Nutri-Score and NutrInform Battery: Effects on Performance and Preference in Italian Consumers

In May 2020, the European Commission announced a proposal for a mandatory front-of-pack label (FoPL) for all European Union (EU) countries. Indeed, FoPLs have been recognized by several public institutions as a cost-effective measure to guide consumers toward nutritionally favorable food products. The aim of this study was to compare the performance and consumer preference of two FoPLs currently proposed or implemented in EU countries, the interpretive format Nutri-Score and the non-interpretive format NutrInform Battery, among Italian consumers. The experimental study was conducted in 2021 on a representative sample of 1064 Italian adults (mean age = 46.5 +/- 14.1 years; 48% men). Participants were randomized to either Nutri-Score or NutrInform and had to fill out an online questionnaire testing their objective understanding of the FoPL on three food categories (breakfast products, breakfast cereals and added fats) as well as purchase intention, subjective understanding and perception. Multivariable logistic regressions and t-tests were used to analyze the answers. In terms of the capacity of participants to identify the most nutritionally favorable products, Nutri-Score outperformed NutrInform in all food categories, with the highest odds ratio being observed for added fats (OR = 21.7 [15.3-31.1], p < 0.0001). Overall, with Nutri-Score, Italian participants were more likely to intend to purchase nutritionally favorable products than with NutrInform (OR = 5.29 [4.02-6.97], p < 0.0001). Focusing on olive oil, participants of the Nutri-Score group had higher purchase intention of olive oil compared to those in the NutrInform group (OR = 1.92 [1.42-2.60], p < 0.0001) after manipulating the label. The interpretive format Nutri-Score appears to be a more efficient tool than NutrInform for orienting Italian consumers towards more nutritionally favorable food choices

Body weight, body composition and the risk of SARS‐CoV‐2 infection in a large population‐based sample

International audienc

Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights

Epidemiological studies have suggested a role for ultra-processed foods in numerous chronic inflammatory diseases such as inflammatory bowel diseases and metabolic syndrome. Preclinical and clinical studies are accumulating to better decipher the effects of various aspects of food processing and formulation on the aetiology of chronic, debilitating inflammatory diseases. In this Review, we provide an overview of the current data that highlight an association between ultra-processed food consumption and various chronic diseases, with a focus on epidemiological evidence and mechanistic insights involving the intestinal microbiota

Comportements alimentaires des personnes atteintes du syndrome de Lynch présentant un risque élevé de cancer colorectal : Résultats de l'étude AAS-lynch

