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A study of ultra-processing marker profiles in 22,028 packaged ultra-processed foods using the Siga classification. J Food Compost Anal 2021. [DOI: 10.1016/j.jfca.2021.103848] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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102
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Velázquez AL, Vidal L, Varela P, Ares G. Sugar reduction in products targeted at children: Why are we not there yet? J SENS STUD 2021. [DOI: 10.1111/joss.12666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ana Laura Velázquez
- Sensometrics & Consumer Science Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República Pando Uruguay
- Graduate Program in Chemistry Facultad de Química, Universidad de la República Pando Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República Pando Uruguay
| | | | - Gastón Ares
- Sensometrics & Consumer Science Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República Pando Uruguay
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Smaira FI, Mazzolani BC, Esteves GP, André HCS, Amarante MC, Castanho DF, de Campos KJ, Benatti FB, Pinto AJ, Roschel H, Gualano B, Nicoletti CF. Poor Eating Habits and Selected Determinants of Food Choice Were Associated With Ultraprocessed Food Consumption in Brazilian Women During the COVID-19 Pandemic. Front Nutr 2021; 8:672372. [PMID: 34055859 PMCID: PMC8155283 DOI: 10.3389/fnut.2021.672372] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/31/2021] [Indexed: 12/04/2022] Open
Abstract
Background: The aim of this study was to investigate possible associations between food consumption and eating habits and food choice determinants in women during COVID-19 pandemic. Methods: This is a cross-sectional survey conducted in Brazil between June and September, 2020, during which time social distancing measures were in place. Results: Participants (n = 629) were aged 34.0 years and mostly within normal weight according to BMI (60.4%). "Snacking" and "liking" associated with increased energy (β = 164.27 and β = 110.24) and carbohydrate intake (β = 1.97 and β = 1.80), and with reduced protein intake (β = -1.54 and β = -1.18). In contrast, "dieting" and "weight control" associated with reduced energy (β = -162.57 and β = -111.49) and carbohydrate intake (β = -2.78 and β = -2.07), and with increased protein intake (β = 3.78 and β = 1.65). "Dieting" (β = 7.27), "need and hunger" (β = 3.34), and "health" (β = 4.94) associated with an increased consumption of unprocessed and minimally processed foods, whereas "replacing main meals with snacks" (β = -8.98), "snacking" (β = -6.92) and binge eating symptoms (β = -0.34) associated with reduced consumption of foods within this processing level. In contrast, "use of delivery services" (β = 3.39), "replacing main meals with snacks" (β = 5.49), "visual appeal" (β = 2.17), "social norms" (β = 2.19) and "affect regulation" (β = 2.01) associated with increased ultraprocessed food consumption. Overall, associations were more frequent and pronounced when analyzing food consumption by processing level rather than by macronutrient intake. Conclusion: Some eating habits and food choice determinants ("snacking," "replacing meals with snacks," "use of delivery services") observed during the COVID-19 pandemic were associated with an unhealthy diet (high energy and carbohydrate consumption, increased ultraprocessed food consumption and reduced unprocessed/minimally processed foods consumption) in Brazilian women.
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Affiliation(s)
- Fabiana Infante Smaira
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
| | - Bruna Caruso Mazzolani
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
| | - Gabriel Perri Esteves
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
| | | | - Milla Cordeiro Amarante
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
| | - Daniela Fernandes Castanho
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
| | - Karen Jennifer de Campos
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
| | - Fabiana Braga Benatti
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
- School of Applied Sciences, State University of Campinas, Limeira, Brazil
| | - Ana Jéssica Pinto
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
- Food Research Center, University of São Paulo, São Paulo, Brazil
| | - Carolina Ferreira Nicoletti
- Applied Physiology & Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de São Paulo, São Paulo, Brazil
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104
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TV advertising and dietary intake in adolescents: a pre- and post- study of Chile's Food Marketing Policy. Int J Behav Nutr Phys Act 2021; 18:60. [PMID: 33947436 PMCID: PMC8097821 DOI: 10.1186/s12966-021-01126-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/19/2021] [Indexed: 01/31/2023] Open
Abstract
Background The first phase of a comprehensive marketing policy was implemented in Chile in 2016. The policy restricted child-directed marketing of foods and beverages considered high in energy, total sugars, sodium or saturated fat (“high-in”). The objective of this study was to examine the role of high-in TV food advertising as a mediator in the association between policy implementation and consumption of high-in foods and beverages between 2016 and 2017. Methods Dietary data were from 24-hour diet recalls collected in 2016 and 2017 in a cohort of 12–14 y children (n = 721). Television use was assessed concurrently and linked to analyses of food advertisements on broadcast and paid television to derive individual-level estimates of exposure to high-in food advertising. A multilevel mediation analysis examined direct and indirect effects of the policy through advertising exposure. Results Following the policy implementation, high-in advertising exposure was significantly reduced (p < 0.01). High-in food intake decreased in adolescents with lower levels, but not higher levels, of high-in advertising at baseline. We did not find evidence of mediation by changes in high-in ad exposure. Conclusions Adolescents’ exposure to high-in TV advertising decreased after the 2016 implementation of the Chilean Food Labeling and Marketing Law. However, evidence that changes in advertisement mediated dietary changes was not found. Further research is needed to understand how marketing changes will relate to dietary changes after full implementation of the law and in the long term. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01126-7.
