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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.

Distribution of SUVpeak, Entropy, HGZE, and SRE in healthy tissues and in tumors as a function of the voxel size: in blue for 4x4x4 mm3, in green for 2x2x2 mm3 and in pink for 1x1x1 mm3.

Textural and shape analysis is gaining considerable interest in medical imaging, particularly to identify parameters characterizing tumor heterogeneity and to feed radiomic models. Here, we present a free, multiplatform, and easy-to-use freeware called LIFEx, which enables the calculation of conventional, histogram-based, textural, and shape features from PET, SPECT, MR, CT, and US images, or from any combination of imaging modalities. The application does not require any programming skills and was developed for medical imaging professionals. The goal is that independent and multicenter evidence of the usefulness and limitations of radiomic features for characterization of tumor heterogeneity and subsequent patient management can be gathered. Many options are offered for interactive textural index calculation and for increasing the reproducibility among centers. The software already benefits from a large user community (more than 800 registered users), and interactions within that community are part of the development strategy.Significance: This study presents a user-friendly, multi-platform freeware to extract radiomic features from PET, SPECT, MR, CT, and US images, or any combination of imaging modalities. Cancer Res; 78(16); 4786–9. ©2018 AACR.

A real-time complete example of radiomic feature calculation from a PET/MR scan, where the same volumes of interest are used to extract PET and MR radiomic features.

Well-known software programs that enable the calculation of radiomic features and associated characteristics.

International audience

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.

Additional file 3. Groups of motives for the increase in legume consumption, in the samples of legume increase and rebalance in meat and legumes, NutriNet-Santé study, 2018 (motives ordered according to the frequency of individuals in “Change-inducing motive” group).

Additional file 1. Motives for meat reduction and legume increase.

Additional file 2. Groups of motives for the reduction of meat consumption, in the samples of meat reduction and rebalance in meat and legumes, NutriNet-Santé study, 2018 (motives ordered according to the frequency of individuals in “Change-inducing motive” group).

Background A shift toward more plant-based foods in diets is required to improve health and to reduce environmental impact. Little is known about food choice motives and associated characteristics of those individuals who have actually reduced their consumption of animal-based foods. The aim of this cross-sectional study was to identify change-inducing motives related to meat and legume consumptions among non-vegetarians. The association between change-inducing motives and individual characteristics was also studied. Methods This study included 25,393 non-vegetarian participants in the French NutriNet-Santé cohort (77.4% women, mean age 55.4 ± 13.9 y.). The motives related to the declared change in meat and legume consumptions (e.g., taste, environment, social pressure) were assessed by an online questionnaire in 2018. For each motive, respondents could be classified into three groups: no motive; motive, not change-inducing; change-inducing motive. Associations between change-inducing motives and individual characteristics were evaluated using multivariable polytomic logistic regressions. Characteristics of participants who rebalanced their meat and legume consumptions were also compared to those who reduced their meat but did not increase their legume consumption. Results Motives most strongly declared as having induced a change in meat or legume consumptions were health and nutrition (respectively 90.7 and 81.0% declared these motives as change-inducing for the meat reduction), physical environment (82.0% for meat reduction only) and taste preferences (77.7% for legume increase only). Other motives related to social influences, meat avoidance and meat dislike were reported by fewer individuals, but were declared as having induced changes in food consumption. Most motives that induced a meat reduction and a legume increase were more likely to be associated with specific individual characteristics, for example being a woman or highly educated for health motives. Conclusions Besides the motives reported as important, some motives less frequently felt important were declared as having induced changes in meat or legume consumptions. Change-inducing motives were reported by specific subpopulations. Public campaigns on health and sustainability could usefully develop new tools to reach populations less willing to change. Trial registrations The study was registered at ClinicalTrials.gov (NCT03335644).

