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Courbet D, Jacquemier L, Hercberg S, Touvier M, Sarda B, Kesse-Guyot E, Galan P, Buttafoghi N, Julia C. A randomized controlled trial to test the effects of displaying the Nutri-Score in food advertising on consumer perceptions and intentions to purchase and consume. Int J Behav Nutr Phys Act 2024; 21:38. [PMID: 38622707 PMCID: PMC11017538 DOI: 10.1186/s12966-024-01588-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Some research shows that advertising for high-fat, sugar, or salt (HFSS) products is contributing to a shift in consumer preferences toward products of poor nutritional quality, leading to unhealthy nutritional intakes that increase the risk of obesity and chronic diseases. A strategy of displaying simple and understandable nutritional information (like the front-of-pack nutrition label Nutri-Score) in food messages could be an aid to help guide consumers' choice towards healthier products. METHODS A randomized controlled experiment was conducted on 27,085 participants randomly assigned to two experimental conditions or a control condition. In both experimental conditions (independent variable: advertising messages with vs. without the Nutri-Score), participants were exposed to advertisements for diversified food products with contrasting nutritional quality and belonging to nine different food categories. Participants were then asked questions about their perception, affective evaluation, and intentions to purchase and consume the products. In the control condition, they were not exposed to the advertisements. RESULTS Overall, interaction effects between the two variables (1) the messages with vs. without the Nutri-Score and (2) the nutritional quality of products, were significant for all dependent variables, with effect sizes between large and medium. Overall, the better the products' nutritional quality, the more positive their perceptions, affective evaluations, and intentions to buy and consume them. When the Nutri-score was displayed in advertising messages (vs. when it was not), perceptions, affective evaluation, and behavioral intentions: (1) became more positive for products of good nutritional quality (Nutri-score A and B), (2) became more negative for products of poor nutritional quality (Nutri-score D and E), (3) changed little or not at all for products of intermediate nutritional quality (Nutri-Score C). CONCLUSIONS This research is the first in the literature to demonstrate that displaying the Nutri-Score in advertising messages assists consumers in directing their choices towards healthier foods. Regulations mandating the display of the Nutri-Score in food advertising could be an effective public health measure.
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Affiliation(s)
- Didier Courbet
- Aix-Marseille Univ, Université de Toulon, IMSIC, InCIAM, Marseille, France.
- Département Techniques de Commercialisation, Aix-Marseille University, IUT d'Aix-en-Provence, 413 Avenue Gaston Berger, Aix-en-Provence, 13100, France.
| | - Laure Jacquemier
- Aix-Marseille Univ, CRETLOG, Aix-en-Provence, France
- Département Techniques de Commercialisation, Aix-Marseille University, IUT d'Aix-en-Provence, 413 Avenue Gaston Berger, Aix-en-Provence, 13100, France
| | - Serge Hercberg
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
- Public Health Department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Mathilde Touvier
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | - Barthélémy Sarda
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | - Emmanuelle Kesse-Guyot
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | - Pilar Galan
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
| | | | - Chantal Julia
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, 93017, France
- Public Health Department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Bobigny, France
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Pacheco Da Silva E, Varraso R, Lenzotti AM, Fezeu LK, Sit G, Galan P, Hercberg S, Touvier M, Paris C, Dumas O, Le Moual N. Household Use of Green Cleaning Products, Disinfecting Wipes, and Asthma Control Among Adults. The Journal of Allergy and Clinical Immunology: In Practice 2024; 12:919-926.e7. [PMID: 38151117 DOI: 10.1016/j.jaip.2023.12.029] [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] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/14/2023] [Accepted: 12/08/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND The use of household disinfectants and cleaning products (HDCPs) may negatively impact asthma control, but studies remain scarce. Moreover, no study considered green products or wipes, increasingly used during home cleaning. OBJECTIVE To assess the associations between the use of HDCPs, including disinfecting wipes and green products, and asthma control based on data from the French Web-based NutriNet-Santé cohort. METHODS Using a standardized questionnaire (2018), we assessed asthma control (never asthma: reference; controlled: Asthma Control Test ≥ 20; uncontrolled: Asthma Control Test < 20) and the use of HDCPs, including 2 types of products (irritants and green products) and 2 application modes (sprays and disinfecting wipes). Cross-sectional associations of the frequency of weekly use of HDCPs at home with asthma control, adjusted for sex, age, smoking status, body mass index, and educational level were assessed by multinomial logistic regressions. RESULTS Analyses were performed on 37,043 adults (mean age 47 y; 75% women; 62% with a weekly use of at least 1 HDCP). Strong associations were observed between weekly use of HDCPs and uncontrolled asthma. In particular, an almost daily use (4-7 d/wk) of irritants (odds ratio [OR] 2.81; 95% confidence interval [95% CI] 1.97-4.00) and green products (OR 2.40; 95% CI 1.70-3.39) as well as sprays (OR 2.69; 95% CI 1.97-3.68) and disinfecting wipes (OR 3.51; 95% CI 2.31-5.33) was associated with uncontrolled asthma. When not co-used with irritants and sprays, associations remained statistically significant for both disinfecting wipes and green products. CONCLUSIONS Weekly use of HDCPs, including green products or wipes, was associated with uncontrolled asthma and should be considered by health practitioners in order to improve asthma control.
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Affiliation(s)
- Emilie Pacheco Da Silva
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, France.
| | - Raphaëlle Varraso
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - Anne-Marine Lenzotti
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, 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
| | - Guillaume Sit
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, 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
| | - 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
| | - Christophe Paris
- Équipe d'Épidémiologie en santé au travail et ergonomie (Ester), Université Rennes 1, Institut de recherche en santé, environnement et travail (Irset), INSERM (U1085), École des Hautes Études en Santé Publique (EHESP), Rennes, France
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, France
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Sarda B, Kesse-Guyot E, Srour B, Deschasaux-Tanguy M, Fialon M, Fezeu LK, Galan P, Hercberg S, Touvier M, Julia C. How far can reformulation participate in improving the nutritional quality of diets at population level? A modelling study using real food market data in France. BMJ Glob Health 2024; 9:e014162. [PMID: 38531542 DOI: 10.1136/bmjgh-2023-014162] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/28/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Food reformulation is promoted as a tool to improve the nutritional quality of population diets. However, the potential impact of industry-wide reformulation on dietary intake has been investigated minimally. OBJECTIVES The aim was to estimate the impact on the French population nutrient intakes of industry-wide reformulation towards healthier products using the updated nutrient profiling system underpinning the front-of-pack nutrition label Nutri-Score (uNS-NPS). METHODS Dietary data were retrieved from the Nutrinet-Santé cohort at baseline (N=100 418), providing detailed information regarding participants' food choices (N>3000 generic food items). Each individual food from 24 hours dietary record was matched with French food market data from OpenFoodFacts database (N=119 073 products). Three scenarios were constructed using nutrient content of currently existing food products: (1) all products available (baseline situation); (2) only existing products of better nutritional quality were available as potential substitutes and (3) only existing products of poorer quality were available. The assessment of the nutritional quality was based on the uNS-NPS score. Finally, dietary intakes were calculated for each scenario after random attribution of healthier/less healthy products as dietary choices. Monte-Carlo iterations (n=300) were conducted to generate uncertainty intervals. RESULTS After simulation of reformulation using scenario 2, reduction in daily intake in comparison with the baseline situation was observed for energy (-55 kcal/day, -2.9%), saturated fat (-2.4g/day, -7.6%), sugar (-4.8g/day, -5.3%) and salt (-0.54g/day, -8.3%) and increase was observed for fibre (+1.0g/day, +4.9%). Improvements in diet quality were observed regardless of the overall quality of diet. The most important contributors to diet improvement were the followings: (1) sugars: sugary products, sweet bakery products and dairy products; (2) saturated fat: sweet bakery products, dairy products and prepared dishes and (3) salt: bread, prepared dishes, vegetable preparations and soups. CONCLUSION Widespread reformulation of food offer appeared to be an opportunity for improving nutritional status at population level in France.
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Affiliation(s)
- 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), 74 rue Marcel Cachin, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, Bobigny, France
| | - 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), 74 rue Marcel Cachin, 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), 74 rue Marcel Cachin, 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), 74 rue Marcel Cachin, Bobigny, France
| | - Léopold K Fezeu
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, 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), 74 rue Marcel Cachin, 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), 74 rue Marcel Cachin, Bobigny, France
- Public health Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), 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), 74 rue Marcel Cachin, 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), 74 rue Marcel Cachin, Bobigny, France
- Public health Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
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Sarda B, Kesse-Guyot E, Deschamps V, Ducrot P, Galan P, Hercberg S, Deschasaux-Tanguy M, Srour B, Fezeu LK, Touvier M, Julia C. Consistency of the Initial and Updated Version of the Nutri-Score with Food-Based Dietary Guidelines: A French Perspective. J Nutr 2024; 154:1027-1038. [PMID: 38311063 PMCID: PMC10942857 DOI: 10.1016/j.tjnut.2024.01.029] [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: 10/30/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND To help consumers to make healthier food choices, 7 European countries have implemented the front-of-pack nutrition label Nutri-Score. The algorithm was updated in 2022-2023 by the Nutri-Score European scientific committee, based on the current scientific knowledge. OBJECTIVES The aim of this study was to investigate the consistency of the newly internationally developed algorithm with the French food-based dietary guidelines (FBDG) and compare the respective performances of the initial and updated algorithm. METHODS Three complementary French food composition databases were used to access extensive coverage of the food supply in France (n = 46,752): the Oqali, OpenFoodFacts, and CIQUAL databases. Based on the French FBDG, a list of 41 criteria was defined by which the consistency between French FBDG and the Nutri-Score was assessed (eg, consumption of fresh vegetables is promoted in FBDG, thus the Nutri-Score should rate favorably such products). RESULTS Of all criteria, the initial algorithm met 63% (26/41) of them, whereas the revised algorithm met 85% (35/41) of them. Improvements achieved by the updated version of the Nutri-Score in alignment with the FBDG were particularly observed for high-fat products (ie, fatty fish, nuts, and seeds), sweet products (ie, ice creams and sweet spreads), salty products (ie, savory snacks and salted nuts), dairy beverages, and beverages with artificial sweeteners. CONCLUSIONS The Nutri-Score's updated nutrient profiling system appears to rate foods more consistently regarding the French dietary guidelines and improved the currently existing system. This work supports the implementation of the updated nutrient profiling system underlying Nutri-Score.
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Affiliation(s)
- Barthelemy Sarda
- Sorbonne Paris Nord University, Inserm, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris Cité (CRESS), Bobigny, France.
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris Cité (CRESS), Bobigny, France
| | - Valérie Deschamps
- Nutritional Epidemiology Surveillance Team (ESEN), Santé Publique France, The French Public Health Agency, Bobigny, France
| | - Pauline Ducrot
- Santé publique France, French national public health agency, F-94415, Saint- Maurice, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris Cité (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris Cité (CRESS), Bobigny, France; Public health Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Melanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Inserm, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris Cité (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Inserm, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris Cité (CRESS), Bobigny, France
| | - Leopold K Fezeu
- Sorbonne Paris Nord University, Inserm, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris Cité (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris Cité (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris Cité (CRESS), Bobigny, France; Public health Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
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Kose J, Duquenne P, Hercberg S, Galan P, Touvier M, Fezeu LK, Andreeva VA. Co-occurrence of habit-forming risk behaviors and their socio-demographic, health status and lifestyle determinants: a population-based cross-sectional study. Arch Public Health 2024; 82:26. [PMID: 38419088 PMCID: PMC10900606 DOI: 10.1186/s13690-024-01251-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Although habit-forming risk behaviors frequently co-occur, determinants of concurrent risk behaviors have rarely been investigated. The aim of the present study was to investigate socio-demographic, health status, and lifestyle determinants of single versus concurrent risk behaviors in general-population adults. METHODS We analyzed data from 32,622 participants (74.5% female; mean age = 57.9 ± 14.2 years) of the NutriNet-Santé cohort who completed the Alcohol Use Disorders Identification Test, the 12-item Cigarette Dependence Scale, the modified Yale Food Addiction Scale 2.0, and the Internet Addiction Test in 2021-2022. Using established cutoffs, participants were first split into 2 groups (presence versus absence) for each risk variable (alcohol use disorders, nicotine dependence, food addiction, Internet addiction) and were then divided into 3 groups (no risk behavior, 1 risk behavior (reference), and ≥ 2 risk behaviors). The association between socio-demographic, health status, and lifestyle exposures and individual/concurrent risk behaviors were investigated with polytomous logistic regression. RESULTS Younger age (Odds Ratio (OR) = 2.04; 95% Confidence Interval (CI: 1.62-2.56), current financial difficulties (OR = 1.29; CI: 1.08-1.54), self-perceived poor health (OR = 1.70; CI: 1.32-2.20), overall poor dietary quality (OR = 2.88; CI: 2.06-4.02), being underweight (OR = 1.46; CI: 1.05-2.04), having obesity (OR = 1.62; CI: 1.31-1.99), lack of affection during childhood (OR = 1.41; CI: 1.18-1.69), and a lifetime prevalence or medication use for a mental disorder (OR = 1.46; CI: 1.24-1.73) were positively associated with having ≥ 2 versus 1 risk behavior (all p < 0.05). The comparison of none versus 1 risk behavior revealed the same determinants in addition to having a higher education, being physically active at work, and being overweight. CONCLUSIONS We investigated determinants of concurrent habit-forming risk behaviors among adults in a large, population-based study. The findings could serve as impetus for future research in this domain and ultimately help guide addiction prevention efforts.
