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1.
Am J Prev Med ; 65(2): 201-212, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37479421

RESUMO

INTRODUCTION: Explicit weight bias is an underlying cause of weight stigma, but its associations with individual characteristics are not well known. This study aimed to assess explicit weight bias in French adults and to explore the associations with weight status and sociodemographic characteristics. METHODS: Adults from the NutriNet-Santé cross-sectional study (France, 2020, n=33,948, 52% women after weighting procedures) completed the Anti-Fat Attitudes Questionnaire assessing three dimensions: Dislike (antipathy toward people with obesity), Fear of fat (concerns about body weight), and Willpower (belief in weight controllability). Associations with weight status and sociodemographic characteristics were examined using multivariable ANCOVA models in 2022. RESULTS: Fear of fat and Willpower scores were higher than Dislike scores (mean [SD]=4.0 [2.0], 3.3 [1.7] and 1.9 [1.3], respectively). Fear of fat was higher among women, whereas Dislike and Willpower were higher among men (all p<0.0001). Obesity was associated with greater Fear of fat scores (p<0.0001, mean difference versus normal-weight participants [95% CI]=0.35 [0.24, 0.46] in women, 0.36 [0.17, 0.56] in men), lower Dislike scores (-0.38 [-0.45, -0.32] in women, -0.43 [-0.56, -0.30] in men), and lower Willpower scores (-1.00 [-0.18, -0.90] in women, -0.40 [-0.57, -0.23] in men). In both genders, lower income was associated with lower Dislike, Fear of fat, and Willpower scores (all p<0.0001), and lower education was associated with greater Fear of fat and Willpower scores (all p<0.0001). CONCLUSIONS: Explicit weight bias was driven by the fear of gaining weight and the belief in weight controllability. This study provides new insights into which population subgroups should be targeted by interventions aimed at reducing explicit weight bias.


Assuntos
Preconceito de Peso , Adulto , Humanos , Feminino , Masculino , Peso Corporal , Estudos Transversais , Obesidade/epidemiologia , Aumento de Peso
2.
Nutrients ; 14(14)2022 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-35889904

RESUMO

BACKGROUND: Long-chain omega-3 and omega-6 fatty acids (n-3, n-6 FAs) may modulate inflammation and affect the risk of developing rheumatoid arthritis (RA). However, whether n-3/n-6 FA status affects RA after disease onset is unknown. This study aimed to assess whether FA profiles are independently associated with disease activity in a large prospective cohort of patients with early RA. METHODS: Baseline serum FAs were quantified in 669 patients in the ESPOIR cohort. Principal component analysis identified three serum FA patterns that were rich in n-7-9, n-3 and n-6 FAs (patterns ω7-9, ω3 and ω6), respectively. The association of pattern tertiles with baseline variables and 6-month disease activity was tested using multivariable logistic regression. RESULTS: Pattern ω3 was associated with low baseline and pattern ω6 with high baseline C-reactive protein level and disease activity. Both patterns ω3 and ω6 were associated with reduced odds of active disease after 6 months of follow-up (pattern ω3: odds ratio, tertile three vs. one, 0.49 [95% CI 0.25 to 0.97] and pattern ω6: 0.51 [0.28 to 0.95]; p = 0.04 and 0.03, respectively). CONCLUSIONS: In a cohort of early RA patients, a serum lipid profile rich in n-3 FAs was independently associated with persistently reduced disease activity between baseline and 6-month follow-up. An n-6 FA profile was also associated with lower 6-month disease activity.


Assuntos
Artrite Reumatoide , Ácidos Graxos Ômega-3 , Estudos de Coortes , Ácidos Graxos/metabolismo , Humanos , Estudos Prospectivos
3.
Nutrients ; 13(12)2021 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-34960065

RESUMO

(1) Background: Specific foods, and more particularly, fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs) are often considered as triggers of digestive symptoms in Irritable Bowel Syndrome (IBS). Our aim was to study FODMAP consumption in controls and IBS participants in a large French population-based cohort; (2) Methods: Participants from the NutriNet-Santé cohort study completed the Rome IV and IBS-SSS questionnaire in a cross sectional study. Among them, 27,949 eligible participants had previously completed three 24-h recalls as well as anthropometrics, socio-demographical and lifestyle data. Total FODMAP intake (in g/day) was computed using a specific composition table. The association between FODMAPs and IBS was estimated through multivariable logistic regression models; (3) Results: Included participants were mainly women (75.4%) and the mean age was 43.4 ± 14.1 years. FODMAPs accounted for a mean daily intake of 19.4 ± 9.5 g/day. Overall 1295 participants (4.6%) were identified with an IBS. After adjusting for confounding factors, IBS participants had lower intakes in FODMAPs than non-IBS ones (aOR: 0.88, 95% CI: 0.82-0.95, p-value: 0.001). IBS severity was associated with more frequent low FODMAP intakes (<9 g/day); (4) Conclusions: Participants tended to consume 19 g of FODMAPs per day, but slightly less for IBS participants than for controls. In IBS participants, higher severity was associated with lower intakes.


