Association between dietary pesticide exposure profiles and body weight change in French adults: Results from the NutriNet-Santé cohort.

BACKGROUND: Pesticides cause a wide range of deleterious health effects, including metabolic disorders. Little is known about the effects of dietary pesticide exposure on body weight (BW) change in the general population. We aimed to investigate the role of dietary pesticide exposure in BW change among NutriNet-Santé participants, focusing on potential sexual dimorphism. METHODS: Participants completed a Food Frequency Questionnaire (2014), assessing conventional and organic food consumption. Dietary exposure from plant foods of 25 commonly used pesticides was estimated using a residue database, accounting for agricultural practices (conventional and organic). Exposure profiles based on dietary patterns were computed using Non-negative Matrix Factorization (NMF). Mixed models were used to estimate the associations between BW change and exposure to pesticide mixtures, overall and after stratification by sex and menopausal status. RESULTS: The final sample included 32,062 participants (8,211 men, 10,637 premenopausal, and 13,214 postmenopausal women). The median (IQR) follow-up was 7.0 (4.4; 8.0) years. Four pesticides profiles were inferred. Overall, men and postmenopausal women lost BW during follow-up, whereas premenopausal women gained BW. Higher exposure to NMF3, reflecting a lower exposure to synthetic pesticides, was associated with a lower BW gain, especially in premenopausal women (ß(95 %CI) = -0.04 (-0.07; 0) kg/year, p = 0.04). Higher exposure to NMF2, highly positively correlated with a mixture of synthetic pesticides (azoxystrobin, boscalid, chlorpropham, cyprodinil, difenoconazole, fenhexamid, iprodione, tebuconazole, and lamda-cyhalothrin), was associated with a higher BW loss in men (ß(95 %CI) = -0.05 (-0.08; -0.03) kg/year, p < 0.0001). No associations were observed for NMF1 and 4. CONCLUSIONS: This study suggests a role of pesticide exposure, inferred from dietary patterns, on BW change, with sexually dimorphic actions, including a potential role of a lower exposure to synthetic pesticides on BW change in women. In men, exposure to a specific pesticide mixture was associated with higher BW loss. The underlying mechanisms need further elucidation.

Environmental pressures and pesticide exposure associated with an increase in the share of plant-based foods in the diet.

Diets rich in plant-based foods are encouraged for human health and to preserve resources and the environment but the nutritional quality and safety of such diets is debated. This study aimed to model nutritionally adequate diets with increasing plant food content and to characterise the derived diets using a multicriteria approach including, nutrients intake, environmental pressures and exposure to pesticides. Using data of the NutriNet-Santé cohort (N = 29,413), we implemented stepwise optimization models to identified maximum plant-food content under nutritional constraints. Environmental indicators at the production level were derived from the DIALECTE database, and exposure to pesticide residues from plant food consumption was estimated using a contamination database. Plant-based foods contributed to 64.3% (SD = 10.6%) of energy intake in observed diets and may reach up to 95% in modelled diets without jeopardizing nutritional status. Compared to the observed situation, an increase in plant-based foods in the diets led to increases in soy-based products (+ 480%), dried fruits (+ 370%), legumes (+ 317%), whole grains (+ 251%), oils (+ 144%) and vegetables (+ 93%). Animal products decreased progressively until total eviction, except for beef (- 98%). Dietary quality (estimated using the Diet Quality Index Based on the Probability of Adequate Nutrient Intake) was improved (up to 17%) as well as GHGe (up to - 65%), energy demand (up to - 48%), and land occupation (- 56%) for production. Exposures to pesticides from plant-based foods were increased by 100% conventional production and to a much lesser extent by 100% organic production. This study shows that shifting to nutritionally-adequate plant-based diets requires an in-depth rearrangement of food groups' consumption but allows a drastic reduction environmental impact. Increase exposure to pesticide residues and related risks can be mitigated by consuming foods produced with low pesticide input.