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Affiliation(s)
- Junko Kose
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Pauline Duquenne
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
- Department of Public Health, AP-HP Paris Seine-Saint-Denis Hospital System, Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Léopold K Fezeu
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Valentina A Andreeva
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France.
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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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7
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Sarda B, Kesse-Guyot E, Deschamps V, Ducrot P, Galan P, Hercberg S, Deschasaux-Tanguy M, Srour B, Fezeu LK, Touvier M, Julia C. Complementarity between the updated version of the front-of-pack nutrition label Nutri-Score and the food-processing NOVA classification. Public Health Nutr 2024; 27:e63. [PMID: 38297466 PMCID: PMC10897572 DOI: 10.1017/s1368980024000296] [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: 07/26/2023] [Revised: 01/04/2024] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVE To compare the initial and the updated versions of the front-of-pack label Nutri-Score (related to the nutritional content) with the NOVA classification (related to the degree of food processing) at the food level. DESIGN Using the OpenFoodFacts database - 129,950 food products - we assessed the complementarity between the Nutri-Score (initial and updated) with the NOVA classification through a correspondence analysis. Contingency tables between the two classification systems were used. SETTINGS The food offer in France. PARTICIPANTS Not applicable. RESULTS With both versions (i.e. initial and updated) of the Nutri-Score, the majority of ultra-processed products received medium to poor Nutri-Score ratings (between 77·9 % and 87·5 % of ultra-processed products depending on the version of the algorithm). Overall, the update of the Nutri-Score algorithm led to a reduction in the number of products rated A and B and an increase in the number of products rated D or E for all NOVA categories, with unprocessed foods being the least impacted (-3·8 percentage points (-5·2 %) rated A or B and +1·3 percentage points (+12·9 %) rated D or E) and ultra-processed foods the most impacted (-9·8 percentage points (-43·4 %) rated A or B and +7·8 percentage points (+14·1 %) rated D or E). Among ultra-processed foods rated favourably with the initial Nutri-Score, artificially sweetened beverages, sweetened plant-based drinks and bread products were the most penalised categories by the revision of Nutri-Score while low-sugar flavoured waters, fruit and legume preparations were the least affected. CONCLUSION These results indicate that the update of the Nutri-Score reinforces its coherence with the NOVA classification, even though both systems measure two distinct health dimensions at the food level.
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Affiliation(s)
- Barthélemy 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), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Valérie Deschamps
- Nutritional Epidemiology Surveillance Team (ESEN), Santé publique France, The French Public Health Agency, Bobigny, France
| | - Pauline Ducrot
- Santé publique France, French National Public Health Agency, Saint- Maurice, 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), 74 rue Marcel Cachin, F-93017Bobigny, 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), 74 rue Marcel Cachin, F-93017Bobigny, France
- Public health Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Melanie 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), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - 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), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Leopold K Fezeu
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, 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), 74 rue Marcel Cachin, F-93017Bobigny, 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), 74 rue Marcel Cachin, F-93017Bobigny, France
- Public health Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
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8
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Meyer A, Dong C, Chan SSM, Touvier M, Julia C, Huybrechts I, Nicolas G, Oldenburg B, Heath AK, Tong TYN, Key TJ, Tjønneland A, Kyrø C, Kaaks R, Katzke VA, Bergman MM, Palli D, Masala G, Tumino R, Sacerdote C, Colorado‐Yohar SM, Sánchez M, Guevara M, Grip O, Holmgren J, Cross A, Karling P, Hultdin J, Murphy N, Deschasaux‐Tanguy M, Hercberg S, Galan P, Mahamat‐Saleh Y, Amiot A, Gunter MJ, Boutron‐Ruault M, Carbonnel F. Dietary index based on the Food Standards Agency nutrient profiling system and risk of Crohn's disease and ulcerative colitis. Aliment Pharmacol Ther 2024; 59:558-568. [PMID: 38100159 PMCID: PMC10952778 DOI: 10.1111/apt.17835] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/22/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Nutri-score is now widely available in food packages in Europe. AIM To study the overall nutritional quality of the diet in relation to risks of Crohn's disease (CD) and ulcerative colitis (UC), in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort METHODS: We collected dietary data at baseline from validated food frequency questionnaires. We used a dietary index based on the UK Food Standards Agency modified nutrient profiling system (FSAm-NPS-DI) underlying the Nutri-Score label, to measure the nutritional quality of the diet. We estimated the association between FSAm-NPS-DI score, and CD and UC risks using Cox models stratified by centre, sex and age; and adjusted for smoking status, BMI, physical activity, energy intake, educational level and alcohol intake. RESULTS We included 394,255 participants (68.1% women; mean age at recruitment 52.1 years). After a mean follow-up of 13.6 years, there were 184 incident cases of CD and 459 incident cases of UC. Risk of CD was higher in those with a lower nutritional quality, that is higher FSAm-NPS-DI Score (fourth vs. first quartile: aHR: 2.04, 95% CI: 1.24-3.36; p-trend: <0.01). Among items of the FSAm-NPS-DI Score, low intakes of dietary fibre and fruits/vegetables/legumes/nuts were associated with higher risk of CD. Nutritional quality was not associated with risk of UC (fourth vs. first quartile of the FSAm-NPS-DI Score: aHR: 0.91, 95% CI: 0.69-1.21; p-trend: 0.76). CONCLUSIONS A diet with low nutritional quality as measured by the FSAm-NPS-DI Score is associated with a higher risk of CD but not UC.
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Affiliation(s)
- Antoine Meyer
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, Team 9Institut Gustave Roussy, Université Paris SaclayParisFrance
- Department of GastroenterologyUniversity Hospital of Bicêtre, Assistance Publique‐Hôpitaux de Paris and Université Paris‐SaclayParisFrance
| | - Catherine Dong
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, Team 9Institut Gustave Roussy, Université Paris SaclayParisFrance
- Department of GastroenterologyUniversity Hospital of Bicêtre, Assistance Publique‐Hôpitaux de Paris and Université Paris‐SaclayParisFrance
| | - Simon S. M. Chan
- Department of MedicineNorwich Medical School, University of East AngliaNorwichUK
- Department of GastroenterologyNorfolk and Norwich University Hospital NHS TrustNorwichUK
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research CenterUniversity Paris Cité (CRESS)BobignyFrance
| | - Chantal Julia
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research CenterUniversity Paris Cité (CRESS)BobignyFrance
- Department of Public Health, GHU Paris‐Seine‐Saint‐DenisAssistance Publique des Hôpitaux de Paris (AP‐HP)BobignyFrance
| | - Inge Huybrechts
- International Agency for Research on CancerNutrition and Metabolism branchLyonFrance
| | - Geneviève Nicolas
- International Agency for Research on CancerNutrition and Metabolism branchLyonFrance
| | - Bas Oldenburg
- Department of Gastroenterology and HepatologyUniversity Medical CentreUtrechtthe Netherlands
| | - Alicia K. Heath
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Tammy Y. N. Tong
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Anne Tjønneland
- Danish Cancer Society Research CenterCopenhagenDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - Cecilie Kyrø
- Danish Cancer Society Research CenterCopenhagenDenmark
| | - Rudolf Kaaks
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | | | | | - Domenico Palli
- Molecular and Nutritional Epidemiology UnitCancer Research and Prevention Institute – ISPOFlorenceItaly
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology UnitCancer Research and Prevention Institute – ISPOFlorenceItaly
| | - Rosario Tumino
- Cancer Registry and Histopathology DepartmentAzienda Sanitaria Provinciale (ASP)RagusaItaly
| | - Carlotta Sacerdote
- Unit of Cancer EpidemiologyCittà della Salute e della Scienza University‐HospitalTurinItaly
| | - Sandra M. Colorado‐Yohar
- Department of EpidemiologyMurcia Regional Health Council, IMIB‐ArrixacaMurciaSpain
- CIBER Epidemiologia y Salud Pública (CIBERESP)MadridSpain
- Research Group on Demography and HealthNational School of Public Health, University of AntioquiaMedellínColombia
| | - Maria‐Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP)GranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Department of Preventive Medicine and Public HealthUniversity of GranadaGranadaSpain
| | - Marcela Guevara
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Instituto de Salud Pública y Laboral de NavarraPamplonaSpain
| | - Olof Grip
- Department of Gastroenterology and HepatologyUniversity Hospital MalmöMalmöSweden
| | - Johanna Holmgren
- Department of Gastroenterology and HepatologyUniversity Hospital MalmöMalmöSweden
| | - Amanda Cross
- Public Health Policy Evaluation UnitSchool of Public Health, Imperial College LondonLondonUK
| | - Pontus Karling
- Department of Public Health and Clinical Medicine, MedicineUmeå UniversityUmeåSweden
| | - Johan Hultdin
- Department of Medical Biosciences, Clinical ChemistryUmeå UniversityUmeåSweden
| | - Neil Murphy
- International Agency for Research on CancerWorld Health OrganizationLyonFrance
| | - Mélanie Deschasaux‐Tanguy
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research CenterUniversity Paris Cité (CRESS)BobignyFrance
- Department of Public Health, GHU Paris‐Seine‐Saint‐DenisAssistance Publique des Hôpitaux de Paris (AP‐HP)BobignyFrance
| | - Serge Hercberg
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research CenterUniversity Paris Cité (CRESS)BobignyFrance
- Department of Public Health, GHU Paris‐Seine‐Saint‐DenisAssistance Publique des Hôpitaux de Paris (AP‐HP)BobignyFrance
| | - Pilar Galan
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research CenterUniversity Paris Cité (CRESS)BobignyFrance
- Department of Public Health, GHU Paris‐Seine‐Saint‐DenisAssistance Publique des Hôpitaux de Paris (AP‐HP)BobignyFrance
| | - Yahya Mahamat‐Saleh
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, Team 9Institut Gustave Roussy, Université Paris SaclayParisFrance
| | - Aurélien Amiot
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, Team 9Institut Gustave Roussy, Université Paris SaclayParisFrance
- Department of GastroenterologyUniversity Hospital of Bicêtre, Assistance Publique‐Hôpitaux de Paris and Université Paris‐SaclayParisFrance
| | - Marc J. Gunter
- Department of Medical Biosciences, Clinical ChemistryUmeå UniversityUmeåSweden
| | - Marie‐Christine Boutron‐Ruault
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, Team 9Institut Gustave Roussy, Université Paris SaclayParisFrance
| | - Franck Carbonnel
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, Team 9Institut Gustave Roussy, Université Paris SaclayParisFrance
- Department of GastroenterologyUniversity Hospital of Bicêtre, Assistance Publique‐Hôpitaux de Paris and Université Paris‐SaclayParisFrance
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9
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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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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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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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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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Deraz O, Van Sloten T, Climie R, Debras C, Fezeu LK, Deschasaux-Tanguy M, Jouven X, Kesse-Guyot E, Galan P, Hercberg S, Touvier M, Empana JP. Person-centered and measured life's simple 7 cardiovascular health concordance and association with incident cardiovascular disease. Sci Rep 2023; 13:5247. [PMID: 37002422 PMCID: PMC10066211 DOI: 10.1038/s41598-023-32219-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Person-centered cardiovascular health (CVH) may facilitate cardiovascular disease primordial prevention in low resources settings. The study aims to assess the validity of person-centered CVH compared to gold standard measured CVH by examining the concordance between person-centered vs. measured CVH together with their respective association with incident cardiovascular disease events (CVD). Life's Simple 7 (LS7) CVH metrics, including non-smoking, Body Mass Index, diet, physical activity, blood glycemia, blood pressure, and blood cholesterol were collected from 19,473 adults participating in the e-cohort NutriNet-Santé study from 2011 to 2014 and were followed until September 2020. Clinical examinations and blood analyses defined the measured biological metrics, while diagnoses, medication, or treatment for type 2 diabetes, hypertension, and hypercholesterolemia defined person-centered biological metrics. Declared behavioral metrics were common for both measured and person-centered CVH. The study included 18,714 CVD-free participants (mean age 51 years, 73% women), among whom 16.52% and 38.75% had 5-7 ideal LS7 metrics according to measured and person-centered CVH, respectively. Weighted concordance of person-centered and measured CVH was 0.87 [0.86; 0.88]. Over median follow-up of 8.05 years, 749 CVD events occurred. There was a 7% (HR 0.93 [0.88; 0.99]) and 13% (HR 0.87 [0.83; 0.92]) risk reduction of CVD risk by additional measured and person-centered ideal metrics, respectively. In conclusion, person-centered CVH may represent a reliable alternative to measured CVH.
