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

Author

Emmanuelle Kesse-Guyot, Benjamin Allès, Joséphine Brunin, Brigitte Langevin, Hélène Fouillet, Alison Dussiot, Florine Berthy, Anouk Reuzé, Elie Perraud, Pauline Rebouillat, Mathilde Touvier, Serge Hercberg, François Mariotti, Denis Lairon, Philippe Pointereau, and Julia Baudry

Subjects
Medicine, Science
Abstract

Abstract 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.

Published
2023
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2. The nature of protein intake as a discriminating factor of diet sustainability: a multi-criteria approach

Author

Hafsa Toujgani, Joséphine Brunin, Elie Perraud, Benjamin Allès, Mathilde Touvier, Denis Lairon, François Mariotti, Philippe Pointereau, Julia Baudry, and Emmanuelle Kesse-Guyot

Subjects
Medicine, Science
Abstract

Abstract 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.

Published
2023
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3. Associations between measures of socio-economic position and sustainable dietary patterns in the NutriNet-Santé study

Author

Julia Baudry, Benjamin Allès, Brigitte Langevin, Anouk Reuzé, Joséphine Brunin, Mathilde Touvier, Serge Hercberg, Denis Lairon, Sandrine Péneau, Philippe Pointereau, and Emmanuelle Kesse-Guyot

Subjects
Diet sustainability, Socio-economic status, Diet quality, Environmental sustainability, Observational study, Public aspects of medicine, RA1-1270, Nutritional diseases. Deficiency diseases, RC620-627
Abstract

Abstract 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 (β primary 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 (β manual workers v. intermediate professionals = -0·43, 95 % CI (−0·52, −0·33) and β employees 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.

Published
2023
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4. Do individual sustainable food purchase motives translate into an individual shift towards a more sustainable diet? A longitudinal analysis in the NutriNet-Santé cohort

Author

Joséphine Brunin, Benjamin Allès, Sandrine Péneau, Anouk Reuzé, Philippe Pointereau, Mathilde Touvier, Serge Hercberg, Denis Lairon, Julia Baudry, and Emmanuelle Kesse-Guyot

Subjects
Dietary transition, Dietary changes, Food purchase motives, Plant-based food, Organic food, Food sustainability, Environmental effects of industries and plants, TD194-195, Economic growth, development, planning, HD72-88
Abstract

Many studies have demonstrated the environmental and health weaknesses of the food systems and the need for transformation is now recognised. Although some consumer segments seem to be more aware of sustainability issues, sustainable motives do not systematically translate into purchasing behaviour. The aims of this study were to identify a typology of dietary changes and to analyse whether these actual dietary changes towards more sustainable consumption during the years 2014–2018, (considering nutritional quality, plant-based foods and organic consumption) were related to a set of consumer food purchase motives measured in 2013.In the French NutriNet-Santé cohort, 13,292 individuals completed a food frequency questionnaire in 2014 and 2018 and a validated food purchase motives questionnaire in 2013, with a particular focus on sustainability. A typology was built to identify clusters using a Reduce Rank Regression (RRR) statistical model, with differences in food consumption as predictor variables and a set of dietary scores (reflecting nutritional quality, plant-based food and organic consumption) as response variables. Associations between dietary changes and food purchase motives were evaluated using ANCOVA.Participants with the most sustainable diet in 2014 and that has continued to improve over time (increased healthy plant-based foods and organic consumption) showed higher sustainable food-purchase motives. These were more often women, young and graduates. Participants with the lowest sustainable motives had at the same time a rather unsustainable diet and changed to a greatly improved diet in 2018. Participants with strong motives related to price, innovation and convenience showed a decrease in diet quality over time (increase in unhealthy plant- and animal-based food, alcoholic drinks, decrease in organic consumption). This cluster had the highest proportion of men, less educated and older than 65.Our results indicate that a part of the population was interested in sustainable food purchase and improved the sustainability of their diet over a short period of time. Some participants, with specific socio-demographic characteristics, were unaware of their diet's sustainability. Therefore, targeting awareness of food sustainability to a certain part of the population is essential.

