The Mediterranean diet is often proposed as a sustainable diet model. This study aimed to evaluate the associations between adherence to the Mediterranean diet and sustainability domains in a cohort of French adults, using multiple criteria including nutritional quality, environmental pressures, monetary cost and dietary pesticide exposure. Food intakes of 29 210 NutriNet-Santé volunteers were assessed in 2014 using a semi-quantitative FFQ. Adherence to the Mediterranean diet was evaluated using the validated literature-based adherence score (MEDI-LITE). The associations between the MEDI-LITE and various sustainability indicators were examined using ANCOVA models, adjusted for sex, age and energy intake. Higher adherence to the MEDI-LITE was associated with higher nutritional quality scores, better overall nutrient profile as well as reduced environmental impact (land occupation: Q5 v. Q1: −35 %, greenhouse gas emissions: −40 % and cumulative energy demand: −17 %). In turn, monetary cost increased with increasing adherence to the Mediterranean diet (Q5 v. Q1: +15 %), while higher adherents to the Mediterranean diet had overall higher pesticide exposure due to their high plant-based food consumption. In this large cohort of French adults, greater adherence to the Mediterranean diet was associated with nutritional and environmental benefits, but also with higher monetary cost and greater exposure to pesticides, illustrating the necessity to develop large-scale strategies for healthy, safe (pesticide- and contaminant-free) and environmentally sustainable diets for all.

The rising popular belief that gluten is unhealthy has led to growth in gluten avoidance in people without coeliac disease. Little information is available on their dietary profiles and their dietary behaviours. Our aim was to compare the consumption of organic foods between gluten avoiders and non-avoiders, and their places of food purchase. We described their sociodemographic and dietary profiles. The study population included participants of the NutriNet-Santé cohort who completed both a food exclusion questionnaire and an organic semi-quantitative FFQ (n 23 468). Food intake and organic food consumption ratios were compared using multivariable adjusted ANCOVA models. Associations between gluten avoidance and organic food consumption as well as places of food purchase were investigated with multivariable logistic regression. Participants avoiding gluten were more likely to be women and had a healthier dietary profile. Organic food consumption was higher among gluten avoiders (48·50 % of total diet for total avoiders, 17·38 % for non-avoiders). After adjustments for confounders, organic food consumption and purchase in organic stores were positively associated with gluten avoidance: adjusted OR (aOR)Q5 v.Q1 organic food = 4·95; 95 % CI 3·70, 6·63 and aORorganic stores v.supermarkets = 1·82; 95 % CI 1·42, 2·33 for total avoiders. Our study highlights that individuals avoiding gluten are high organic consumers and frequently purchase their foods in organic stores which propose an extended offer of gluten-free food. Further research is needed to determine the underlying common motivations and the temporality of the dietary behaviours of healthy people avoiding gluten.

Pesticides are used in large quantities in current agriculture all over Europe. Some pesticides are suspected of having negative effects on human health. While the risk associated with occupational exposure is getting well-documented, evidence of dietary exposure to these molecules in the general population is lacking. The aim of this study is to describe dietary exposure to pesticides among NutriNet-Santé cohort participants’.

NutriNet-Santé is a web-based cohort of French middle-aged adults launched in 2009. BioNutriNet is an ancillary study launched in 2014, aiming to measure organic and conventional food consumption and evaluate different dimensions of diet sustainability. Dietary intake of organic and conventional foods was assessed using a 264 items self-administered semi-quantitative food frequency questionnaire. Exposure to 25 commonly used pesticides was evaluated using contamination data from CVUA Stuttgart accounting for farming system. Dietary pesticide exposure profiles were identified using Non-Negative Matrix factorization (NMF), specially adapted for non-negative data with excess zeros. The NMF scores were then introduced in a hierarchical clustering process. Identified clusters were described in terms of sociodemographics, dietary patterns and exposure to pesticides.

A total of 34,442 participants were selected. Four clusters were identified. All clusters seemed to be exposed to the same molecules, with gradual intensity. The first cluster was characterized by the lowest energy-intake, highest organic food consumption (26.9%) and lowest dietary pesticide exposure; participants had highest consumption levels of organic food groups, including fruits and vegetables. Proportion of male participants and of rural residents was higher than in other groups. Clusters 2 and 3 were characterized by intermediate energy intake, and low organic food consumption. High conventional fruits and vegetables intake and moderate pesticide exposure were observed in cluster 2, composed of a lower smokers’ proportion. Cluster 3 individuals were less exposed to pesticides than clusters 2 and 4, except for Spinosad and Pyrethrins. Cluster 4 was characterized by the highest energy intake, lowest organic food consumption (12.2%), and highest pesticide exposure ; high consumption levels of conventional fruits, vegetables and a higher proportion of vegetarians were observed. This cluster was composed of 85.6% female participants, mainly retired (47.5%), mostly living in cities of 200 000 inhabitants and more (48.2%), and physically active.