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Affiliation(s)
- Omar Deraz
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Thomas Van Sloten
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rachel Climie
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Menzies Institute for Medical Research, University of Tasmania, Hobert, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Charlotte Debras
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Léopold K Fezeu
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Xavier Jouven
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Jean-Philippe Empana
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France.
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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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15
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Bellicha A, Wendeu-Foyet G, Coumoul X, Koual M, Pierre F, Guéraud F, Zelek L, Debras C, Srour B, Sellem L, Kesse-Guyot E, Julia C, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Abstract P2-06-03: Dietary exposure to acrylamide and breast cancer risk: results from the NutriNet-Santé cohort. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p2-06-03] [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: 03/06/2023]
Abstract
Abstract
Background: Acrylamide is classified as a probable human carcinogen by the IARC but epidemiological evidence on the carcinogenicity of acrylamide from dietary sources is limited. This study aimed to investigate the associations between dietary acrylamide and breast cancer risk in the NutriNet-Santé cohort. Methods: This prospective cohort study included 80,597 French women (mean [SD] age at baseline: 40.8 [14] years) during a mean (SD) follow-up of 8.8 (2.3) years. Acrylamide intake was evaluated using repeated 24h dietary records (n= 5.5 [SD 3.0]), linked to a comprehensive food composition database. Associations between acrylamide intake and breast cancer risk (overall, premenopausal and post-menopausal) were assessed by Cox hazard models adjusted for known risk factors. Results: The mean (SD) dietary acrylamide intake was 30.1 (21.9) µg/d (main contributors: coffee, potato fries and chips, pastries and cakes, and bread). During follow-up, 1016 first incident breast cancer cases were diagnosed (431 premenopausal, 585 postmenopausal). A borderline significant positive association was observed between acrylamide intake and breast cancer risk overall (HRQ4 vs Q1= 1.21 [95% CI: 1.00-1.47]) and a positive association was observed with premenopausal cancer (HRQ4 vs Q1= 1.40 [95% CI: 1.04-1.88]). Restricted cubic spline analyses suggested evidence for non-linearity of these associations, with higher HR for intermediate (Q2) and high (Q4) exposures. Receptor-specific analyses revealed a positive association with estrogen receptor-positive breast cancer, which represented 86% of total cancer cases. Acrylamide intake was not associated with post-menopausal breast cancer. Conclusions: Results from this large prospective cohort study suggest the potential deleterious role of dietary acrylamide in breast cancer etiology, especially in premenopausal women, and provide new insights that should encourage further mitigation strategies to reduce the content of acrylamide in food.
Citation Format: Alice Bellicha, Gaëlle Wendeu-Foyet, Xavier Coumoul, Meriem Koual, Fabrice Pierre, Françoise Guéraud, Laurent Zelek, Charlotte Debras, Bernard Srour, Laury Sellem, Emmanuelle Kesse-Guyot, Chantal Julia, Pilar Galan, Serge Hercberg, Mélanie Deschasaux-Tanguy, Mathilde Touvier. Dietary exposure to acrylamide and breast cancer risk: results from the NutriNet-Santé cohort [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-06-03.
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Affiliation(s)
- Alice Bellicha
- 1Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Gaëlle Wendeu-Foyet
- 2Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Xavier Coumoul
- 3Université Paris Cité, INSERM UMR-S1124, T3S, Toxicologie Environnementale, Cibles thérapeutiques, Signalisation cellulaire et Biomarqueurs, Paris, Ile-de-France, France
| | - Meriem Koual
- 4Université Paris Cité, INSERM UMR-S1124, T3S, Toxicologie Environnementale, Cibles thérapeutiques, Signalisation cellulaire et Biomarqueurs, Paris, France. Service de Chirurgie Cancérologique Gynécologique et du Sein, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Ile-de-France, France
| | - Fabrice Pierre
- 5Toulouse University, Toxalim (Research Centre in Food Toxicology), INRAE, ENVT, INP-Purpan, UPS, Toulouse, Midi-Pyrenees, France
| | - Françoise Guéraud
- 6Toulouse University, Toxalim (Research Centre in Food Toxicology), INRAE, ENVT, INP-Purpan, UPS, Toulouse, Midi-Pyrenees, France
| | - Laurent Zelek
- 7Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, France. Oncology Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, Ile-de-France, France
| | - Charlotte Debras
- 8Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Bernard Srour
- 9Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Laury Sellem
- 10Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Emmanuelle Kesse-Guyot
- 11Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Chantal Julia
- 12Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Pilar Galan
- 13Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Serge Hercberg
- 14Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Mélanie Deschasaux-Tanguy
- 15Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
| | - Mathilde Touvier
- 16Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center – University Paris Cité (CRESS), 93017 Bobigny, Ile-de-France, France
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16
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Mervant L, Tremblay-Franco M, Olier M, Jamin E, Martin JF, Trouilh L, Buisson C, Naud N, Maslo C, Héliès-Toussaint C, Fouché E, Kesse-Guyot E, Hercberg S, Galan P, Deschasaux-Tanguy M, Touvier M, Pierre F, Debrauwer L, Guéraud F. Urinary Metabolome Analysis Reveals Potential Microbiota Alteration and Electrophilic Burden Induced by High Red Meat Diet: Results from the French NutriNet-Santé Cohort and an In Vivo Intervention Study in Rats. Mol Nutr Food Res 2023; 67:e2200432. [PMID: 36647294 DOI: 10.1002/mnfr.202200432] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/22/2022] [Indexed: 01/18/2023]
Abstract
SCOPE High red and processed meat consumption is associated with several adverse outcomes such as colorectal cancer and overall global mortality. However, the underlying mechanisms remain debated and need to be elucidated. METHODS AND RESULTS Urinary untargeted Liquid Chromatography-Mass Spectrometry (LC-MS) metabolomics data from 240 subjects from the French cohort NutriNet-Santé are analyzed. Individuals are matched and divided into three groups according to their consumption of red and processed meat: high red and processed meat consumers, non-red and processed meat consumers, and at random group. Results are supported by a preclinical experiment where rats are fed either a high red meat or a control diet. Microbiota derived metabolites, in particular indoxyl sulfate and cinnamoylglycine, are found impacted by the high red meat diet in both studies, suggesting a modification of microbiota by the high red/processed meat diet. Rat microbiota sequencing analysis strengthens this observation. Although not evidenced in the human study, rat mercapturic acid profile concomitantly reveals an increased lipid peroxidation induced by high red meat diet. CONCLUSION Novel microbiota metabolites are identified as red meat consumption potential biomarkers, suggesting a deleterious effect, which could partly explain the adverse effects associated with high red and processed meat consumption.
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Affiliation(s)
- Loïc Mervant
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, 31077, France.,French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France
| | - Marie Tremblay-Franco
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, 31077, France
| | - Maïwenn Olier
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France
| | - Emilien Jamin
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, 31077, France
| | - Jean-Francois Martin
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, 31077, France
| | - Lidwine Trouilh
- Plateforme Genome et Transcriptome (GeT-Biopuces), Toulouse Biotechnology Institute (TBI), Université ide Toulouse, CNRS, INRAE, INSA, 135 avenue de Rangueil, Toulouse, F-31077, France
| | - Charline Buisson
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France
| | - Nathalie Naud
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France
| | - Claire Maslo
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France
| | - Cécile Héliès-Toussaint
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France
| | - Edwin Fouché
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France
| | - Emmanuelle Kesse-Guyot
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France.,Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 74 rue Marcel Cachin, Bobigny, 93017, France
| | - Serge Hercberg
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France.,Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 74 rue Marcel Cachin, Bobigny, 93017, 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), 74 rue Marcel Cachin, Bobigny, 93017, France
| | - Mélanie Deschasaux-Tanguy
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France.,Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 74 rue Marcel Cachin, Bobigny, 93017, France
| | - Mathilde Touvier
- French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France.,Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 74 rue Marcel Cachin, Bobigny, 93017, France
| | - Fabrice Pierre
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France
| | - Laurent Debrauwer
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, 31077, France
| | - Francoise Guéraud
- Toxalim, Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, 31027, France.,French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, 78352, France
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17
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Hercberg S, Galan P, Touvier M. European JRC Report: One More Stone for the (Scientific) Building of Nutri-Score. Ann Nutr Metab 2023; 79:3-4. [PMID: 36318886 DOI: 10.1159/000527852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/21/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inrae U1125, Cnam, Sorbonne Paris Nord University, Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inrae U1125, Cnam, Sorbonne Paris Nord University, Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inrae U1125, Cnam, Sorbonne Paris Nord University, Bobigny, France
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18
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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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19
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Fialon M, Babio N, Salas-Salvadó J, Galan P, Kesse-Guyot E, Touvier M, Deschasaux-Tanguy M, Sarda B, Hercberg S, Khoury N, Nabec L, Julia C. Comparative understanding and preference of Nutri-Score and NutrInform Battery in a sample of Spanish consumers. Eur J Public Health 2023; 33:293-298. [PMID: 36661062 PMCID: PMC10066476 DOI: 10.1093/eurpub/ckad002] [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: 01/21/2023] Open
Abstract
BACKGROUND Interpretive front-of-pack labels (FoPLs) are supported by World Health Organization as an important policy tool to promote healthy diets. At present, various FoPLs formats co-exist in the European Union (EU). However, as part of the Farm to Fork strategy published in 2020, the European Commission stated that it would propose a single mandatory FoPL. The aim of this study was to analyze Spanish consumers' preference and objective understanding of Nutri-Score and NutrInform, two FoPLs that are currently the subject of debate in the EU. METHODS In a representative sample of 1026 Spanish adults (50% women, mean age ± SD = 46 ± 14 years), objective understanding was assessed by asking participants to identify the healthiest food products in three food categories (breakfast products, breakfast cereals and added fats). The preference dimensions were tested by asking participants about the perceived helpfulness of the FoPL in discriminating the nutritional quality of food products (subjective understanding) and their overall assessment of the FoPL's ease of use, informativeness, trust and liking (perception). RESULTS In terms of objective understanding, Nutri-Score was significantly associated with an increase in consumers' ability to identify healthier food products across all food categories compared with NutrInform [OR (odds ratio) = 19.1 [14.2-25.7], P < 0.0001]. On the preference dimension, Nutri-Score was perceived as significantly easier to use and was more liked than NutrInform (standardized principal component analysis dimension, respectively, 0.32 ± 1.58 vs. -0.29 ± 1.66, P < 0.0001 and 0.080 ± 1.18 vs. -0.072 ± 1.17, P = 0.039). CONCLUSIONS This study provides new evidence to support Nutri-Score in comparison with NutrInform in Spanish consumers, on both objective understanding and preference aspects.