Published
2022
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5. Nutritionally adequate and environmentally respectful diets are possible for different diet groups: an optimized study from the NutriNet-Santé cohort

Author

Emmanuelle Kesse-Guyot, Benjamin Allès, Joséphine Brunin, Hélène Fouillet, Alison Dussiot, François Mariotti, Brigitte Langevin, Florine Berthy, Mathilde Touvier, Chantal Julia, Serge Hercberg, Denis Lairon, Carine Barbier, Christian Couturier, Philippe Pointereau, and Julia Baudry

Subjects
Meat, Nutrition and Dietetics, Diet, Vegetarian, Vegetables, Humans, Medicine (miscellaneous), Diet, Vegetarians
Abstract

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.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.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.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.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.

Published
2022
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7. Higher adherence to the EAT-Lancet reference diet is associated with higher nutrient adequacy in the NutriNet-Santé cohort: a cross-sectional study

Author

Florine Berthy, Joséphine Brunin, Benjamin Allès, Anouk Reuzé, Mathilde Touvier, Serge Hercberg, Denis Lairon, Philippe Pointereau, François Mariotti, Julia Baudry, Emmanuelle Kesse-Guyot, Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Agence de l'Environnement et de la Maîtrise de l'Energie (ADEME), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Association Solagro (Solagro), Physiologie de la Nutrition et du Comportement Alimentaire (PNCA (UMR 0914)), and AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Nutrition and Dietetics, Medicine (miscellaneous), [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, food system, sustainable diet, nutritional quality assessment, healthy eating
Abstract

International audience; In 2019, the EAT-Lancet Commission proposed a planetary and healthy reference diet; however, its nutritional quality has been rarely evaluated.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.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.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.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.

Published
2023
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8. Key Findings of the French BioNutriNet Project on Organic Food–Based Diets: Description, Determinants, and Relationships to Health and the Environment

Author

Jean-Pierre Cravedi, Louise Seconda, Pauline Rebouillat, Pilar Galan, Julia Baudry, Christine Boizot-Santai, Serge Hercberg, Sandrine Péneau, Denis Lairon, Joséphine Brunin, Emmanuelle Kesse-Guyot, Benjamin Allès, Philippe Pointereau, Laurent Debrauwer, Bruno Taupier-Letage, Rodolphe Vidal, Véronique Ducros, Louis-Georges Soler, Mathilde Touvier, Marie-Josèphe Amiot, Brigitte Langevin, Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Agence de l'Environnement et de la Maîtrise de l'Energie (ADEME), Institut Technique de l'Agriculture Biologique (ITAB), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Alimentation et sciences sociales (ALISS), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire [Grenoble] (CHU), ToxAlim (ToxAlim), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Metatoul AXIOM (E20 ), MetaboHUB-MetaToul, MetaboHUB-Génopole Toulouse Midi-Pyrénées [Auzeville] (GENOTOUL), Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-MetaboHUB-Génopole Toulouse Midi-Pyrénées [Auzeville] (GENOTOUL), Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-ToxAlim (ToxAlim), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Association Solagro (Solagro), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Analyse de Xénobiotiques, Identification, Métabolisme (E20 Metatoul-AXIOM), MetaToul-MetaboHUB, Génopole Toulouse Midi-Pyrénées [Auzeville] (GENOTOUL), Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Génopole Toulouse Midi-Pyrénées [Auzeville] (GENOTOUL), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-ToxAlim (ToxAlim), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Solagro, Université de Toulouse (UT)-Ecole d'Ingénieurs de Purpan (INP - PURPAN), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Ecole d'Ingénieurs de Purpan (INP - PURPAN), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Toulouse III - Paul Sabatier (UT3)

Subjects
Observational data, Dietary greenhouse gas emissions, 030309 nutrition & dietetics, Health Status, [SDV]Life Sciences [q-bio], Medicine (miscellaneous), Review, Environment, Dietary pesticide exposure, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Monetary diet cost, medicine, Humans, Sustainability indicators, 030212 general & internal medicine, 2. Zero hunger, Consumption (economics), 0303 health sciences, Nutrition and Dietetics, Land use, Pesticide residue, medicine.disease, Obesity, Dietary scores, Diet, 3. Good health, Cumulative energy demand, Diabetes Mellitus, Type 2, 13. Climate action, Chronic diseases, Greenhouse gas, Organic farming, Food systems, Food, Organic, Business, Organic food consumption, Externality, Food Science
Abstract

International audience; 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.

