Mehdi Menai

Association between maternal blood cadmium during pregnancy and birth weight and the risk of fetal growth restriction: The EDEN mother–child cohort study

The objective of this study is to investigate the potential effect of maternal environmental cadmium (Cd) exposure on birth weight and fetal growth restriction (FGR). A total of 901 pregnant women from the EDEN cohort study were enrolled from two maternity units. Blood Cd was measured at mid-pregnancy and associations with birth weight and FGR were analyzed. Maternal Cd levels were associated with reduced birth weight in the offspring of women who smoked during pregnancy (b=-113.7; p=0.001). Smoking during pregnancy and maternal blood Cd concentrations had comparable effects on FGR incidence (OR 1.89; 95% CI: 1.00-3.58 and OR=1.41; 95% CI: 1.00-1.99, respectively). This study highlights the effect of Cd toxicity on fetal growth through the probable accumulation and transmission of this metal through the placenta. The close relationship between blood Cd levels and smoking habits indicates that Cd may be a relevant biomarker for smoking toxicity on fetal development.

Spatial heterogeneity of the relationships between environmental characteristics and active commuting: towards a locally varying social ecological model

BackgroundAccording to the social ecological model of health-related behaviors, it is now well accepted that environmental factors influence habitual physical activity. Most previous studies on physical activity determinants have assumed spatial homogeneity across the study area, i.e. that the association between the environment and physical activity is the same whatever the location. The main novelty of our study was to explore geographical variation in the relationships between active commuting (walking and cycling to/from work) and residential environmental characteristics.Methods4,164 adults from the ongoing Nutrinet-Santé web-cohort, residing in and around Paris, France, were studied using a geographically weighted Poisson regression (GWPR) model. Objective environmental variables, including both the built and the socio-economic characteristics around the place of residence of individuals, were assessed by GIS-based measures. Perceived environmental factors (index including safety, aesthetics, and pollution) were reported by questionnaires.ResultsOur results show that the influence of the overall neighborhood environment appeared to be more pronounced in the suburban southern part of the study area (Val-de-Marne) compared to Paris inner city, whereas more complex patterns were found elsewhere. Active commuting was positively associated with the built environment only in the southern and northeastern parts of the study area, whereas positive associations with the socio-economic environment were found only in some specific locations in the southern and northern parts of the study area. Similar local variations were observed for the perceived environmental variables.ConclusionsThese results suggest that: (i) when applied to active commuting, the social ecological conceptual framework should be locally nuanced, and (ii) local rather than global targeting of public health policies might be more efficient in promoting active commuting.

Descriptive study of sedentary behaviours in 35,444 French working adults: cross-sectional findings from the ACTI-Cités study

BackgroundGiven the unfavourable health outcomes associated with sedentary behaviours, there is a need to better understand the context in which these behaviours take place to better address this public health concern. We explored self-reported sedentary behaviours by type of day (work/non-work), occupation, and perceptions towards physical activity, in a large sample of adults.MethodsWe assessed sedentary behaviours cross-sectionally in 35,444 working adults (mean ± SD age: 44.5 ± 13.0 y) from the French NutriNet-Santé web-based cohort. Participants self-reported sedentary behaviours, assessed as domain-specific sitting time (work, transport, leisure) and time spent in sedentary entertainment (TV/DVD, computer and other screen-based activities, non-screen-based activities) on workdays and non-workdays, along with occupation type (ranging from mainly sitting to heavy manual work) and perceptions towards physical activity. Associations of each type of sedentary behaviour with occupation type and perceptions towards physical activity were analysed by day type in multiple linear regression analyses.ResultsOn workdays, adults spent a mean (SD) of 4.17 (3.07) h/day in work sitting, 1.10 (1.69) h/day in transport sitting, 2.19 (1.62) h/day in leisure-time sitting, 1.53 (1.24) h/day viewing TV/DVDs, 2.19 (2.62) h/day on other screen time, and 0.97 (1.49) on non-screen time. On non-workdays, this was 0.85 (1.53) h/day in transport sitting, 3.19 (2.05) h/day in leisure-time sitting, 2.24 (1.76) h/day viewing TV/DVDs, 1.85 (1.74) h/day on other screen time, and 1.30 (1.35) on non-screen time. Time spent in sedentary behaviours differed by occupation type, with more sedentary behaviour outside of work (both sitting and entertainment time), in those with sedentary occupations, especially on workdays. Negative perceptions towards physical activity were associated with more sedentary behaviour outside of work (both sitting and entertainment time), irrespective of day type.ConclusionsA substantial amount of waking hours was spent in different types of sedentary behaviours on workdays and non-workdays. Being sedentary at work was associated with more sedentary behaviour outside of work. Negative perceptions towards physical activity may influence the amount of time spent in sedentary behaviours. These data should help to better identify target groups in public health interventions to reduce sedentary behaviours in working adults.

Prospective association between a dietary quality index based on a nutrient profiling system and cardiovascular disease risk.

