Table 2.
Data extraction table - Observational Studies.
| Ref | Study Population | n | Design and Duration | Exposure/Treatment | Outcome Measures | Results | Definition of Organic |
|---|---|---|---|---|---|---|---|
| Jensen (1996) [50] | Denmark Age: mean 33 years 100% male Members of organic farming organisations (n = 55) / airline company (n = 141) |
196 | Cross-sectional study. Analysis of semen samples for sperm quality in male organic farmers and airline workers. | Diet, working conditions, health, and lifestyle were assessed with questionnaire. Those with >25% organic diet defined as organic group. Self-reported FFQ. | Comparison of sperm concentration, seminal volume, total sperm count, and sperm morphology. | Sperm concentration was 43.1% (95%CI 3.2%–98.8%, p = 0.033) higher among men eating organically produced food. Seminal volume, total sperm count, and sperm morphology were not different between groups. This was a short report and missing detail on organic diet definitions between groups. | No specific definition of organic. |
| Juhler (1999) [51] | Denmark Age: mean 38 years 100% male Organic farmers (n = 85) / conventional farmers (n = 171) |
256 | Cross-sectional study. Analysis of semen samples for sperm quality in organic vs. conventional farmers. | Farmers divided into three groups, according to organic production/proportion of organic food consumption: none (N, 0%), medium (M, 1–49%), or a high (H, 50–100%) proportion FV consumed. Self-reported FFQ. | Correlation between estimated dietary pesticide intakes and semen parameters (including sperm concentration, seminal volume, total sperm count, and sperm morphology). | Group N showed a significantly lower proportion of morphologically normal spermatozoa, but no difference in 14 other semen parameters. A higher intake of five specific pesticides equated with a lower percentage of dead spermatozoa. No other significant differences were found. | No specific definition of organic. |
| Chiu (2018) [52] | United States; Environment and Reproductive Health (EARTH) Study Age: mean 35 years 100% female Women attending fertility clinic |
325 | Prospective cohort. Artificially assisted reproduction (AAR) outcomes in women, including pregnancy/birth outcomes associated with high and low dietary pesticide exposure. |
Self-reported FFQ, prior to starting AAR. A total Pesticide Residue Burden Score (PRBS) was calculated (based on pesticide residue data and organic FV intake). Classifications were organic >3 times/week, or non-organic <3 times/week. | Clinical outcomes included implantation, clinical pregnancy, live birth. Early ART end points included markers of ovarian responses to stimulation (peak estradiol levels, endometrial thickness, oocyte development, total oocytes), fertilization rate, and embryo quality. | High PRBS was inversely associated with probability of clinical pregnancy and live birth per initiated cycle. Compared with women in the lowest quartile of high-pesticide residue FV intake (<1 serving/day), women in the highest quartile (≥2.3 servings/d) had 18% (95%CI, 5%–30%) lower probability of clinical pregnancy and 26% (95%CI, 13%–37%) lower probability of live birth. No association was found between quartiles and early ART end points. The adjusted probabilities of total pregnancy loss were 7% (95%CI, 3%–15%), 23% (95%CI, 16%–33%), 24% (95% CI, 15%–36%), and 34% (95% CI, 20%–51%) for women in increasing quartiles of high–pesticide residue FV intake. | No specific definition of organic. Volunteers were asked to provide information on frequency of organic FV consumption (<3 vs ≥3 times/week). |
| Baudry (2018) [53] | France; Nutri-Net Santé Cohort study Age: mean 44 years 78% female General population |
68,946 | Prospective observational cohort study (internet-based). Followed for up to 7 years, looking at all first primary cancers diagnosed between study inclusion and November 2016. | FFQ and cancer data (self-reported, but verified with medical records in >90% of cases). Estimated intake of 16 organic food/beverage items recorded to determine an organic score. Organic quartiles: Q4 = highest organic food intake, Q1 = lowest organic food intake. | All first primary cancers diagnosed between study inclusion and November 2016. All cancer types considered cases except for basal cell skin carcinoma, which was not considered cancer. | High organic food scores were linearly and negatively associated with the overall risk of cancer (HR for Q4 vs Q1, 0.75; 95%CI, 0.63–0.88; P for trend = .001; absolute risk reduction, 0.6%; HR for a 5-point increase, 0.92; 95% CI, 0.88–0.96). Within individual cancer types, a significantly reduced HR was seen for those with Q4 intake vs. Q1 for all lymphomas, non-Hodgkin lymphoma and post-menopausal breast cancer. | No specific definition of organic. Consumption frequency of 264 food and drink items used to calculate organic score. |