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105
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Harris RM, Rose AMC, Soares-Wynter S, Unwin N. Ultra-processed food consumption in Barbados: evidence from a nationally representative, cross-sectional study. J Nutr Sci 2021; 10:e29. [PMID: 34094510 PMCID: PMC8141678 DOI: 10.1017/jns.2021.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022] Open
Abstract
Our objective was to describe, for the first time in an English-speaking Caribbean country, the contribution of ultra-processed foods (UPFs) to nutrients linked to non-communicable disease. Using a cross-sectional study design, dietary data were collected from two non-consecutive 24-h dietary recalls. Recorded food items were then classified according to their degree of processing by the NOVA system. The present study took place in Barbados (2012-13). A representative population-based sample of 364 adult Barbadians (161 males and 203 females) aged 25-64 years participated in the study. UPFs represented 40⋅5 % (838 kcal/d; 95 % CI 791, 885) of mean energy intake. Sugar-sweetened beverages made the largest contribution to energy within the UPF category. Younger persons (25-44 years) consumed a significantly higher proportion of calories from UPF (NOVA group 4) compared with older persons (45-64 years). The mean energy shares of UPF ranged from 22⋅0 to 58⋅9 % for those in the lowest tertile to highest tertile. Within each tertile, the energy contribution was significantly higher in the younger age group (25-44 years) compared with the older (45-64 years). One-quarter of persons consume ≥50 % of their daily calories from UPF, this being significantly higher in younger persons. The ultra-processed diet fraction contained about six times the mean of free sugars and about 0⋅8 times the dietary fibre of the non-ultra-processed fraction (NOVA groups 1-3). Targeted interventions to decrease the consumption of UPF especially in younger persons is thus of high priority to improve the diet quality of Barbadians.
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Key Words
- Barbados
- CARICOM, Caribbean community and common market
- CI, Confidence interval
- CROSQ, CARICOM Regional Organisation for Standards and Quality
- DRs, Dietary recalls
- Diet
- HotN, Health of the Nation survey
- NCDs, Non-communicable diseases
- PAHO, Pan American Health Organization
- SSBs, Sugar-sweetened beverages
- Sugar-sweetened beverages
- UPFs, ultra-processed foods
- USDA, United States Department of Agriculture
- Ultra-processed food
- WHO, World Health Organization
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Affiliation(s)
- Rachel M. Harris
- The George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados
- Faculty of Medical Sciences, The University of the West Indies, Bridgetown, Barbados
| | - Angela M. C. Rose
- The George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados
- Epidemiology Department, Epiconcept, Paris, France
| | - Suzanne Soares-Wynter
- Tropical Metabolism Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Nigel Unwin
- The George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
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106
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Shim JS, Shim SY, Cha HJ, Kim J, Kim HC. Socioeconomic Characteristics and Trends in the Consumption of Ultra-Processed Foods in Korea from 2010 to 2018. Nutrients 2021; 13:1120. [PMID: 33805412 PMCID: PMC8065678 DOI: 10.3390/nu13041120] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 12/21/2022] Open
Abstract
There is growing evidence for a global transition to a more highly processed diet. While the dietary share of ultra-processed foods depends on a country's economic status, food choice and consumption are also influenced by the socioeconomic situation of individuals. This study investigated whether ultra-processed food consumption differed across socioeconomic subgroups and over time (2010-2018) in Korea. Cross-sectional data from the Korea National Health and Nutrition Examination Survey 2010-2018 were analyzed. Food and beverages reported in a one-day 24 h recall were classified according to the NOVA food classification criteria. The dietary energy contribution of ultra-processed foods was high among men and urban residents, and increased with education and income level; additionally, it reached its peak in adolescents and thereafter decreased with increasing age. After adjusting the socioeconomic variables, such associations remained significant, except for income level. The overall contribution of ultra-processed foods increased from 23.1% (2010-2012) to 26.1% (2016-2018), and the same trend over time was observed in all age groups and socioeconomic strata. In the Korean population, ultra-processed food consumption differed by individual socioeconomic characteristics, but gradually increased over time, and this trend was consistently found in all socioeconomic subgroups. Future strategies to promote healthy food choices are needed for the Korean population.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.-J.C.); (H.C.K.)
| | - Sun-Young Shim
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea;
| | - Hee-Jeung Cha
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.-J.C.); (H.C.K.)
| | - Jinhee Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon 16499, Korea;
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.-J.C.); (H.C.K.)
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107
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Araya C, Corvalán C, Cediel G, Taillie LS, Reyes M. Ultra-Processed Food Consumption Among Chilean Preschoolers Is Associated With Diets Promoting Non-communicable Diseases. Front Nutr 2021; 8:601526. [PMID: 33842518 PMCID: PMC8032866 DOI: 10.3389/fnut.2021.601526] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 03/03/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction: In adults, intake of ultra-processed foods (UPF) has been linked with poor diets and adverse health outcomes. In young children, evidence is scarcer but suggests a higher dietary share of UPF. Objective: To quantify the intake of UPF and its association with the nutrient composition of the diet in a sample of preschoolers in Santiago, Chile. Methods: Cross-sectional analysis of dietary data (24-h recall survey) from 960 preschoolers. Foods were categorized according to the extent and purpose of processing (NOVA classification) and participants were classified in quintiles of UPF intake. We explored the associations between UPF intake (% of the total energy) and intake of nutrients of concern for non-communicable disease development (carbohydrates, total sugars, fats, and sodium), and nutrients for promotion (proteins, polyunsaturated fats, iron, calcium, zinc, vitamins A, D, C, and B12, folate, and fiber) using multivariate regression after controlling for covariates. Results: UPF constituted 49% of the total energy intake. Preschoolers with higher intake consumed more energy, saturated and monounsaturated fats, carbohydrates, total sugars, and vitamin D, compared to preschoolers in the lowest quintile of UPF intake. In contrast, UPF intake was negatively associated with the consumption of proteins, polyunsaturated fats, fiber, zinc, vitamin A, and sodium (p < 0.05). Conclusion: In Chilean preschoolers, UPF was the primary source of energy intake. The dietary share of UPF was associated with the nutrient composition of the diet. Improving children's diet should consider not only promoting healthy food consumption but also limiting UPF consumption.