The nature of protein intake as a discriminating factor of diet sustainability: a multi-criteria approach.

Animal production is responsible for 56-58% of the GHG emissions and limiting meat consumption would strongly contribute to reducing human health risks in Western countries. This study aimed to investigate the nature of protein intake as a discriminating factor for diets' sustainability. Using data from 29,210 French adults involved in the NutriNet-Santé cohort, we identified clusters according to 23 protein sources. A multicriteria (environmental, economic, nutritional and health) sustainability analysis was then conducted on the identified clusters. The economic analysis focused on both food and protein expenditure structures, using a budget coefficient approach. Relative values of clusters compared to the whole sample were calculated. We identified five clusters: milk-based, meat-based, fast food-based, healthy-fish-based, and healthy-plant-based. We found that the healthy-plant-based and healthy-fish-based clusters were the most sustainable, conciliating the compromise between human health (0.25 and 0.53 respectively for the Health Risk Score) and the protection of the environment (- 62% and - 19% respectively for the pReCiPe indicator). Conversely, the highest environmental impacts (+ 33% for the pReCiPe indicator) and the highest health risk (0.95 for the HRS) were observed for the meat-based cluster, which was associated with the lowest nutritional scores (- 61% for the PNNS-GS2 score). The economic analysis showed that the healthy-plant-based cluster was the one with the highest food budget coefficient (+ 46%), followed by the healthy-fish-based cluster (+ 8%), partly explained by a strong share of organic food in the diet. However, the meat-based cluster spent more of their food budget on their protein intake (+ 13%), while the healthy-plant-based cluster exhibited the lowest expenditure for this intake (- 41%). Our results demonstrate that the nature of protein intake is a discriminating factor in diet sustainability. Also, reducing animal protein consumption would generate co-benefits beyond environmental impacts, by being favorable for health, while reducing the monetary cost associated with protein intake.

Sustainability analysis of the Mediterranean diet: results from the French NutriNet-Santé study.

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.

Higher adherence to the EAT-Lancet reference diet is associated with higher nutrient adequacy in the NutriNet-Santé cohort: a cross-sectional study.

BACKGROUND: In 2019, the EAT-Lancet Commission proposed a planetary and healthy reference diet; however, its nutritional quality has been rarely evaluated. OBJECTIVE: Across different adherence levels to the EAT-Lancet reference diet, the following were our objectives:1) describe the food and nutritional intakes of the French population, 2) evaluate the nutrient quality, and 3) investigate the consistency between the French national recommendations and the EAT-Lancet reference diet. METHODS: This cross-sectional study was conducted among participants of the NutriNet-Santé cohort, and the sample was weighted on the characteristics of the general French population. Adherence to the EAT-Lancet reference diet was estimated using the EAT-Lancet Diet Index (ELD-I). Usual nutrient intakes were obtained using the variance reduction method. We used the estimated average requirements cut-point method to estimate the proportion of participants who meet their respective nutritional requirements. Furthermore, the adequacy of the French food-based dietary recommendations [Programme National Nutrition Santé (PNNS)] according to adherence to the EAT-Lancet reference diet was studied. RESULTS: The weighted sample was composed of 98,465 participants. Except for bioavailable zinc and vitamin B12, we observed a decrease in the nutrient inadequacy prevalence when the adherence to the EAT-Lancet reference diet increased, particularly for vitamin B9 (Q1 = 37.8% compared with Q5 = 5.5%, P < 0.0001) and vitamin C (Q1 = 59.0% compared with Q5 = 10.8 %, P < 0.0001). However, inadequacy prevalence remained high in all ELD-I quintiles, particularly for fiber (95.9%), vitamin B1 (70.8%), iodine (48.4%), and magnesium (76.8%). Higher ELD-I score was associated with higher adherence for most components of the PNNS, except for food groups that are not specifically included in the EAT-Lancet reference diet and are typical of the French diet, including alcohol, processed meat, and salt. CONCLUSION: In the French context, although issues with the intake of certain nutrients may occur, a diet that remains within the planetary limits as the EAT-Lancet reference diet allows a favorable nutritional quality. This trial was registered at clinicaltrials.gov as NCT03335644.

