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A 25% reduction in cancer risk has been observed among “regular” organic food consumers, compared to consumers who eat organic less often. These were the findings of an epidemiological study conducted by a team from Inra, Inserm, University of Paris 13, CNAM, following analysis of a sample of 68,946 participants in the NutriNet‐Santé cohort. Although a link between cause and effect cannot be established based on this study alone, the results suggest that a diet rich in organic foods could limit the incidence of cancer. Additional research is nonetheless necessary in order for appropriate, targeted public health measures to be introduced. This study was published in JAMA Internal Medicine on October 22, 2018.

The organic food market has grown tremendously in recent years. In addition to ethical and environmental aspects, one of the main driving factors for eating organic is that these foods are grown without crop protection products and synthetic inputs, and could therefore be associated with health benefits. However, insufficient epidemiological data are currently available to conclude that an organic diet has a protective effect on health (or that there is an increased risk related to the consumption of conventionally farmed foods). Although contact with chemical inputs, particularly via occupational exposure among farmers, has been associated with an increased risk of disease (notably prostate cancer, lymphoma, and Parkinson’s disease), the risk to the general population via food is unknown.

Researchers from the Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (Inra/ Inserm/University of Paris 13/CNAM) conducted an epidemiological study based on the analysis of a sample of 68,946 participants (78% females, mean age 44 years) in the NutriNet-Santé cohort (see text box below). Data on their conventional or organic food consumption were collected at inclusion, using a questionnaire on the frequency of consumption (never, occasionally, most of the time) for 16 food groups[1]. This analysis also took sociodemographic characteristics, lifestyle and nutritional habits into account.

Over the seven-year follow-up period (2009-2016), 1,340 new cancer cases were recorded and validated based on medical records. A 25% reduction in cancer risk (all types combined ) was observed among “regular” organic food consumers compared to more occasional consumers.

Several hypotheses could explain these data: the much more common presence of synthetic pesticide residues at higher doses in conventionally farmed foods, compared to organic foods. Another possible explanation: potentially higher concentrations of certain micronutrients (carotenoid antioxidants, polyphenols, vitamin C, or more beneficial fatty acid profiles) in organic foods.

The conclusions of this study need to be confirmed by other investigations conducted on other study populations, in different contexts. Nevertheless, these results support the recommendations issued by the Haut Conseil de Santé Publique (HCSP) in 2017, for the future dietary indicators of the French National Nutrition and Health Program (Programme National Nutrition Santé – PNNS), aiming to prioritize foods cultivated using methods reducing exposure to pesticides, for fruit, vegetables, pulses, and wholegrain products.

[1] Fruit, vegetables, soy-based products, dairy products, meat/fish/eggs, starchy foods/pulses, bread/cereals, flour, oils/condiments, ready meals, coffee/tea/herbal teas, wine, biscuits/chocolate/sugar/confectionary, other foods, and food supplements.

Photo by George Kourounis on Unsplash

Researchers from Inserm at the Bordeaux Population Health Research Center, the Paris Cardiovascular Research Center, the University of Bordeaux and the Three-City Cohort have demonstrated that combining several factors and behaviors beneficial for the heart and maintaining them at optimal levels is associated with a reduced risk of developing dementia and cognitive decline after the age of 65. The researchers used the concept of optimal cardiovascular health as defined by the American Heart Association in its 2020 Impact Goal concerning cardiovascular disease prevention. This study has been published in JAMA.

As part of a new epidemiological study conducted in the largest French cohort, the Three-City Cohort, initiated in 1999 to elucidate the impact of vascular risk factors on cognitive aging and dementia, researchers from Inserm (at the Bordeaux Population Health Research Center and the Paris Cardiovascular Research Center) followed 6 626 adults aged 65 and over in France for a period of 16 years. To date, a number of studies have shown the relevance of a preventive approach in cardiovascular diseases. Given the biological links and the presence of shared risk factors between cardiovascular diseases and dementia, the research team was interested in the benefits of prevention of vascular risk factors on dementia and cognitive decline.

The concept of “optimal cardiovascular health”, as defined by the American Heart Association, is based on 7 parameters which include 4 health behaviors (not smoking, healthy weight, being physically active and a diet in accordance with public health recommendations) and 3 biological components (ideal blood pressure, cholesterol and blood sugar levels without treatment).

While this study has its limits –notably the study population being from an urban environment and the possible variation of the parameters considered – it nevertheless shows that maintaining optimal cardiovascular health (7 parameters at ideal levels) is associated with a major decrease in dementia risk and an attenuation of the associated cognitive decline.

Therefore, each parameter at ideal level is linked to a 10% reduced risk of dementia (and if the 7 parameters are at optimal level, the risk reduction is 70% in comparison with those with none).