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Affiliation(s)
- C Araya
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.,Escuela de Nutrición y Dietética, Facultad de Salud, Universidad Santo Tomás, Santiago, Chile
| | - C Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - G Cediel
- Department of Nutrition, University of São Paulo, São Paulo, Brazil.,School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - L S Taillie
- Department of Nutrition, Carolina Population Center, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - M Reyes
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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108
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Matos RA, Adams M, Sabaté J. Review: The Consumption of Ultra-Processed Foods and Non-communicable Diseases in Latin America. Front Nutr 2021; 8:622714. [PMID: 33842521 PMCID: PMC8024529 DOI: 10.3389/fnut.2021.622714] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/24/2021] [Indexed: 12/15/2022] Open
Abstract
The objective of this article is to assess current trends in Latin America with respect to the consumption of ultra-processed foods and non-communicable diseases. This review addresses the rapid growth of the ultra-processed foods market in Latin America which, along with other social and environmental factors, has been shown to be highly influential in the prevalence of non-communicable diseases such as obesity, type 2 diabetes, hypertension and cardiovascular disease, cancer, and all-cause mortality. Ultra-processed foods represent a health concern for a number of reasons. They are generally calorically dense and high in sodium, sugar, and saturated and trans fats, and low in fiber and protein. Additionally, they may contain additives and neoformed compounds that affect health in ways that have not been adequately researched. Furthermore, the packaging of ultra-processed foods may contain hormone disruptors whose effects on humans are not entirely clear. Associations between ultra-processed foods and cardio-metabolic dysfunction, as well as several plausible mechanisms, will be evaluated.
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Affiliation(s)
- Rodrigo A Matos
- EP Ingeniería de Industrias Alimentarias, Facultad de Ingeniería y Arquitectura, Universidad Peruana Unión, Lima, Peru
| | - Michelle Adams
- Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, United States
| | - Joan Sabaté
- Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, United States
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Oliveira RR, Peter NB, Muniz LC. [Food consumption according to the level of processing among adolescents from the rural area of a municipality in the south of Brazil]. CIENCIA & SAUDE COLETIVA 2021; 26:1105-1114. [PMID: 33729363 DOI: 10.1590/1413-81232021263.06502019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/14/2019] [Indexed: 11/21/2022] Open
Abstract
The scope of the study was to assess food consumption according to the level of processing and the ingestion of nutrients among adolescents in the rural areas of Pelotas-RS. It involved a cross-sectional census-type study with 462 students in grades 6 through 9 of elementary school from 21 municipal schools in the rural area. Food consumption was evaluated by 24-hour dietary recall (24HR), with food products being classified into four groups according to the level of processing in line with the NOVA classification. The average daily energy intake was 1,921 calories, namely 48.2% from in natura or minimally processed food and 31.9% from ultra-processed food. The products that contributed most to the total daily calory intake were rice, meat, legumes, sugar, homemade bread, cookies, candies, soda, and artificial juices. A higher proportion of macro and micronutrients was observed from ingestion of in natura or minimally processed food, although carbohydrates, fat and iron contents derived from ultra-processed food was also high. The results of the study indicate that adolescents in rural areas have a higher energy intake from fresh or minimally processed food, however, it is observed that ultra-processed food is also part of their diet, thereby revealing the nutritional transition.
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Affiliation(s)
- Riceli Rodeghiero Oliveira
- Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas. R. Gomes Carneiro 01, Centro. 96010-610 Pelotas RS Brasil.
| | - Nathalia Brandão Peter
- Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas. R. Gomes Carneiro 01, Centro. 96010-610 Pelotas RS Brasil.
| | - Ludmila Correa Muniz
- Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas. R. Gomes Carneiro 01, Centro. 96010-610 Pelotas RS Brasil.
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110
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Associations between ultraprocessed food consumption and total water intake in the US population. J Acad Nutr Diet 2021; 121:1695-1703. [PMID: 33745880 DOI: 10.1016/j.jand.2021.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/23/2021] [Accepted: 02/08/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Longitudinal studies have shown significant dose-response associations between dietary share of ultraprocessed foods and the incidence of several noncommunicable diseases and all-cause mortality. Several attributes of ultraprocessed foods are potential mechanisms for their link with health outcomes, including their typically unbalanced nutrient profile, high glycemic loads, high energy intake rate, and the presence of food additives, neoformed substances, and substances released by synthetic packaging materials. However, no studies have assessed the plausibility of reduced water intake as an additional association of diets rich in ultraprocessed foods. OBJECTIVE To assess the association between ultraprocessed food consumption and total water intake. DESIGN This cross-sectional secondary analysis used data from the National Health and Nutrition Examination Survey, cycles 2011 to 2016, in the United States. PARTICIPANTS/SETTINGS This study included 24,505 participants aged ≥1 year who completed the first 24-hour dietary recall interview. MAIN OUTCOMES MEASURES The main outcome evaluated was the mean of total water intake. STATISTICAL ANALYSIS Crude and adjusted linear regressions were applied to investigate the association between quintiles of the dietary share of ultraprocessed foods and the total water intake. RESULTS A significant linear reduction in the daily mean total water intake was observed across ultraprocessed food quintiles, amounting to 706 mL between the lower and the upper quintiles. Important increases across quintiles were observed for the intake of sugar-sweetened and artificially sweetened drinks, whereas important reductions occurred for unsweetened drinks, plain water, and water present in solid foods and dishes. CONCLUSIONS Reduced total water intake and an imbalance between sources of water that favors energy-dense and nutrient-poor sources were associated with increased consumption of ultraprocessed food, suggesting that decreased total water consumption might be a negative outcome of diets rich in ultraprocessed foods. This relationship should be further investigated in longitudinal or clinical trials.
