The Internet has become a major source of health and nutrition information. Little is known about the type of consulted websites (institutional v. non-institutional) and the tendency to discuss with a healthcare professional (HCP) the information found on the Internet. The aim of this cross-sectional study was to investigate health- and nutrition-related Internet use in a large French population-based study. Data were collected in 2013 using self-administered, web-based questionnaires from 42 113 participants of the NutriNet-Santé study (mean age=51·2 years, 76 % women). Unconditional multivariate logistic regression analyses and χ 2 tests were used for comparisons. In total, 85·1 % of the subjects used the Internet to search for health and/or nutrition information, and 23·6 % used the Internet to read or post messages on health/nutrition forums. Only 16·0 % discussed with a HCP the information found online. This proportion was lower in subjects with lower educational level (OR 0·77; 95 % CI 0·72, 0·82) and lower computer skills (OR 0·70; 95 % CI 0·65, 0·76). In total, 8038 health/nutrition websites were cited, with institutional websites representing only 12·9 % of that number. Only one institutional website was present in the top 10. Older subjects (OR 1·49; 95 % CI 1·28-1·74), those with lower educational level (OR 2·08; 95 % CI 1·75, 2·50) and lower nutritional knowledge (OR 1·33; 1·12, 1·59) were more likely to cite non-institutional websites. This large population-based study showed that institutional websites were infrequently accessed and that a few participants discussed the information found online with their HCP. This particular trend was especially visible among individuals who were more vulnerable regarding misleading information. This supports the need to increase awareness of high-quality websites providing reliable health/nutrition information.
These results show important differences between walking and cycling in their association with obesity markers in men and women. These findings provide some evidence for the need to consider separately walking and cycling when designing public health measures for prevention of obesity in adults.
Read moreIn this large sample, these findings suggest that dietary intake of subjects suffering from IBS differs from that of control subjects. They may have adapted their diet according to symptoms following medical or non-medical recommendations.
Read moreHigher intakes of polyphenols, especially of anthocyanins, catechins, and flavonols, were associated with a statistically significant decreased cardiovascular disease risk.
Read moreExperimental studies suggest that carotenoids and retinol may play a role in carcinogenesis, but epidemiological evidence is lacking. We investigated the prospective associations between plasma concentrations of major carotenoids and retinol, and overall and breast cancer risk. A nested case-control study included all first incident cancer cases diagnosed in the SU.VI.MAX cohort between 1994 and 2002 (n = 159 cases, 1 matched control/case). Baseline plasma concentrations of carotenoids and retinol were measured by high-performance liquid chromatography. Conditional logistic regression was used to assess odds ratios for an increase of 0.1 μmol/L [odds ratio (OR)] and 95% confidence intervals (CI). Plasma β-carotene (OR = 0.95, 95% CI = 0.90-0.99, Ptrend = 0.04) and β-cryptoxanthin concentrations (OR = 0.89, 95% CI = 0.81-0.99, Ptrend = 0.03) were inversely associated with overall cancer risk. Plasma β-cryptoxanthin concentration was inversely associated with breast cancer risk (OR = 0.83, 95% CI = 0.71-0.96, Ptrend = 0.02). The OR between plasma lycopene concentration and overall cancer risk was 1.07 (0.99-1.15), Ptrend = 0.06. This association turned significant (Ptrend = 0.01) when excluding cancer cases diagnosed during the first year of follow-up. This prospective study suggests an inverse association between plasma concentrations of β-cryptoxanthin and both overall and breast cancer risk, and an inverse association between β-carotene and overall cancer risk. The direct association between lycopene concentration and cancer risk deserves further investigation.
Read moreNutri-Score, with a summarized graded and color-coded format, using semantic colours, is associated to a higher objective understanding than monochrome and nutrient-specific labels. Furthermore, though objective understanding may differ according to individual characteristics of subjects, the magnitude of effect of the Nutri-Score largely outweighed this effect, even in the at-risk populations.
Read moreThe self-administered version of the Web-based NutriCog cognitive test battery provided similar information as the supervised version. Thus, integrating repeated cognitive evaluations into large cohorts via the implementation of self-administered online versions of traditional test batteries appears to be feasible.
Read moreChanges in sedentary behaviours and physical activity according to retirement status need to be better defined. Retirement is a critical life period that may influence a number of health behaviours. We assessed past-year sedentary behaviours (television, computer and reading time during leisure, occupational and domestic sitting time, in h/week) and physical activity (leisure, occupational and domestic, in h/week) over 6 years (2000-2001 and 2007) using the Modifiable Activity Questionnaire in 2,841 participants (mean age: 57.3±5.0 y) of the SU.VI.MAX (Supplementation with Antioxidants and Minerals) cohort. Analyses were performed according to retirement status. Subjects retired in 2001 and 2007 (40%) were those who spent most time in sedentary behaviour and in physical activity during and outside leisure (p<0.001). Leisure-time sedentary behaviours increased in all subjects during follow-up (p<0.001), but subjects who retired between 2001 and 2007 (31%) were those who reported the greatest changes (+8.4±0.42 h/week for a combined indicator of leisure-time sedentary behaviour). They also had the greatest increase in time spent in leisure-time physical activity (+2.5±0.2 h/week). In subjects not retired 2001 and 2007 (29%), changes in time spent watching television were found positively associated with an increase in occupational physical activity (p = 0.04) and negatively associated with changes in leisure-time physical activity (p = 0.02). No consistent association between changes in sedentary behaviours and changes in physical activity was observed in subjects retired in 2001 and 2007. Public health interventions should target retiring age populations not only to encourage physical activity but also to limit sedentary behaviours.