Associations between measures of socio-economic position and sustainable dietary patterns in the NutriNet-Santé study.

OBJECTIVE: We aimed to explore the relationship between socio-economic characteristics and sustainable dietary patterns. DESIGN: Dietary data were derived from a web-based FFQ. Diet sustainability was evaluated using a modified Sustainable Diet Index, comprising nutritional, environmental and cultural components (higher scores expressing higher sustainability). The socio-economic position markers were education, household income and occupation status. Multi-adjusted linear and Poisson regression models were used to assess the cross-sectional association of the markers of socio-economic status with a sustainable diet and sustainability subcomponents, respectively. SETTING: France. PARTICIPANTS: 29 119 NutriNet-Santé participants. RESULTS: Individuals with a more sustainable diet had slightly higher diet monetary cost, lower total energy intake and consumed less animal-based foods than their counterparts. Lower education level was associated with lower overall diet sustainability (ßprimary v. postgraduate = -0·62, 95 % CI (-0·72, -0·51)) and nutrition, socio-cultural and environmental subscores. Manual workers and employees had a lower modified Sustainable Diet Index than intermediate professionals (ßmanual workers v. intermediate professionals = -0·43, 95 % CI (-0·52, -0·33) and ßemployees v. intermediate professionals = -0·56, 95 % CI (-0·64, -0·48)). Participants with the lowest v. highest incomes had a higher environmental subscore but a lower socio-cultural subscore, whereas the results were less marked for occupational status. CONCLUSIONS: Overall, our results documented associations between socio-economic status and the level of diet sustainability, arguing for the implementation of appropriate food policies to promote sustainable diets at lower cost.

Nutritionally adequate and environmentally respectful diets are possible for different diet groups: an optimized study from the NutriNet-Santé cohort.

BACKGROUND: Research has shown that vegetarian diets have a low environmental impact, but few studies have examined the environmental impacts and nutritional adequacy of these diets together, even though vegetarian diets can lead to nutritional issues. OBJECTIVES: Our objective was to optimize and compare 6 types of diets with varying degrees of plant foods (lacto-, ovolacto-, and pescovegetarian diets and diets with low, medium, and high meat content) under nutritional constraints. METHODS: Consumption data in 30,000 participants were derived from the French NutriNet-Santé cohort using an FFQ. Diets were optimized by a nonlinear algorithm minimizing the diet deviation while meeting multiple constraints at both the individual and population levels: nonincrease of the cost and environmental impacts (as partial ReCiPe accounting for greenhouse gas emissions, cumulative energy demand, and land occupation, distinguishing production methods: organic and conventional), under epidemiologic, nutritional (based on nutrient reference values), and acceptability (according to the diet type) constraints. RESULTS: Optimized diets were successfully identified for each diet type, except that it was impossible to meet the EPA (20:5n-3) + DHA (22:6n-3) requirements in lacto- and ovolactovegetarians. In all cases, meat consumption was redistributed or reduced and the consumption of legumes (including soy-based products), whole grains, and vegetables were increased, whereas some food groups, such as potatoes, fruit juices, and alcoholic beverages, were entirely removed from the diets. The lower environmental impacts (as well as individual indicators) observed for vegetarians could be attained even when nutritional references were reached except for long-chain n-3 (omega-3) fatty acids. CONCLUSIONS: A low-meat diet could be considered as a target for the general population in the context of sustainable transitions, although all diets tested can be overall nutritionally adequate (except for n-3 fatty acids) when planned appropriately.This trial was registered at clinicaltrials.gov as NCT03335644.

Association between adherence to the EAT-Lancet diet and risk of cancer and cardiovascular outcomes in the prospective NutriNet-Santé cohort.

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.

