OBJECTIVES:There is no molecular biomarker available in the clinical practice to assess the prognosis of advanced pancreatic carcinoma. This multicenter prospective study aimed to investigate the role ofKRASmutation subtypes within the primary tumor to determine the prognosis of advanced pancreatic

There is a growing availability of industrial plant-based meat and dairy substitutes that can be classified as ultra-processed foods (UPFs). Very little is known about the consumption of UPFs by vegetarians. The aim of this cross-sectional study, from the NutriNet-Santé cohort, was to describe the contribution of UPFs to different vegetarian diets, in relation to the nutritional quality of their diet, and determinants of UPF consumption, including duration and age at vegetarian diet initiation. The study population (n = 21,212) was divided into 4 groups: 19,812 meat eaters, 646 pesco-vegetarians, 500 vegetarians, and 254 vegans. Daily food intakes were collected using repeated 24-h dietary records. Vegetarian diets were described by the proportion of energy from UPFs and the nutritional quality of the diet using healthy and unhealthy plant-based diet indices (PDIs). In a subsample without meat eaters (n = 1,400), a multivariable linear regression model was performed to study the association between UPF consumption and its determinants. Higher avoidance of animal-based foods was associated with a higher consumption of UPFs (P < 0.001), with UPFs supplying 33.0%, 32.5%, 37.0%, and 39.5% of energy intakes for meat eaters, pesco-vegetarians, vegetarians, and vegans. The nutritional quality of diets was also associated with the level of animal-based foods avoidance (P < 0.001), with healthy PDIs at 53.5, 60.6, 61.3 and 67.9 for meat-eaters, pesco-vegetarians, vegetarians, and vegans. Short duration and young age at diet initiation were associated with an increased consumption of UPFs (βage at initiation = -0.003, P = 0.001; βduration = -0.002, P < 0.001). Not all vegetarian diets necessarily have health benefits, because of potential adverse effects of UPFs on nutritional quality and healthiness of diet. UPF consumption by vegetarians and their diet characteristics should be considered in future studies on the links between vegetarianism and health. This trial was registered at clinicaltrials.gov as NCT03335644.

Background: Climate change poses unprecedented challenges, ranging from global and local policy challenges to personal and social action. Heat-related deaths are largely preventable, but interventions for the most vulnerable populations need improvement. Therefore, the prior identification of high risk areas at the community level is required to better inform planning and prevention. We aimed to demonstrate a simple and flexible conceptual framework relying upon satellite thermal data and other digital data with the goal of easily reproducing this framework in a variety of urban configurations. Results: The study area encompasses Rennes, a medium-sized French city. A Landsat ETM + image (60 m resolution) acquired during a localized heatwave (June 2001) was used to estimate land surface temperature (LST) and derive a hazard index. A land-use regression model was performed to predict the LST. Vulnerability was assessed through census data describing four dimensions (socio-economic status, extreme age, population density and building obsolescence). Then, hazard and vulnerability indices were combined to deliver a heatwave health risk index. The LST patterns were quite heterogeneous, reflecting the land cover mosaic inside the city boundary, with hotspots of elevated temperature mainly observed in the city center. A spatial error regression model was highly predictive of the spatial variation in the LST (R ² = 0.87) and was parsimonious. Three land cover descriptors (NDVI, vegetation and water fractions) were negatively linked with the LST. A sensitivity analysis (based on an image acquired on July 2000) yielded similar results. Southern areas exhibited the most vulnerability, although some pockets of higher vulnerability were observed northeast and west of the city. The heatwave health risk map showed evidence of infra-city spatial clustering, with the highest risks observed in a north–south central band. Another sensitivity analysis gave a very high correlation between 2000 and 2001 risk indices (r = 0.98, p < 10^-12). Conclusions: Building on previous work, we developed a reproducible method that can provide guidance for local planners in developing more efficient climate impact adaptations. We recommend, however, using the health risk index together with hazard and vulnerability indices to implement tailored programs because exposure to heat and vulnerability do not require the same prevention strategies.

Diet is widely recognized as one of the main modifiable drivers of gut microbiota variability, and its influence on microbiota composition is an active area of investigation. The present work aimed to explore the associations between usual diet and gut microbiota composition in a large sample of healthy French adults. Gut microbiota composition was established through sequencing of the 16S rRNA gene in stool samples from 862 healthy French adults of the Milieu Intérieur study. Usual dietary consumptions were determined through the administration of a food-frequency questionnaire. The associations between dietary variables and α- and β-diversity indexes and relative taxa abundances were tested using Spearman correlations, permutational ANOVAs, and multivariate analyses with linear models, respectively. Foods generally considered as healthy (raw fruits, fish) were positively associated with α-diversity, whereas food items for which a limited consumption is generally recommended (fried products, sodas or sugary drinks, fatty sweet products, processed meats, ready-cooked meals, and desserts) were negatively associated with α-diversity. Fruits, fried products, ready-cooked meals, and cheese contributed to shifts within microbiota composition (β-diversity). Our results also highlighted a number of associations between various food group intakes and abundances of specific phyla, genera, and species. For instance, the consumption of cheese was negatively associated with Akkermansia muciniphila abundance. This large-scale population-based study supports that the usual consumption of certain food items is associated with several gut microbial features, and extends the mechanistic arguments linking Western diet to an altered microbiota composition. These results provide new insights into the understanding of complex diet-gut microbiota relations, and their implications for host health deserve further investigation because altered microbiota diversity was consistently linked to increased risk of several health outcomes. This trial was registered at clinicaltrials.gov as NCT01699893.

Background: The incidence of inflammatory bowel diseases (IBDs) tended to increase for several decades. Diet is suspected to be a major determinant of the occurrence of these diseases. This prospective study aimed to assess the associations among occurrence of IBD, dietary patterns, and ultra-processed food in the French NutriNet-Santé cohort.Methods: Participants of the NutriNet-Santé cohort who completed at least three 24-hour dietary records were included. Incident IBD cases were identified from 3 questionnaires and confirmed by phone or email interview. Major dietary patterns (DPs) were computed using a principal component analysis (PCA) based on 29 food groups’ consumption, whereas proportions of ultra-processed foods (UPFs) were obtained using the NOVA classification. Multivariable Poisson models were performed to evaluate associations among DP quintiles, UPF proportion (UPFp) in the diet, and incident IBD.Results: A total of 105,832 participants were included, contributing 238,924 person-years in a mean follow-up of 2.3 ± 2.2 years. Among them, 75 participants reported an incident IBD. Three major DPs were retained: “healthy,” “traditional,” and “western.” No significant association was found for DPs and UPFp after adjustments for covariates.Conclusions: In this study, neither DPs nor UPF proportion in the diet were significantly associated with the risk of incident IBD after adjustments for covariates. Further studies are needed to investigate the long-term association between diet and IBD.