Published
2022
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9. Trade-offs between water use and greenhouse gas emissions related to food systems: an optimization study in French adults

Author

Emmanuelle Kesse-Guyot, Philippe Pointereau, Joséphine Brunin, Elie Perraud, Hafsa Toujgani, Florine Berthy, Benjamin Allès, Mathilde Touvier, Denis Lairon, François Mariotti, Julia Baudry, and Hélène Fouillet

Abstract

Water use (WU) and greenhouse gas emissions (GHGe) are two main issues facing food systems. Still, they have rarely been studied together even though they are potentially conflicting because their levers for improvement are not necessarily the same. Data on food-related environmental pressures suggest that GHGe and WU can be improved jointly, but their potential conflicts and trade-offs have not been explored. This is what we studied here by a compromise programming approach, using multi-criteria non-linear optimization under a set of nutritional and epidemiological constraints. We used food consumption data of adults aged 18-64 years (n=1,456) from the French representative study INCA 3 (2014-2015) coupled with food environmental impact data from the Agribalyse ® database. A full range of scenarios was identified by prioritizing the two objectives differently, giving weight from 0% to 100%, by 5-% steps, to GHGe improvement over WU improvement.Overall, we showed that it is possible to achieve significant joint reductions in WU and GHGe relative to their observed values: across the prioritization scenarios, WU reduction ranged from -36% to -14% as its prioritization decreased, while GHGe reduction varied less, from -44 to -52% as its prioritization increased. These joint important reductions in GHGe and WU required the removal of meat consumption (beef, pork, poultry and processed meat), while the consumptions of offal and dairy products remained moderate in order to meet nutrient reference values. However, the consumption of some foods varied according to the priority given to WU over GHGe reductions (namely, vegetables, fruit juice, dairy products, eggs, refined cereal, substitutes, offal and potatoes). Fish, whole grains, and fruit remained more constant due to the epidemiological constraints used. Whatever the scenario, the modeled diets were more plant-based than the observed diet from which they differed significantly (only 23-31% of common food consumptions), and were therefore healthier (63-76% reduction in distance to theoretical minimum risk of chronic disease).To conclude, while focusing solely on WU reduction induces a joint GHGe reduction that is near-maximal, the reverse is not true, showing that there is good alignment but also some divergence between these objectives. This suggests that food systems WU should be better considered in dietary guidelines for healthy and sustainable diet.

Published
2023
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10. Associations between measures of socio-economic position and sustainable dietary patterns in the NutriNet-Santé study

Author

Julia Baudry, Benjamin Allès, Brigitte Langevin, Anouk Reuzé, Joséphine Brunin, Mathilde Touvier, Serge Hercberg, Denis Lairon, Sandrine Péneau, Philippe Pointereau, Emmanuelle Kesse-Guyot, Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Association Solagro (Solagro), Agence de l'Environnement et de la Maîtrise de l'Energie (ADEME), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Nutrition and Dietetics, Environment sustainability, Observational study, Diet sustainability, Socio-economic status, Public Health, Environmental and Occupational Health, Medicine (miscellaneous), [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Diet quality
Abstract

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 (βprimary 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 (βmanual workers v. intermediate professionals = -0·43, 95 % CI (−0·52, −0·33) and βemployees 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.

Published
2022
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11. Environmental impacts associated with UPF consumption: which food chain stages matter the most? Findings from a representative sample of French adults

Author

Emmanuelle Kesse-Guyot, Benjamin Allès, Joséphine Brunin, Hélène Fouillet, Alison Dussiot, Florine Berthy, Elie Perraud, Serge Hercberg, Chantal Julia, François Mariotti, Mélanie Deschasaux-Tanguy, Bernard Srour, Denis Lairon, Philippe Pointereau, Julia Baudry, Mathilde Touvier, Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Physiologie de la Nutrition et du Comportement Alimentaire (PNCA (UMR 0914)), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Aix-Marseille Université - École de médecine (AMU SMPM MED), Aix-Marseille Université - Faculté des sciences médicales et paramédicales (AMU SMPM), Aix Marseille Université (AMU)-Aix Marseille Université (AMU), and Chercheur indépendant

