Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, United Kingdom.
PLoS One. 2019 Sep 4;14(9):e0219420. doi: 10.1371/journal.pone.0219420. eCollection 2019.
Despite suggestive observational epidemiology and laboratory studies, there is limited experimental evidence regarding the effect of organic diet on human health. A cluster-randomized 40-day-organic (vs. 40-day-conventional) crossover trial was conducted among children (11-12 years old) from six schools in Cyprus. One restaurant provided all organic meals, and adherence to the organic diet intervention was measured by parent-provided diet questionnaire/diary data. Biomarkers of pyrethroid and neonicotinoid pesticide exposures were measured using tandem mass spectrometry, and oxidative stress/inflammation (OSI) biomarkers using immunoassays or spectrophotometry. Associations were assessed using mixed-effect regression models including interactions of treatment with time. Seventy-two percent of neonicotinoid biomarkers were non-detectable and modeled as binary (whether detectable). In post-hoc analysis, we considered the outcome of age-and-sex-standardized BMI. Multiple comparisons were handled using Benjamini-Hochberg correction for 58 regression parameters. Outcome data were available for 149 children. Children had lower pesticide exposures during the organic period (pyrethroid geometric mean ratio, GMR = 0.297; [95% confidence interval (95% CI): 0.237, 0.373], Q-value<0.05); odds for detection of neonicotinoids (OR = 0.651; [95% CI: 0.463, 0.917), Q-value<0.05); and decreased OSI biomarker 8-OHdG (GMR = 0.888; [95% CI: 0.808, 0.976], Q-value<0.05). An initial increase was followed by a countervailing decrease over time in the organic period for OSI biomarkers 8-iso-PGF2a and MDA. BMI z-scores were lower at the end of the organic period (β = -0.131; [95% CI: 0.179, -0.920], Q-value<0.05). Energy intake during the conventional period was reported to be higher than the recommended reference levels. The organic diet intervention reduced children's exposure to pyrethroid and neonicotinoid pesticides and, over time lowered biomarkers of oxidative stress/inflammation (8-iso-PGF2a, 8-OHdG and MDA). The several-week organic diet intervention also reduced children's age-and-sex-standardized BMI z-scores, but causal inferences regarding organic diet's physiological benefits are limited by the confounding of the organic diet intervention with caloric intake reduction and possible lifestyle changes during the trial. Trial registration: This trial is registered with ClinicalTrials.gov, number: NCT02998203.
尽管有一些提示性的观察性流行病学和实验室研究，但关于有机饮食对人类健康影响的实验证据有限。在塞浦路斯的六所学校中，进行了一项为期 40 天的有机（vs. 40 天常规）交叉试验，参与者为 11-12 岁的儿童。一家餐厅提供所有有机餐，通过父母提供的饮食问卷/日记数据来衡量对有机饮食干预的依从性。使用串联质谱法测量拟除虫菊酯和新烟碱类农药暴露的生物标志物，使用免疫测定或分光光度法测量氧化应激/炎症（OSI）生物标志物。使用混合效应回归模型评估关联，其中包括治疗与时间的相互作用。72%的新烟碱类生物标志物无法检测到，并建模为二进制（是否可检测）。在事后分析中，我们考虑了年龄和性别标准化 BMI 的结果。使用 Benjamini-Hochberg 方法对 58 个回归参数进行多重比较校正。149 名儿童的结果数据可用。在有机期，儿童的农药暴露水平较低（拟除虫菊酯几何平均比，GMR=0.297；[95%置信区间（95%CI）：0.237，0.373]，Q 值<0.05）；新烟碱类的检出几率（OR=0.651；[95%CI：0.463，0.917]，Q 值<0.05）；以及 OSI 生物标志物 8-OHdG 降低（GMR=0.888；[95%CI：0.808，0.976]，Q 值<0.05）。在有机期，OSI 生物标志物 8-iso-PGF2a 和 MDA 的初始增加后，随着时间的推移，其含量呈相反的下降趋势。在有机期结束时，BMI z 分数较低（β=-0.131；[95%CI：0.179，-0.920]，Q 值<0.05）。据报道，常规期的能量摄入高于推荐的参考水平。有机饮食干预降低了儿童对拟除虫菊酯和新烟碱类农药的暴露，随着时间的推移降低了氧化应激/炎症的生物标志物（8-iso-PGF2a、8-OHdG 和 MDA）。为期数周的有机饮食干预也降低了儿童的年龄和性别标准化 BMI z 分数，但由于有机饮食干预与热量摄入减少以及试验期间可能发生的生活方式改变相混淆，关于有机饮食生理益处的因果推论受到限制。试验注册：本试验在 ClinicalTrials.gov 注册，编号：NCT02998203。