Dietary pesticide exposures seem to vary across the clusters and depending on the proportion of organic food in the diet. High consumers of conventional fruits and vegetables consumers seem to be more exposed to our selection of pesticides.

Organic food consumption has risen in many countries during the past decades, but individual behaviors leading to these choices remain unclear.. The aim of this study was to evaluate the associations between cognitive restraint, weight loss diet history and organic food intake, in French adults. This cross-sectional analysis included 21,516 participants from the NutriNet-Santé cohort (26.4% male, mean age 55.3 years; SD = 13.8). Cognitive restraint was evaluated by the Three-Factor Eating Questionnaire and practice of weight-loss diet in the past years was assessed by an ad hoc questionnaire. Organic food intake of 17 food groups was assessed by the Organic-Food Frequency Questionnaire. Adjusted means of proportions of organic food intakes out of total food intakes were compared across quartiles of the cognitive restraint score and weight loss diet history. Analyses were adjusted for sociodemographic and lifestyle factors. Women with higher levels of cognitive restraint had in average a lower contribution of organic foods in their diet (26.5% in Q4 vs. 30.9% in Q1; p < 0.0001). In addition, women with a history of weight loss diet had in average a lower contribution of organic foods in their diet (27.1% in current/past vs. 28.5% in never dieters; p = 0.0012). Associations were observed in men for specific food groups. Overall, individuals, and in particular women, with higher cognitive restraint scores or with a history of weight loss diet consumed less organic food. Results suggest that it can be too complex to follow both weight control and organic food choice strategies at the same time.

In the current context of unsustainable food systems, we aimed to develop and validate an index, the sustainable diet index (SDI), assessing the sustainability of dietary patterns, including multidimensional individual indicators of sustainability. Based on the FAO’s definition of sustainable diets, the SDI includes seven indicators categorised into four standardised sub-indexes, respectively, environmental, nutritional, economic and sociocultural. The index (range: 4–20) was obtained by summing the sub-indexes. We computed the SDI for 29 388 participants in the NutriNet-Santé cohort study, estimated its validity and identified potential socio-demographic or lifestyle differences across the SDI quintile. In our sample, the SDI (mean=12·10/20; 95 % CI 12·07, 12·13) was highly correlated to all the sub-indexes that exerted substantial influence on the participants’ ranking. The environmental and economical sub-indexes were the most and less correlated with the SDI (Pearson R2 0·66 and 0·52, respectively). Dietary patterns of participants with a high SDI (considered as more sustainable) were concordant with the already published sustainable diets. Participants with high SDI scores were more often women (24 %), post-secondary graduates (22 %) and vegetarians or vegans (7 %), without obesity (16 %). Finally, the SDI could be a useful tool to easily assess the sustainability-related changes in dietary patterns, estimate the association with long-term health outcomes and help guide future public health policies.

A lower BMI has been reported among consumers of organic foods, but this relationship has never been examined in a prospective design study. Our aim was to prospectively investigate the association between frequency of organic food consumption and weight change. We analysed data from 62 224 participants of the NutriNet-Santé cohort (78 % women, mean age=45 years) with information on consumption frequency of organic foods, dietary intake and repeated anthropometric data. For sixteen products, participants reported their consumption frequency of labelled organic foods (never, occasionally, most of the time). An organic score (OS) with a maximum of thirty-two points was computed. The associations of the OS (modeled as quartiles (Q)) with change in BMI during follow-up (on average 3·1 years) and with the risk of overweight and obesity were estimated by ANCOVA and multivariable logistic regression. A lower BMI increase was observed across quartiles of the OS (mean difference Q4 v. Q1=−0·16 (95 % CI −0·32, −0·01). An increase in the OS was associated with a lower risk of overweight and obesity (among non-overweight and non-obese participants at inclusion): OR for Q4 v. Q1 were 0·77 (95 % CI 0·68, 0·86) and 0·69 (95 % CI 0·58, 0·82), respectively. Concerning obesity risk, the association was stronger among participants with higher adherence to nutritional guidelines. This study supports a strong protective role of consumption frequency of organic foods with regard to the risk of overweight and obesity that depends on overall dietary quality. Upon confirmation, these results may contribute to fine-tune nutritional guidelines by accounting for farming practices in food production.