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Affiliation(s)
- Morgane Fialon
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 74 rue Marcel Cachin, 93017 Bobigny Cedex, France
| | - Nancy Babio
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - 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), 74 rue Marcel Cachin, 93017 Bobigny Cedex, 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), 74 rue Marcel Cachin, 93017 Bobigny Cedex, 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), 74 rue Marcel Cachin, 93017 Bobigny Cedex, 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), 74 rue Marcel Cachin, 93017 Bobigny Cedex, France
| | - Barthélémy Sarda
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 74 rue Marcel Cachin, 93017 Bobigny Cedex, 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), 74 rue Marcel Cachin, 93017 Bobigny Cedex, France.,Public Health Department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Nadine Khoury
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Lydiane Nabec
- Centre de Recherche Réseaux, Innovation, Territoire et Mondialisation (RITM), Université Paris-Saclay, 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), 74 rue Marcel Cachin, 93017 Bobigny Cedex, France.,Public Health Department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
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20
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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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21
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Belda E, Voland L, Tremaroli V, Falony G, Adriouch S, Assmann KE, Prifti E, Aron-Wisnewsky J, Debédat J, Le Roy T, Nielsen T, Amouyal C, André S, Andreelli F, Blüher M, Chakaroun R, Chilloux J, Coelho LP, Dao MC, Das P, Fellahi S, Forslund S, Galleron N, Hansen TH, Holmes B, Ji B, Krogh Pedersen H, Le P, Le Chatelier E, Lewinter C, Mannerås-Holm L, Marquet F, Myridakis A, Pelloux V, Pons N, Quinquis B, Rouault C, Roume H, Salem JE, Sokolovska N, Søndertoft NB, Touch S, Vieira-Silva S, Galan P, Holst J, Gøtze JP, Køber L, Vestergaard H, Hansen T, Hercberg S, Oppert JM, Nielsen J, Letunic I, Dumas ME, Stumvoll M, Pedersen OB, Bork P, Ehrlich SD, Zucker JD, Bäckhed F, Raes J, Clément K. Impairment of gut microbial biotin metabolism and host biotin status in severe obesity: effect of biotin and prebiotic supplementation on improved metabolism. Gut 2022; 71:2463-2480. [PMID: 35017197 PMCID: PMC9664128 DOI: 10.1136/gutjnl-2021-325753] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/15/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Gut microbiota is a key component in obesity and type 2 diabetes, yet mechanisms and metabolites central to this interaction remain unclear. We examined the human gut microbiome's functional composition in healthy metabolic state and the most severe states of obesity and type 2 diabetes within the MetaCardis cohort. We focused on the role of B vitamins and B7/B8 biotin for regulation of host metabolic state, as these vitamins influence both microbial function and host metabolism and inflammation. DESIGN We performed metagenomic analyses in 1545 subjects from the MetaCardis cohorts and different murine experiments, including germ-free and antibiotic treated animals, faecal microbiota transfer, bariatric surgery and supplementation with biotin and prebiotics in mice. RESULTS Severe obesity is associated with an absolute deficiency in bacterial biotin producers and transporters, whose abundances correlate with host metabolic and inflammatory phenotypes. We found suboptimal circulating biotin levels in severe obesity and altered expression of biotin-associated genes in human adipose tissue. In mice, the absence or depletion of gut microbiota by antibiotics confirmed the microbial contribution to host biotin levels. Bariatric surgery, which improves metabolism and inflammation, associates with increased bacterial biotin producers and improved host systemic biotin in humans and mice. Finally, supplementing high-fat diet-fed mice with fructo-oligosaccharides and biotin improves not only the microbiome diversity, but also the potential of bacterial production of biotin and B vitamins, while limiting weight gain and glycaemic deterioration. CONCLUSION Strategies combining biotin and prebiotic supplementation could help prevent the deterioration of metabolic states in severe obesity. TRIAL REGISTRATION NUMBER NCT02059538.
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Affiliation(s)
- Eugeni Belda
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France,Integrative Phenomics, Paris, France
| | - Lise Voland
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Valentina Tremaroli
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Goteborg, Sweden
| | - Gwen Falony
- Center for Microbiology, VIB, Leuven, Belgium,Vlaams Instituut voor Biotechnologie, VIB-KU Leuven, Heverlee, Flanders, Belgium
| | - Solia Adriouch
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Karen E Assmann
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Edi Prifti
- Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, Sorbonne Université, IRD, Bondy, France
| | - Judith Aron-Wisnewsky
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France,Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Jean Debédat
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Tiphaine Le Roy
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Trine Nielsen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Chloé Amouyal
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Sébastien André
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Fabrizio Andreelli
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Matthias Blüher
- Medical Department III - Endocrinology, Nephrology, Rheumatology - Medical Center, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Rima Chakaroun
- Medical Department III - Endocrinology, Nephrology, Rheumatology - Medical Center, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Julien Chilloux
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London Faculty of Medicine, London, UK
| | - Luis Pedro Coelho
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany,Molecular Medicine Partnership Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Maria Carlota Dao
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Promi Das
- Department of Biology, Chalmers University of Technology, Goteborg, Sweden
| | - Soraya Fellahi
- Functional Unit, Biochemistry and Hormonology Department, enon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France,Saint-Antoine Research Center, Sorbonne Université, INSERM, Paris, France
| | - Sofia Forslund
- Max Delbrück Center for Molecular Medicine, MDC, Berlin-Buch, Germany
| | - Nathalie Galleron
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France
| | - Tue H Hansen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Bridget Holmes
- Centre Daniel Carasso, Global Nutrition Department, Danone Nutricia Research, Palaiseau, France
| | - Boyang Ji
- Department of Biology, Chalmers University of Technology, Goteborg, Sweden
| | - Helle Krogh Pedersen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Phuong Le
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | | | | | - Louise Mannerås-Holm
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Goteborg, Sweden
| | - Florian Marquet
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Antonis Myridakis
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Veronique Pelloux
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Nicolas Pons
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France
| | - Benoit Quinquis
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France
| | - Christine Rouault
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Hugo Roume
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France
| | - Joe-Elie Salem
- Department of Pharmacology and CIC-1421, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Nataliya Sokolovska
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Nadja B Søndertoft
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Sothea Touch
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Sara Vieira-Silva
- Center for Microbiology, VIB, Leuven, Belgium,Vlaams Instituut voor Biotechnologie, VIB-KU Leuven, Heverlee, Flanders, Belgium
| | | | - Pilar Galan
- Nutritional Epidemiology Unit, INSERM, INRAE, CNAM, Paris 13 University, Bobigny, France
| | - Jens Holst
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Jens Peter Gøtze
- Department of Clinical Biochemistry, Rigshospitalet, Kobenhavn, Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, Kobenhavn, Denmark
| | - Henrik Vestergaard
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark,Steno Diabetes Center, Copenhagen, Gentofte, Denmark
| | - Torben Hansen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Serge Hercberg
- Nutritional Epidemiology Unit, INSERM, INRAE, CNAM, Paris 13 University, Bobigny, France
| | - Jean-Michel Oppert
- Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Jens Nielsen
- Department of Biology, Chalmers University of Technology, Goteborg, Sweden
| | | | - Marc-Emmanuel Dumas
- Department of Surgery and Cancer, Section of Computational and Systems Medicine, Imperial College London, London, UK,National Heart & Lung Institute, Section of Genomic & Environmental Medicine, Imperial College London, London, UK
| | - Michael Stumvoll
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München, University of Leipzig Faculty of Medicine, Leipzig, Germany
| | - Oluf Borbye Pedersen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Peer Bork
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany,Molecular Medicine Partnership Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Stanislav Dusko Ehrlich
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France,Center for Host Microbiome Interactions, King's College London Dental Institute, London, UK
| | - Jean-Daniel Zucker
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France,Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, Sorbonne Université, IRD, Bondy, France
| | - Fredrik Bäckhed
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Goteborg, Sweden
| | - Jeroen Raes
- Center for Microbiology, VIB, Leuven, Belgium,Vlaams Instituut voor Biotechnologie, VIB-KU Leuven, Heverlee, Flanders, Belgium
| | - Karine Clément
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France .,Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, France
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22
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Sit G, Varraso R, Fezeu LK, Galan P, Orsi F, Pacheco Da Silva E, Touvier M, Hercberg S, Paris C, Le Moual N, Dumas O. Occupational Exposures to Irritants and Sensitizers, Asthma and Asthma Control in the Nutrinet-Santé Cohort. J Allergy Clin Immunol Pract 2022; 10:3220-3227.e7. [PMID: 36108925 DOI: 10.1016/j.jaip.2022.08.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/11/2022] [Accepted: 08/26/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The role of chronic occupational exposures to irritants in asthma remains not well-defined. Few studies have examined their associations with asthma and its control. OBJECTIVE To study the associations of occupational exposures with asthma and its control, with specific interest for irritants, including disinfectants and cleaning products (DCPs) and solvents. METHODS Analyses included 4,469 adults (3,792 with neither asthma nor respiratory symptoms, 677 with current asthma; 75.9% women, mean age 54 years) of a case-control study (2018) from the French NutriNet-Santé cohort. Current asthma was defined by ever asthma with symptoms, medication or asthma attacks in the past 12 months, adult-onset asthma by age at first asthma attack older than 16 years, and uncontrolled asthma was defined by an Asthma Control Test score less than 20. Ever/current exposures were assessed with the Occupational Asthma-specific Job Exposure Matrix. Associations were evaluated by multinomial logistic regressions adjusted for sex, age, smoking status, and body mass index. RESULTS Ever exposures to sensitizers (high molecular weight [HMW]: OR 1.53, 95% CI 1.18-2.00; and low molecular weight [LMW]: OR 1.42; 95% CI 1.09-1.87), irritants (OR 1.32; 95% CI 1.03-1.68), and DCPs (OR 1.43; 95% CI 1.10-1.85) were associated with current adult-onset asthma. Significant associations between ever exposures and uncontrolled adult-onset asthma were observed for high molecular weight (OR 2.69; 95% CI 1.52-4.78) and low molecular weight (OR 2.27; 95% CI 1.24-4.37) sensitizers, irritants (OR 2.32; 95% CI 1.36-3.95), and DCPs (OR 2.59; 95% CI 1.48-4.54). Results were similar for current exposures, with higher ORs. No association was observed with solvents. CONCLUSIONS Occupational exposures to both sensitizers and irritants were associated with current adult-onset asthma and uncontrolled asthma. Irritant and sensitizing agents should be carefully considered in asthma management.
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Affiliation(s)
- Guillaume Sit
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
| | - Raphaëlle Varraso
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
| | - Léopold 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
| | - Florence Orsi
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
| | - Emilie Pacheco Da Silva
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, 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
| | - 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
| | - Christophe Paris
- Équipe d'Épidémiologie en santé au travail et ergonomie (ESTER), Université Rennes 1, Institut de recherche en santé, environnement et travail (IRSET), Inserm (U1085), École des Hautes Études en Santé Publique (EHESP), Rennes, France
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France.
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
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23
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Muacevic A, Adler JR, Kotsiou OS, Fradelos EC, Papathanasiou IV, Malli F, Papagiannis D, Mantzaris DC, Julia C, Hercberg S, Galan P, Fialon M, Gourgoulianis KI. Guideline Daily Amounts Versus Nutri-Score Labeling: Perceptions of Greek Consumers About Front-of-Pack Label. Cureus 2022; 14:e32198. [PMID: 36620800 PMCID: PMC9811601 DOI: 10.7759/cureus.32198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2022] [Indexed: 12/11/2022] Open
Abstract
Nutrition information is becoming more urgent than ever so that consumers can make informed choices when buying food. This study aimed to investigate consumers' perceptions and behavior of the front-of-pack label (FOPL), between two specific labeling systems, the Nutri-Score and the Guideline Daily Amounts (GDA). This is a post hoc analysis of data from a previous, more extensive cross-sectional study conducted from April 2021 to June 2021. A total of 510 participants were included in the study, of whom 49.6% were women. Participants' perceptions were assessed in nine questions on a five-point Likert scale (1=strongly disagree, 5=strongly agree). Multivariate variance analysis (MANOVA) was performed to test the effects of the label GDA vs. Nutri-Score on the overall positive and negative perceptions. We found that the Nutri-Score label was significantly more understandable (p=0.003), clear, visible, and preferable (p<0.001) than the GDA label, which required more time to be understood. The findings indicate that the interpretive label, Nutri-Score, was superior to the non-interpretive label GDA, in terms of consumers' perception, more visibility, less time-consuming, and reliability. The FOPL can improve the ability of consumers in Greece to understand the healthfulness of food products.