If the objective is to achieve optimal cardiovascular health, the study shows that having just one parameter at ideal level is linked to a reduced risk of dementia. Cécilia Samieri, Inserm researcher in charge of the study, specifies: “In practice, this objective appears more realistic, making it possible to reach a larger number of people and therefore have a greater impact. While health promotion is a collective challenge for public authorities and healthcare professionals, it also involves each individual taking ownership of their own health”.

The conclusions of a new study coordinated by Inserm show that excessive long-term alcohol consumption is linked to an increased risk of dementia. The results also suggest an increased risk among those who abstain, even if the underlying mechanisms in the two groups are very likely to differ. With those consuming to excess, the cases of hospitalization for chronic alcohol-related disease were linked to a four times higher risk of dementia, while in the abstainers this risk is only 1.5 times higher and can be explained in part by an increased risk of cardiometabolic disease. These results were published in British Medical Journal based on data from the British Whitehall II cohort.

With the increase in life expectancy, the number of people affected by dementia is expected to triple by 2050. However, not all of its risk factors have been identified. That is why a team of Inserm researchers based in France and the UK undertook to study the link between alcohol consumption in midlife (between the ages of 40 and 60) and the risk of developing dementia in the 23 years that followed. They also examined whether cardiometabolic diseases (which include stroke, coronary heart disease and diabetes) had any effect on this link.

Their study reveals that those who abstain from drinking alcohol or those who consume more than 14 units of alcohol per week between the ages of 40 and 60 present an increased risk of developing dementia with aging.

The results they obtained are based on 9,087 British civil servants aged between 35 and 55 in 1985 who participated in Whitehall II, a study which examined the consequences of social, economic, biological and lifestyle factors on long-term health. At regular intervals between 1985 and 1993, the participants (average age 50) were evaluated for their alcohol consumption and alcohol dependence.

Hospital admissions for alcohol-related chronic diseases and dementia cases from 1991, as well as cardiometabolic diseases were identified from hospitalization records.

Out of the 9,087 participants, 397 cases of dementia were recorded over an average follow-up period of 23 years. The average age when dementia was diagnosed was 76 years.

After taking into account sociodemographic data, lifestyle and health-related factors which could have affected the results, the researchers discovered that abstinence or the consumption of more than 14 units of alcohol (112 g of alcohol) per week were linked to a higher risk of dementia compared with a weekly consumption of between 1 and 14 units of alcohol. Among those consuming more than 14 units of alcohol per week, each additional 7 units consumed per week was linked to a 17 % increase in dementia risk.

Cases of hospitalization for alcohol-related chronic diseases were linked to a four times higher risk of dementia.

While these findings show that both abstinence and excessive alcohol consumption are linked to an increased risk of dementia, the researchers agree than the underlying mechanisms in each of the two groups are very likely to differ.

In the abstainers, the researchers show that part of the additional dementia risk was linked to a higher risk of cardiometabolic disease. However, other health factors, alcohol consumption earlier in life, other unmeasured sociodemographic characteristics could also explain the excess risk of dementia observed in the abstainers.

For Séverine Sabia, Inserm researcher and principal author of this research: “these findings support the data according to which excessive alcohol consumption is a risk factor for dementia, and they encourage the recommendation of lower consumption thresholds to promote better cognitive aging. In no way should the results observed in the abstainers encourage people who currently do not drink to start doing so because, according to French Public Health Agency figures, alcohol consumption is responsible in France for 49,000 deaths from cancer, cirrhosis, psychosis and alcohol dependence”.

In France, the public health recommendations in terms of “acceptable risk” are 10 glasses per week and no more than two glasses per day on the basis that one glass in France corresponds to 10 g of alcohol, i.e. 100 g per week. These recommendations are now the same for both men and women.

Finally, given that this is an observational study, it is not possible to draw definitive conclusions as to a causal relationship.

After reporting the first positive results of renal denervation in blood pressure (HBP) resistant in the journal The Lancetin 2015, the team of the Center of Excellence in Hypertension and CIC1418 APHP-INSERM led by Dr. Michel Azizi and that of the interventional radiology department led by Prof. Marc Sapoval from European Georges Pompidou Hospital, AP-HP , obtained promising new results in hypertensive patients receiving no antihypertensive therapy as part of an international study. They provide, for the first time, evidence of the reduction in blood pressure after renal denervation focused ultrasound in this indication. The findings of the RADIANCE-SOLO study, coordinated by the European Hospital Georges Pompidou, AP-HP, were presented at EuroPCR in Paris and at the Congress of the European Society of Hypertension in Barcelona. They are published in the journal The Lancet . This opens new perspectives for treatment in this disease that affects 30% of the French population to consider in the future an alternative to drug therapy for some patients.

