Aliments ultra-transformés, maladies chroniques, et mortalité : résultats de la cohorte prospective NutriNet-Santé
TL;DR: In this article, a cohort of NutriNet-Sante (2009-en cours), sept etudes ont ete realisees, sur des sous-echantillons allant de 26,000-a plus de 100,000 participants, allant of which were all participants in the cohort.
Abstract: Resume Au cours des dernieres decennies, l’offre agro-alimentaire s’est considerablement etoffee en matiere d’aliments dits « ultra-transformes » (AUT). Il s’agit de produits ayant subi d’importants procedes de transformation impactant fortement la matrice alimentaire et/ou contenant des additifs alimentaires ou autres substances d’origine industrielle (huiles hydrogenees, maltodextrine, sirop de glucose, etc.). Dans la cohorte NutriNet-Sante (2009-en cours), sept etudes ont ete realisees, sur des sous-echantillons allant de 26 000 a plus de 100 000 participants. Ces travaux ont mis en evidence des associations entre consommation d’AUT et incidences de cancers, maladies cardiovasculaires, mortalite, diabete de type 2, symptomes depressifs, surpoids et obesite, et presence de troubles fonctionnels digestifs. Les analyses tenaient compte de nombreux facteurs de confusion potentiels, y compris nutritionnels. Au-dela des aspects de qualite nutritionnelle, d’autres facteurs pourraient donc etre impliques, tels que certains additifs alimentaires, des composes neoformes lors des procedes de transformation, ou des contaminants issus des emballages. Ces resultats sont en coherence avec un nombre croissant d’etudes epidemiologiques et experimentales recentes a travers le monde qui suggerent un role etiologique des AUT dans la survenue de differentes maladies. Sur la base de ces travaux, les autorites de sante publique en France et dans divers pays recommandent aujourd’hui d’en limiter la consommation.
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TL;DR: A survey was conducted among a representative sample of the urban and rural population in the Fez-Meknes region (654 people aged 15 years and over), of which 326 people reside in the urban commune of Fez and 328 in the rural commune in the province of Taounate as mentioned in this paper .
Abstract: This article aimed to evaluate the different epidemiological aspects of the population (Fez-Meknes region), expose the secular trends of the food habits related to it, present the basic concepts and mechanisms of food in urban and rural areas in the Fez-Meknes region, and finally to analyze the results in the light of a literature review.A survey was conducted among a representative sample of the urban and rural population in the Fez-Meknes region (654 people aged 15 years and over, of which 326 people reside in the urban commune of Fez and 328 in the rural commune of Loulja in the province of Taounate).The results are, a difference between the two urban and rural groups concerning the rhythm of taking meals outside the home (P < 0,001); the average frequency of consumption of certain foods according to social class (p < 0,001); the frequency of food consumption per week of legumes, olive oil, fermented milk, and tea is more increased than that recorded in the urban environment (p < 0,001). On the other hand, the quantification of the consumption of sweet products, dairy products, and whole grains did not conclude a significant difference between the two study environments (p > 0,05).Changing dietary patterns over the past few decades, including more shift work, more meals eaten outside the home or family setting, and more irregular eating patterns, including skipping breakfast and eating late at night.A disparity in eating habits between urban and rural areas was noted. It would be necessary to act judiciously on the environmental factors by encouraging the Moroccan populations to maintain, as much as possible, their good traditional habits, and to reinforce the new good food habits.
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TL;DR: A survey of the literature on the different classification systems, as well as their limitations can be found in this paper , where nine classifications are discussed and compared, and some of them are described with more precise rules, but none of these classifications is based on a real algorithm, nor does it propose an official classification that users could use as a “gold standard”.
Abstract: La part des aliments transformés dans les régimes alimentaires n’a cessé de croître ces dernières décennies. Ils répondent aux attentes et besoins des modes de vie contemporains, et couvrent une grande part des besoins nutritionnels. Toutefois, de nombreuses études épidémiologiques ont pu identifier des liens entre la consommation d’aliments dits « ultra » ou « très » transformés et la santé. Ces études s’appuient sur des systèmes de classement des aliments selon leur niveau de transformation. Cet article s’appuie sur une analyse de la littérature et vise à présenter les différents systèmes de classement, ainsi que les limites de ces derniers Neuf classifications sont discutées et comparées. Si certaines sont décrites avec des règles plus précises, aucune de ces classifications ne s’appuie sur un réel algorithme et ne propose pas non plus de classement « officiel » que les utilisateurs pourraient utiliser comme « gold standard », expliquant pour partie le manque de robustesse de ces classifications. Par ailleurs, aucun consensus ne semble se dégager sur les facteurs déterminant le niveau de transformation d’un aliment, montrant le besoin d’un travail interdisciplinaire afin de proposer un système de classification robuste et universel des aliments selon leur niveau de transformation. The proportion of processed foods in diets of many countries increased over the past decades. Processed foods meet the expectations and needs of contemporary lifestyles, and contribute to a large extent to covering nutritional needs. However, numerous epidemiological studies have identified links between the consumption of so-called “ultra” or “highly” processed foods and health. These studies are based on food classification systems according to their level of processing. This article gives an overview of the literature on the different classification systems, as well as their limitations. Nine classifications are discussed and compared. Although some of them are described with more precise rules, none of these classifications is based on a real algorithm, nor does it propose an “official” classification that users could use as a “gold standard”. This observation partly explains the lack of robustness of these classifications. Furthermore, there is no consensus on what factors determine the level of food processing, showing the need for interdisciplinary work in order to propose a robust and universal classification system for foods according to their level of processing.