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24
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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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25
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Kose J, Duquenne P, Srour B, Debras C, Léger D, Péneau S, Galan P, Hercberg S, Touvier M, Andreeva VA. Synthèse narrative sur le lien entre les apports en glucides et la santé mentale : focus sur l’anxiété et l’insomnie chez les adultes. Cahiers de Nutrition et de Diététique 2022. [DOI: 10.1016/j.cnd.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Fialon M, Babio N, Salas J, Galan P, Kesse-Guyot E, Touvier M, Sarda B, Hercberg S, Nabec L, Julia C. Comparative Effectiveness in terms of Understanding of Nutri-Score and NutrInform in Spain. Eur J Public Health 2022. [PMCID: PMC9594717 DOI: 10.1093/eurpub/ckac129.339] [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: 12/05/2022] Open
Abstract
Background Interpretive Front-of-Pack Labels (FoPLs) are supported by WHO as a key policy tool to promote healthy diets. At present, various FoPLs formats co-exist in the European Union (EU). However, as part of the Farm to Fork strategy, the European Commission stated it would adopt a single mandatory FoPL in 2022. The aim of this study was to analyze Spanish consumers reactions to Nutri-Score and NutrInform, two FoPLs that are currently the subject of debate in EU, testing preference through subjective understanding and perception but also performance through objective understanding of the FoPLs. Methods The experimental study was conducted in 2021 on a representative sample of 1026 Spanish adults (50% women, mean age±SD = 46±14 years), through an online randomized questionnaire where participants were exposed to Nutri-Score or NutrInform. Performance of and preference for these two FoPLs were assessed in three food categories (Breakfast Products, Breakfast Cereals and Added Fats). Performance was tested using multivariate logistic regression while preference using principal component analysis and t-tests. Results In terms of objective understanding, Nutri-Score was significantly associated with an increase in consumers’ ability to identify healthier food products across all food categories compared to NutrInform (OR = 19.1 [14.2-25.7], p < 0.0001). On the preference dimension, Nutri-Score was perceived as significantly easier to use and was more liked than NutrInform (standardized PCA dimension resp. 0.32±1.58 vs. -0.29±1.66, p < 0.0001 and 0.080±1.18 vs. -0.072±1.17, p = 0.039) and participants found Nutri-Score more helpful to discriminate the nutritional quality of Breakfast Products and Breakfast Cereals (resp. 1.32±1.00 vs. 1.14±1.02, p < 0.01 and 1.33±1.00 vs. 1.00±1.03, p < 0.0001). Conclusions Results of this study provide new evidence to support Nutri-Score in comparison with the NutrInform battery, on both performance and preference aspects. Key messages • Nutri-Score better helps participants identify healthier food products than NutrInform. • European Commission should consider results of this study in its decision on a harmonized Front-of-Pack Label.
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Affiliation(s)
- M Fialon
- Nutritional Epidemiology Research Team, University of Paris , Bobigny Cedex, France
| | - N Babio
- Unitat de Nutrició Humana, Universitat Rovira i Virgili , Reus, Spain
- Institut Investigació Sanitària Pere Virgili , Reus, Spain
- CIBEROBN, Instituto de Salud Carlos III , Madrid, Spain
| | - J Salas
- Unitat de Nutrició Humana, Universitat Rovira i Virgili , Reus, Spain
- Institut Investigació Sanitària Pere Virgili , Reus, Spain
- CIBEROBN, Instituto de Salud Carlos III , Madrid, Spain
| | - P Galan
- Nutritional Epidemiology Research Team, University of Paris , Bobigny Cedex, France
| | - E Kesse-Guyot
- Nutritional Epidemiology Research Team, University of Paris , Bobigny Cedex, France
| | - M Touvier
- Nutritional Epidemiology Research Team, University of Paris , Bobigny Cedex, France
| | - B Sarda
- Nutritional Epidemiology Research Team, University of Paris , Bobigny Cedex, France
| | - S Hercberg
- Nutritional Epidemiology Research Team, University of Paris , Bobigny Cedex, France
- Public Health Department, Assistance Publique des Hôpitaux de Paris , Paris, France
| | - L Nabec
- RITM, Université Paris-Saclay , Paris, France
| | - C Julia
- Nutritional Epidemiology Research Team, University of Paris , Bobigny Cedex, France
- Public Health Department, Assistance Publique des Hôpitaux de Paris , Paris, France
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27
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Sarda B, Fialon M, Ducrot P, Serry AJ, Galan P, Kesse-Guyot E, Hercberg S, Touvier M, Julia C. Motivations and strategies underlying the adoption of the front-of-pack labelling scheme Nutri-Score. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.099] [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
Front-of-pack nutrition labellings (FoPL) have gained traction in the European Union as tools to tackle the burden of nutrition-related chronic diseases. Multiple FoPL have been implemented by both governments and private actors. Under the European food labelling regulation, any FoPL is optional to display, although the legal framework is being revised for a harmonized FoPL to emerge. Since the implementation of the Nutri-Score in France in 2017, little data is available to understand the motivations and strategies underlying the adoption of the FoPL from a food business’ perspective. A cross-sectional study was conducted in March 2021 on food businesses having adopted the Nutri-Score in France through an online questionnaire. In total, 121 businesses completed the questionnaire, representing 32% of companies adopting the scheme and covering a variety of company types. Engaged businesses had a rather healthier portfolio of products according to the Nutri-Score (on average, 69% of engaged products were A or B and 12% were D or E), with disparities between retailers and national brands. Businesses mostly reported their engagement was motivated by a will to be transparent (76%) and to simplify nutritional information (67%) but still 19% reported that they engaged following external pressures. External pressures were more likely to play a role in the engagement if the company engaged in 2020 compared to those engaged before 2018 (P = 0.032), if the company was larger (P = 0.044) and if the scope of engagement included D or E products (poorer nutritional quality) (P = 0.033). Our study showed that the Nutri-Score, as an optional measure, is mainly used by businesses, especially national brands, as a tool to promote rather healthier products, while companies with products of lower nutritional quality are more likely to engage following external pressure. This highlights the relevance of enforcing a mandatory FoPL system, in line with the Farm to Fork strategy.
Key messages
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Affiliation(s)
- B Sarda
- EREN, Sorbonne Paris Nord University , Bobigny, France
| | - M Fialon
- EREN, Sorbonne Paris Nord University , Bobigny, France
| | - P Ducrot
- Physical Activity and Diet Department, Public Health France, Saint- Maurice, France
| | - AJ Serry
- Physical Activity and Diet Department, Public Health France, Saint- Maurice, France
| | - P Galan
- EREN, Sorbonne Paris Nord University , Bobigny, France
| | - E Kesse-Guyot
- EREN, Sorbonne Paris Nord University , Bobigny, France
| | - S Hercberg
- EREN, Sorbonne Paris Nord University , Bobigny, France
- Public Health Department, Hopital Avicenne , Bobigny, France
| | - M Touvier
- EREN, Sorbonne Paris Nord University , Bobigny, France
| | - C Julia
- EREN, Sorbonne Paris Nord University , Bobigny, France
- Public Health Department, Hopital Avicenne , Bobigny, France
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28
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Berthy F, Brunin J, Allès B, Fezeu LK, Touvier M, Hercberg S, Galan P, Pointereau P, Lairon D, Baudry J, Kesse-Guyot E. Association between adherence to the EAT-Lancet diet and risk of cancer and cardiovascular outcomes in the prospective NutriNet-Santé cohort. Am J Clin Nutr 2022; 116:980-991. [PMID: 35918246 DOI: 10.1093/ajcn/nqac208] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 12/10/2021] [Accepted: 07/29/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The EAT-Lancet commission proposed, in 2019, a planetary, healthy, and universal dietary pattern. However, this diet has rarely been studied in relation to various health outcomes. OBJECTIVES We aimed to prospectively estimate the association between the EAT-Lancet diet and cancer and cardiovascular disease (CVD) risk. METHODS The study was conducted in participants of the NutriNet-Santé cohort (2009-2021). The endpoints were the incident outcomes (cancer and CVDs and mortality from these diseases), combined and separately. Adherence to the EAT-Lancet diet was estimated using the EAT-Lancet Diet Index (ELD-I) modeled as quintiles (Qs). Multivariable Cox proportional hazard models were used to estimate HRs and 95% CIs, adjusted for potential confounders and moderators. RESULTS A total of 62,382 subjects were included; 2475 cases of cancer and 786 cases of cardiovascular events occurred during a median follow-up of 8.1 y. The sample was 76% female, the mean ± SD age at inclusion was 51.0 ± 10.2 y. The ELD-I ranged from -162 to 332 points with a mean ± SD score of 45.4 ± 25.6 points. In multivariable models, no significant association between the EAT-Lancet diet and the risk of cancer and CVD combined, and separately, was observed. Alcohol consumption was an effect modifier of the association. A significant association was observed among low drinkers (HRQ5vs.Q1: 0.86; 95% CI: 0.73, 1.02; P-trend = 0.02). A higher ELD-I was significantly associated with a lower risk of overall cancer only among females (HRQ5vs.Q1: 0.89; 95% CI: 0.75, 1.05; P-trend = 0.03). Both associations were largely attenuated by BMI. CONCLUSIONS Contrary to our hypothesis, our results documented significant associations between adherence to the EAT-Lancet diet and incidence of cancer only in some subgroups, and no association with CVD.This trial was registered at clinicaltrials.gov as NCT03335644.
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Affiliation(s)
- Florine Berthy
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Joséphine Brunin
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 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), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 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), Bobigny, France.,Department of Public Health, Avicenne Hospital, 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), Bobigny, France
| | | | - Denis Lairon
- Aix Marseille University, INSERM, INRAE, 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), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
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29
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Bellicha A, Wendeu-Foyet G, Coumoul X, Koual M, Pierre F, Guéraud F, Zelek L, Debras C, Srour B, Sellem L, Kesse-Guyot E, Julia C, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Dietary exposure to acrylamide and breast cancer risk: results from the NutriNet-Santé cohort. Am J Clin Nutr 2022; 116:911-919. [PMID: 36055962 DOI: 10.1093/ajcn/nqac167] [Citation(s) in RCA: 1] [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: 04/01/2022] [Revised: 05/10/2022] [Accepted: 06/07/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Acrylamide is classified as a probable human carcinogen by the International Agency for Research on Cancer but epidemiologic evidence on the carcinogenicity of acrylamide from dietary sources is limited. OBJECTIVES This study aimed to investigate the associations between dietary acrylamide and breast cancer risk in the NutriNet-Santé cohort, accounting for menopausal and hormone receptor status. METHODS This prospective cohort study included 80,597 French females (mean ± SD age at baseline: 40.8 ± 14 y) during a mean ± SD follow-up of 8.8 ± 2.3 y. Acrylamide intake was evaluated using repeated 24-h dietary records (n ± SD = 5.5 ± 3.0), linked to a comprehensive food composition database. Associations between acrylamide intake and breast cancer risk (overall, premenopausal, and postmenopausal) were assessed by Cox hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). RESULTS The mean ± SD dietary acrylamide intake was 30.1 ± 21.9 µg/d (main contributors: coffee, potato fries and chips, pastries, cakes, bread). During follow-up, 1016 first incident breast cancer cases were diagnosed (431 premenopausal, 585 postmenopausal). A borderline significant positive association was observed between dietary acrylamide exposure and breast cancer risk overall (HR for quartile 4 compared with 1: 1.21; 95% CI: 1.00, 1.47) and a positive association was observed with premenopausal cancer (HRQ4vs.Q1: 1.40; 95% CI: 1.04, 1.88). Restricted cubic spline analyses suggested evidence for nonlinearity of these associations, with higher HRs for intermediate (quartile 2) and high (quartile 4) exposures. Receptor-specific analyses revealed positive associations with estrogen receptor-positive breast cancer (total and premenopausal). Acrylamide intake was not associated with postmenopausal breast cancer. CONCLUSIONS Results from this large prospective cohort study suggest a positive association between dietary acrylamide and breast cancer risk, especially in premenopausal females, and provide new insights that support continued mitigation strategies to reduce the content of acrylamide in food.This trial was registered at clinicaltrials.gov as NCT03335644.