Limited information is available on large-scale populations regarding the socio-demographic and nutrient profiles and eating behaviour of consumers, taking into account both organic and conventional foods. The aims of this study were to draw up a typology of consumers according to their eating habits, based both on their dietary patterns and the mode of food production, and to outline their socio-demographic, behavioural and nutritional characteristics. Data were collected from 28 245 participants of the NutriNet-Santé study. Dietary information was obtained using a 264-item, semi-quantitative, organic FFQ. To identify clusters of consumers, principal component analysis was applied on sixteen conventional and sixteen organic food groups followed by a clustering procedure. The following five clusters of consumers were identified: (1) a cluster characterised by low energy intake, low consumption of organic food and high prevalence of inadequate nutrient intakes; (2) a cluster of big eaters of conventional foods with high intakes of SFA and cholesterol; (3) a cluster with high consumption of organic food and relatively adequate nutritional diet quality; (4) a group with a high percentage of organic food consumers, 14 % of which were either vegetarians or vegans, who exhibited a high nutritional diet quality and a low prevalence of inadequate intakes of most vitamins except B12; and (5) a group of moderate organic food consumers with a particularly high intake of proteins and alcohol and a poor nutritional diet quality. These findings may have implications for future aetiological studies investigating the potential impact of organic food consumption.

The dietary and health traits of organic food (OF) consumers have not been comprehensively described. The aim of this study was to identify factors associated with OF consumption. Data were collected from 54 283 participants from the NutriNet-Santé cohort using self-administered web-based questionnaires. Occasional organic food consumers and regular organic food consumers (ROFC) were compared with non-organic food consumers (NOFC) using logistical regression providing an OR and 95 % CI. Adherence to the French food-based guidelines and interactions between nutritional knowledge and OF consumption in adherence to dietary guidelines were investigated. Medical history was also assessed in relation to OF consumption. Compared with NOFC, ROFC were more likely to be vegetarian (OR 9·93; 95 % CI 7·42, 13·29 in women; OR 13·07; CI 7·00, 24·41 in men) and were less likely to be aware of nutritional guidelines regarding meat consumption (OR 0·37; CI 0·34, 0·40 in women; OR 0·41; CI 0·36, 0·47 in men). Compared with NOFC, ROFC had a lower risk of type II diabetes, hypertension and CVD; however, this effect was only significant for men. In contrast, organic consumers were more likely to report food allergies. Consuming OF appeared to affect the relationship between nutritional knowledge and adequate intake of meat/poultry/seafood/eggs and starchy food among both sexes. Our study provides new insights into the diet- and health-related behaviours of OF consumers in a large sample of participants residing in France. This should be taken into account in future studies investigating relationships between health and OF consumption.

The xanthophylls lutein and zeaxanthin probably play a role in visual function and may participate in the prevention of age-related eye diseases. Although a minimum amount of TAG is required for an optimal bioavailability of these carotenoids, the effect of the type of TAG fatty acids (FA) is less clear. The aim was to assess the effect of the type of TAG FA on bioavailability of these xanthophylls. A total of three complementary models were used: an in vitro digestion model to study bioaccessibility, Caco-2 cells to study uptake efficiency and orally administered rats to study in vivo bioavailability. Results showed that lutein and zeaxanthin bioaccessibility was greater (about 20–30 %, P< 0·05) with butter and palm oil than with olive and fish oils. Mixed micelle size, which was significantly lower (about 8 %, P< 0·05) with SFA than with unsaturated FA, was inversely related to lutein and zeaxanthin bioaccessibility. There was no significant effect of the type of TAG FA on xanthophyll uptake by Caco-2 cells, but some compounds present in natural oils significantly affected xanthophyll uptake. Oral administration of rats with spinach and butter over 3 d led to a higher fasting plasma lutein concentration than oral administration with olive or fish oils. In conclusion, dietary fats rich in SFA lead to a higher bioavailability of lutein and zeaxanthin, as compared with fats rich in MUFA and PUFA. This is due partly to the higher bioaccessibility of these xanthophylls in the smaller mixed micelles produced when SFA are incorporated into mixed micelles.

In mice, hepatic functions can be greatly affected by dietary trans-10, cis-12-conjugated linoleic acid (CLA). However, this phenomenon has been less documented in hamsters. In the present study, male hamsters were fed two doses of the trans-10, cis-12-CLA (0·5 and 1 %, w/w diet) or linoleic acid (0·5 %) for 6 weeks. The effects on the liver were examined by measuring the expression of thirty-six genes representing key metabolic pathways. CLA-responsive genes and their relationships with physiological outcomes were examined by a multivariate analysis procedure. Compared with control hamsters, those receiving either 0·5 or 1 % CLA exhibited similar fat loss (15–24 %; P ≤  0·05) and liver enlargement (21–28 %; P ≤ 0·05), with no signs of steatosis. We also observed a dose-dependent increase in the transcription of genes involved in lipid breakdown and lipid harvesting from blood, and in genes related to the oxidative stress and inflammatory responses. These responsive genes varied in parallel with cell membrane lipids (R2 0·31–0·42) and to a lesser extent with liver enlargement (R2 0·22) (all P < 0·05). We conclude that in hamsters, liver enlargement induced by trans-10, cis-12-CLA is accompanied by an increased metabolic potential to process fatty acids from mobilised adipose stores. This elevated metabolic activity, comprised of anabolic pathways and their catabolic counterparts, can trigger inflammation and the oxidant stress defence pathways in a dose-dependent manner. These results provide novel insights into the mechanisms by which trans-10, cis-12-CLA affects pathways related to liver function.