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111
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Calixto Andrade G, Julia C, Deschamps V, Srour B, Hercberg S, Kesse-Guyot E, Allès B, Chazelas E, Deschasaux M, Touvier M, Augusto Monteiro C, Bertazzi Levy R. Consumption of Ultra-Processed Food and Its Association with Sociodemographic Characteristics and Diet Quality in a Representative Sample of French Adults. Nutrients 2021; 13:nu13020682. [PMID: 33672720 PMCID: PMC7924346 DOI: 10.3390/nu13020682] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/29/2020] [Accepted: 01/09/2021] [Indexed: 01/03/2023] Open
Abstract
The present study aims to describe ultra-processed food (UPF) consumption in a representative sample of French adults and to evaluate the association between UPF consumption and socioeconomic characteristics and nutritional profile of the diet. This is a cross-sectional study using food consumption data from the Étude Nationale Nutrition Santé (ENNS), conducted with 2642 participants (18-74 years old), between February 2006 and March 2007 in France. Dietary data were collected through three 24-h dietary recalls. All food and beverages were classified according to the NOVA classification. The energy contribution of NOVA food groups to total energy intake was presented by categories of sociodemographic characteristics. Linear and logistic regression models were used to estimate the association between the percentage of UPF in the diet with nutritional indicators. The mean daily energy consumption of the adult French population was 2111 kcal, of which 31.1% came from UPF. This percentage was higher among younger individuals, and in the urban area, and lower among individuals with incomplete high school and individuals who were retired. The consumption of UPF was positively associated with the dietary energy density and the dietary contents of total carbohydrates, free sugar, and total and saturated fat, as well as with inadequate dietary energy density, saturated fat, free sugar, and fiber intakes.
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Affiliation(s)
- Giovanna Calixto Andrade
- Department of Preventive Medicine, School of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil;
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo 01246-904, Brazil;
- Correspondence:
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
- Public Health Department, Avicenne Hospital, AP-HP, 93017 Bobigny, France
| | - Valérie Deschamps
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
- Santé Publique France, The French Public Health Agency, Nutritional Epidemiology Surveillance Team (ESEN), 93017 Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
- Public Health Department, Avicenne Hospital, AP-HP, 93017 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Eloi Chazelas
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Mélanie Deschasaux
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Carlos Augusto Monteiro
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo 01246-904, Brazil;
- Department of Nutrition, School of Public Health, University of São Paulo (FSP/USP), São Paulo 01246-904, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil;
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo 01246-904, Brazil;
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112
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Dinu M, Bonaccio M, Martini D, Madarena MP, Vitale M, Pagliai G, Esposito S, Ferraris C, Guglielmetti M, Rosi A, Angelino D. Reproducibility and validity of a food-frequency questionnaire (NFFQ) to assess food consumption based on the NOVA classification in adults. Int J Food Sci Nutr 2021; 72:861-869. [PMID: 33550856 DOI: 10.1080/09637486.2021.1880552] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
NOVA is a classification that divides foods into four groups according to processing. Since no questionnaires have been validated to assess the consumption of foods with different levels of processing in the general adult population, we tested the reliability and validity of a 94-item Food Frequency Questionnaire (NFFQ) designed to estimate the intake (g/day) and the weight ratio (%) of the NOVA food groups in Italian adults. Time reliability and validity were tested by administrating the NFFQ to 110 subjects on two different occasions and comparing it with a weighed dietary record (WDR). Strong correlations between NFFQs (r > 0.7, p < 0.001) and intraclass correlation coefficients (ICC) of 0.851-0.940 indicated good test-retest reliability. Moderate correlations between the NFFQ and the WDR (0.6<r < 0.7), ICC of 0.536-0.741, and consistent agreement for intake percentages as revealed by Bland-Altman plots indicated moderate to good validity. The NFFQ could be useful for future investigations in this research field.
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Affiliation(s)
- Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
| | - Maria Pia Madarena
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Italy
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | - Cinzia Ferraris
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Monica Guglielmetti
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Alice Rosi
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Donato Angelino
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
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113
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Illescas-Zárate D, Batis C, Ramírez-Silva I, Torres-Álvarez R, Rivera JA, Barrientos-Gutiérrez T. Potential Impact of the Nonessential Energy-Dense Foods Tax on the Prevalence of Overweight and Obesity in Children: A Modeling Study. Front Public Health 2021; 8:591696. [PMID: 33634061 PMCID: PMC7902009 DOI: 10.3389/fpubh.2020.591696] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/30/2020] [Indexed: 11/22/2022] Open
Abstract
Background: Consumption of foods high in energy, sugar, fat, and salt contributes to the increase in body mass index and the prevalence of overweight and obesity in children. Mexico implemented an 8% tax to non-essential energy-dense foods (NEDF) in 2014 as part of a national strategy to reduce obesity. Objective: We modeled the potential effect of the NEDF tax on body mass index and overweight and obesity in Mexican children (6–17 years). Materials and Methods: We used the Dynamic Childhood Growth and Obesity Model calibrated to Mexican children to simulate the potential 1-year effect of the NEDF tax on body weight. Inputs for the model included NEDF consumption, weight, and height, obtained from the 2012 Mexican National Health and Nutrition Survey. To project the potential impact of the tax, we ran a first simulation without intervention and another reducing the caloric intake from NEDF in the proportion observed in the Mexican population after the tax (−5.1%). The tax effect was defined as the absolute difference in body mass index and prevalence of overweight and obesity between both models. Results: The tax on NEDF should lead to a mean reduction of 4.1 g or 17.4 kcal/day of NEDF at the population level. One year after the tax, mean body weight and body mass index should decrease 0.40 kg and 0.19 kg/m2; this translates into −1.7 and −0.4% points in overweight and obesity, respectively. Conclusions: The use of fiscal instruments to discourage the consumption of NEDF could help to reduce the prevalence of overweight and obesity in children.