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Affiliation(s)
- Alice Bellicha
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University Paris Cité (CRESS), Bobigny, France.,Nutrition And Cancer Research Network (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 Paris Cité (CRESS), Bobigny, France.,Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Xavier Coumoul
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France.,University Paris Cité, French National Institute of Health and Medical Research (INSERM UMR-S1124), T3S, Environmental Toxicity, Therapeutic Targets, Cellular Signaling and Biomarkers, Paris Cité University, Paris, France
| | - Meriem Koual
- University Paris Cité, French National Institute of Health and Medical Research (INSERM UMR-S1124), T3S, Environmental Toxicity, Therapeutic Targets, Cellular Signaling and Biomarkers, Paris Cité University, Paris, France.,Department of Gynecological and Breast Cancer Surgery, European Hospital Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Fabrice Pierre
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France.,Toxalim (Research Centre in Food Toxicology), French National Institute for Agricultural Research (INRAE), École Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique-Purpan (INP-Purpan), Université Paul Sabatier (UPS), Toulouse University, Toulouse, France
| | - Françoise Guéraud
- Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France.,Toxalim (Research Centre in Food Toxicology), French National Institute for Agricultural Research (INRAE), École Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique-Purpan (INP-Purpan), Université Paul Sabatier (UPS), Toulouse University, Toulouse, France
| | - Laurent Zelek
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University Paris Cité (CRESS), Bobigny, France.,Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France.,Oncology Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Charlotte Debras
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University Paris Cité (CRESS), Bobigny, France.,Nutrition And Cancer Research Network (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 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 Paris Cité (CRESS), Bobigny, France.,Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University Paris Cité (CRESS), Bobigny, France.,Nutrition And Cancer Research Network (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 Paris Cité (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University 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 Paris Cité (CRESS), Bobigny, France.,Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France.,Public Health Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (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 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 Paris Cité (CRESS), Bobigny, France.,Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France
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30
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Dalle C, Tournayre J, Mainka M, Basiak-Rasała A, Pétéra M, Lefèvre-Arbogast S, Dalloux-Chioccioli J, Deschasaux-Tanguy M, Lécuyer L, Kesse-Guyot E, Fezeu LK, Hercberg S, Galan P, Samieri C, Zatońska K, Calder PC, Fiil Hjorth M, Astrup A, Mazur A, Bertrand-Michel J, Schebb NH, Szuba A, Touvier M, Newman JW, Gladine C. The Plasma Oxylipin Signature Provides a Deep Phenotyping of Metabolic Syndrome Complementary to the Clinical Criteria. Int J Mol Sci 2022; 23:ijms231911688. [PMID: 36232991 PMCID: PMC9570185 DOI: 10.3390/ijms231911688] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 11/06/2022] Open
Abstract
Metabolic syndrome (MetS) is a complex condition encompassing a constellation of cardiometabolic abnormalities. Oxylipins are a superfamily of lipid mediators regulating many cardiometabolic functions. Plasma oxylipin signature could provide a new clinical tool to enhance the phenotyping of MetS pathophysiology. A high-throughput validated mass spectrometry method, allowing for the quantitative profiling of over 130 oxylipins, was applied to identify and validate the oxylipin signature of MetS in two independent nested case/control studies involving 476 participants. We identified an oxylipin signature of MetS (coined OxyScore), including 23 oxylipins and having high performances in classification and replicability (cross-validated AUCROC of 89%, 95% CI: 85–93% and 78%, 95% CI: 72–85% in the Discovery and Replication studies, respectively). Correlation analysis and comparison with a classification model incorporating the MetS criteria showed that the oxylipin signature brings consistent and complementary information to the clinical criteria. Being linked with the regulation of various biological processes, the candidate oxylipins provide an integrative phenotyping of MetS regarding the activation and/or negative feedback regulation of crucial molecular pathways. This may help identify patients at higher risk of cardiometabolic diseases. The oxylipin signature of patients with metabolic syndrome enhances MetS phenotyping and may ultimately help to better stratify the risk of cardiometabolic diseases.
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Affiliation(s)
- Céline Dalle
- UNH, INRAE, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Jérémy Tournayre
- UNH, INRAE, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Malwina Mainka
- Faculty of Mathematics and Natural Sciences, University of Wuppertal, 42119 Wuppertal, Germany
| | - Alicja Basiak-Rasała
- Department of Social Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Mélanie Pétéra
- Plateforme d’Exploration du Métabolisme, MetaboHUB Clermont, UNH, INRAE, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Sophie Lefèvre-Arbogast
- Bordeaux Population Health Research Center, Université de Bordeaux, INSERMUMR 1219, 33076 Bordeaux, France
| | - Jessica Dalloux-Chioccioli
- MetaToul, MetaboHUB, Inserm/UPS UMR 1048-I2MC, Institut des Maladies Métaboliques et Cardiovasculaires, 31400 Toulouse, France
| | - Mélanie Deschasaux-Tanguy
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, Cnam, Epidemiology and Statistics Research Center, University Paris Cité (CRESS), 93017 Bobigny, France
| | - Lucie Lécuyer
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, Cnam, Epidemiology and Statistics Research Center, University Paris Cité (CRESS), 93017 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, Cnam, Epidemiology and Statistics Research Center, University Paris Cité (CRESS), 93017 Bobigny, France
| | - Léopold K. Fezeu
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, Cnam, Epidemiology and Statistics Research Center, University Paris Cité (CRESS), 93017 Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, Cnam, Epidemiology and Statistics Research Center, University Paris Cité (CRESS), 93017 Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, Cnam, Epidemiology and Statistics Research Center, University Paris Cité (CRESS), 93017 Bobigny, France
| | - Cécilia Samieri
- Bordeaux Population Health Research Center, Université de Bordeaux, INSERMUMR 1219, 33076 Bordeaux, France
| | - Katarzyna Zatońska
- Department of Social Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Philip C. Calder
- Faculty of Medicine, School of Human Development and Health, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Mads Fiil Hjorth
- Obesity and Nutritional Sciences, Novo Nordisk Foundation, 2900 Hellerup, Denmark
| | - Arne Astrup
- Obesity and Nutritional Sciences, Novo Nordisk Foundation, 2900 Hellerup, Denmark
| | - André Mazur
- UNH, INRAE, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Justine Bertrand-Michel
- MetaToul, MetaboHUB, Inserm/UPS UMR 1048-I2MC, Institut des Maladies Métaboliques et Cardiovasculaires, 31400 Toulouse, France
| | - Nils Helge Schebb
- Faculty of Mathematics and Natural Sciences, University of Wuppertal, 42119 Wuppertal, Germany
| | - Andrzej Szuba
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, Cnam, Epidemiology and Statistics Research Center, University Paris Cité (CRESS), 93017 Bobigny, France
| | - John W. Newman
- Obesity and Metabolism Research Unit, United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA 95616, USA
- University of California Davis Genome Center, University of California, Davis, CA 95616, USA
- Department of Nutrition, University of California, Davis, CA 95616, USA
| | - Cécile Gladine
- UNH, INRAE, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
- Correspondence: ; Tel.: +33-473-624-230
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31
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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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32
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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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Egnell M, Boutron I, Péneau S, Ducrot P, Touvier M, Galan P, Fezeu L, Porcher R, Ravaud P, Hercberg S, Kesse-Guyot E, Julia C. Impact of the Nutri-Score front-of-pack nutrition label on purchasing intentions of individuals with chronic diseases: results of a randomised trial. BMJ Open 2022; 12:e058139. [PMID: 36038180 PMCID: PMC9438084 DOI: 10.1136/bmjopen-2021-058139] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To our knowledge, the effect of front-of-pack nutrition labels such as the Nutri-Score on food purchases has never been assessed among individuals suffering from nutrition-related chronic diseases specifically, while dietary modifications are generally part of their care. This study aimed to investigate the effect of the Nutri-Score on the nutritional quality of purchasing intentions among adults suffering from a cardiometabolic disease, compared with no label and the Reference Intakes (RIs), a label already implemented by some food manufacturers in France. SETTING Secondary prevention-mainland France. PARTICIPANTS 2431 eligible participants were randomly assigned and 1180 participants (65.5% women, mean age 65.0±7.1 years) completed the shopping task and were included in the analyses. INTERVENTION A three-arm randomised controlled trial using an experimental online supermarket was conducted in 2017. Participants with cardiometabolic diseases were invited to simulate food purchases with the Nutri-Score, the RIs or no label. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the nutritional quality of the shopping cart, estimated using the French-modified Food Standard Agency Nutrient Profiling System (FSAm-NPS), and secondary outcomes included the nutrient content of purchases. RESULTS The mean (SD) FSAm-NPS score was significantly lower in the Nutri-Score arm (1.29 (3.61) points), reflecting a higher overall nutritional quality of purchasing intentions, compared with the RIs (1.86 (3.23) points) and no label (1.92 (2.90) points) arms (p=0.01). Moreover, the Nutri-Score led to significantly lower content in calories and saturated fatty acids compared with the two other arms. These differences resulted from participants avoiding some packaged products (sweets, dairy and starches) and purchasing larger amounts of fresh fruit and meat. CONCLUSIONS The Nutri-Score exhibited a significant higher nutritional quality of purchasing intentions, encouraging healthier food choices among individuals suffering from cardiometabolic chronic diseases. TRIAL REGISTRATION NUMBER NCT02769455.
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Affiliation(s)
- Manon Egnell
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Isabelle Boutron
- METHODS team, Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Paris, Île-de-France, France
- Centre d'Epidémiologie Clinique, Hôtel Dieu, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Sandrine Péneau
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pauline Ducrot
- Santé publique France, Saint-Maurice, Île-de-France, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Léopold Fezeu
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Raphaël Porcher
- METHODS team, Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Paris, Île-de-France, France
| | - Philippe Ravaud
- METHODS team, Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Paris, Île-de-France, France
- Centre d'Epidémiologie Clinique, Hôtel Dieu, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
- Public Health Department, Hôpitaux Paris Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
- Public Health Department, Hôpitaux Paris Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (AP-HP), 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-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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Touvier M, Srour B, Hercberg S, Galan P, Kesse-Guyot E, Julia C. Health impact of foods: Time to switch to a 3D-vision. Front Nutr 2022; 9:966310. [PMID: 35923202 PMCID: PMC9340250 DOI: 10.3389/fnut.2022.966310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- 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), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–Université Paris Cité (CRESS), Bobigny, France
- *Correspondence: Bernard Srour
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–Université Paris Cité (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–Université Paris Cité (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–Université Paris Cité (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–Université Paris Cité (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
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36
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Hercberg S, Galan P, Kesse E, Deschasaux M, Srour B, Touvier M. [Démystifier les fake news concernant Nutri-Score]. Rev Prat 2022; 72:599-604. [PMID: 35899658] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
DEBUNKING FAKE NEWS ABOUT NUTRI-SCORE The Nutri-Score is a front-of-pack nutrition label (FoPNL) officially adopted in France to be affixed on food packaging. It is intended to allow to easily compare the nutritional quality of foods and help consumers to orient their choices towards better nutritional quality alternatives. It is a sciencebased public health tool. But the agri-food lobbies are opposed to its deployment and they spread out many fake news aimed at discrediting Nutri-Score. These fake news are sometimes taken up by people in good faith who do not know enough about the issue FoPNL or by certain actors defending economic or sometimes ideological interests. This article aims to debunk some of these fake news widely relayed by lobbies.
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Affiliation(s)
- Serge Hercberg
- Équipe de recherche en épidémiologie nutritionnelle (EREN), CRESS U1153 Inserm/ Inrae/Cnam/université Sorbonne Paris-Nord/ GHU Paris Seine-Saint- Denis (AP-HP), France
| | - Pilar Galan
- Équipe de recherche en épidémiologie nutritionnelle (EREN), CRESS U1153 Inserm/ Inrae/Cnam/université Sorbonne Paris-Nord/ GHU Paris Seine-Saint- Denis (AP-HP), France
| | - Emmanuelle Kesse
- Équipe de recherche en épidémiologie nutritionnelle (EREN), CRESS U1153 Inserm/ Inrae/Cnam/université Sorbonne Paris-Nord/ GHU Paris Seine-Saint- Denis (AP-HP), France
| | - Mélanie Deschasaux
- Équipe de recherche en épidémiologie nutritionnelle (EREN), CRESS U1153 Inserm/ Inrae/Cnam/université Sorbonne Paris-Nord/ GHU Paris Seine-Saint- Denis (AP-HP), France
| | - Bernard Srour
- Équipe de recherche en épidémiologie nutritionnelle (EREN), CRESS U1153 Inserm/ Inrae/Cnam/université Sorbonne Paris-Nord/ GHU Paris Seine-Saint- Denis (AP-HP), France
| | - Mathilde Touvier
- Équipe de recherche en épidémiologie nutritionnelle (EREN), CRESS U1153 Inserm/ Inrae/Cnam/université Sorbonne Paris-Nord/ GHU Paris Seine-Saint- Denis (AP-HP), France
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37
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Aguenaou H, Babio N, Deschasaux-Tanguy M, Galan P, Hercberg S, Julia C, Jones A, Karpetas G, Kelly B, Kesse-Guyot E, Kontopoulou L, Labonté ME, Ni Mhurchu C, Pravst I, Pettigrew S, Riboli E, Salas-Salvadó J, Srour B, Touvier M, Vandevijvere S. Comment on Muzzioli et al. Are Front-of-Pack Labels a Health Policy Tool? Nutrients 2022, 14, 771. Nutrients 2022; 14:nu14102165. [PMID: 35631306 PMCID: PMC9145939 DOI: 10.3390/nu14102165] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023] Open
Abstract
As scientists working and publishing in the field of front-of-pack nutrition labelling (FOPNL) for many years, we have read with interest and concern the narrative review regarding their effectiveness by Muzzioli et al. [...].