| Baudry (2018) [20] | France; Nutri-Net Santé Cohort study Age: mean 58 years 70% female General population |
300 | Nested matched case-control study of 300 participants (150 low and 150 high organic food consumers), with available fasting blood samples for analysis. | Self-reported FFQ used to estimate organic food intake. Low and high organic food consumers were grouped according to proportion of organic food below 10% or above 50%. The average proportions of organic food in the diet were 3% (± 3) and 67% (± 13) in the conventional and organic groups, respectively. | Plasma concentrations of vitamins A and E as well as 6 carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein, zeaxanthin, and lycopene), copper, cadmium, magnesium, iron, transferrin and ferritin, fatty acid composition. | No significant differences were found between the 2 groups for α-tocopherol and retinol, cadmium, copper, ferritin or transferrin. Organic consumers exhibited higher plasma concentrations of α-carotene, β-carotene, lutein, and zeaxanthin with no differences for other carotenoids. Organic consumers had higher magnesium, lower iron, lower palmitoleic acid, γ-linolenic acid, and docosapentaenoic acid, and higher linoleic acid. | No specific definition of organic. Consumption frequency of 264 food and drink items used to calculate organic score. |
| Baudry (2019) [54] |
France; Nutri-Net Santé Cohort study Age: mean 58 years 70% female General population |
300 | Nested matched case-control study of 300 participants (150 low and 150 high organic food consumers), with available urine samples for analysis. | Self-reported FFQ used to estimate organic food intake. Low and high organic food consumers were grouped according to proportion of organic food below 10% or above 50%. The average proportions of organic food in the diet were 3% (± 3) and 67% (± 13) in the conventional and organic groups, respectively. | Urinary pesticide and metabolite concentrations (organophosphorus, pyrethroid, and azole compounds). | Pesticide concentrations were mostly below LOD. For pesticide metabolites, significantly higher levels of DETP, DMTP, total DAPs (organophosphorus metabolites) and free 3-PBA (a pyrethroid metabolite) were found among conventional consumers compared to organic consumers, with median concentration levels of diethylphosphate (0.196 versus 0.297), dimethylphosphate (0.620 versus 1.382), and total dialkylphosphates (0.12 versus 0.16), p < 0.05. | No specific definition of organic. Consumption frequency of 264 food and drink items used to calculate organic score. |
| Brantsæter (2016) [55] | Norway; The Norwegian Mother and Child Cohort Study (MoBa). 100% female Pregnant women who delivered a singleton male infant. |
35,107 | Prospective cohort. Pregnant women at gestational week 22 surveyed for organic food consumption with results correlated to prevalence of male infants born with hypospadias or cryptorchidism. |
Self-reported FFQ collected information about average dietary intake since start of pregnancy over six groups of organically produced food (vegetables, fruit, bread/cereal, milk/dairy products, eggs, and meat). | Association between non-organic/organic food consumption (never/seldom vs sometimes/often/mostly) and development of hypospadias or cryptorchidism in male newborns. | Seventy-four male newborns were diagnosed with hypospadias (0.2%), and 151 with cryptorchidism (0.4%). Women who consumed any organic food during pregnancy were less likely to give birth to a boy with hypospadias (OR = 0.42; 95% CI: 0.25, 0.70, based on 21 exposed cases) than women who reported they never or seldom consumed organic food. Associations with specific organic foods were strongest for vegetable (OR = 0.36; 95% CI: 0.15, 0.85; 10 exposed cases) and milk/dairy (OR = 0.43; 95% CI: 0.17, 1.07; 7 exposed cases) consumption. No association was observed for consumption of organic food and cryptorchidism. | All food sold as organic in Norway must be certified by Debio. Debio is accredited organic by Norwegian Accreditation and by IFOAM. |
| Torjusen (2016) [56] | Norway; The Norwegian Mother and Child Cohort Study (MoBa) Age: mean 28 years 100% female Nulliparous pregnant females. |
28,192 | Prospective cohort. Pregnant women at gestational week 22 surveyed for organic food consumption with results correlated to prevalence of pre-eclampsia. |