Assuntos
Dieta/efeitos adversos , Dissacarídeos/efeitos adversos , Síndrome do Intestino Irritável/induzido quimicamente , Monossacarídeos/efeitos adversos , Oligossacarídeos/efeitos adversos , Adulto , Estudos de Coortes , Feminino , Fermentação , Análise de Alimentos , França , Humanos , Masculino , Pessoa de Meia-Idade , Polímeros
4.
J Nutr ; 151(10): 3180-3186, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34224572

RESUMO

BACKGROUND: Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are increasingly studied because they are suspected unfavorably to impact health (irritable bowel syndrome in particular). However, little is known about FODMAP intake in the general population, or which groups are more likely to consume them, because their intakes are usually assessed in inpatient settings. OBJECTIVES: This study aimed to describe FODMAP consumption in a large French cohort and its association with sociodemographic and lifestyle characteristics. METHODS: This cross-sectional study described FODMAP intakes in 109,362 volunteers (78.0% female, mean age 43.8 ± 14.7 y) from the French NutriNet-Santé cohort, using an ad hoc FODMAP composition table. Associations between FODMAP intakes and sociodemographic characteristics were investigated using χ2 tests or Kruskal-Wallis tests according to the qualitative or quantitative status of the variable, and multinomial logistic regressions were performed after adjusting for energy intake in sensitivity analyses. Eligible participants had completed ≥3 detailed 24-h food records. RESULTS: We observed a mean intake of 18.9 ± 9.5 g/d FODMAPs in this French cohort, and 11.7% of participants had intakes <9 g/d (i.e., low-FODMAP diets). Participants with FODMAP intakes <9 g/d were more likely to have lower caloric intakes (Δ = 383 kcal/d compared with participants with FODMAP intakes ≥16 g/d), to be smokers, to have lower incomes, and to have lower levels of physical activity. Total FODMAPs accounted for a mean intake of 18.9 ± 9.5 g/d, which was 3.7 ± 2.0% of total energy intake. The highest intake of FODMAPs was represented by lactose followed by excess fructose, fructans, polyols, and galacto-oligo-saccharides. CONCLUSIONS: FODMAP consumption by a large sample of adults from the general population is ∼19 g/d, with half of the population having a FODMAP intake >16 g/d.This trial was registered at www.clinicaltrials.gov as NCT03335644.


Assuntos
Síndrome do Intestino Irritável , Monossacarídeos , Adulto , Estudos Transversais , Dissacarídeos , Feminino , Fermentação , Humanos , Masculino , Pessoa de Meia-Idade , Oligossacarídeos
5.
BMJ Open ; 11(2): e041196, 2021 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-33558350

RESUMO

BACKGROUND: The Nutri-Score, a front-of-pack nutrition label, has been adopted in 2017 in France but its impact on low-income populations is unknown, and they are more at risk of having unhealthy diets. The present study assessed the effects of the Nutri-Score on the nutritional quality of purchasing intentions among low-income individuals, compared with the current French labelling situation: references intakes (RIs) and no label, using a three-arm parallel-group randomised controlled trial. METHODS: Low-income active adults from the NutriNet-Santé cohort (household income below €1200/month) were asked to perform a shopping task in an experimental online supermarket after being randomised in one of the three conditions (Nutri-Score, RIs or no labelling). The main outcome was the overall nutritional quality of the virtual shopping cart, assessed with the French-modified Food Standards Agency Nutrient Profiling System (FSAm-NPS), and secondary outcomes were the nutrient content of the shopping carts. 524 subjects were randomised, and 336 included in the analyses. RESULTS: The Nutri-Score resulted in the highest overall nutritional quality of the shopping cart, as reflected by a FSAm-NPS score (1.86 (SD 3.59) points) significantly lower (reflecting higher nutritional quality) than the RIs (3.21 (SD 4.14) points, p≤0.05) but not significantly lower than no label (2.60 (SD 3.09) points, p=0.3). The Nutri-Score also resulted into significantly lower contents in calories and saturated fatty acids in the shopping cart, compared with the RIs only (p≤0.05). CONCLUSION: The implementation of the front of pack nutrition label Nutri-Score, adopted in France and in different European countries, appears to have the potential to encourage purchasing intentions of foods from higher nutritional quality among low-income individuals, compared with the RIs label promoted by food manufacturers.Trial registration number: NCT02769455.