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Affiliation(s)
- Daniel Illescas-Zárate
- Center for Nutrition and Health Research, National Institute of Public Health of Mexico, Cuernavaca, Morelos, Mexico
| | - Carolina Batis
- CONACYT-Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ivonne Ramírez-Silva
- Center for Nutrition and Health Research, National Institute of Public Health of Mexico, Cuernavaca, Morelos, Mexico
| | - Rossana Torres-Álvarez
- Center for Research in Population Health, National Institute of Public Health of Mexico, Cuernavaca, Morelos, Mexico
| | - Juan A Rivera
- Center for Nutrition and Health Research, National Institute of Public Health of Mexico, Cuernavaca, Morelos, Mexico
| | - Tonatiuh Barrientos-Gutiérrez
- Center for Research in Population Health, National Institute of Public Health of Mexico, Cuernavaca, Morelos, Mexico
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114
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Louzada MLDC, Costa CDS, Souza TN, Cruz GLD, Levy RB, Monteiro CA. Impacto do consumo de alimentos ultraprocessados na saúde de crianças, adolescentes e adultos: revisão de escopo. CAD SAUDE PUBLICA 2021; 37:e00323020. [DOI: 10.1590/0102-311x00323020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste trabalho foi realizar uma revisão de escopo da literatura acerca da associação entre o consumo de alimentos ultraprocessados e desfechos em saúde. A busca foi realizada nas bases PubMed, Web of Science e LILACS. Foram elegíveis os estudos que avaliaram a associação entre o consumo de alimentos ultraprocessados identificados com base na classificação NOVA e os desfechos em saúde. O processo de revisão resultou na seleção de 63 estudos, os quais foram analisados em termos de qualidade com base em ferramenta do Instituto Nacional de Saúde dos Estados Unidos. Os desfechos encontrados incluíram indicadores de obesidade, marcadores de risco metabólico, diabetes, doenças cardiovasculares, câncer, asma, depressão, fragilidade, doenças gastrointestinais e mortalidade. A evidência foi particularmente consistente para obesidade (ou indicadores relacionados a ela) em adultos, cuja associação com o consumo de ultraprocessados foi demonstrada, com efeito dose-resposta, em estudos transversais com amostras representativas de cinco países, em quatro grandes estudos de coorte e em um ensaio clínico randomizado. Grandes estudos de coorte também encontraram associação significativa entre o consumo de alimentos ultraprocessados e o risco de doenças cardiovasculares, diabetes e câncer, mesmo após ajuste para obesidade. Dois estudos de coorte demonstraram associação do consumo de alimentos ultraprocessados com depressão e quatro estudos de coorte com mortalidade por todas as causas. Esta revisão sumarizou os resultados de trabalhos que descreveram a associação entre o consumo de alimentos ultraprocessados e as diversas doenças crônicas não transmissíveis e seus fatores de risco, o que traz importantes implicações para a saúde pública.
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115
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Baker P, Machado P, Santos T, Sievert K, Backholer K, Hadjikakou M, Russell C, Huse O, Bell C, Scrinis G, Worsley A, Friel S, Lawrence M. Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers. Obes Rev 2020; 21:e13126. [PMID: 32761763 DOI: 10.1111/obr.13126] [Citation(s) in RCA: 384] [Impact Index Per Article: 96.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022]
Abstract
Understanding the drivers and dynamics of global ultra-processed food (UPF) consumption is essential, given the evidence linking these foods with adverse health outcomes. In this synthesis review, we take two steps. First, we quantify per capita volumes and trends in UPF sales, and ingredients (sweeteners, fats, sodium and cosmetic additives) supplied by these foods, in countries classified by income and region. Second, we review the literature on food systems and political economy factors that likely explain the observed changes. We find evidence for a substantial expansion in the types and quantities of UPFs sold worldwide, representing a transition towards a more processed global diet but with wide variations between regions and countries. As countries grow richer, higher volumes and a wider variety of UPFs are sold. Sales are highest in Australasia, North America, Europe and Latin America but growing rapidly in Asia, the Middle East and Africa. These developments are closely linked with the industrialization of food systems, technological change and globalization, including growth in the market and political activities of transnational food corporations and inadequate policies to protect nutrition in these new contexts. The scale of dietary change underway, especially in highly populated middle-income countries, raises serious concern for global health.