Among the 28,192 women in this study, the majority reported never/rarely eating organic food; 39.8% ate at least one organic food ‘sometimes’; 7% ate at least one organic food ‘often’; and 1.8% reported use of any organic food ‘mostly’. | Pre-eclampsia in pregnant women. | The prevalence of pre-eclampsia in the study sample was 5.3% (n = 1,491). Women who reported eating organic ‘often’ or ‘mostly’ (n = 2,493, 8.8%) had lower risk of pre-eclampsia than those who reported ‘never/rarely’ or ‘sometimes’ (crude OR = 0.76, 95%CI 0.61, 0.96; adjusted OR = 0.79, 95%CI 0.62, 0.99). The lower risk was evident also when adjusting for overall dietary quality. | No specific definition of organic. Frequent organic consumption was defined as eating organic food ‘often’ for at least one of the six food categories. |
| Christensen (2013) [57] | Denmark 100% female Mothers of boys operated on for hypospadias (n = 306) and matching control group (n = 306) |
612 | Retrospective case-control study. Retrospective interviews of organic dietary habits in mothers with male infant born with hypospadias and matched controls. |
FFQ listed choice of organic food items in the first trimester for milk, other dairy, eggs, meat, FV. Responses consisted of often, sometimes, rarely and never. Current dietary habits (up to several years post-pregnancy) were taken as proxy for pregnancy diet. | Association between organic food consumption of specified food groups during pregnancy and prevalence of hypospadias in infant sons. | Higher OR for hypospadias was found with rare or no consumption of organic non-milk dairy products, however, the association was not statistically significant after adjustment (OR = 1.36, 95%CI 0.95, 1.94). A similar association was observed for mothers rarely or never choosing organic eggs (OR = 1.28, 95%CI 0.92, 1.79). Total organic intake showed no statistically significant association, however, mothers who never or rarely chose any organic products had nonsignificant increased odds of giving birth to a boy with hypospadias (adjusted OR = 1.31, 95%CI 0.78, 2.21). | No specific definition of organic. |
| Rist (2007) [58] | Netherlands; KOALA Birth Cohort Age: mean 33 years 100% female Breastfeeding mothers with conventional (NO) or alternative (O) lifestyle |
312 | Cross-sectional study. Analysis of breast milk for fatty acid content from lactating women with predominantly organic or non-organic food consumption. | FFQ at gestational week 34. Classification into four groups based on the origin of meat/dairy products only. Organic = >90% organic Moderate = 50-90% organic Conventional = <50% organic |
Amount of conjugated linoleic acids in breast milk of lactating women, measured as trans-vaccenic acid (TVA) and cis-9,trans-11-octadecadienoic acid (Rumenic). | Rumenic acid increased in a statistically significant way moving from a conventional diet (n = 186) to a moderately organic diet (n = 33), to a strict organic diet (n = 37). TVA levels were higher in the two mostly organic quartiles than in the conventional or minimal groups. | No specific definition of organic. Food origin specified as conventional or organic and % of food group as <50 %, 50–90% or >90%. |
| Mueller (2010) [59] | Netherlands; KOALA Birth Cohort Age: mean 33 years 100% female Breastfeeding mothers with conventional (NO) or alternative (O) lifestyle |
310 | Cross-sectional study. Analysis of breast milk for trans fatty acid content from lactating women with predominantly organic or non-organic food consumption. | FFQ at gestational week 34. Classification into four groups based on the origin of meat/dairy products only. Organic = >90% organic Moderate = 50-90% organic Conventional = <50% organic |
Amount of trans fatty acids (TFA) in breast milk of lactating women, measured as different trans fatty acid isomers. | Total TFA content of mothers’ milk in the compared groups ranged between 3 and 3.3% of total fatty acids. There were no significant differences in the total TFA content between groups of organic vs. non-organic intake or amount of dairy fat intake reported. | No specific definition of organic. Food origin specified as conventional or organic and % of food group as <50 %, 50–90% or >90%. |
| Kummeling (2008) [60] | Netherlands; KOALA birth Cohort Age: 2 years Infants with non-organic (NO) (n = 2,135), or organic diet (O) (n = 463) |
2598 | Prospective cohort. Mothers of infants surveyed about child’s organic food consumption and allergy symptoms at 3, 7, 12 and 24 months of age. | Parents completed FFQ at each time-point. Infants diet classified as: ‘conventional’ (<50% organic); ‘moderately organic’ (50–90% organic); ‘strictly organic’ (>90% organic). | Association between allergic symptoms reported by parents (including eczema, wheeze occurrence, rash) and intake of organic vs. conventional foods; IgE antibodies measured in a subset of children (n = 815). | Consumption of organic dairy products was associated with lower eczema risk (OR = 0·64, 95%CI 0·44, 0·93), but there was no association for development of eczema, wheeze or atopic sensitisation. No statistically significant associations were observed between organic food consumption and recurrent wheeze (OR = 0·51, 95%CI 0·26, 0·99) during the first 2 years of life. | In the Netherlands ‘organic’ products include biodynamic production, which carry the registered ‘EKO’ certification. |