Assuntos
Rotulagem de Alimentos , Intenção , Adulto , Comportamento do Consumidor , Europa (Continente) , Preferências Alimentares , França , Humanos , Pobreza , Supermercados
6.
Inflamm Bowel Dis ; 27(1): 65-73, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32055825

RESUMO

BACKGROUND: The incidence of inflammatory bowel diseases (IBDs) tended to increase for several decades. Diet is suspected to be a major determinant of the occurrence of these diseases. This prospective study aimed to assess the associations among occurrence of IBD, dietary patterns, and ultra-processed food in the French NutriNet-Santé cohort. METHODS: Participants of the NutriNet-Santé cohort who completed at least three 24-hour dietary records were included. Incident IBD cases were identified from 3 questionnaires and confirmed by phone or email interview. Major dietary patterns (DPs) were computed using a principal component analysis (PCA) based on 29 food groups' consumption, whereas proportions of ultra-processed foods (UPFs) were obtained using the NOVA classification. Multivariable Poisson models were performed to evaluate associations among DP quintiles, UPF proportion (UPFp) in the diet, and incident IBD. RESULTS: A total of 105,832 participants were included, contributing 238,924 person-years in a mean follow-up of 2.3 ± 2.2 years. Among them, 75 participants reported an incident IBD. Three major DPs were retained: "healthy," "traditional," and "western." No significant association was found for DPs and UPFp after adjustments for covariates. CONCLUSIONS: In this study, neither DPs nor UPF proportion in the diet were significantly associated with the risk of incident IBD after adjustments for covariates. Further studies are needed to investigate the long-term association between diet and IBD.


Assuntos
Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Dieta/estatística & dados numéricos , Fast Foods/estatística & dados numéricos , Doenças Inflamatórias Intestinais/epidemiologia , Adulto , Colite Ulcerativa/etiologia , Doença de Crohn/etiologia , Dieta/efeitos adversos , Registros de Dieta , Inquéritos sobre Dietas , Fast Foods/efeitos adversos , Comportamento Alimentar , Feminino , França/epidemiologia , Humanos , Incidência , Doenças Inflamatórias Intestinais/etiologia , Masculino , Pessoa de Meia-Idade , Análise de Componente Principal , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários
7.
J Nutr ; 151(1): 120-131, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-32692345

RESUMO

BACKGROUND: There is a growing availability of industrial plant-based meat and dairy substitutes that can be classified as ultra-processed foods (UPFs). Very little is known about the consumption of UPFs by vegetarians. OBJECTIVE: The aim of this cross-sectional study, from the NutriNet-Santé cohort, was to describe the contribution of UPFs to different vegetarian diets, in relation to the nutritional quality of their diet, and determinants of UPF consumption, including duration and age at vegetarian diet initiation. METHODS: The study population (n = 21,212) was divided into 4 groups: 19,812 meat eaters, 646 pesco-vegetarians, 500 vegetarians, and 254 vegans. Daily food intakes were collected using repeated 24-h dietary records. Vegetarian diets were described by the proportion of energy from UPFs and the nutritional quality of the diet using healthy and unhealthy plant-based diet indices (PDIs). In a subsample without meat eaters (n = 1,400), a multivariable linear regression model was performed to study the association between UPF consumption and its determinants. RESULTS: Higher avoidance of animal-based foods was associated with a higher consumption of UPFs (P < 0.001), with UPFs supplying 33.0%, 32.5%, 37.0%, and 39.5% of energy intakes for meat eaters, pesco-vegetarians, vegetarians, and vegans. The nutritional quality of diets was also associated with the level of animal-based foods avoidance (P < 0.001), with healthy PDIs at 53.5, 60.6, 61.3 and 67.9 for meat-eaters, pesco-vegetarians, vegetarians, and vegans. Short duration and young age at diet initiation were associated with an increased consumption of UPFs (ßage at initiation = -0.003, P = 0.001; ßduration = -0.002, P < 0.001). CONCLUSIONS: Not all vegetarian diets necessarily have health benefits, because of potential adverse effects of UPFs on nutritional quality and healthiness of diet. UPF consumption by vegetarians and their diet characteristics should be considered in future studies on the links between vegetarianism and health. This trial was registered at clinicaltrials.gov as NCT03335644.