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Affiliation(s)
- Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Priscila Machado
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Thiago Santos
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Katherine Sievert
- School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Michalis Hadjikakou
- School of Life and Environmental Sciences, Deakin University, Geelong, Victoria, Australia
| | - Cherie Russell
- School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Oliver Huse
- Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Colin Bell
- Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Gyorgy Scrinis
- School of Agriculture and Food, University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Sharon Friel
- School of Regulation and Global Governance, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mark Lawrence
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
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116
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Early consumption of ultra-processed foods among children under 2 years old in Brazil. Public Health Nutr 2020; 24:3341-3351. [DOI: 10.1017/s1368980020004759] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To evaluate the complementary food consumption according to the extent and purpose of food processing based on NOVA classification among children aged 6–24 months of Federal District, Brazil.Design:We performed a cross-sectional study using a 24-h recall to estimate the daily energy intake and nutrients according to NOVA classification. We conducted a linear regression to assess the association between the processed and ultra-processed foods (UPF) energy intake and the daily energy intake from saturated fat, daily energy intake from total sugars and daily intake of sodium.Setting:Federal District, Brazil.Participants:Five hundred and thirty-eight children aged between 6 and 24 months attended at Primary Health Care Units from March 2017 to March 2018.Results:On average, children aged from 6 to 12 and from 12 to 24 months consumed 2393 and 4054 kJ/d, respectively, and processed and UPF represented one-third of dietary energy intake. Group 2 (processed and UPF) was higher carbohydrate contributors, and lower protein, fibre and most micronutrient contributors, when compared with Group 1 (unprocessed, minimally processed foods and processed culinary ingredients). In addition, the higher the energy intake from processed and UPF, the higher was the daily energy intake from saturated fat, daily energy intake from total sugar and daily intake of sodium.Conclusion:Children are being exposed early to processed and UPF and their share affect the diet’s nutritional quality.
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117
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Angelovičová M, Zeleňáková L, Zajác P, Čapla J. The NOVA system and ultra-processed foods in relation to consumer decision-making in foods choice. POTRAVINARSTVO 2020. [DOI: 10.5219/1358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The purpose of the study was to investigate strawberry yogurt according to the NOVA food classification system. The object of research were strawberry yogurts from 6 different manufacturers, which are commonly available to food consumers, were randomly selected to investigate food samples under the NOVA food classification system. Based on this food, we present a methodology for assessing food safety with the application of the procedure. At the same time, we justify the classified food to Group 4, i.e. one of the 4 groups according to the NOVA system of food classification on a scientific basis, knowledge from the scientific literature. The evaluated results of the labeling of strawberry yogurt from various producers indicate that they are all classified as ultra-processed foods. Their characteristic feature is that they are industrial products with five or more, and usually many, items. Strawberry yogurt samples from various manufacturers evaluated contained 7 to 12 specific items that are not basic raw material, i.e. unprocessed or minimally processed food of Group 1.
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118
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Cattafesta M, Petarli GB, Zandonade E, Bezerra OMDPA, de Abreu SMR, Salaroli LB. Energy contribution of NOVA food groups and the nutritional profile of the Brazilian rural workers' diets. PLoS One 2020; 15:e0240756. [PMID: 33112887 PMCID: PMC7592810 DOI: 10.1371/journal.pone.0240756] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/02/2020] [Indexed: 11/18/2022] Open
Abstract
We estimated the caloric contribution of minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods in Brazilian farmers' diets and their association with the nutritional profile of the diet. It is an epidemiological study of cross-sectional, analytical and quantitative design with 740 farmers adults of Southeastern Brazil. Food intake data were obtained by applying three 24-hour recalls and were classified according to the degree and purpose of processing. The largest caloric contribution came from the group of minimally processed foods (64.7%), followed by ultra-processed foods (17.7%), processed culinary ingredients (12.4%), and processed foods (5.2%). Individuals in the fourth quartile of caloric contribution from minimally processed foods showed lower energy consumption (β -0.16, P<0.001) and greater consumption of all 15 micronutrients analyzed. In contrast to what was identified for this food group, the higher caloric contribution from ultra-processed foods was associated with a greater caloric content of the diet (β 0.17, P<0.001) and lower consumption of all 23 analyzed nutrients. Therefore, the caloric contribution from the consumption of ultra-processed foods in the rural area is still lower than the national average. However, measures aimed at delaying isocaloric exchanges for the group of ultra-processed foods must be carried out, maintaining the local food culture, since this group had worse nutritional levels. In addition, incentives to the greater consumption of minimally processed foods should be carried out, due to their nutritional quality.
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Affiliation(s)
- Monica Cattafesta
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Glenda Blaser Petarli
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Eliana Zandonade
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil
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119
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Smiljanec K, Mbakwe AU, Ramos-Gonzalez M, Mesbah C, Lennon SL. Associations of Ultra-Processed and Unprocessed/Minimally Processed Food Consumption with Peripheral and Central Hemodynamics, and Arterial Stiffness in Young Healthy Adults. Nutrients 2020; 12:nu12113229. [PMID: 33105677 PMCID: PMC7690393 DOI: 10.3390/nu12113229] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/05/2020] [Accepted: 10/20/2020] [Indexed: 12/17/2022] Open
Abstract
Consumption of ultra-processed food (UPF) replaces the intake of freshly prepared unprocessed/minimally processed food (MPF) and is positively associated with hypertension and cardiovascular disease (CVD). The objective of this observational study was to investigate the relation between (1) UPF and (2) MPF with peripheral and central blood pressure (BP), wave reflection, and arterial stiffness. Habitual dietary intake, ambulatory BP, augmentation index (AIx), and pulse wave velocity (PWV) were assessed in 40 normotensive young adults (15 M/25 W; 27 ± 1 y; body mass index 23.6 ± 0.5 kg/m2). UPF consumption was positively associated with overall and daytime peripheral systolic BP (B = 0.25, 95% confidence interval (CI) 0.03, 0.46, p = 0.029; B = 0.32, 95% CI 0.09, 0.56, p = 0.008, respectively), daytime diastolic BP (B = 0.18, 95% CI 0.01, 0.36, p = 0.049) and daytime peripheral pulse pressure (PP; B = 0.22, 95% CI 0.03, 0.41, p = 0.027). MPF consumption was inversely associated with daytime peripheral PP (B = −0.27, 95% CI −0.47, −0.07, p = 0.011), overall and daytime central systolic BP (B = −0.27, 95% CI −0.51, −0.02, p = 0.035; B = −0.31, 95% CI −0.58, −0.04, p = 0.024, respectively), and nighttime central PP (B = −0.10, 95% CI −0.19, −0.01, p = 0.042). Both UPF and MPF were not associated with AIx nor PWV. These data suggest avoidance of UPF and consumption of more MPF may reduce CVD risk factors.