| Stenius (2011) [61] | Sweden; ALLADIN Study Age: foetal period (2nd trimester of mother) – 24 months |
330 | Prospective cohort. Anthroposophic or non-anthroposophic families followed for development of allergic sensitisation in children, correlated with lifestyle factors (including organic food choice). | FFQ completed by pregnant women in 2nd trimester. Child followed for allergic sensitisation to 24 months. Organic food consumption in AL group was 80% and 5% in CL group. | IgE in cord blood and sensitisation to common allergens and total IgE at 6, 12, and 24 months of age. | Children of families with AL had a markedly decreased risk of sensitisation during the first 2 years of life compared with children of CL families with adjusted OR = 0.25 (95%CI 0.10, 0.64), p = 0.004. Children from families with a partly anthroposophic lifestyle had similar result with adjusted OR = 0.31 (95%CI 0.15, 0.54), p = 0.002. | No specific definition of organic. Organic/biodynamic diet evaluated as one of many lifestyle questions, with no detail of how this was quantified. |
| Buscail (2015) [62] | France; PELAIGE mother-child cohort Age: foetal period (from gestation) – 24 months |
1505 | Prospective observational cohort study. Mothers consumption of organic food mid-pregnancy and when infant is 2 years, correlated to episodes of otitis media. | Pregnant women completed questionnaires reporting domestic use of pesticides and consumption of organic diet during pregnancy at 19 weeks of gestation and again at age 2 of infant. Children were assessed for otitis media during early childhood. | Episodes of otitis media (OM) and recurrent OM in children. Urinary samples to measure pesticides (n = 248). Associations between pesticide measurements and OM. | Children whose mothers reported an organic diet during pregnancy had a reduced risk of OM (at least one episode, p trend = 0.01). No association was found between any outcome and residential proximity to crops. The presence in maternal urine of dealkylated triazine metabolites (herbicide) was positively associated with recurrent OM (OR = 2.12 (1.01 to 4.47)). | No specific definition of organic. Fruit, vegetables and cereals from a non-organic diet were selected as proxies for insecticide exposure. |
| Kesse-Guyot (2017) [63] | France; Nutri-Net Santé Cohort study Age: mean 45 years 78% Female General population |
62,224 | Prospective cohort (internet-based). Followed for up to 10 years, looking at body weight change, risk of overweight or obesity and consumption of organic food. | Self-reported FFQ and anthropometric data completed annually (average 3.1 year follow-up). Estimated intake of 16 organic food/beverage items recorded to determine an organic score (OS). Organic diet quartiles: Q4 = highest rate of organic food consumption, Q1 = lowest rate of organic food consumption. | Correlation between the OS and change in BMI during follow-up and risk of overweight and obesity. | Lower BMI increase was observed across quartiles of the OS (mean difference Q4 v.Q1 = −0.16 (95%CI −0.32, −0.01). An increase in the OS was associated with a lower risk of overweight and obesity (among non-overweight and non-obese participants at inclusion): OR for Q4 v. Q1 were 0.77 (95%CI 0.68, 0.86) and 0.69 (95%CI 0.58, 0.82), respectively. The association remained strong and highly significant, with a reduction in the risk of obesity of 37% at follow-up. A similar association was observed for overweight, although the strength of the association was smaller. | No specific definition of organic. Consumption frequency of 264 food and drink items used to calculate organic score. |
| Baudry (2017) [64] | France; Nutri-Net Santé Cohort study Age: mean 45 years 78% Female General population |
8174 | Cross-sectional analysis of proportion of organic food in the diet (overall and by food group) and prevalence of metabolic syndrome. | Participants filled out a self-administered FFQ, including 264 food and beverage items. Separated into tertiles of organic food consumption. | Correlation between level of organic food intake and prevalence of metabolic syndrome. | Higher organic food consumption was associated with a lower probability of metabolic syndrome, being negatively associated with prevalence, 0.69 (95%CI 0.61, 0.78) when comparing the third tertile of proportion of organic food in the diet with the first one (p < 0.0001). | No specific definition of organic. Consumption frequency of 264 food and drink items used to calculate organic score. |