Résumé

Alors que l'alimentation de l'homme a beaucoup évoluée depuis ses origines, le génome humain est resté très stable. Pourtant, de très nombreux gènes ont des polymorphismes connus. En fait, on considère maintenant que les principales pathologies humaines (maladies cardiovasculaires, diabète, obésité et cancers) résultent d'une interaction entre des facteurs de succeptibilité génétique et des facteurs de l'environement, dont l'alimentation. Dans le domaine du métabolisme des lipoprotéines et des maladies cardiovasculaires, des polymorphimes de plusieurs gènes ont été identifiés et associés aux niveaux des paramètres lipidiques ou aà des réponses variables aux régimes, comme pour les apoprotéines (apo) E, B, A-IV et C-III, le LDL récepteur, la protéine microsomiale de transport (MTP), la protéine de liason des acides gras (FABP), la protéine de transport des esters de cholésterol (CETP), la lipoprotéine lipase ou la lipase hepatique. Nous réalisons une étude d'intervention à Marseille dans le but d'étudier l'interaction

The interindividual variation in ApoE plasma concentration is considerable, mainly determined by apoE genotype and sex. However, a large amount of variability remains unexplained by these factors. We have evaluated whether the quantity and quality of dietary fat interacts with the apoE genotype and sex modifying ApoE plasma levels in young healthy subjects. Eighty-four volunteers (sixty-six apoE3/3, eight apoE4/3 and ten apoE3/2) were subjected to three dietary periods, each lasting 4 weeks. The first was a SFA-enriched diet (38 % fat and 20 % SFA), which was followed by a carbohydrate (CHO)-rich diet (30 % fat, < 10 % SFA and 55 % carbohydrate) or a MUFA-rich diet (38 % fat and 22 % MUFA) following a randomised crossover design. apoE2 carriers have the highest ApoE levels, whereas apoE4 individuals show the lowest concentration after the SFA, CHO and MUFA diets. Women had significantly higher ApoE concentration than men only after the consumption of the SFA diet. The SFA diet increased the ApoE plasma concentration when compared with the CHO- and MUFA-rich diets in women, but not in men. In women, but not in men, the shift from the SFA- to CHO- or MUFA-rich diets significantly decreased the ApoE concentration in apoE3/2 and apoE3/3 subjects, whereas no differences were observed in women with the apoE4/3 genotype. Sex and apoE genotype determine ApoE plasma levels; however, this effect is dependent on dietary fat.

Plasma concentrations of vitamin E and carotenoids are governed by several factors, including genetic factors. Single nucleotide polymorphisms (SNP) in some genes involved in lipid metabolism have recently been associated with fasting plasma concentrations of these fat-soluble micronutrients. To further investigate the role of genetic factors that modulate the plasma concentrations of these micronutrients, we assessed whether SNP in five candidate genes (apo C-III, CETP, hepatic lipase, I-FABP and MTP) were associated with the plasma concentrations of these micronutrients. Fasting plasma vitamin E and carotenoid concentrations were measured in 129 French Caucasian subjects (forty-eight males and eighty-one females). Candidate SNP were genotyped by PCR amplification followed by restriction fragment length polymorphisms. Plasma γ-tocopherol, α-carotene and β-carotene concentrations were significantly different (P < 0·05) in subjects who carried different SNP variants in hepatic lipase. Plasma α-tocopherol concentrations were significantly different in subjects who had different SNP variants in apo C-III and cholesteryl ester transfer protein (CETP). Plasma lycopene concentrations were significantly different (P < 0·05) in women who had different SNP variants in intestinal fatty acid binding protein (I-FABP). Finally, there was no effect of SNP variants in microsomal TAG transfer protein upon the plasma concentrations of these micronutrients. Most of the observed differences remained significant after the plasma micronutrients were adjusted for plasma TAG and cholesterol. These results suggest that apo C-III, CETP and hepatic lipase play a role in determining the plasma concentrations of tocopherols while hepatic lipase and I-FABP may modulate plasma concentrations of carotenoids.