Key Findings of the French BioNutriNet Project on Organic Food-Based Diets: Description, Determinants, and Relationships to Health and the Environment.

Few studies have investigated the relationships between organic food consumption, dietary patterns, monetary diet cost, health, and the environment. To address these issues, a consortium of French epidemiologists, nutritionists, economists, and toxicologists launched the BioNutriNet project in 2013. In 2014, an FFQ documented the usual organic and nonorganic (conventional) food consumption of approximately 35,000 NutriNet-Santé participants. Then, individual organic and conventional food intakes were merged with price, environmental, and pesticide residue data sets, which distinguished between conventional and organic farming methods. Many studies were conducted to characterize organic consumers and their environmental impacts (i.e., greenhouse gas emissions, energy demand, and land use) and organic food consumption impacts on health. We observed that organic consumers had diets that were healthier and richer in plant-based food than nonorganic consumers. Their diets were associated with higher monetary costs, lower environmental impacts, and reduced exposure to certain pesticide residues. Regular consumption of organic food was associated with reduced risks of obesity, type 2 diabetes, postmenopausal breast cancer, and lymphoma. Although several observations have been confirmed by several studies conducted in other countries, our results should be replicated in other cultural settings and coupled with experimental studies to be able to draw causal conclusions. Finally, the main finding of the BioNutriNet project is that while organic food consumption could be associated with positive externalities on human health and the environment, organic-based diets should be accompanied by dietary shifts toward plant-based diets to allow for better planetary and human health.

Are recent dietary changes observed in the NutriNet-Santé participants healthier and more sustainable?

PURPOSE: While intensive modern food systems have significant unfavourable impacts on health and the environment, new sustainable food consumption trends have been emerging in recent years. This study identified recent dietary trends over a 4-year period in terms of overall dietary patterns and organic foods consumption and associated socio-demographic determinants. METHODS: Food intakes were assessed among 18,108 participants of the NutriNet-Santé cohort in 2014 and 2018. A food frequency questionnaire was used to estimate organic and conventional food consumption. Change in food consumption, quality of the diet (assessed by the adherence to the French national guidelines), plant-based diet using published scores, organic food intake were evaluated in regard with various socio-demographic factors. The paired student t test to compare dietary intake and the Kruskal-Walllis test to consider socio-demographic characteristics were used. RESULTS: Consumption of meat and processed meat decreased respectively by 5.09 g/day (SD 51.15) and 1.12 g/day (SD 26.05). The average total consumption of organic products increased by 12% (+ 93 g/day) while consumption of organic fish and seafood (- 1.4 g/day), poultry (- 1 g/day), processed meat (- 0.3 g/day) and meat (- 3.3 g/day) decreased. The dietary towards healthier diets was more pronounced in certain population subgroups. For example, females, young individuals and postgraduate participants were more likely to increase their consumption of healthful plant and animal-based foods, organic foods and to improve the overall nutritional quality of their diets during the follow-up period than their counterparts. CONCLUSION: Our results indicate a slight inflexion towards healthier and plant-based diets over a 4-year period at least in some segments of the population. A decrease in the consumption of animal products and an increase in the consumption of healthful plant-based foods and organic foods suggests a potential trend towards more sustainable diets among certain subgroups. The environmental impacts of these changes need to be assessed in further works as well as the way to sustain and improve them, in particular those who do not initiate sustainable transition.

Halving food-related greenhouse gas emissions can be achieved by redistributing meat consumption: Progressive optimization results of the NutriNet-Santé cohort.