Background Public health strategies are essential to guide consumers’ choices and produce a substantial population impact on cardiovascular disease risk prevention through nutrition. Our aim was to investigate the prospective association between the Food Standards Agency nutrient profiling system dietary index (FSA-NPS DI) and cardiovascular disease risk. The FSA-NPS has been proposed to serve as a basis for a five-colour nutrition label suggested in France to be put on the front of pack of food products. Methods and results A total of 6515 participants to the SU.VI.MAX cohort (1994–2007), who completed at least six 24-hour dietary records during the first two years of the study, were followed for a median of 12.4 years (25th–75th percentiles: 11.0–12.6). Multivariable Cox proportional hazards models were used to characterise the associations between FSA-NPS DI (continuous and sex-specific quartiles) and the incidence of cardiovascular diseases. Interactions with individual characteristics were tested; 181 major cardiovascular events were reported (59 myocardial infarctions, 43 strokes, 79 anginas). A higher FSA-NPS DI, characterising poorer food choices, was associated with an overall increase in cardiovascular disease risk (HRfor a 1-point increment = 1.14 (1.03–1.27); HRQ4vs.Q1 = 1.61 (1.05–2.47), Ptrend Q4-Q1 = 0.03). This association tended to be stronger in smokers (HRfor a 1-point increment = 1.39 (1.11–1.73); Pinteraction = 0.01) and those less physically active (HRfor a 1-point increment = 1.26 (1.08–1.46); Pinteraction = 0.04). Conclusions Our results suggest that poorer food choices, as reflected by a higher FSA-NPS DI, may be associated with a significant increase in cardiovascular risk, especially in at-risk individuals (smokers and physically inactive persons). This score could be a useful tool for public health prevention strategies. Clinical trial registration ClinicalTrials.gov identifier: NCT00272428.

Changes in Sedentary Behaviours and Associations with Physical Activity through Retirement: A 6-Year Longitudinal Study

Changes 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.

Variations of physical activity and sedentary behavior between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Santé cohort.

AbstractPhysical activity (PA) but also reduced sedentary behavior may be associated with better prognosis and lower risk of recurrence in cancer patients. Our aim was to quantify the variations in PA and time spent sedentary between before and after diagnosis, relying on prospective data in French adults. We also investigated sociodemographic and lifestyle factors associated with these variations.Subjects (n = 942) were incident cancer cases diagnosed in the NutriNet-Santé cohort between 2009 and 2015. PA and sedentary behavior were prospectively collected with the 7-day short version of the IPAQ questionnaire every year since subjects’ inclusion (i.e., an average of 2 year before diagnosis). All PA and sitting time points before and after diagnosis was compared by mixed model. Factors associated with decrease in PA and increase in sitting time were investigated using logistic regressions.Overall and vigorous PA decreased after diagnosis (P = 0.006, −32.8 ± 36.8 MET-hour/week on average, in those who decreased their overall PA and P = 0.005, −21.1 ± 36.8 MET-hour/week for vigorous PA, respectively), especially in prostate (−39.5 ± 36.3 MET-hour/week) and skin (−35.9 ± 38 MET-hour/week) cancers, in men (−40.8 ± 46.3MET-hour/week), and in those professionally inactive (−34.2 ± 37.1 MET-hour/week) (all P < 0.05). Patients with higher PA level before diagnosis were more likely to decrease their PA (odds ratio [OR]: 4.67 [3.21–6.81], P < 0.0001). Overweight patients more likely to decrease moderate PA (OR: 1.45 [1.11–1.89], P = 0.006) and walking (OR: 1.30 [1.10–1.70], P = 0.04). Sitting time increased (P = 0.02, +2.44 ± 2.43 hour/day on average, in those who increased their sitting time), especially in women (+2.48 ± 2.48 hour/day), older patients (+2.48 ± 2.57 hour/day), and those professionally inactive (2.41 ± 2.40 hour/day) (all P < 0.05). Patients less sedentary before diagnosis were more likely to increase their sitting time (OR: 3.29 [2.45–4.42], P < 0.0001).This large prospective study suggests that cancer diagnosis is a key period for change in PA and sedentary behavior. It provides insights to target the subgroups of patients who are at higher risk of decreasing PA and increasing sedentary behavior after cancer diagnosis.

Association Between Blood Pressure and Adherence to French Dietary Guidelines

BACKGROUND Adopting a healthy diet like the Dietary Approach to Stop Hypertension (DASH) or Mediterranean diet (MD) represents a major lifestyle for blood pressure (BP) control in general population. Nutritional policies, such as the French Nutrition and Health Program (Programme National Nutrition Santé or PNNS), have been implemented in several countries with the aims of preventing chronic diseases. The objective of our study was to investigate association between BP and adherence to PNNS guidelines compared with adherence to DASH or MD. METHODS We conducted a cross-sectional study in 11,302 untreated participants from the NutriNet-Santé study, a French web-based cohort study. Three validated scores reflecting adherence to PNNS guidelines, DASH diet, and MD were calculated from repeated 24-hour records. Three BP measurements using a standardized protocol were collected. Multivariate linear models were used to assess the associations between the dietary scores and BP. RESULTS In women, independent of age, socioeconomic status, body mass index, tobacco use, alcohol consumption, and physical activity, adherence to PNNS guidelines was inversely significantly associated with systolic BP (β = -0.63, P < 0.0001). This association was of similar amplitude that between BP and adherence to DASH-style diet (β = -0.66, P < 0.0001) or MD (β = -0.63, P = 0.0002). No significant association was found in men. CONCLUSION Adherence to French nutritional recommendations was found negatively associated with BP at the same magnitude as adherence to well-known dietary pattern in the prevention and treatment of hypertension.