International audienceBackground & Aims: Individuals with Lynch syndrome (LS) have a high lifetime risk of developing colorectal cancer (CRC) due to genetic alterations. Nutrition is one of the main modifiable risk factors for sporadic CRC, however this has not been established in LS patients. The present study aimed to give a detailed overview of dietary intakes in individuals with LS, and associated individual characteristics. Methods: Dietary behaviours of individuals with LS from the AAS-Lynch clinical trial (2017-2022) were obtained using a food frequency questionnaire. Dietary intakes, food group consumption and overall diet quality (dietary patterns, adherence to the Mediterranean diet) were described according to sociodemographic, anthropometric and clinical characteristics, and compared to participants without LS from the NutriNet-Santé study (matched on sex, age, BMI and region). Results: 280 individuals with LS were included in this analysis and matched with 547 controls. Compared to controls, LS patients consumed less fibre, legumes, fruit and vegetables and more red and processed meat (all p<0.01). They also had a lower Mediterranean diet score (p=0.002). Among LS patients, men, younger patients, or those with disadvantaged situation had a diet of poorer nutritional quality with lower adherence to a "Healthy" diet (all p≤0.01). LS Patients with prevalent CRC had a higher consumption of dairy products than recommended, while those with prevalent adenoma consumed more vegetables, and less sugar and sweets (all p≤0.01). Conclusions: Although patients with LS were aware of their high lifetime risk of developing cancer, their diets were not optimal and included nutritional risk factors associated to CRC. The study is registered with # NCT04791644 at ClinicalTrials.gov.Contexte et objectifs : Les personnes atteintes du syndrome de Lynch (LS) présentent un risque élevé de développer un cancer colorectal au cours de leur vie en raison d'altérations génétiques. L'alimentation est l'un des principaux facteurs de risque modifiables pour le CCR sporadique, mais cela n'a pas été établi chez les patients atteints du syndrome de Lynch. Cette étude visait à donner un aperçu détaillé des apports alimentaires chez les personnes atteintes de LS et des caractéristiques individuelles associées. Méthodes : Les comportements alimentaires des personnes atteintes de LS de l'essai clinique AAS-Lynch (2017-2022) ont été obtenus à l'aide d'un questionnaire de fréquence alimentaire. Les apports alimentaires, la consommation de groupes d'aliments et la qualité globale de l'alimentation (modèles alimentaires, adhésion au régime méditerranéen) ont été décrits en fonction des caractéristiques sociodémographiques, anthropométriques et cliniques, et comparés à des participants sans LS de l'étude NutriNet-Santé (appariés sur le sexe, l'âge, l'IMC et la région). Résultats : 280 personnes atteintes de LS ont été incluses dans cette analyse et appariées à 547 témoins. Par rapport aux témoins, les patients atteints de LS consommaient moins de fibres, de légumineuses, de fruits et de légumes et plus de viande rouge et de viande transformée (tous p<0,01). Ils avaient également un score de régime méditerranéen plus faible (p=0,002). Parmi les patients LS, les hommes, les jeunes patients ou les patients défavorisés avaient une alimentation de moins bonne qualité nutritionnelle avec une plus faible adhésion à un régime "sain" (tous les p≤0,01). Les patients LS atteints de CCR prévalent avaient une consommation de produits laitiers supérieure aux recommandations, tandis que ceux atteints d'adénome prévalent consommaient plus de légumes et moins de sucre et de sucreries (tous p≤0,01). Conclusions : Bien que les patients atteints de LS soient conscients de leur risque élevé de développer un cancer au cours de leur vie, leur régime alimentaire n'était pas optimal et incluait des facteurs de risque nutritionnels associés au CCR. L'étude est enregistrée sous le numéro NCT04791644 sur ClinicalTrials.gov

La résilience est associée aux troubles du comportement alimentaire dans la cohorte NutriNet-Santé

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Food additive emulsifiers and cancer risk: results from the French prospective NutriNet-Santé cohort

International audienceAbstract Background Food additive emulsifiers are found in thousands of industrial foods and may exert deleterious effects on gut microbiota and carcinogenesis according to experimental studies. However, their associations with cancer risk has not been investigated yet. This study aimed to investigate these associations in a large population-based prospective cohort. Methods This study included 102,485 French adults from the NutriNet-Santé cohort (42.1y [14.5], 78.8% female, 2009-2021). Food additive emulsifier intakes were estimated using repeated 24h dietary records linked to brand-specific food composition databases on food additives. Associations with incident cancer risk were assessed using Multivariable Cox models. Results 3,511 incident cancer cases were diagnosed during follow-up (1,026 breast, 431 prostate, and 279 colorectal cancers). Intakes of sodium citrate (E331, HR = 1.12 [1.02-1.23], p-trend=0.009), xanthan gum (E415, HR = 1.11 [1.02-1.21], p-trend=0.02), and mono- and diglycerides of fatty acids (E471, HR = 1.17 [1.06-1.28], p-trend=0.001 and total: E471, E472a-b-c-e, HR = 1.11, [1.02-1.22], p-trend=0.02) were associated with increased overall cancer risk. Higher intakes of E331 (p-trend = 0.046), sodium stearoyl-2-lactylate (E481, p-trend=0.01), total lactylates (E481-482, p-trend=0.01), total celluloses (E460-468, p-trend=0.03), carob bean gum (E410, p-trend=0.01), and E471 (p-trend=0.006) were associated with increased overall breast cancer risk. Higher intakes of carrageenan (E407, p-trend=0.04), E415 (p-trend=0.02), and triphosphates (E451, p-trend=0.03) were associated with increased post-menopausal breast cancer risk. Conclusions These results are the first to investigate and report direct associations between cancer risk and exposures to seven individual and three groups of food additive emulsifiers. If replicated, they may have an important public health impact, considering the omnipresence of these additives in industrial foods globally. Key messages • This study is the first to precisely assess exposures to food additive emulsifiers in a population-based study. • Intakes of food additive emulsifiers were associated with increased risk of cancer