| Bradbury (2014) [65] | United Kingdom; The Million Women Study Age: mean 59 years 100% Female General population |
623,080 | Prospective cohort. Study correlates frequency of organic food intake to cancer incidence in women, followed on average for 9.3 years. | Women without cancer at baseline completed a questionnaire asking ‘Do you eat organic food?’ with four possible responses: ‘never, sometimes, usually, and always.’ Repeated at follow-up (on average 9.3 yr). | Association of organic diet with cancer, including all cancers combined (except non-melanoma skin cancer), oral, oesophageal, stomach, colorectum, pancreas, lung, malignant melanoma, breast, endometrium, ovary, kidney, bladder, brain, non-Hodgkin lymphoma, multiple myeloma, and leukaemia. | At baseline, 30%, 63% and 7% of women reported never, sometimes, or usually/always eating organic food, respectively. Consumption of organic food was not associated with a reduction in the incidence of all cancer (n = 53,769 cases in total) (RR for usually/always vs never = 1.03, 95%CI 0.99, 1.07), soft tissue sarcoma (RR = 1.37, 95%CI 0.82, 2.27), or breast cancer (RR = 1.09, 95%CI 1.02, 1.15), but was associated with reduced risk for non-Hodgkin lymphoma (RR = 0.79, 95%CI 0.65, 0.96). | No specific definition of organic. |
| McGuire (2016) [66] | United States Age: mean 29 years 100% female Breastfeeding women 1–3 months postpartum |
41 | Cross-sectional study. Single milk and urine sample from each woman to assess level of pesticides. | 5 question survey that documented potential glyphosate exposure from environment and diet. 42% of the women identified as having "strictly or mainly organic food choices" | Glyphosate and AMPA concentrations in human milk, correlated with pesticide excretion in urine samples. | Glyphosate and AMPA were not detectable in milk samples. There were no significant effects of consuming organic over conventional foods or living on/near a farm compared with living in an urban/suburban region on concentrations of glyphosate (p = 0.1870 and 0.8773, respectively), or AMPA in urine (p = 0.1414 and 0.2525, respectively). | No specific definition of organic. Food intake was self-reported as either mainly organic or mainly conventional. |
| Curl (2003) [33] | United States Age: 2–5 years 56% Male Children |
39 | Cross-sectional study. Level of organic food (%) in diet correlated to pesticide excretion in urine. Food frequency data and urine samples were collected. | Parents of children interviewed about diet, health information and pesticide use, with 2 day food diary completed on day of child's urine sampling. Diet reported as mostly organic or mostly conventional. | 24-hour urine samples measured for urinary DAP or DMP concentrations. | The median total DMP concentration was approximately six times higher for children with conventional diets than for children with organic diets (0.17 and 0.03 µmol/L; p = 0.0003); mean concentrations differed by a factor of nine (0.34 and 0.04 µmol/L). | No specific definition of organic. >75% of dietary intake as organic or conventionally separated the two groups. |
| Curl (2015) [32] | United States Age: 45–84 years 50% Female Adults with subclinical cardiovascular disease |
6814 | Cross-sectional study. Food frequency data and urine samples were collected, correlating organic intake to urinary excretion of pesticides. | Diet was reported as mostly organic or conventional. Participants were asked about their “usual” intake of specific foods and beverages “over the past year.” Average pesticide intake was then calculated. | Correlation between pesticide intake and excretion of pesticides in urine. Sub-group analysis of urine samples for pesticides (n = 240). | Among conventional consumers, increasing tertile of estimated dietary organophosphate exposure was associated with higher DAP concentrations (p < 0.05). DAP concentrations were also significantly lower in groups reporting more frequent consumption of organic produce (p < 0.02). | No specific definition of organic. Foods eaten are correlated to US Dept Agriculture data on pesticide residues and a pesticide exposure number assigned. |
Abbreviations: AAR: artficially assisted reproduction; AL: anthroposophic lifestyle; ART: assisted reproductive technology; AMPA: aminomethylphosphonic acid; BMI: body mass index; CL: conventional lifestyle; DAP: dialkylphosphate; DETP: diethylthiophosphate; DMP: dimethylphosphate; DMTP: dimethylthiophosphate; FFQ: food frequency questionnaire; FV: fruits and vegetables; HR: hazard ratio; LOD: limit of detection; NO: non-organic group; O: organic group; OM: otitis media; OS: organic score; PBA: 3-phenoxybenzoic acid; PRBS: pesticide residue burden score; TFA: trans-fatty acid; TVA: trans-vaccenic acid; Vit: vitamin.