Assuntos
Dieta/classificação , Comportamento Alimentar , Manipulação de Alimentos , Veganos , Vegetarianos , Adolescente , Adulto , Idoso , Envelhecimento , Animais , Estudos Transversais , Feminino , Peixes , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
Int J Eat Disord ; 53(10): 1696-1708, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32748531

RESUMO

OBJECTIVE: The objective of this cross-sectional study was to assess whether optimism is associated with body mass index (BMI), eating behavior and eating disorders (EDs) in a population-based study. METHOD: In 2016, a total of 32,805 participants aged ≥18 years from the NutriNet-Santé cohort completed the Life Orientation Test-Revised, assessing dispositional optimism. Height and weight were self-reported. Eating behavior was assessed with the revised 21-item Three-Factor Eating Questionnaire. Risk of EDs was evaluated with the Sick-Control-One-Fat-Food Questionnaire. Linear and Logistic regression was used to analyze the association between optimism, BMI categories, eating behavior and ED risk, controlling for sociodemographic, lifestyle and depressive symptom characteristics. RESULTS: Our sample was composed of 73.5% women, and the mean age was 55.39 ± 13.70 years. More optimistic participants were less likely to be underweight (OR = 0.82; 95% CI: 0.75, 0.89), or obese, particularly class III obese (BMI ≥40 kg/m2 ) (OR = 0.69; 95% CI: 0.56, 0.84) compared with less optimistic individuals. Optimism was negatively associated with cognitive restraint (ß = -.07; 95%CI: -0.08; -0.06), emotional eating (ß = -.17; 95% CI: -0.19, -0.16) and uncontrolled eating (ß = -.10; 95% CI: -0.11, -0.09). In addition, more optimistic participants had a lower risk of EDs (OR = 0.60; 95% CI: 0.56, 0.64). DISCUSSION: Our findings showed that optimism was associated with weight status, eating behavior and risk of EDs in both women and men. The causal structure of the underlying observed association remains unclear and should be further investigated.


Assuntos
Peso Corporal/fisiologia , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Otimismo/psicologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Vigilância da População
9.
Am J Gastroenterol ; 115(8): 1293-1297, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32467505

RESUMO

INTRODUCTION: This study aimed to assess the association between incident Crohn's disease (CD) or incident ulcerative colitis (UC) and dietary zinc intake. METHODS: NutriNet-Santé cohort's participants who completed at least three 24-hour dietary records were included and incident CD or UC cases were identified. Multivariable Poisson models were performed to assess associations between tertiles of zinc intake and CD or UC. RESULTS: Among the 105,832 participants, 27 reported incident CD and 48 reported incident UC. The relative risks of CD decreased with dietary zinc intakes. Compared with participants with the lowest tertile of zinc intake, the relative risks for CD were 0.60 (95% confidence interval [0.22-1.66]) and 0.12 (95% confidence interval [0.02-0.73]) for the second and the highest tertiles, respectively (Ptrend = 0.02). No significant association was observed for UC. DISCUSSION: Dietary zinc intake was inversely associated with incident CD.


Assuntos
Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Suplementos Nutricionais , Zinco/administração & dosagem , Adulto , Estudos de Coortes , Registros de Dieta , Feminino , França/epidemiologia , Humanos , Incidência , Masculino , Fatores de Risco
10.
Nutr J ; 19(1): 6, 2020 01 20.
Artigo em Inglês | MEDLINE | ID: mdl-31959166

RESUMO

BACKGROUND: Dispositional optimism is a psychological trait that has been associated with positive health outcomes such as reduced risk of cardiovascular diseases. However, there is little knowledge on the relationship between optimism and dietary intake in the population. The objective of this cross-sectional study was to assess whether optimism was associated with overall diet quality, food group consumption and snacking. METHODS: In 2016, 32,806 adult participants from the NutriNet-Santé study completed the Life-Orientation Test Revised (LOT-R) which assesses dispositional optimism. Overall diet quality (assessed by the mPNNS-Guideline Score) and consumption of 22 food groups were evaluated using at least three self-reported 24-h dietary records. Snacking behavior was evaluated by an ad-hoc question. Logistic and linear regressions were used to analyze the associations between optimism and these dietary behaviors, taking into account socio-demographic, lifestyle and depressive symptomatology characteristics. RESULTS: Optimism was associated with greater overall diet quality (ß (95% CI) = 0.07 (0.004-0.11), P < 0.0001) and higher consumption of fruit and vegetables, seafood, whole grains, fats, dairy and meat substitutes, legumes, non-salted oleaginous fruits, and negatively associated with consumption of meat and poultry, dairy products, milk-based desserts, sugar and confectionery. In addition, optimism was associated with less snacking (OR (95% CI) = 0.89 (0.84, 0.95)). In contrast, optimism was associated with higher consumption of alcoholic beverage (ß (95% CI) = 5.71 (2.54-8.88), P = 0.0004) and appetizers (OR (95% CI) = 1.09 (1.04, 1.14)). Finally, no association was observed between optimism and energy intake. CONCLUSIONS: Optimism was associated with better overall diet quality and less snacking. It was also associated with consumption of healthy food groups as well as unhealthy food groups typically consumed in social eating occasions. These findings suggest that optimism could be taken into account in the promotion of a healthy eating behavior.