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TL;DR: The CES-D scale as discussed by the authors is a short self-report scale designed to measure depressive symptomatology in the general population, which has been used in household interview surveys and in psychiatric settings.
Abstract: The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
48,339 citations
TL;DR: Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings.
Abstract: CRAIG, C. L., A. L. MARSHALL, M. SJOSTROM, A. E. BAUMAN, M. L. BOOTH, B. E. AINSWORTH, M. PRATT, U. EKELUND, A. YNGVE, J. F. SALLIS, and P. OJA. International Physical Activity Questionnaire: 12-Country Reliability and Validity. Med. Sci. Sports Exerc., Vol. 35, No. 8, pp. 1381-1395, 2003. Background: Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Methods: Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Results: Overall, the IPAQ questionnaires produced repeatable data (Spearman's clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. Conclusions: The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment. Key Words: MEASUREMENT, SURVEILLANCE, EPIDEMIOLOGY
15,345 citations
01 May 2014
TL;DR: There is substantial global variation in the relative burden of stroke compared with IHD, and the disproportionate burden from stroke for many lower-income countries suggests that distinct interventions may be required.
Abstract: Background—Although stroke and ischemic heart disease (IHD) have several well-established risk factors in common, the extent of global variation in the relative burdens of these forms of vascular disease and reasons for any observed variation are poorly understood. Methods and Results—We analyzed mortality and disability-adjusted life-year loss rates from stroke and IHD, as well as national estimates of vascular risk factors that have been developed by the World Health Organization Burden of Disease Program. National income data were derived from World Bank estimates. We used linear regression for univariable analysis and the Cuzick test for trends. Among 192 World Health Organization member countries, stroke mortality rates exceeded IHD rates in 74 countries (39%), and stroke disability-adjusted life-year loss rates exceeded IHD rates in 62 countries (32%). Stroke mortality ranged from 12.7% higher to 27.2% lower than IHD, and stroke disability-adjusted life-year loss rates ranged from 6.2% higher to 10.2% lower than IHD. Stroke burden was disproportionately higher in China, Africa, and South America, whereas IHD burden was higher in the Middle East, North America, Australia, and much of Europe. Lower national income was associated with higher relative mortality (P 0.001) and burden of disease (P 0.001) from stroke. Diabetes mellitus prevalence and mean serum cholesterol were each associated with greater relative burdens from IHD even after adjustment for national income. Conclusions—There is substantial global variation in the relative burden of stroke compared with IHD. The disproportionate burden from stroke for many lower-income countries suggests that distinct interventions may be required. (Circulation. 2011; 124:314-323.)
7,265 citations
TL;DR: The criteria outlined in "The Environment and Disease: Association or Causation?" help identify the causes of many diseases, including cancers of the reproductive system.
Abstract: In 1965, Austin Bradford Hill published the article "The Environment and Disease: Association or Causation?" in the Proceedings of the Royal Society of Medicine. In the article, Hill describes nine criteria to determine if an environmental factor, especially a condition or hazard in a work environment, causes an illness. The article arose from an inaugural presidential address Hill gave at the 1965 meeting of the Section of Occupational Medicine of the Royal Society of Medicine in London, England. The criteria he established in the article became known as the Bradford Hill criteria and the medical community refers to them when determining whether an environmental condition causes an illness. The criteria outlined in "The Environment and Disease: Association or Causation?" help identify the causes of many diseases, including cancers of the reproductive system.
6,992 citations
Journal Article•
TL;DR: This paper contrasts Bradford Hill’s approach with a currently fashionable framework for reasoning about statistical associations – the Common Task Framework – and suggests why following Bradford Hill, 50+ years on, is still extraordinarily reasonable.
Abstract: In 1965, Sir Austin Bradford Hill offered his thoughts on: “What aspects of [an] association should we especially consider before deciding that the most likely interpretation of it is causation?” He proposed nine means for reasoning about the association, which he named as: strength, consistency, specificity, temporality, biological gradient, plausibility, coherence, experiment, and analogy. In this paper, we look at what motivated Bradford Hill to propose we focus on these nine features. We contrast Bradford Hill’s approach with a currently fashionable framework for reasoning about statistical associations – the Common Task Framework. And then suggest why following Bradford Hill, 50+ years on, is still extraordinarily reasonable.
5,542 citations