Resilience Is Associated with Less Eating Disorder Symptoms in the NutriNet-Santé Cohort Study

International audienceResilience is a positive psychological trait associated with a lower risk of some physical and mental chronic diseases and could be an important protective factor against eating disorders (EDs). The aim of this study was to assess cross-sectional and longitudinal associations between resilience and ED in a large cohort of French adults. In 2017, a total of 25,000 adults from the NutriNet-Santé cohort completed the Brief Resilience Scale (BRS). ED symptoms were measured in 2017 and 2020, with the Sick-Control-One-Fat-Food (SCOFF) questionnaire. Cross-sectional and longitudinal associations between resilience and EDs were analyzed using logistic regression, controlling for sociodemographic and lifestyle characteristics. Cross-sectional analyses showed that more resilient participants exhibited EDs less frequently than did less resilient participants (p < 0.0001). Longitudinal analyses showed that, during the three years of follow up, higher resilience was negatively associated with incident EDs (OR: 0.67, 95%CI: 0.61–0.74), persistent EDs (0.46 (0.42–0.51)), and intermittent EDs (0.66 (0.62–0.71)), compared with no ED. More resilient participants were also less likely to have a persistent ED than to recover from EDs (0.73 (0.65–0.82)). This study showed that resilience was associated with less ED symptoms and a higher chance of recovery

Nitrites, Nitrates, and Cardiovascular Outcomes: Are We Living “La Vie en Rose” With Pink Processed Meats?

International audienceBackground Nitrates and nitrites are used as food additives in processed meats. They are also commonly ingested from water and several foods. Several short‐term clinical studies suggested beneficial effects of dietary nitrates on blood pressure, while deleterious effects on oxidative damage have been suggested in some experimental studies. However, there is a lack of evidence from longitudinal epidemiological studies linking foods and water‐originated and additives‐originated nitrites and nitrates, separately, to hypertension and cardiovascular diseases risk. We aimed to study these associations in a large population‐based cohort. Methods and Results Overall, 106 288 adults from the French NutriNet‐Santé cohort (2009–2022) were included. Associations between nitrites and nitrates intakes and hypertension and cardiovascular disease risks were assessed using multi‐adjusted Cox proportional hazard models. During follow‐up, 3810 incident cases of hypertension and 2075 cases of cardiovascular diseases were ascertained. Participants with higher intakes of additives‐originated nitrites (sodium nitrite in particular [European code e250]) had a higher hypertension risk compared with nonconsumers (hazard ratio, 1.19 [95% CI, 1.08–1.32], P =0.001, and 1.19 [95% CI, 1.08–1.32], P =0.002), respectively. No association was detected between foods and water‐originated nitrites, or nitrates with hypertension risk (all P values >0.3). We found no association between nitrites or nitrates and risks of cardiovascular diseases (all P values >0.2). Conclusions These results do not support a protective role of nitrites or nitrates in cardiovascular health. Instead, they suggest a positive association between nitrites from food additives and hypertension risk, which needs confirmation in other large‐scale studies. These findings provide new evidence in the context of current discussions about updating regulations on the use of nitrites as food additives

Resilience is associated with healthier food intake and less eating disorders in a population-based study

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