Introduction et but de l’étude:La littérature récente sur la diminution de consommation de viande suggère que les individus déclarent un ensemble de motifs (ou raisons, ex : préservation de l’environnement, de sa santé), et que certains de ces motifs auraient une plus grande capacité à induire cette diminution. Certaines combinaisons de motifs, ou profils motivationnels, pourraient être associées à la diminution de la viande. Cette étude transversale avait pour objectif d’identifier des profils motivationnels en lien avec la diminution de consommation de viande et d’évaluer leurs associations avec la qualité nutritionnelle de l'alimentation et les caractéristiques sociodémographiques, anthropométriques et du mode de vie.Matériel et méthodes:Cette étude a été menée en 2018 auprès de 14 866 adultes non-végétariens de la cohorte NutriNet-Santé. Douze items en lien avec la diminution de consommation de viande ont été évalués. Pour chaque item, le motif puis sa capacité ou non à induire un changement ont été évaluées par deux échelles de Likert en 5 points, permettant de classer les participants en trois groupes : pas de motivation, motivation sans capacité de changement, motivation avec capacité de changement. A partir de ces variables de motifs, nous avons mené une analyse en clusters par classification hiérarchique ascendante des individus afin d’identifier des profils motivationnels. Une description des profils a été réalisée en fonction de la déclaration d’un changement de consommation en légumineuses, de la durée déclarée de diminution de consommation de viande et des caractéristiques nutritionnelles, sociodémographiques, anthropométriques, et du mode de vie.Résultats et Analyse statistique:Cinq clusters ont été identifiés. Le Cluster 1 (17,7% de l’échantillon total) correspondait à des personnes faiblement motivées, le Cluster 2 (52,6%), à des personnes motivées par la santé, l'environnement et le bien-être animal, avec capacités de changement, et le Cluster 3 (11,8%), à des personnes motivées par la santé, l'environnement et l'hédonisme, avec capacités de changement. Les Clusters 4 et 5 (respectivement 16,7% et 1,3%) présentaient des motivations similaires mais avec des capacités de changement plus faibles. Les consommations en viandes les plus faibles étaient observées dans les Clusters 2 et 3, avec respectivement 65,6±0,4 g/j et 53,5±0,8 g/j, alors que les consommations les plus élevées étaient observées dans le Cluster 1, avec 79,9±0,7 g/j (ajustées sur le sexe, l’âge et l’apport énergétique). Une plus grande proportion d’hommes a été observée dans les Clusters 1 et 4. Parmi les clusters, les individus plus âgés étaient davantage représentés dans le Cluster 1, et les individus plus jeunes, dans le Cluster 4. La déclaration d’une diminution de viande datant de plus de deux ans était davantage observée dans le Cluster 5.Conclusion:Les deux profils d’individus fortement motivés par des dimensions de durabilité correspondraient à des participants avec des apports alimentaires reflétant un rééquilibrage entre produits animaux et végétaux.

Self-management of irritable bowel syndrome (IBS) is increasingly focusing on exclusion diets. In particular, patients are showing a significant interest in the gluten-free diet for the treatment of IBS. However, the lack of scientific evidence prevents the establishment of clear dietary guidelines and attention is needed as dietary restriction can lead to potentially adverse effects. This cross-sectional study aims to explore the practice of gluten avoidance in participants identified with IBS in a large cohort of non-celiac French adults. The population included 15,103 participants of the NutriNet-Santé study who completed a functional gastrointestinal disorder questionnaire based on the Rome III criteria to identify IBS in 2013 and a food avoidance questionnaire in 2016. Data on diet and anthropometric and sociodemographic characteristics were collected. Multivariate logistic regression models were used to compare the avoidance of gluten between IBS and non-IBS participants. Participants were mainly women (73.4%) and the mean age in this population was 55.8 ± 13.2 years. Among these individuals, 804 (5.4%) participants were identified as IBS cases. Among them, the prevalence of gluten avoidance was estimated at 14.8%, of which 3.0% reported total avoidance, versus 8.8% and 1.6% in non-IBS participants. After adjustments, gluten avoidance was higher in IBS participants compared to their non-IBS counterparts: (OR = 1.86, 95%CI = 1.21, 2.85) for total and (OR = 1.71, 95%CI = 1.36, 2.14) for partial avoidance. Participants identified with IBS were more associated with gluten avoidance than non-IBS participants. Further studies are needed to explore the long-term consequences of dietary interventions and to provide consistent dietary guidance connected to patient perception.