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Affiliation(s)
- Hassan Aguenaou
- Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Ibn Tofail University-CNESTEN, Rabat, Kenitra 14000, Morocco;
| | - Nancy Babio
- Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana. (IISPV), Universitat Rovira i Virgili, 43201 Reus, Spain; (N.B.); (J.S.-S.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28014 Madrid, Spain
| | - 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), 93017 Bobigny, France; (M.D.-T.); (P.G.); (S.H.); (E.K.-G.); (B.S.); (M.T.)
| | - 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), 93017 Bobigny, France; (M.D.-T.); (P.G.); (S.H.); (E.K.-G.); (B.S.); (M.T.)
| | - 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), 93017 Bobigny, France; (M.D.-T.); (P.G.); (S.H.); (E.K.-G.); (B.S.); (M.T.)
- Public Health Department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), 93000 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), 93017 Bobigny, France; (M.D.-T.); (P.G.); (S.H.); (E.K.-G.); (B.S.); (M.T.)
- Public Health Department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), 93000 Bobigny, France
- Correspondence:
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (A.J.); (S.P.)
| | - Georgios Karpetas
- Laboratory Teaching Staff, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece;
| | - Bridget Kelly
- Early Start, School of Health & Society, University of Wollongong, Wollongong, NSW 2522, Australia;
| | - 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), 93017 Bobigny, France; (M.D.-T.); (P.G.); (S.H.); (E.K.-G.); (B.S.); (M.T.)
| | - Lamprini Kontopoulou
- Laboratory Teaching Staff, Nursing Department, University of Thessaly, 41500 Larissa, Greece;
| | - Marie-Eve Labonté
- Centre Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec City, QC G1V 0A6, Canada;
- School of Nutrition, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, The University of Auckland, Auckland 1142, New Zealand;
| | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Trzaska Cesta 40, 1000 Ljubljana, Slovenia;
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (A.J.); (S.P.)
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK;
| | - Jordi Salas-Salvadó
- Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana. (IISPV), Universitat Rovira i Virgili, 43201 Reus, Spain; (N.B.); (J.S.-S.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28014 Madrid, Spain
| | - 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), 93017 Bobigny, France; (M.D.-T.); (P.G.); (S.H.); (E.K.-G.); (B.S.); (M.T.)
| | - 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), 93017 Bobigny, France; (M.D.-T.); (P.G.); (S.H.); (E.K.-G.); (B.S.); (M.T.)
| | - Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Service of Lifestyle and Chronic Diseases, 1050 Brussels, Belgium;
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Figueiredo N, Kose J, Srour B, Julia C, Kesse-Guyot E, Péneau S, Allès B, Paz Graniel I, Chazelas E, Deschasaux-Tanguy M, Debras C, Hercberg S, Galan P, Monteiro CA, Touvier M, Andreeva VA. Ultra-processed food intake and eating disorders: Cross-sectional associations among French adults. J Behav Addict 2022; 11:588-599. [PMID: 35380986 PMCID: PMC9295249 DOI: 10.1556/2006.2022.00009] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/13/2022] [Accepted: 03/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background and aims Data regarding the association between ultra-processed food (UPF) consumption and eating disorders (ED) are scarce. Our aim was to investigate whether UPF intake was associated with different ED types in a large population-based study. Methods 43,993 participants (mean age = 51.0 years; 76.1% women) of the French NutriNet-Santé web-cohort who were screened for ED in 2014 via the Sick-Control-One stone-Fat-Food (SCOFF) questionnaire, were included in the analysis. The clinical algorithm Expali TM tool was used to identify four ED types: restrictive, bulimic, binge eating, and other (not otherwise specified). Mean dietary intake was evaluated from at least 2 self-administered 24-h dietary records (2013-2015); categorization of food as ultra-processed or not relied on the NOVA classification. The associations between UPF intake (as percent and reflecting mean daily UPF quantity (g/d) within the dietary intake, %UPF) and ED types were evaluated using polytomous logistic regression models. Results 5,967 participants (13.6%) were categorized as likely ED (restrictive n = 444; bulimic n = 1,575; binge eating n = 3,124; other ED n = 824). The fully-adjusted analyses revealed a positive association between UPF intake and bulimic, binge eating, and other ED: ED risk (odds ratio, OR) for an absolute 10-percentage point incremental increase in %UPF intake were 1.08 (1.01-1.14; P = 0.02), 1.21 (1.16-1.26; P < 0.0001), and 1.11 (1.02-1.20; P = 0.02), respectively. No significant association was detected for restrictive ED. Discussion and Conclusion This study revealed an association of UPF intake with different ED types among French adults. Future research is needed to elucidate the direction of the observed associations.
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Affiliation(s)
- Natasha Figueiredo
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- Health Services Research Group (RESHAPE), INSERM U1290, Claude Bernard University - Lyon 1, Lyon, France
| | - Junko Kose
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
| | - Bernard Srour
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- National Nutrition and Cancer Research Network (NACRE), Jouy-en-Josas, France
| | - Chantal Julia
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- Department of Public Health, AP-HP Paris Seine-Saint-Denis Hospital System, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- National Nutrition and Cancer Research Network (NACRE), Jouy-en-Josas, France
| | - Sandrine Péneau
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
| | - Benjamin Allès
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
| | - Indira Paz Graniel
- Human Nutrition Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University, Tarragona, Spain
| | - Eloi Chazelas
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- National Nutrition and Cancer Research Network (NACRE), Jouy-en-Josas, France
| | - Mélanie Deschasaux-Tanguy
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- National Nutrition and Cancer Research Network (NACRE), Jouy-en-Josas, France
| | - Charlotte Debras
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- National Nutrition and Cancer Research Network (NACRE), Jouy-en-Josas, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- National Nutrition and Cancer Research Network (NACRE), Jouy-en-Josas, France
- Department of Public Health, AP-HP Paris Seine-Saint-Denis Hospital System, Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- National Nutrition and Cancer Research Network (NACRE), Jouy-en-Josas, France
| | - Carlos A. Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Mathilde Touvier
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
- National Nutrition and Cancer Research Network (NACRE), Jouy-en-Josas, France
| | - Valentina A. Andreeva
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS) – University of Paris, Bobigny, France
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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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Julia C, Touvier M, Kesse-Guyot E, Galan P, Hercberg S. Nutri-Score in tug-of-war between public health and economic interests in the European Union. Nat Food 2022; 3:181. [PMID: 37117639 DOI: 10.1038/s43016-022-00476-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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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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Debras C, Chazelas E, Srour B, Julia C, Kesse-Guyot E, Andreeva V, Galan P, Hercberg S, Deschasaux-Tanguy M, Touvier M. Consommation d’édulcorants et risque de cancer dans la cohorte NutriNet-Santé. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.031] [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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Kose J, Paz Graniel I, Péneau S, Julia C, Hercberg S, Galan P, Touvier M, Andreeva V. Étude sur la comorbidité des troubles de comportement alimentaire et l’anxiété, son lien avec les apports en macronutriments. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.048] [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: 11/29/2022]
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Škorić-Milosavljević D, Tadros R, Bosada FM, Tessadori F, van Weerd JH, Woudstra OI, Tjong FV, Lahrouchi N, Bajolle F, Cordell HJ, Agopian A, Blue GM, Barge-Schaapveld DQ, Gewillig M, Preuss C, Lodder EM, Barnett P, Ilgun A, Beekman L, van Duijvenboden K, Bokenkamp R, Müller-Nurasyid M, Vliegen HW, Konings TC, van Melle JP, van Dijk AP, van Kimmenade RR, Roos-Hesselink JW, Sieswerda GT, Meijboom F, Abdul-Khaliq H, Berger F, Dittrich S, Hitz MP, Moosmann J, Riede FT, Schubert S, Galan P, Lathrop M, Munter HM, Al-Chalabi A, Shaw CE, Shaw PJ, Morrison KE, Veldink JH, van den Berg LH, Evans S, Nobrega MA, Aneas I, Radivojkov-Blagojević M, Meitinger T, Oechslin E, Mondal T, Bergin L, Smythe JF, Altamirano-Diaz L, Lougheed J, Bouma BJ, Chaix MA, Kline J, Bassett AS, Andelfinger G, van der Palen RL, Bouvagnet P, Clur SAB, Breckpot J, Kerstjens-Frederikse WS, Winlaw DS, Bauer UM, Mital S, Goldmuntz E, Keavney B, Bonnet D, Mulder BJ, Tanck MW, Bakkers J, Christoffels VM, Boogerd CJ, Postma AV, Bezzina CR. Common Genetic Variants Contribute to Risk of Transposition of the Great Arteries. Circ Res 2022; 130:166-180. [PMID: 34886679 PMCID: PMC8768504 DOI: 10.1161/circresaha.120.317107] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 12/21/2022]
Abstract
RATIONALE Dextro-transposition of the great arteries (D-TGA) is a severe congenital heart defect which affects approximately 1 in 4,000 live births. While there are several reports of D-TGA patients with rare variants in individual genes, the majority of D-TGA cases remain genetically elusive. Familial recurrence patterns and the observation that most cases with D-TGA are sporadic suggest a polygenic inheritance for the disorder, yet this remains unexplored. OBJECTIVE We sought to study the role of common single nucleotide polymorphisms (SNPs) in risk for D-TGA. METHODS AND RESULTS We conducted a genome-wide association study in an international set of 1,237 patients with D-TGA and identified a genome-wide significant susceptibility locus on chromosome 3p14.3, which was subsequently replicated in an independent case-control set (rs56219800, meta-analysis P=8.6x10-10, OR=0.69 per C allele). SNP-based heritability analysis showed that 25% of variance in susceptibility to D-TGA may be explained by common variants. A genome-wide polygenic risk score derived from the discovery set was significantly associated to D-TGA in the replication set (P=4x10-5). The genome-wide significant locus (3p14.3) co-localizes with a putative regulatory element that interacts with the promoter of WNT5A, which encodes the Wnt Family Member 5A protein known for its role in cardiac development in mice. We show that this element drives reporter gene activity in the developing heart of mice and zebrafish and is bound by the developmental transcription factor TBX20. We further demonstrate that TBX20 attenuates Wnt5a expression levels in the developing mouse heart. CONCLUSIONS This work provides support for a polygenic architecture in D-TGA and identifies a susceptibility locus on chromosome 3p14.3 near WNT5A. Genomic and functional data support a causal role of WNT5A at the locus.
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Affiliation(s)
- Doris Škorić-Milosavljević
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
- Department of Human Genetics, Amsterdam University Medical Centers, The Netherlands (D.S.-M., E.M.L., A.V.P.)
| | - Rafik Tadros
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
- Department of Medicine, Cardiovascular Genetics Center, Montreal Heart Institute and Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada (R.T., M.-A.C.)
| | - Fernanda M. Bosada
- Department of Medical Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, the Netherlands (F.M.B., J.H.v.W., P.B., A.I., K.v.D., V.M.C., A.V.P.)
| | - Federico Tessadori
- Hubrecht Institute-KNAW and University Medical Center Utrecht, the Netherlands (F.T., J.B., C.J.B.)
| | - Jan Hendrik van Weerd
- Department of Medical Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, the Netherlands (F.M.B., J.H.v.W., P.B., A.I., K.v.D., V.M.C., A.V.P.)
| | - Odilia I. Woudstra
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
- Department of Cardiology, University Medical Center Utrecht, The Netherlands (O.I.W., G.T.S., F.M.)
| | - Fleur V.Y. Tjong
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
| | - Najim Lahrouchi
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
| | - Fanny Bajolle
- German Heart Center Berlin, Department of Congenital Heart Disease, Pediatric Cardiology, DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany (F.B., S.S.)
| | - Heather J. Cordell
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom (H.J.C.)
| | - A.J. Agopian
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX (A.J.A.)
| | - Gillian M. Blue
- Heart Centre for Children, The Children’s Hospital at Westmead and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia (G.M.B., D.S.W.)
| | | | | | - Christoph Preuss
- Cardiovascular Genetics, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Québec, Canada (C.P., G.A.)