BACKGROUND: Diet-related greenhouse gas emissions (GHGe) mainly comes from animal-sourced foods. As progressive changes are more acceptable for a sustainable food transition, we aimed to identify nutritionally adequate and culturally acceptable optimized diets ensuring a gradual reduction in GHGe, using observed diet from a large sample of French adults, while considering the mode of food production (organic vs conventional farming) and the co-production link between milk and beef. MATERIAL AND METHOD: Based on the consumption of 257 organic and conventional foods among 29,413 participants (75% women, age: 53.5 ± 14.0y) of the NutriNet-Santé study, we modelled optimal diets according to GHGe reduction scenarios in 5% steps, from 0 to 50% with nutritional, acceptability, and coproduct constraints, for men, premenopausal and menopausal women separately. RESULTS: Gradual GHGe decrease under these constraints led to optimal diets with an overall decrease in animal foods, with marked reductions in dairy products (up to -83%), together with a stable but largely redistributed meat consumption in favor of poultry (up to +182%) and pork (up to +46%) and at the expense of ruminant meat (down to -92%). Amounts of legumes increases dramatically (up to +238%). The greater the reduction in diet-related GHGe, the lower the cumulative energy demand (about -25%) and land use (about -43%). The proportion of organic food increased from ~30% in the observed diets to ~70% in the optimized diets. CONCLUSION: Our results suggest that meeting both nutrient reference value and environmental objectives of up to 50% GHGe reduction requires the reduction of animal foods together with important substitutions between animal food groups, which result in drastic reductions in beef and dairy products. Further research is required to explore alignment with long-term health value and conflict with acceptability, in particular for even greater GHGe reductions.

Conservative to disruptive diets for optimizing nutrition, environmental impacts and cost in French adults from the NutriNet-Santé cohort.

Improving the sustainability of diets requires the identification of diets that meet the nutritional requirements of populations, promote health, are within planetary boundaries, are affordable and are acceptable. Here we explore the extent to which dimensions of sustainability could be optimally aligned and identify more sustainable dietary solutions, from the most conservative to the most disruptive, among 12,166 participants of the NutriNet-Santé cohort. We aim to concomitantly lower environmental impacts (including greenhouse gas emissions, cumulative energy demand and land occupation), increase organic food consumption and study departure from observed diets (considered as a proxy for acceptability). From the most conservative to the most disruptive scenario, optimized diets were gradually richer in fruits, vegetables and soya-based products and markedly poorer in animal-based foods and fatty and sweet foods. The contribution of animal protein to total protein intake gradually decreased by 12% to 70% of the observed value. The greenhouse gas emissions from food production for the diets gradually decreased across scenarios (as a percentage of observed values) by 36-86%, land occupation for food production by 32-78% and energy demand by 28-72%. Our results offer a benchmark of scenarios of graded dietary changes against graded sustainability improvements.

Prospective associations between sustainable dietary pattern assessed with the Sustainable Diet Index (SDI) and risk of cancer and cardiovascular diseases in the French NutriNet-Santé cohort.

To ensure a sustainable development, it is essential to better characterize the relationships between diet sustainability and health. We investigated the associations between sustainable dietary patterns, assessed using the Sustainable Diet Index (SDI) and the risk of cancer and cardiovascular diseases in a large prospective cohort of French volunteers. We computed the SDI among 25,592 participants of the NutriNet-Santé cohort using a database developed within the BioNutriNet project comprising nutritional, behavioral, environmental and economic data. Health status of each participant was collected from 2014 to 2018 and validated by physicians. Associations between the SDI and risk of chronic diseases (cancer and cardiovascular diseases) were assessed using multivariable Cox models. 640 incident chronic diseases occurred during the 3.8-year follow-up (483 cancer cases and 158 cardiovascular disease cases). A higher SDI was associated with a lower risk of overall chronic diseases after adjustment for potential confounding factors. Participants in the fourth quartile, reflecting the highest sustainable dietary patterns, exhibited a significant decrease in risk of cancers or cardiovascular diseases (HRQ4 vs. Q1 = 0.61 (95% CI 0.47-0.80), P-trend = 0.0002). More specifically, this association was observed for cancers in the fully adjusted model but was not statistically significant for cardiovascular diseases. Although these results need to be confirmed by other observational studies, they support the fact that a wide adoption of sustainable dietary patterns may contribute to improving global health in France and argue for existing dietary patterns exhibiting cobenefits for human health and the environment.