Assuntos
Dieta/métodos , Dieta/psicologia , Comportamento Alimentar/psicologia , Qualidade dos Alimentos , Otimismo/psicologia , Lanches/psicologia , Estudos Transversais , Inquéritos sobre Dietas/métodos , Inquéritos sobre Dietas/estatística & dados numéricos , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade
11.
Cancers (Basel) ; 11(11)2019 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-31717747

RESUMO

PURPOSE: Expediting the diagnosis of pancreatic ductal adenocarcinoma (PDAC) would benefit care management, especially for the start of treatments requiring histological evidence. This study evaluated the combined diagnostic performance of circulating biomarkers obtained by peripheral and portal blood liquid biopsy in patients with resectable PDAC. EXPERIMENTAL DESIGN: Liquid biopsies were performed in a prospective translational clinical trial (PANC-CTC #NCT03032913) including 22 patients with resectable PDAC and 28 noncancer controls from February to November 2017. Circulating tumor cells (CTCs) were detected using the CellSearch® method or after RosetteSep® enrichment combined with CRISPR/Cas9-improved KRAS mutant alleles quantification by droplet digital PCR. CD63 bead-coupled Glypican-1 (GPC1)-positive exosomes were quantified by flow cytometry. RESULTS: Liquid biopsies were positive in 7/22 (32%), 13/22 (59%), and 14/22 (64%) patients with CellSearch® or RosetteSep®-based CTC detection or GPC1-positive exosomes, respectively, in peripheral and/or portal blood. Liquid biopsy performance was improved in portal blood only with CellSearch®, reaching 45% of PDAC identification (5/11) versus 10% (2/22) in peripheral blood. Importantly, combining CTC and GPC1-positive-exosome detection displayed 100% of sensitivity and 80% of specificity, with a negative predictive value of 100%. High levels of GPC1+-exosomes and/or CTC presence were significantly correlated with progression-free survival and with overall survival when CTC clusters were found. CONCLUSION: This study is the first to evaluate combined CTC and exosome detection to diagnose resectable pancreatic cancers. Liquid biopsy combining several biomarkers could provide a rapid, reliable, noninvasive decision-making tool in early, potentially curable pancreatic cancer. Moreover, the prognostic value could select patients eligible for neoadjuvant treatment before surgery. This exploratory study deserves further validation.

12.
BMC Surg ; 19(1): 115, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438917

RESUMO

BACKGROUND: The European Consensus 2018 established a new algorithm with absolute and relative criteria for intraductal papillary mucinous neoplasms of the pancreas (IPMN) management. The aim of this study was to validate these criteria and analyse the outcomes in function of the surgical procedure and IPMN subtype. METHODS: Clinical, radiological and surgical data (procedure, morbidity/mortality rates) of patients who underwent surgery for IPMN between 2007 and 2017. The predictive value of the different criteria was analysed. RESULTS: 124 patients (men 67%; mean age 65 years) underwent surgery for IPMN (n = 62 malignant tumours; 50%). Jaundice, cyst ≥4 cm and Wirsung duct size 5-9.9 mm or ≥ 10 mm were significantly associated with malignancy (4.77 < OR < 11.85 p < 0.0001). The positive predictive value of any isolated criterion ranged from 71 to 87%, whereas that of three relative criteria together reached 100%. The mortality and morbidity (grade III-IV complications according to the Dindo-Clavien classification) rates were 3 and 8%, respectively. Morbidity/mortality after duodenopancreatectomy and total pancreatectomy were significantly higher for benign IPMN (p = 0.01). CONCLUSION: Considering the morbidity associated with extended surgery, particularly for benign IPMN, the results of the present study suggest that high-risk surgery should be considered only in the presence of three relative criteria and including the surgery type in the decision-making algorithm.


Assuntos
Tomada de Decisão Clínica , Neoplasias Intraductais Pancreáticas/patologia , Neoplasias Intraductais Pancreáticas/cirurgia , Guias de Prática Clínica como Assunto , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Feminino , Humanos , Icterícia/patologia , Masculino , Pessoa de Meia-Idade , Pancreatectomia/efeitos adversos , Cisto Pancreático/patologia , Ductos Pancreáticos/patologia , Neoplasias Intraductais Pancreáticas/diagnóstico por imagem , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias , Radiografia , Estudos Retrospectivos
13.
Transl Oncol ; 12(11): 1395-1403, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31400579