Objective: To compare the performance of conventional and machinelearning approaches for the diagnosis of tumor recurrence after radiation therapy of brain metastases. Methods: 184 symptomatic patients with solitary metastatic brain lesions treated with radiation therapy were enrolled in a monocentric retrospective study from June 2013 to May 2018. The diagnosis was tumor recurrence (n=71) and radiation necrosis (n=113) using as reference standard expert-consensus derived from pathology and long-term follow-up. 37 potential predictors were recorded at the time of radiological progression (7-15 months after therapy): 6 clinical features and 31 imaging features including 20 radiomics features derived from standard of care 3D T1-gadolinium sequences. We compared four approaches (A, B, C, D): expert report using MRI sequences without (A) and with delayedcontrast MRI (TRAM) sequences (B), 11 non-Radiomics imaging features alone (C) and a signature combining variables selected using unsupervised machinelearning algorithms (D), training:validation sets: n=144:40 pts). Results: Overall (n=184), approaches B and C (using TRAM sequence alone) reached comparable performances with respective AUCs [95% CI] of 78.7% [72.3%-85.1%] and 76.8% [70.3%-83.3%]. Both significantly outperformed approach A with AUC [95% CI] of 57.4% [50.7%-64.1%] (DeLong’s test, p-value=10-7). In the validation set (n=40), the signature reached an AUC [95% CI] of 92% [87%-97%]. Conclusion: A quantitative analysis of TRAM sequence seems the best approach for the diagnosis of recurrent tumor after radiation therapy. It is parsimonious, objective and less time-consuming than interpreting all sequences. A signature derived from the analysis of standard of care 3D T1- gadolinium sequence showed promising results that warrant prospective validation.

Radiomics extracts high-throughput quantitative data from medical images to contribute to precision medicine. Radiomic shape features have been shown to correlate with patient outcomes. However, how radiomic shape features vary in function of tumor complexity and tumor volume, as well as with method used for meshing and voxel resampling, remains unknown. The aims of this study are to create tumor models with varying degrees of complexity, or spiculatedness, and evaluate their relationship with quantitatively extracted shape features. Twenty-eight tumor models were mathematically created using spherical harmonics with the spiculatedness degree d being increased by increments of 3 (d = 11 to d = 92). Models were 3D printed with identical bases of 5 cm, imaged with a CT scanner with two different slice thicknesses, and semi-automatically delineated. Resampling of the resulting masks on a 1 × 1 × 1 mm3 grid was performed, and the voxel size of each model was then calculated to eliminate volume differences. Four MATLAB-based algorithms (isosurface (M1), isosurface filter (M2), isosurface remeshing (M3), and boundary (M4)) were used to extract nine 3D features (Volume, Surface area, Surface-to-volume, Compactness1, Compactness2, Compactness3, Spherical Disproportion, Sphericity and Fractional Concavity). To quantify the impact of 3D printing, acquisition, segmentation and meshing, features were computed directly from the stereolithography (STL) file format that was used for 3D printing, and compared to those computed. Changes in feature values between 0.6 and 2 mm slice acquisitions were also compared. Spearman’s rank-order correlation coefficients were computed to determine the relationship of each shape feature with spiculatedness for each of the four meshing algorithms. Percent changes were calculated between shape features extracted from the original and resampled contoured images to evaluate the influence of spatial resampling. Finally, the percent change in shape features when the volume was changed from 25% to 150% of their original volume was quantified for three distinct tumor models and compared to the percent change observed when modifying the spiculatedness of the model from d = 11 to d = 92. Values extracted using isosurface remeshing method are the closest to the STL reference ones, with mean differences less than 10.8% (Compactness2) for all features. Seven of the eight features had strong significant correlations with tumor model complexity irrespective of the meshing algorithm (r > 0.98, p < 10-4), with fractional concavity having the lowest correlation coefficient (r = 0.83, p < 10-4, M2). Comparisons of features extracted from the 0.6 and 2 mm slice thicknesses showed that mean differences were from 2.1% (Compactness3) to 12.7% (Compactness2) for the isosurface remeshing method. Resampling on a 1 × 1 × 1 mm3 grid resulted in between 1.3% (Compactness3) to 9.5% (Fractional Concavity) mean changes in feature values. Compactness2, Compactness3, Spherical Disproportion, Sphericity and Fractional Concavity were the features least affected by volume changes. Compactness1 had a 90.4% change with volume, which was greater than the change between the least and most spiculated models. This is the first methodological study that directly demonstrates the relationship of tumor spiculatedness with radiomic shape features, that also produced 3D tumor models, which may serve as reference phantoms for future radiomic studies. Surface Area, Surface-to-volume, and Spherical Disproportion had direct relationships with spiculatedness while the three formulas for Compactness, Sphericity and Fractional Concavity had inverse relationships. The features Compactness2, Compactness3, Spherical Disproportion, and Sphericity should be prioritized as these have minimal variations with volume changes, slice thickness and resampling.