Prospective association between organic food consumption and the risk of type 2 diabetes: findings from the NutriNet-Santé cohort study

Emmanuelle Kesse-Guyot, Pauline Rebouillat, Laurence Payrastre, Benjamin Allès, Léopold K Fezeu, Nathalie Druesne-Pecollo, Bernard Srour, Wei Bao, Mathilde Touvier, Pilar Galan, Serge Hercberg, Denis Lairon, Julia Baudry, Emmanuelle Kesse-Guyot, Pauline Rebouillat, Laurence Payrastre, Benjamin Allès, Léopold K Fezeu, Nathalie Druesne-Pecollo, Bernard Srour, Wei Bao, Mathilde Touvier, Pilar Galan, Serge Hercberg, Denis Lairon, Julia Baudry

Abstract

Background: Organic food (OF) consumption has substantially increased in high income countries, mostly driven by environmental concerns and health beliefs. Lower exposure to synthetic pesticides has been systematically documented among consumers of organic products compared to non-consumers. While experimental studies suggest that pesticides currently used in food production may be associated with type 2 diabetes (T2D), no well-conducted prospective studies have investigated the potential association between consumption of organic products and the risk of T2D, controlling for potential confounding factors. The objective of this prospective study was to estimate the association between OF consumption and the risk of T2D.

Methods: A total of 33,256 participants (76% women, mean (SD) age: 53 years (14)) of the French NutriNet-Santé prospective cohort study who completed the organic food frequency questionnaire were included (2014-2019). The proportion of OF in the diet (as weight without drinking water) was computed. The associations between the proportion of OF in the diet (as 5% increment and as quintiles) and the risk of T2D were estimated using multivariable Hazard Ratio (HR) and 95% confidence interval (95% CI) derived from proportional hazards models adjusted for confounders (sociodemographic, anthropometric, lifestyle, medical and nutritional factors).

Results: During follow-up (mean = 4.05 y, SD = 1.03 y, 134,990 person-years), 293 incident cases of T2D were identified. After adjustment for confounders including lifestyle (physical activity, smoking status, alcohol consumption) and nutritional quality of the diet assessed by the adherence to the French food-based dietary guidelines, OF consumption was associated with a lower risk of T2D. Participants with the highest quintile of OF consumption, compared with those with the lowest quintile, had 35% lower risk of T2D (95% CI = 0.43-0.97). Each increment of 5% in the proportion of OF in the diet was associated with 3% lower risk of T2D (HR 0.97, 95% CI = 0.95-0.99).

Conclusions: In this large prospective cohort study, OF consumption was inversely associated with the risk of T2D. Further experimental and prospective studies should be conducted to confirm these observations.

Clinical trial registry: The study was registered at ClinicalTrials.gov ( NCT03335644 ).

Keywords: Organic food, Pesticides, Diabetes, Nutrition, Cohort.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Selection of the sample
Fig. 2
Fig. 2
Linearity assumption of the association between the proportion of organic food in the diet and type 2 diabetes risk1,2. 1Spline plot modeling the association between the proportion of organic food in the diet and type 2 diabetes risk using Restricted cubic spline (RCS) SAS Macro® developed by Desquilbet and Mariotti. 2P for overall association = 0.02, P for non-linear association = 0.12

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