Association between sustainable dietary patterns and body weight, overweight, and obesity risk in the NutriNet-Santé prospective cohort.

BACKGROUND: Improving the sustainability of current food systems may prevent future public health, environmental, and social concerns. OBJECTIVE: Our objective was to investigate the associations between sustainable dietary patterns, assessed using the Sustainable Diet Index (SDI), and the risk of obesity, overweight, and weight gain in French adults, with a prospective design. METHODS: In 2014, the SDI was computed among 15,626 participants of the NutriNet-Santé study (of whom 76% were women) using data collected within the BioNutriNet project. The SDI ranges from 4 (lowest sustainability) to 20 points and includes 4 subindexes representing the 4 pillars of a sustainable diet. Longitudinal data of weight and height were collected yearly from 2014 to 2018. We used mixed models to estimate the associations between sex-specific quintiles (Qs) of the SDI and weight change and Cox proportional hazard models with different levels of adjustments to assess the association between sex-specific Qs of the SDI and risk of obesity and overweight (mean follow-up time: 2.8 y). RESULTS: At baseline, a higher percentage of participants with overweight was observed in the first SDI Q, reflecting the lowest sustainable dietary patterns (Q1), than in Q5 (29.83% compared with 12.71%). Compared with Q5, a slight increase (at the population level) of almost 160 g/y was observed in Q1, whereas weight remained relatively stable among participants in other Qs. In total, 281 incident cases of obesity and 777 cases of overweight were identified during the follow-up. Participants in Q1 had a higher risk of obesity and overweight than participants in Q5 (HR comparing Q1 with Q5: 4.03; 95% CI: 2.42, 6.10; P-trend < 0.001; and HR comparing Q1 with Q5: 1.49; 95% CI: 1.13, 1.95; P-trend < 0.001, respectively). CONCLUSIONS: The findings support a potential protective role for more sustainable diets to prevent the risk of weight gain, overweight, and obesity.This trial was registered at clinicaltrials.gov as NCT03335644.

Development and validation of an individual sustainable diet index in the NutriNet-Santé study cohort.

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 R 2 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.

Improvement of diet sustainability with increased level of organic food in the diet: findings from the BioNutriNet cohort.

BACKGROUND: Organic food consumption has steadily increased over the past decade in westernized countries. OBJECTIVE: The aim of this study, based on observational data, was to compare some sustainability features of diets from consumers with varying levels of organic food. METHODS: The diet sustainability among 29,210 participants of the NutriNet-Santé study was estimated using databases developed within the BioNutriNet project. Four dimensions (nutrition, environment, economy, and toxicology) of diet sustainability were assessed using: 1) nutritional indicators through dietary intakes and dietary scores, and BMI; 2) environmental indicators (greenhouse gas emissions, cumulative energy demand, and land occupation); 3) economic indicators via diet monetary costs; and 4) estimated daily food exposures to 15 pesticides. Adjusted means (95% CI) across weighted quintiles of organic food consumption in the diet were estimated via ANCOVA. Breakdown methods were used to disentangle the contribution of the production system (organic compared with conventional) from the dietary pattern in the variation of diet-related environmental impacts, monetary costs, and pesticide exposure, between the 2 extreme quintiles. RESULTS: Higher organic food consumption was associated with higher plant-food and lower animal-food consumption, overall nutritional quality (higher dietary scores), and lower BMI. Diet-related greenhouse-gas emissions, cumulative energy demand, and land occupation gradually decreased with increasing organic food consumption, whereas total diet monetary cost increased. Diet exposure to most pesticides decreased across quintiles. CONCLUSIONS: Diets of high organic food consumers were generally characterized by strong nutritional and environmental benefits. The latter were mostly driven by the low consumption of animal-based foods, whereas the production system was responsible for the higher diet monetary costs, and the overall reduced dietary pesticide exposure.

