chazelas
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Mélanie Deschasaux
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Serge Hercberg
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Pilar Galan
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Carlos A. Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr Arnaldo 715, São Paulo 01246-904, Brazil
| | - Chantal Julia
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Mathilde Touvier
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
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