Read moreSince Oct 31, 2017, a front-of-pack labelling system named Nutri-Score (a synthetic information system based on colours and letters from green/A to red/E), allowing consumers to see and compare at a glance the nutritional value of pre-packaged foods is being implemented, on a voluntary basis, in France.1Journal Officiel de la République FrançaiseArrêté du 31 octobre 2017 fixant la forme de présentation complémentaire à la déclaration nutritionnelle recommandée par l'Etat en application des articles L. 3232-8 et R. 3232-7 du code de la santé publique.https://www.legifrance.gouv.fr/eli/arrete/2017/10/31/SSAP1730474A/jo/texteDate: 2017Google Scholar Although some experts warned that the Nutri-Score might constitute an obstacle to EU trade,2EU Food PolicyNutri-Score: health benefits justifies trade risk, says Commission.http://www.eufoodpolicy.com/cgi-bin/view_article.pl?id=14786Date: 2017Google Scholar the measure appeared justified on public health grounds. The adoption of the Nutri-Score label was made after a lengthy 4 year process, during which intense lobbying by agro-industry opposed scientific evidence. Although implementation of policies based on research evidence has been repeatedly shown to be necessary by the public health community and policy makers, the reality of political process is often disappointing. Therefore, the French experience with front-of-pack labelling is a compelling model. Front-of-pack labelling has been identified for several years by WHO and the Organisation for Economic Co-operation and Development as an important strategy to tackle nutrition-related diseases, because it helps consumers make informed decisions on the healthiness of their purchases.3OECDPromoting sustainable consumption—good practices in OECD countries. Organisation for Economic Co-operation and Development, Paris2008Google Scholar Moreover, front-of-pack labelling can provide strong incentives to the agro-industry to reformulate its products to improve their nutritional quality.3OECDPromoting sustainable consumption—good practices in OECD countries. Organisation for Economic Co-operation and Development, Paris2008Google Scholar Dietary risk factors are leading causes of mortality and disability in the world; dietary risks were estimated to account for 10·3 million deaths worldwide in 2016.4GBD 2016 Risk Factors CollaboratorsGlobal, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016.Lancet. 2017; 390: 1345-1422Summary Full Text Full Text PDF PubMed Scopus (1652) Google Scholar Therefore, curbing the adverse effects of unhealthy diet is a major challenge in public health. Implementation of front-of-pack labelling was first proposed to the French Minister of Health in 2014;5Hercberg S Propositions pour un nouvel élan de la politique nutritionnelle française de santé publique dans le cadre de la stratégie nationale de santé. 1ère partie: mesures concernant la prévention nutritionnelle.http://www.ladocumentationfrancaise.fr/rapports-publics/144000068/index.shtmlDate: 2014Google Scholar it was incorporated—in principle—in the Health Law of 2016. The selection of the final graphical format for front-of-pack labelling was controversial and prolonged, involving multiple stakeholders in a consultation process in which scientific evidence finally prevailed. Studies of the nutrient profiling system underlying the Nutri-Score, and comparative studies of the perception, understanding, and use of various strategies of front-of-pack labelling, done between 2014 and 2017 concluded that the Nutri-Score was superior to other formats.6Julia C Hercberg S Development of a new front-of-pack nutrition label in France: the five-colour Nutri-Score.Public Health Panorama. 2017; 3: 712-725Google Scholar The scientific evidence weighted heavily in the decision by health authorities to adopt the Nutri-Score in France. The framework in which this political decision was made, with reliance on science, was commended by the EU regional office of WHO.7WHO EuropeFrance becomes one of the first countries in region to recommend colour-coded front-of-pack nutrition labeling system.http://www.euro.who.int/en/countries/france/news/news/2017/03/france-becomes-one-of-the-first-countries-in-region-to-recommend-colour-coded-nutrition-labelling-systemDate: 2017Google Scholar This experience shows how scientific evidence can help policy makers to face trade and commercial forces. The Nutri-Score provides a tool for adjusting regulatory pressure on the marketing, availability, and pricing of food products to form the basis of consistent policy actions targeting not only consumers, but also their food environment. FE reports grants from AXA Research Fund, outside the submitted work. CJ and SH declare no competing interests. Tackling obesity seriously: the time has comeAccording to WHO data, worldwide, more than 1·9 billion adults are overweight—of these over 650 million are obese. 41 million children under the age of 5 years and 340 million children and adolescents aged 5–19 years are overweight or obese. Obesity is a major risk factor for non-communicable diseases, such as cardiovascular disease, diabetes, and several cancers. Crucially, obesity is preventable. So how is it that obesity has nearly tripled worldwide since 1975? Full-Text PDF Open Access
Read more