- The Jackson Laboratory, Bar Harbor, ME (C.P.)
| | - Elisabeth M. Lodder
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
- Department of Human Genetics, Amsterdam University Medical Centers, The Netherlands (D.S.-M., E.M.L., A.V.P.)
| | - Phil Barnett
- Department of Medical Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, the Netherlands (F.M.B., J.H.v.W., P.B., A.I., K.v.D., V.M.C., A.V.P.)
| | - Aho Ilgun
- Department of Medical Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, the Netherlands (F.M.B., J.H.v.W., P.B., A.I., K.v.D., V.M.C., A.V.P.)
| | - Leander Beekman
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
| | - Karel van Duijvenboden
- Department of Medical Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, the Netherlands (F.M.B., J.H.v.W., P.B., A.I., K.v.D., V.M.C., A.V.P.)
| | - Regina Bokenkamp
- Division of Pediatric Cardiology, Department of Pediatrics (R.B., R.L.F.v.d.P.), Leiden University Medical Center, The Netherlands
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany (M.M.-N.)
- IBE, Faculty of Medicine, LMU Munich, Germany (M.M.-N.)
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center, Johannes Gutenberg University, Mainz, Germany (M.M.-N.)
| | - Hubert W. Vliegen
- Department of Cardiology (H.W.V.), Leiden University Medical Center, The Netherlands
| | - Thelma C. Konings
- Department of Cardiology, Amsterdam University Medical Centers, VU Amsterdam, The Netherlands (T.C.K.)
| | - Joost P. van Melle
- Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (J.P.v.M.)
| | - Arie P.J. van Dijk
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands (A.P.J.v.D., R.R.J.v.K.)
| | - Roland R.J. van Kimmenade
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands (A.P.J.v.D., R.R.J.v.K.)
- Department of Cardiology, Maastricht University Medical Center, The Netherlands (R.R.J.v.K.)
| | - Jolien W. Roos-Hesselink
- Department of Cardiology, Erasmus Medical Center, Erasmus University, Rotterdam, The Netherlands (J.W.R.-H.)
| | - Gertjan T. Sieswerda
- Department of Cardiology, University Medical Center Utrecht, The Netherlands (O.I.W., G.T.S., F.M.)
| | - Folkert Meijboom
- Department of Cardiology, University Medical Center Utrecht, The Netherlands (O.I.W., G.T.S., F.M.)
| | - Hashim Abdul-Khaliq
- Saarland University Medical Center, Department of Pediatric Cardiology, Homburg, Germany (H.A.-K.)
| | - Felix Berger
- Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de référence Malformations Cardiaques Congénitales Complexes - M3C, Hôpital Necker Enfants Malades, APHP and Université Paris Descartes, Sorbonne Paris Cité, Paris, France (F.B., D.B.)
- Charité, Universitätsmedizin Berlin, Department for Paediatric Cardiology, Germany (F.B.)
| | - Sven Dittrich
- Department of Pediatric Cardiology, Friedrich-Alexander-University of Erlangen-Nuernberg (FAU), Germany (S.D., J.M.)
| | - Marc-Phillip Hitz
- Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital Schleswig-Holstein/Campus Kiel, DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany (M.-P.H.)
- Department of Human Genetics, University Medical Center Schleswig-Holstein, Kiel, Germany (M.-P.H.)
| | - Julia Moosmann
- Department of Pediatric Cardiology, Friedrich-Alexander-University of Erlangen-Nuernberg (FAU), Germany (S.D., J.M.)
| | - Frank-Thomas Riede
- Leipzig Heart Center, Department of Pediatric Cardiology, University of Leipzig, Germany (F.-T.R.)
| | - Stephan Schubert
- German Heart Center Berlin, Department of Congenital Heart Disease, Pediatric Cardiology, DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany (F.B., S.S.)
- Heart and Diabetes Center NRW, Center of Congenital Heart Disease, Ruhr-University of Bochum, Bad Oeynhausen, Germany (S.S.)
| | - 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 (P.G.)
| | - Mark Lathrop
- McGill Genome Centre and Department of Human Genetics, McGill University, Montreal, Québec, Canada (M.L., H.M.M.)
| | - Hans M. Munter
- McGill Genome Centre and Department of Human Genetics, McGill University, Montreal, Québec, Canada (M.L., H.M.M.)
| | - Ammar Al-Chalabi
- Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, King’s College London, United Kingdom (A.A.-C.)
| | - Christopher E. Shaw
- United Kingdom Dementia Research Institute Centre, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom (C.E.S.)
- Centre for Brain Research, University of Auckland, New Zealand (C.E.S.)
| | - Pamela J. Shaw
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield and NIHR Sheffield Biomedical Research Centre for Translational Neuroscience, United Kingdom (P.J.S.)
| | - Karen E. Morrison
- Faculty of Medicine Health & Life Sciences, Queens University Belfast, United Kingdom (K.E.M.)
| | - Jan H. Veldink
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands (J.H.V., L.H.v.d.B.)
| | - Leonard H. van den Berg
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands (J.H.V., L.H.v.d.B.)
| | - Sylvia Evans
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego (S.E.)
| | | | - Ivy Aneas
- Department of Human Genetics, University of Chicago, IL (M.A.N., I.A.)
| | | | - Thomas Meitinger
- Helmholtz Zentrum Munich, Institut of Human Genetics, Neuherberg, Germany (M.R.-B., T.M.)
- Division of Cardiology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada (T.M.)
| | - Erwin Oechslin
- Peter Munk Cardiac Center, Toronto Congenital Cardiac Centre for Adults and University of Toronto, Canada (E.O.)
| | - Tapas Mondal
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (T.M.)
| | - Lynn Bergin
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, ON, Canada (L.B.)
| | - John F. Smythe
- Division of Cardiology, Department of Pediatrics, Kingston General Hospital, ON, Canada (J.F.S.)
| | | | - Jane Lougheed
- Division of Cardiology, Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Canada (J.L.)
| | - Berto J. Bouma
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
| | - Marie-A. Chaix
- Department of Medicine, Cardiovascular Genetics Center, Montreal Heart Institute and Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada (R.T., M.-A.C.)
| | - Jennie Kline
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY (J.K.)
| | - Anne S. Bassett
- Clinical Genetics Research Program, Centre for Addiction and Mental Health (A.S.B.)
- Department of Psychiatry, University of Toronto, Toronto General Hospital, University Health Network, Ontario, Canada (A.S.B.)
| | - Gregor Andelfinger
- Cardiovascular Genetics, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Québec, Canada (C.P., G.A.)
| | - Roel L.F. van der Palen
- Division of Pediatric Cardiology, Department of Pediatrics (R.B., R.L.F.v.d.P.), Leiden University Medical Center, The Netherlands
| | - Patrice Bouvagnet
- CPDPN, Hôpital MFME, CHU Martinique, Fort de France, Martinique, France (P.B.)
| | - Sally-Ann B. Clur
- Department of Pediatric Cardiology, Emma Children’s Hospital Amsterdam University Medical Centers (AMC), The Netherlands (S.-A.B.C.)
- Centre for Congenital Heart Disease Amsterdam-Leiden (CAHAL) (S.-A.B.C.)
| | - Jeroen Breckpot
- Hubrecht Institute-KNAW and University Medical Center Utrecht, the Netherlands (F.T., J.B., C.J.B.)
- Center for Human Genetics University Hospitals KU Leuven, Belgium (J.B.)
| | | | - David S. Winlaw
- Heart Centre for Children, The Children’s Hospital at Westmead and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia (G.M.B., D.S.W.)
| | - Ulrike M.M. Bauer
- National Register for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research), Berlin, Germany (U.M.M.B.)
| | - Seema Mital
- Hospital for Sick Children, University of Toronto, Ontario, Canada (S.M.)
| | - Elizabeth Goldmuntz
- Division of Cardiology, Children’s Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (E.G.)
| | - Bernard Keavney
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom (B.K.)
| | - Damien Bonnet
- Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de référence Malformations Cardiaques Congénitales Complexes - M3C, Hôpital Necker Enfants Malades, APHP and Université Paris Descartes, Sorbonne Paris Cité, Paris, France (F.B., D.B.)
| | - Barbara J. Mulder
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
| | - Michael W.T. Tanck
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health (APH), Amsterdam University Medical Centers, University of Amsterdam, The Netherlands (M.W.T.T.)
| | - Jeroen Bakkers
- Division of Heart and Lungs, Department of Medical Physiology, University Medical Center Utrecht, the Netherlands (J.B.)
| | - Vincent M. Christoffels
- Department of Medical Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, the Netherlands (F.M.B., J.H.v.W., P.B., A.I., K.v.D., V.M.C., A.V.P.)
| | - Cornelis J. Boogerd
- Hubrecht Institute-KNAW and University Medical Center Utrecht, the Netherlands (F.T., J.B., C.J.B.)
| | - Alex V. Postma
- Department of Human Genetics, Amsterdam University Medical Centers, The Netherlands (D.S.-M., E.M.L., A.V.P.)
- Department of Medical Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, the Netherlands (F.M.B., J.H.v.W., P.B., A.I., K.v.D., V.M.C., A.V.P.)
| | - Connie R. Bezzina
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, The Netherlands (D.S.-M., R.T., O.I.W., F.V.Y.T., N.L., E.M.L., L.B., B.J.B., B.J.M., C.R.B.)
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50
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Deschasaux-Tanguy M, Barrubés Piñol L, Sellem L, Debras C, Srour B, Chazelas E, Wendeu-Foyet G, Hercberg S, Galan P, Kesse-Guyot E, Julia C, Babio Sánchez NE, Salas Salvadó J, Touvier M. Dairy product consumption and risk of cancer: a short report from the NutriNet-Santé prospective cohort study. Int J Cancer 2022; 150:1978-1986. [PMID: 35041764 DOI: 10.1002/ijc.33935] [Citation(s) in RCA: 1] [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: 07/15/2021] [Revised: 12/19/2021] [Accepted: 01/05/2022] [Indexed: 12/24/2022]
Abstract
The impact of dairy product consumption for long-term health remains unclear, in particular regarding their involvement in cancer etiology for frequent locations like breast or prostate. Besides, little is known about potentially different effects of dairy producto subtypes. Our objective was therefore to evaluate the associations between dairy product consumption (total and subtypes) and cancer risk. A total of 101,279 participants from the French NutriNet-Santé cohort study were included (78.7% women; mean (SD) age=42.2 (14.5) years). Dairy product consumption was assessed using validated web-based 24-hour dietary records. Multi-adjusted Cox models were computed. After a median [interquartile range] follow-up time of 5.9 [2.7-8.3] years, we documented 2,503 incident cancer cases (783 breast, 323 prostate, and 182 colorectal cancers). Total dairy product consumption was not significantly associated with cancer. However, the consumption of "fromage blanc" (a French type of quark/cottage cheese) was associated with an increased risk of cancer overall [HR for 1 serving increment (95% CI)=1.11 (1.01-1.21); P-trend=0.03] and of colorectal cancer [HR=1.39 (1.09-1.77); P-trend<0.01]. Besides, sugary dairy dessert consumption was directly associated with colorectal cancer risk [HR for 1 serving increment=1.58 (1.01-2.46); P-trend=0.046]. No association was observed between the consumption of dairy products or sugary dairy desserts and the risk of prostate and breast cancers. In our study, the consumption of dairy products was not associated with the risk of overall, colorectal, breast or prostate cancers. The consumption of "fromage blanc" and sugary dairy desserts were associated to an increased risk of colorectal cancer, but this warrants further investigations.
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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.,French network for Nutrition And Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Laura Barrubés Piñol
- 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.,Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari de Sant Joan de Reus, Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Laury Sellem
- 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.,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
| | - 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - Nancy Elvira Babio Sánchez
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari de Sant Joan de Reus, Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Salas Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari de Sant Joan de Reus, Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - 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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