RESUMO

Tumor-released extracellular vesicles (EVs) contain tumor-specific cargo distinguishing them from healthy EVs, and making them eligible as circulating biomarkers. Glypican 1 (GPC1)-positive exosome relevance as liquid biopsy elements is still debated. We carried out a prospective study to quantify GPC1-positive exosomes in sera from pancreatic ductal adenocarcinoma (PDAC) patients undergoing up-front surgery, as compared to controls including patients without cancer history and patients displaying pancreatic preneoplasic lesions. Sera were enriched in EVs, and exosomes were pulled down with anti-CD63 coupled magnetic beads. GPC1-positive bead percentages determined by flow cytometry were significantly higher in PDAC than in the control group. Diagnosis accuracy reached 78% (sensitivity 64% and specificity 90%), when results from peripheral and portal blood were combined. In association with echo-guided-ultrasound-fine-needle-aspiration (EUS-FNA) negative predictive value was 80% as compared to 33% for EUS-FNA only. This approach is clinically relevant as a companion test to the already available diagnostic tools, since patients with GPC1-positive exosomes in peripheral blood showed decreased tumor free survival.

14.
Br J Nutr ; 122(2): 231-239, 2019 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-31232248

RESUMO

The number of people avoiding gluten is growing in many Western countries. However, little information is available on their sociodemographic and dietary profiles. We aimed to describe sociodemographic, behavioural and dietary profiles of participants avoiding gluten in the NutriNet-Santé cohort. Participants of the NutriNet-Santé cohort - excluding coeliac patients - who completed a questionnaire about food exclusions, with complete data on sociodemographic characteristics and dietary intake were included (n 20 456). Food group consumptions and nutrient intakes according to self-reported avoidance of gluten were estimated using ANCOVA adjusted for age, sex and daily energy intake. Based on principal component analysis, three dietary patterns (DP) were identified. Association between DP and avoidance of gluten was investigated using multivariate logistic regression. All data were weighted on the French census. A total of 10·31 (95 % CI 9·90, 10·73) % of the participants declared avoiding gluten, of which 1·65 % totally. They were more likely to be women, older persons, non-smokers, to have a lower educational level and declared more food intolerances. They had higher consumption of fruit, vegetables and lower consumption of dairy products, salty/sweet and fatty foods and alcohol. After adjustments on confounders, a healthy dietary pattern was positively associated with total gluten avoidance (ORQuintile5vsQuintile1 = 14·44, 95 % CI 8·62, 24·19). Our study highlighted that, in this population, individuals who avoid gluten from their diet tend to have a diet more favourable to health. These results can serve as a basis for future studies investigating the potential consequences of a gluten-free diet in non-coeliac population.


Assuntos
Dieta Livre de Glúten/estatística & dados numéricos , Dieta , Motivação , Adulto , Idoso , Doença Celíaca , Estudos de Coortes , Dieta Saudável/estatística & dados numéricos , Escolaridade , Ingestão de Energia , Feminino , França , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos
15.
Am J Public Health ; 109(8): 1122-1129, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31219721

RESUMO

Objectives. To assess the effects of the Nutri-Score label (relative to the Reference Intakes label or no label) on the nutritional quality of students' food purchases. Methods. A 3-arm randomized controlled trial was conducted in France in 2017; 2907 participants were randomized into 1 of the 3 study arms (Nutri-Score, Reference Intakes, no label) and invited to purchase groceries from an experimental Web-based supermarket. The main outcome was the overall nutritional quality of purchases, measured according to a modified version of the Food Standards Agency Nutrient Profiling System (FSAm-NPS/HCSP) score. Results. The mean (±SD) FSAm-NPS/HCSP score was lower in the Nutri-Score group (2.02 ±3.56) than in the Reference Intakes group (2.69 ±3.44), reflecting higher nutritional quality; however, there was no significant difference between the Nutri-Score and no-label (2.45 ±3.28) groups or between the Reference Intakes and no-label groups. Shopping cart content was lower in calories and saturated fatty acids and higher in fruits and vegetables in the Nutri-Score arm than in the other arms. Conclusions. The Nutri-Score label appeared to improve the nutritional composition of students' food purchases relative to the Reference Intakes label or no label.


Assuntos
Rotulagem de Alimentos/métodos , Preferências Alimentares/psicologia , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Valor Nutritivo , Estudantes/psicologia , Adulto , Feminino , França , Humanos , Masculino , Adulto Jovem
16.
Am J Clin Nutr ; 109(5): 1472-1483, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31051503

