dimanche 28 octobre 2018

Bio et cancer ? Certains journalistes sont irresponsables, et certains politiques aussi

On lit dans  The Guardian, sous la plus de Gideon Meyerowitz-Katz  :

Don't believe the hype, organic food doesn't prevent cancer  : ce qui signifie "ne gobez pas n'importe quoi, les aliments bio ne préviennent pas le cancer.

Puis : Alarmist fearmongering over the scary chemicals in your food is all the rage, the reality is far more humdrum, ce qui signifie que les alertes sont les affreux produits chimiques de son aliments font rage, mais la réalité est bien autre.
Pour le reste, l'article que je vous laisse ici en anglais (utiliser la fonction traduction de Google par exemple) dit en substance que l'article publié par quelques nutritionnistes français n'établit certainement pas ce qui a été dit par une certaine presse française :

Pesticide-free, with no genetic modifications, organic food must be better for our health. Photograph: alexialex/Getty Images/iStockphoto
One of the most enduring health fads of the last decades has been the organic movement. Maybe it’s because we are all terrified of chemicals, or perhaps the marketing has just done its job; either way, virtually every wellness pitch these days comes with the same advice:
“Eat organic. It’s better for your health.”
In our modern world, the idea rings so true. Pesticide-free, with no genetic modifications, organic food must be better for our health.
And a new story has popped up across the world that seems to support this idea. Media everywhere is reporting that eating organic is not just good for the planet, it can prevent cancer as well.
But while alarmist fearmongering over the scary chemicals in your food is all the rage, the reality is far more humdrum. It turns out that organics probably don’t prevent cancer after all.
The current noise in the media is over a large epidemiological study that looked at French adults and their eating habits. The researchers asked a group of 70,000 people what they ate, and then followed them up a number of years later. They then grouped people together according to how much organic food they ate, and compared the risk of getting cancer across groups.
They found that people who scored highest on their organic food eating scale, after controlling for potential confounding variables, were also less likely to get cancer. There were also protective effects on some specific cancers — postmenopausal breast and lymphoma — although this was not true for prostate, colorectal, skin, or premenopausal breast cancer.
But overall — organics stopped people getting cancer! Good news for organic eaters, surely?
Sadly, that’s not the end of the story.
At the outset, I should say that this was one of the best epidemiological trials I’ve seen in a while. The analysis was brilliant, the subject very interesting, and while I don’t think it means very much at all, it’s still a well done piece of science.
There were lots of major limitations of this study. For anyone who actually read the paper, they were mostly acknowledged by the authors.
1. The measure of organic food intake wasn’t great, as it was based on a very simplistic questionnaire. This makes it very hard to know if this study accurately represents the intakes of organic foods, particularly as it directly contradicts other research.
2. Residual confounding is a huge issue in studies like this – the authors controlled for the variables they know about, but there’s a good chance that there are additional things that may have influenced the results.
3. People who ate organic foods were much healthier than those who didn’t. The group with the highest organic food intake scored better on every other measure of health (smoking, weight, heart disease etc) than those who ate the least, making residual confounding much more likely.
4. The study is hard to generalize, as the participants were mostly affluent French women, who aren’t really representative of the world in general.
5. The absolute risk difference was very small. While those who ate the most organics were 25% less likely to get cancer, this actually equated to an absolute risk reduction of about 0.5% (cancer is relatively rare, read more about absolute vs relative risk here).
6. The results did not hold true for men, younger adults, less educated people, people who never smoked or smoke currently, or (and this one is important), those with a high overall dietary quality.
Advertisement which brings us to the really interesting question.
What does this study mean (to you)?
It’s always hard to tell what scientific studies actually mean to you, because they aren’t really written with the average person in mind. That being said, there’s a good general rule when it comes to large epidemiological studies that I always advocate:
Don’t worry about epidemiology, it means very little to your life.
This study is a good example. Even if we ignore the many limitations, switching most of your diet to organic, at huge cost, for the rest of your life, to potentially reduce your risk of cancer by less than 1% is a bit of a big ask. You would get much more out of exercising for 30 minutes more a week, or cutting back on the booze, or quitting smoking, than by doubling the cost of your weekly shop.
But taking the limitations into account, it’s hard to take anything out from this study at all. If you are male, well-educated, or don’t smoke, there’s no reason to eat organic based on this study at all. In fact, the main group that eating organics seemed to help was postmenopausal French women, and while that is still an interesting finding it limits the applicability of this study to many people’s lives.
There are also previous studies in this area that have found entirely different results. One study of more than 600,000 people found that eating organic foods conferred no reduction in risk whatsoever, making this new study seem a bit less rosy.
There’s also not much evidence behind the theory that organics are healthier, particularly given that some of the concerns about conventional farming — GMOs are a great example — have been conclusively proven to be safe.
One final thing that is really important: if you looked just at those who had a high score for their dietary quality, organic food did nothing. No difference. It appears that, if you eat a balanced diet with lots of fresh fruit and veg, it doesn’t matter whether you opt for organics or conventionally-farmed foods.
Don’t believe the hype. Organic food doesn’t prevent cancer.
Gideon Meyerowitz-Katz is an epidemiologist working in chronic disease in Sydney’s west, with a particular focus on the social determinants that control our health.
Since you’re here…
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Tout y est juste, y compris les quelques lignes de préambule sur le fait que c’est une excellente étude sur le plan méthodologique…et y compris le ton qui est factuel, non polémique et très clair, ce qui n’empêche pas une descente en flèche, cruelle dans son efficacité, du message du journal Le Monde, qui, lui a été sans aucune nuance, et donc parfaitement faux !
Comment s’assurer que les  journalistes français qui ont trompé leurs lecteurs  liront cet article du Guardian et prendront enfin les leçons de journalismes dont ils ont besoin ?

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