Subjects
Environmental footprint, food chain, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, diet, [SDE.ES]Environmental Sciences/Environmental and Society, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Ultra-processed food
Abstract

BackgroundScientific literature about environmental pressures associated with dietary patterns has been considerably growing over the last decade. However, few studies have analyzed the environmental impacts associated with the consumption of ultra-processed food (UPF) and which steps of the food system that contribute most to environmental pressures. The objective of this study was to investigate, in a representative sample of the adult French population, the environmental pressures of diets according to UPF consumption.MethodsThe study was conducted in 2,121 adults of the French nationally representative survey INCA 3. Food intakes were analyzed to define the %UPF (in weight) in the diet according to NOVA classification. Using detailed environmental data of foods of Agribalyse, we could assess the contribution of UPF to 14 indicators of environmental pressure and details those related to the stage of the food consumed: production, processing, storage, packaging, transport and retailing at the food level. The data was described according to quintiles of % of UPF in the diet and analyzed using crude and energy-adjusted models.ResultsCompared to low consumers of UPF (Q1, median UPF= 7%), high consumers (Q5, median UPF= 35%) had a higher energy intake (+22%) which came along with different environmental pressures (e.g. +15% greenhouse gas emissions (GHGe), +17% land use, -7% water use and +8% cumulative energy demand). Higher pressures could be ascribed to higher energy. However, the processing and packaging stages were significant contributor to energy demand. In Q5, contributions of the UPF category to total pressure were 35%, 39%, 28% and 42% for GHGe, water use land use, and energy demand, respectively, while ranging from 11 to 15% in Q1.ConclusionsDiets rich in UPF, compared to low, were overall associated with intensification in GHGe, land use, and energy demand and with higher contribution of post-farm stages, in particular processing regarding energy demand.HighlightsOverall, higher UPF consumption was associated with higher environmental impact, in particular GHGE and land useLow UPF consumers had overall higher water footprint (due to their high fruit and vegetable intake)A large part of the higher pressures observed among participants with higher UPF consumption was explained by their higher dietary energy intake since the associations did not remain or were even reversed after energy adjustmentRegardless of the % UPF in the diet, GHGe, land use and water use pressures mostly occurred at the stage of agricultural production, in contrast, packaging and processing stages were also important contributors to energy demandContribution of the UPF category to total impact/pressure varied across indicators, with a high contribution of the UPF category to energy demand, due to the packaging and processing stages, but a low contribution to GHGe and land use, because higher consumers of UPF are lower consumers of animal products

Published
2022

12. Changes in animal and healthy plant food consumptions over time: associations with stages of change towards meat reduction and their motives

Author

Anouk Reuzé, Caroline Méjean, Lucie Sirieix, Julia Baudry, Emmanuelle Kesse-Guyot, Nathalie Druesne Pecollo, Joséphine Brunin, Serge Hercberg, Mathilde Touvier, Sandrine Péneau, Benjamin Allès, Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro Montpellier, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Agence de l'Environnement et de la Maîtrise de l'Energie (ADEME), ISBNPA, and Reuzé, Anouk

Subjects
[SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2022

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

Author

Florine Berthy, Joséphine Brunin, Benjamin Allès, Léopold K Fezeu, Mathilde Touvier, Serge Hercberg, Pilar Galan, Philippe Pointereau, Denis Lairon, Julia Baudry, Emmanuelle Kesse-Guyot, Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Agence de l'Environnement et de la Maîtrise de l'Energie (ADEME), Département de Santé Publique [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Association Solagro (Solagro), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Adult, Male, Nutrition and Dietetics, Medicine (miscellaneous), [SDV.CAN]Life Sciences [q-bio]/Cancer, Middle Aged, Diet, healthy eating, Cohort Studies, chronic diseases, nutrition, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Cardiovascular Diseases, Risk Factors, Neoplasms, Humans, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Prospective Studies, food system, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, sustainable diet
Abstract

International audience; 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.

Published
2022
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