RESUMO

BACKGROUND: Diet is widely recognized as one of the main modifiable drivers of gut microbiota variability, and its influence on microbiota composition is an active area of investigation. OBJECTIVE: The present work aimed to explore the associations between usual diet and gut microbiota composition in a large sample of healthy French adults. METHODS: Gut microbiota composition was established through sequencing of the 16S rRNA gene in stool samples from 862 healthy French adults of the Milieu Intérieur study. Usual dietary consumptions were determined through the administration of a food-frequency questionnaire. The associations between dietary variables and α- and ß-diversity indexes and relative taxa abundances were tested using Spearman correlations, permutational ANOVAs, and multivariate analyses with linear models, respectively. RESULTS: Foods generally considered as healthy (raw fruits, fish) were positively associated with α-diversity, whereas food items for which a limited consumption is generally recommended (fried products, sodas or sugary drinks, fatty sweet products, processed meats, ready-cooked meals, and desserts) were negatively associated with α-diversity. Fruits, fried products, ready-cooked meals, and cheese contributed to shifts within microbiota composition (ß-diversity). Our results also highlighted a number of associations between various food group intakes and abundances of specific phyla, genera, and species. For instance, the consumption of cheese was negatively associated with Akkermansia muciniphila abundance. CONCLUSIONS: This large-scale population-based study supports that the usual consumption of certain food items is associated with several gut microbial features, and extends the mechanistic arguments linking Western diet to an altered microbiota composition. These results provide new insights into the understanding of complex diet-gut microbiota relations, and their implications for host health deserve further investigation because altered microbiota diversity was consistently linked to increased risk of several health outcomes. This trial was registered at clinicaltrials.gov as NCT01699893.


Assuntos
Bactérias/crescimento & desenvolvimento , Colo/microbiologia , Dieta , Comportamento Alimentar , Microbioma Gastrointestinal , Adulto , Idoso , Análise de Variância , Bactérias/genética , Estudos Transversais , Inquéritos sobre Dietas , Dieta Ocidental , Fezes/microbiologia , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , RNA Ribossômico 16S , Análise de Sequência de DNA , Adulto Jovem
17.
JAMA Intern Med ; 179(4): 490-498, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30742202

RESUMO

Importance: Growing evidence indicates that higher intake of ultraprocessed foods is associated with higher incidence of noncommunicable diseases. However, to date, the association between ultraprocessed foods consumption and mortality risk has never been investigated. Objective: To assess the association between ultraprocessed foods consumption and all-cause mortality risk. Design, Setting, and Participants: This observational prospective cohort study selected adults, 45 years or older, from the French NutriNet-Santé Study, an ongoing cohort study that launched on May 11, 2009, and performed a follow-up through December 15, 2017 (a median of 7.1 years). Participants were selected if they completed at least 1 set of 3 web-based 24-hour dietary records during their first 2 years of follow-up. Self-reported data were collected at baseline, including sociodemographic, lifestyle, physical activity, weight and height, and anthropometrics. Exposures: The ultraprocessed foods group (from the NOVA food classification system), characterized as ready-to-eat or -heat formulations made mostly from ingredients usually combined with additives. Proportion (in weight) of ultraprocessed foods in the diet was computed for each participant. Main Outcomes and Measures: The association between proportion of ultraprocessed foods and overall mortality was the main outcome. Mean dietary intakes from all of the 24-hour dietary records available during the first 2 years of follow-up were calculated and considered as the baseline usual food-and-drink intakes. Mortality was assessed using CépiDC, the French national registry of specific mortality causes. Hazard ratios (HRs) and 95% CIs were determined for all-cause mortality, using multivariable Cox proportional hazards regression models, with age as the underlying time metric. Results: A total of 44 551 participants were included, of whom 32 549 (73.1%) were women, with a mean (SD) age at baseline of 56.7 (7.5) years. Ultraprocessed foods accounted for a mean (SD) proportion of 14.4% (7.6%) of the weight of total food consumed, corresponding to a mean (SD) proportion of 29.1% (10.9%) of total energy intake. Ultraprocessed foods consumption was associated with younger age (45-64 years, mean [SE] proportion of food in weight, 14.50% [0.04%]; P < .001), lower income (<€1200/mo, 15.58% [0.11%]; P < .001), lower educational level (no diploma or primary school, 15.50% [0.16%]; P < .001), living alone (15.02% [0.07%]; P < .001), higher body mass index (calculated as weight in kilograms divided by height in meters squared; ≥30, 15.98% [0.11%]; P < .001), and lower physical activity level (15.56% [0.08%]; P < .001). A total of 602 deaths (1.4%) occurred during follow-up. After adjustment for a range of confounding factors, an increase in the proportion of ultraprocessed foods consumed was associated with a higher risk of all-cause mortality (HR per 10% increment, 1.14; 95% CI, 1.04-1.27; P = .008). Conclusions and Relevance: An increase in ultraprocessed foods consumption appears to be associated with an overall higher mortality risk among this adult population; further prospective studies are needed to confirm these findings and to disentangle the various mechanisms by which ultraprocessed foods may affect health.