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120
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Rauber F, Chang K, Vamos EP, da Costa Louzada ML, Monteiro CA, Millett C, Levy RB. Ultra-processed food consumption and risk of obesity: a prospective cohort study of UK Biobank. Eur J Nutr 2020; 60:2169-2180. [PMID: 33070213 PMCID: PMC8137628 DOI: 10.1007/s00394-020-02367-1] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
Abstract
Objective The objective of this study was to examine the associations between ultra-processed food consumption and risk of obesity among UK adults. Methods Participants aged 40–69 years at recruitment in the UK Biobank (2006–2019) with dietary intakes collected using 24-h recall and repeated measures of adiposity––body mass index (BMI), waist circumference (WC) and percentage of body fat (% BF)––were included (N = 22,659; median follow-up: 5 years). Ultra-processed foods were identified using the NOVA classification and their consumption was expressed as a percentage of total energy intake. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HR) of several indicators of obesity according to ultra-processed food consumption. Models were adjusted for sociodemographic and lifestyle characteristics. Results 947 incident cases of overall obesity (BMI ≥ 30 kg/m2) and 1900 incident cases of abdominal obesity (men: WC ≥ 102 cm, women: WC ≥ 88 cm) were identified during follow-up. Participants in the highest quartile of ultra-processed food consumption had significantly higher risk of developing overall obesity (HR 1.79; 95% CI 1.06─3.03) and abdominal obesity (HR 1.30; 95% CI 1.14─1.48). They had higher risk of experiencing a ≥ 5% increase in BMI (HR 1.31; 95% CI 1.20─1.43), WC (HR 1.35; 95% CI 1.25─1.45) and %BF (HR 1.14; 95% CI 1.03─1.25), than those in the lowest quartile of consumption. Conclusions Our findings provide evidence that higher consumption of ultra-processed food is strongly associated with a higher risk of multiple indicators of obesity in the UK adult population. Policy makers should consider actions that promote consumption of fresh or minimally processed foods and reduce consumption of ultra-processed foods. Electronic supplementary material The online version of this article (10.1007/s00394-020-02367-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, 01246-904, Brazil. .,Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, 01246-904, Brazil. .,Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, W6 8RP, UK.
| | - Kiara Chang
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, W6 8RP, UK
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, W6 8RP, UK
| | - Maria Laura da Costa Louzada
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, 01246-904, Brazil.,Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, 01246-904, Brazil
| | - Carlos Augusto Monteiro
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, 01246-904, Brazil.,Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, 01246-904, Brazil
| | - Christopher Millett
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, 01246-904, Brazil.,Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, W6 8RP, UK
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, 01246-904, Brazil.,Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, 01246-903, Brazil
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121
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Blondin SA, AlSukait R, Bleiweiss-Sande R, Economos CD, Tanskey LA, Goldberg JP. Processed and Packed: How Refined Are the Foods That Children Bring to School for Snack and Lunch? J Acad Nutr Diet 2020; 121:883-894. [PMID: 33023852 DOI: 10.1016/j.jand.2020.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Increasing consumption of highly processed foods has been associated with adverse health outcomes among children. In the US, children consume up to half of their daily energy intake at school. OBJECTIVES We sought to characterize foods that children bring from home to school according to processing level and to evaluate the effectiveness of a school-based intervention, Great Taste Less Waste (GTLW), in reducing the proportion of energy brought from highly processed foods from home compared with control. DESIGN Secondary data analysis of a 7-month school-based, cluster-randomized trial. PARTICIPANTS/SETTING Third- and fourth-grade students (n = 502, mean age: 9.0 ± 0.62 years) at 10 public elementary schools in Eastern Massachusetts (school year 2012-2013). INTERVENTION GTLW included a 22-lesson classroom curriculum, homework activities, monthly parent newsletters, a food shopping and packing guide for parents, food demonstrations, school-wide announcements, and a poster contest. MAIN OUTCOME MEASURES The energy content of foods brought to school was estimated from digital photographs, and foods were assigned to 1 of 3 processing levels (less processed or unprocessed, moderately processed, or highly processed) based on an established classification system. STATISTICAL ANALYSES PERFORMED The percentage of energy brought from foods categorized into each processing level was calculated and compared pre- and postintervention using hierarchical linear models. RESULTS Most of the food brought from home to school was highly processed (70% of food energy brought). Foods categorized as snack foods and desserts contributed the greatest percentage of total energy to the highly processed category at baseline and follow-up (72% and 69%, respectively). Energy from foods brought for snack tended to be more highly processed than those brought for lunch. No significant differences were observed from pre- to postintervention in the GTLW group compared with control for the percentage of energy brought from highly processed foods in adjusted models (β: -1.1, standard error: 2.2, P = .6) or any other processing level. CONCLUSIONS Highly processed foods were prevalent in home-packed lunches and snacks, and these patterns persisted after a targeted intervention. Further research is needed to identify strategies to improve the healthfulness of foods brought from home to school.