Renal denervation endovascular consists in interrupting the electrical activity of the nerves of the sympathetic nervous system in kidney for delivering focused ultrasound through a catheter into the RADIANCE-SOLO study or by using another technology based on an electric current of low intensity. This new therapeutic approach was originally developed to treat severe hypertension resistant to at least 3 antihypertensive drugs.

An international study led by Professor Michel Azizi of the European Hospital Georges Pompidou, AP-HP – Department Head, Center of Excellence in Hypertension and Coordinator CIC1418 APHP-Inserm – and the University Paris-Descartes and Dr. Laura Mauri (Harvard University, Brigham and Women’s Hospital, Boston, USA) was conducted in collaboration with a US start-up. It was designed to objectively assess the blood pressure efficacy and safety of renal denervation ultrasound against a fictitious speech – called “sham” – for the first time in patients receiving no medication for their hypertension.

A total of 146 patients with moderate hypertension taking no antihypertensive drug were distributed by drawing lots among the group treated with renal denervation or group “sham” limited to a diagnostic arteriography. 

Neither the patients nor the medical team that tracks patients knew which group they were assigned by lottery. The fictional or “sham” surgery with keeping the knowledge of the randomization of patients and medical teams eliminates the placebo effect especially in hypertension and has been approved by health authorities and the protection committee of people in France and worldwide.

After 2 months follow up without addition of antihypertensive treatment except in cases of necessity of safety, study results show that:

• daytime ambulatory systolic pressure was reduced significantly greater extent in the denervation group (-8.5 mmHg) than in the sham group (-2.2 mmHg), a difference of 6.3 mmHg in favor of denervation kidney. 
• over 66% of patients treated with renal denervation had a reduction of 5 mmHg or more daytime ambulatory systolic blood pressure, compared to 33% in the control group.
• 20% of patients treated with renal denervation had normalized their blood pressure without taking any antihypertensive medication against 3% in the control group.
• No serious adverse events were observed.

(* MmHg: millimeters of mercury)

Renal denervation is therefore a medium-term hypotensive effect in patients with hypertension and receiving no antihypertensive drug.

In France, high blood pressure affects about 30% of the population and can lead to serious cardiovascular or renal complications, sometimes fatal. Despite the availability of many different drug classes, hypertension remains uncontrolled in more than 45% of hypertensive patients in France [1] and in the world.

“The long-term maintenance of the reduction in blood pressure after renal denervation procedure would have beneficial consequences in terms of reducing cardiovascular and cerebrovascular events in patients with hypertension. Monitoring at 6, 12 and 36 months is in progress and provide guidance on keeping away from the blood pressure reduction, “   says Dr. Michel Azizi, Georges Pompidou European Hospital, AP-HP. 

The RADIANCE-HTN research program is ongoing to include patients with resistant hypertension is at higher risk of complications. Pioneers patients and the medical community to seek together new perspectives for simplifying and customizing the treatment of hypertension in France and around the world to contribute to its better control and reduce complications.

[1] epidemiological study conducted by Public Health ESTEBAN France and worldwide study Measurement Month May 2017

Crédits: AdobeStock

Researchers from Inserm, CNRS and Université Grenoble Alpes working at the Institute for Advanced Biosciences (Joint Research Unit 1209) have analyzed the consequences of environmental exposure in utero using data collected from a cohort of 668 women. Exposure to atmospheric pollution is associated with epigenetic modifications in the placenta, presenting a risk to the fetus. These findings were published in Environment International on June 21, 2018.

Exposure to air pollution during pregnancy presents a risk to the health of the fetus and child. According to a number of studies, exposure to air pollution is linked to harmful effects, such as preeclampsia (hypertension associated with the presence of protein in the urine) in the pregnant woman, as well as reduced birth weight and possibly also lung function deterioration and neurodevelopmental disorders in the child. The mechanisms that explain the effect of air pollutants on the development of the fetus and child could involve impairment of the placenta.

The researchers conducted a study based on 668 mothers and their children in the EDEN cohort. The pregnant women were recruited between 2003 and 2006 in the university hospitals of Nancy and Poitiers. The scientists observed that the mothers most exposed to nitrogen dioxide (gas produced by automobile, industrial and thermal combustion processes) during their pregnancies presented an epigenetic modification on the ADORA2B gene. “Defects in the expression of this gene have in other studies been associated with preeclampsia, a commonly-occurring condition in pregnancy which can be serious if it is not managed,” explains Inserm researcher, Johanna Lepeuler. The average exposure levels in the population studied were below the annual limit set by the European Union air quality directive (40 mg/m³ for nitrogen dioxide).

The results of this study thereby confirm part of the hypothesis according to which prenatal exposures to air pollutants, at levels commonly found in Europe and France, could be harmful to the health of the pregnant woman and unborn child.

It is the first study on air pollutants to focus on the issue based on an analysis of large-scale epigenetic data (concerning more than 400,000 epigenetic locations). Previous studies focused on specific genes.