Assuntos
Ingestão de Energia , Exercício Físico , Fast Foods/estatística & dados numéricos , Manipulação de Alimentos/estatística & dados numéricos , Obesidade/mortalidade , Medição de Risco/métodos , Causas de Morte/tendências , Feminino , Seguimentos , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/etiologia , Estudos Prospectivos , Fatores de Risco , Taxa de Sobrevida/tendências
18.
BMC Nutr ; 5: 26, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32153939

RESUMO

BACKGROUND: Social inequalities in nutrition lead a high number of families to struggle with food insecurity, even in developed countries. We aimed to assess the impact of fruits and vegetables vouchers on food security among disadvantaged households from a Paris suburb. METHODS: We used a pre-post assessment design. Families answered face-to-face questionnaires on food consumption and food security status before and after a randomly assigned intervention. Households in the intervention group received vouchers to buy exclusively fruits and vegetables over one year. Both intervention and control groups benefitted from nutritional education through workshops performed by dieticians during the study period. The Household Food Security Module (HFSM) was used to assess food security status of households at inclusion. Food Insufficiency Indicator (FSI) was used to assess food security at inclusion and follow-up. Evolution of FSI on both groups was evaluated using McNemar test. RESULTS: Among the 91 families included between May 2015 and May 2016, 64 completed the post assessment questionnaire. At inclusion, 68.3% of families were experiencing food insecurity and 78.1% were experiencing food insufficiency. No association was found between food consumptions and food security status. After one-year follow-up, the prevalence of food insufficiency was significantly decreased in the intervention group (61.8%, with p value = 0.03), and unchanged in the control group. CONCLUSION: In this pilot study, food insufficiency was significantly decreased in families receiving vouchers for fruits and vegetables over a one-year period. TRIAL REGISTRATION: NCT02461238, registered 3 June 2015 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02461238.

19.
J Epidemiol Community Health ; 73(1): 56-64, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30301763

RESUMO

BACKGROUND: On the population level, the association of age and other sociodemographic factors with eating disorders (ED) is unclear. METHODS: We used cross-sectional data from the French general population-based NutriNet-Santé e-cohort (n=49 603 adults; 76.3% women; mean age=50.4±14.6 years). ED were evaluated in 2014 with the 5-item SCOFF screening questionnaire and the Expali algorithmic tool. Likely cases of restrictive, bulimic, hyperphagic and other ED were the dependent variables. Age, marital status, education, occupation, physical activity and smoking were the independent variables. Associations were estimated via gender-stratified multivariable polytomous logistic regression. RESULTS: Among women, age displayed inverse linear associations with both restrictive and bulimic ED, underscoring 18-25 years as the most vulnerable period (adjusted OR=3.37, 95% CI: 2.24 to 5.08 for restrictive ED; adjusted OR=2.98, 95% CI: 2.37 to 3.74 for bulimic ED, respectively). A similar association was observed in men regarding bulimic ED. In women, age was not associated with hyperphagic ED for which living alone, low education, low physical activity, being a homemaker/disabled/unemployed/retired, a manual worker or a former/current smoker had increased importance. In men, 18-39 years emerged as the least vulnerable period regarding hyperphagic ED (adjusted OR=0.74, 95% CI: 0.56 to 0.99). Across gender, having postsecondary education had significant inverse associations with all except restrictive ED, whereas being a student had a significant positive association with restrictive ED. CONCLUSIONS: The findings support gender-specific associations of age with four ED subtypes and could inform future prevention initiatives targeting specific ED among specific age groups. TRIAL REGISTRATION NUMBER: NCT03335644; Pre-results.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Adolescente , Adulto , Fatores Etários , Estudos Transversais , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários
20.
Contemp Clin Trials Commun ; 12: 161-168, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30480163

RESUMO

BACKGROUND: The FLAM study was set up in order to assess the effectiveness of FV vouchers allowed to low-income households, on their FV consumption. The aim of the present study was to investigate issues associated with conducting interventional trials in disadvantaged populations using the FLAM study as an example of reaching target populations and recruitment difficulties. METHODS: Families were recruited in Saint-Denis city (North Paris suburb), via social and municipal structures. Main interest variables in the study (food consumptions) were collected using face-to-face food interviews, either at home or municipal facilities. A qualitative analysis was performed among people who refused to participate in order to understand the barriers to participation. RESULTS: A total of 95 parents-child pairs were included from May 2015 to May 2016. The families were mostly in precarious situation (63.3%), and most of parents were unemployed (71.3%). Almost the two third of children and 79.4% of parents were small consumers of FV (less than 3.5 servings per day). Several reasons for non-participation were reported including time constraints, understanding and mistrust issues. CONCLUSIONS: Though using facilitating strategies, we recruited fewer participants than expected. The population finally included was mainly made of precarious families with a low consumption of FV. These results highlight the importance of identifying effective facilitating strategies to improve recruitment in disadvantaged populations. TRIAL REGISTRATION: ClinicalTrial.gov no. NCT02461238, on June 3, 2015, retrospectively registered.

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