Corrigendum: Environmental Impacts of Plant-Based Diets: How Does Organic Food Consumption Contribute to Environmental Sustainability?

[This corrects the article on p. 8 in vol. 5, PMID: 29479530.].

Environmental Impacts of Plant-Based Diets: How Does Organic Food Consumption Contribute to Environmental Sustainability?

BACKGROUND: Studies investigating diet-related environmental impacts have rarely considered the production method of the foods consumed. The objective of the present study, based on the NutriNet-Santé cohort, was to investigate the relationship between a provegetarian score and diet-related environmental impacts. We also evaluated potential effect modifications on the association between a provegetarian score and the environmental impacts of organic food consumption. METHODS: Food intake and organic food consumption ratios were obtained from 34,442 French adults using a food frequency questionnaire, which included information on organic food consumption for each group. To characterize the overall structure of the diets, a provegetarian score was used to identify preferences for plant-based products as opposed to animal-based products. Moreover, three environmental indicators were used to assess diet-related environmental impacts: greenhouse gas (GHG) emissions, cumulative energy demand (CED), and land occupation. Environmental impacts were assessed using production life cycle assessment (LCA) at the farm level. Associations between provegetarian score quintiles, the level of organic food consumption, and environmental indicators were analyzed using ANCOVAs adjusted for energy, sex, and age. RESULTS: Participants with diets rich in plant-based foods (fifth quintile) were more likely to be older urban dwellers, to hold a higher degree in education, and to be characterized by an overall healthier lifestyle and diet. A higher provegetarian score was associated with lower environmental impacts (GHG emissionsQ5vsQ1 = 838/1,664 kg CO2eq/year, -49.6%, P < 0.0001; CEDQ5vsQ1 = 4,853/6,775 MJ/year, -26.9%, P < 0.0001; land occupationQ5vsQ1 = 2,420/4,138 m2/year, -41.5%, P < 0.0001). Organic food consumption was also an important modulator of the relationship between provegetarian dietary patterns and environmental impacts but only among participants with diets rich in plant-based products. CONCLUSION: Future field studies should endeavor to integrate all the components of a sustainable diet, i.e., both diet composition and production methods.

Farmland biodiversity and agricultural management on 237 farms in 13 European and two African regions.

Farmland is a major land cover type in Europe and Africa and provides habitat for numerous species. The severe decline in farmland biodiversity of the last decades has been attributed to changes in farming practices, and organic and low-input farming are assumed to mitigate detrimental effects of agricultural intensification on biodiversity. Since the farm enterprise is the primary unit of agricultural decision making, management-related effects at the field scale need to be assessed at the farm level. Therefore, in this study, data were collected on habitat characteristics, vascular plant, earthworm, spider, and bee communities and on the corresponding agricultural management in 237 farms in 13 European and two African regions. In 15 environmental and agricultural homogeneous regions, 6-20 farms with the same farm type (e.g., arable crops, grassland, or specific permanent crops) were selected. If available, an equal number of organic and non-organic farms were randomly selected. Alternatively, farms were sampled along a gradient of management intensity. For all selected farms, the entire farmed area was mapped, which resulted in total in the mapping of 11 338 units attributed to 194 standardized habitat types, provided together with additional descriptors. On each farm, one site per available habitat type was randomly selected for species diversity investigations. Species were sampled on 2115 sites and identified to the species level by expert taxonomists. Species lists and abundance estimates are provided for each site and sampling date (one date for plants and earthworms, three dates for spiders and bees). In addition, farmers provided information about their management practices in face-to-face interviews following a standardized questionnaire. Farm management indicators for each farm are available (e.g., nitrogen input, pesticide applications, or energy input). Analyses revealed a positive effect of unproductive areas and a negative effect of intensive management on biodiversity. Communities of the four taxonomic groups strongly differed in their response to habitat characteristics, agricultural management, and regional circumstances. The data has potential for further insights into interactions of farmland biodiversity and agricultural management at site, farm, and regional scale.