Active Mobility and Environment: A Pilot Qualitative Study for the Design of a New Questionnaire

It is generally accepted that active mobility, mainly walking and cycling, contributes to people’s physical and mental health. One of the current challenges is to improve our understanding of this type of behaviour. This study aims to identify factors from the daily-life environment that may be related to active mobility behaviours, in order to design a new questionnaire for a quantitative study of a large adult population. The new questionnaire obtained through this pilot study combines information from interviews with existing questionnaires materials in order to introduce new factors while retaining the factors already assessed. This approach comprises three stages. The first was a content analysis (Reinert method) of interviews with a sample of participants about daily living activities as well as mobility. This stage led to a typology of factors suggested by interviews. The second was a scoping review of the literature in order to identify the active mobility questionnaires currently used in international literature. The last stage was a cross-tabulation of the factors resulting from the written interviews and the questionnaires. A table of the inter-relationships between the interview-based typology and the questionnaires shows discrepancies between factors considered by the existing questionnaires, and factors coming from individual interviews. Independent factors which were ignored in or absent from the questionnaires are the housing situation within the urban structure, overall consideration of the activity space beyond the limits of the residential neighbourhood, the perception of all the transportation modes, and the time scheduling impacting the modes actually used. Our new questionnaire integrates both the usual factors and the new factors that may be related to active mobility behaviours.

Determining the association between types of sedentary behaviours and cardiometabolic risk factors: A 6-year longitudinal study of French adults

AIM This study identified the longitudinal associations between leisure-time sedentary behaviours [television (TV) viewing, computer use and reading (h/week)] and cardiometabolic risk factors, including the metabolic syndrome. METHODS A total of 2517 participants (mean±SD age: 55.5±4.9 years) were assessed in 2001 and in 2007 for physical activity and leisure-time sedentary behaviours, anthropometry, body composition, blood pressure, fasting blood glucose and lipids, using standardized methods. Multivariate generalized linear (beta, 95% CI and P values) and logistic (OR and 95% CI) regression models were used to assess cross-sectional associations between sedentary behaviours and cardiometabolic risk factors, while a 6-year longitudinal study explored these associations as well as the odds of developing the metabolic syndrome, as defined by the NCEP ATPIII. RESULTS Increased TV viewing time over the follow-up period was positively associated with increases in body mass index (BMI; P<0.01) and percent body fat (P<0.001), and marginally with waist circumference (P=0.06). Reverse associations were also found, with changes in BMI, percent fat mass and waist circumference positively associated with TV viewing and computer use. Associations between reading and cardiometabolic risk factors were less consistent. Each 1-h/week increase in baseline TV viewing and in reading was associated with an increase in the chances of developing the metabolic syndrome (OR=1.031, 95% CI: 0.998-1.060, P=0.07; and OR=1.032, 95% CI: 1.002-1.065, P=0.02; respectively). CONCLUSION The present study data emphasizes the notion of differential associations of specific sedentary behaviours with cardiometabolic risk factors. They are also evidence that different longitudinal associations should be taken into account when designing public health objectives of interventions aimed at improving cardiometabolic health.

Cross-Sectional and longitudinal associations of objectively-measured physical activity on blood pressure: evaluation in 37 countries

Background: We examined the cross-sectional and longitudinal associations of objectively-measured physical activity (step counts) and blood pressure (BP) among adults spanning 37 countries. Methods: Across 37 countries, we used data from a pool of 9238 adult owners of Withings’ Pulse activity trackers, which measures steps taken each day, and Wireless Blood Pressure Monitor, which measures BP. Analyses were adjusted on age, sex, number of days where the tracker was worn, and number of BP measurements. Data was collected from 2009 to 2013. Results: Subjects had a mean ± standard deviation (SD) age of 51.6 ± 11.3 years and a body mass index (BMI) of 28.7±5.5 kg/m2. A 1-month increase of more than 3000 steps per day was associated with a decrease of systolic BP (SBP) and diastolic BP (DBP) among the obese (1.57mm Hg and 1.29 mm Hg respectively, both P<0.001) and the overweight population (0.79 mm Hg and 0.84 mm Hg respectively, both P≤0.001), but not in the normal weight population (P=0.60 and P=0.36 respectively). Conclusion: One-month increases in daily step counts was associated with a decrease of SBP and DBP in a large obese and overweight free living population.