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Cuevas A, Barquera S. COVID-19, Obesity, and Undernutrition: A Major Challenge for Latin American Countries. Obesity (Silver Spring) 2020; 28:1791-1792. [PMID: 32640492 PMCID: PMC7361822 DOI: 10.1002/oby.22961] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 01/25/2023]
Abstract
In March of 2020, the World Health Organization declared the SARS‐Cov2 2019 (COVID‐19) outbreak a global pandemic after documenting community scale transmission in every region, including Latin America. The risk factors associated with severity of disease include older age, diabetes, hypertension, cardiovascular and lung diseases, and immune suppression. Additional evidence strongly suggests that obesity is also a risk factor for severe forms of COVID‐19 disease, while other types of malnutrition increase the risk of hospitalization from influenza‐like diseases, regardless of the causative agent of the illness (1). Although detailed data are not yet available on the impact of under nutrition in the evolution of COVID‐19, given the known inflammatory response caused by this condition, it is reasonable to expect a suboptimal immune response and higher risk of severity, as found with obesity (2).
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Affiliation(s)
- Ada Cuevas
- Center for Advanced Metabolic Medicine and Nutrition (CAMMYN)SantiagoChile
| | - Simon Barquera
- Centro de Investigación en Nutrición y SaludInstituto Nacional de Salud PúblicaCuernavacaMorelosMéxico
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The Cost of Diets According to Their Caloric Share of Ultraprocessed and Minimally Processed Foods in Belgium. Nutrients 2020; 12:nu12092787. [PMID: 32933051 PMCID: PMC7551888 DOI: 10.3390/nu12092787] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/01/2020] [Accepted: 09/09/2020] [Indexed: 12/30/2022] Open
Abstract
Background: This study estimated the monetary cost of diets with higher and lower caloric shares of ultraprocessed food products (UPF) and unprocessed/minimally processed foods (MPF) in Belgium for various sociodemographic groups. Methods: Data from the latest nationally representative Food Consumption Survey (FCS) 2014–2015 (n = 3146; 3–64 years) were used. Dietary data were collected through two nonconsecutive 24-hour recalls (food diaries for children). Average prices for >2000 food items (year 2014) were derived from GfK ConsumerScan panel data and linked with foods consumed in the FCS. Foods eaten were categorized by their extent of processing using the NOVA classification. The average caloric share (percentage of daily energy intake) of UPF and MPF were calculated. The mean diet cost was compared across the UPF and MPF contribution tertiles, using linear regression. Results: The average price per 100 kcal for UPF was significantly cheaper (EUR 0.55; 95%CI = 0.45–0.64) than for MPF (EUR 1.29; 95% CI = 1.27–1.31). UPF contributed between 21.9% (female adults) and 29.9% (young boys), while MPF contributed between 29.5% (male adolescents) and 42.3% (female adults) to the daily dietary cost. The contribution of MPF to the daily dietary cost was significantly higher for individuals with a higher household education level compared to those with a lower household education level (p < 0.01). Adjusted for covariates, the average dietary cost per 2000 kcal was significantly lower for individuals in the highest compared to the lowest tertile for the proportion of daily energy consumed from UPF (EUR −0.37 ± 0.13; p = 0.006), and significantly higher for individuals in the highest compared to the lowest tertile for proportion of daily energy consumed from MPF (EUR 1.18 ± 0.12, p < 0.001). Conclusion: Diets with a larger caloric share of UPF were significantly cheaper than those with a lower contribution of these products, while the opposite was found for MPF. Policies that improve relative affordability and accessibility of MPF are recommended.
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Consumption of ultra-processed foods and non-communicable disease-related nutrient profile in Portuguese adults and elderly (2015-2016): the UPPER project. Br J Nutr 2020; 125:1177-1187. [PMID: 32878664 DOI: 10.1017/s000711452000344x] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study aims to investigate the dietary share of ultra-processed foods and its association with the non-communicable disease (NCD)-related nutrient profile of adult and elderly populations in Portugal. Cross-sectional data from the National Food, Nutrition and Physical Activity Survey (2015-2016) of the Portuguese population were analysed. Dietary intake was assessed by two non-consecutive 24-h recalls, and food items were classified according to the NOVA system. We estimated the percentage of dietary energy provided by each of the NOVA food groups and assessed the NCD-related nutrient profile of the overall diet across quintiles of ultra-processed food consumption. Weighted t tests, besides crude and adjusted linear and Poisson regressions, were performed. Ultra-processed foods contributed to around 24 and 16 % of daily energy intake for adults and elderly, respectively. In both groups, as the consumption of ultra-processed foods increased, the dietary content of free sugars, total fats and saturated fats increased, while the dietary content of protein decreased. In adults, total energy intake, dietary energy density and content of carbohydrates also increased as the consumption of ultra-processed foods increased, while the dietary content of fibre, Na and K decreased. The prevalence of those exceeding the upper limits recommended for free sugars and saturated fats increased by 544 and 153 % in adults and 619 and 60 % in elderly, when comparing the lowest with the highest quintile of ultra-processed food consumption. Such a scenario demands for effective strategies addressing food processing in the Portuguese population to improve their diet quality and prevention against diet-related NCD.
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125
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Chen X, Zhang Z, Yang H, Qiu P, Wang H, Wang F, Zhao Q, Fang J, Nie J. Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies. Nutr J 2020; 19:86. [PMID: 32819372 PMCID: PMC7441617 DOI: 10.1186/s12937-020-00604-1] [Citation(s) in RCA: 220] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background Consumption of ultra-processed foods (UPFs) plays a potential role in the development of obesity and other diet-related noncommunicable diseases (NCDs), but no studies have systematically focused on this. This study aimed to summarize the evidence for the association between UPFs consumption and health outcomes. Methods A comprehensive search was conducted in PubMed, Embase, and Web of Science to identify all relevant studies. Epidemiological studies were included, and identified studies were evaluated for risk of bias.A narrative review of the synthesized findings was provided to assess the association between UPFs consumption and health outcomes. Results 20 studies (12 cohort and 8 cross-sectional studies) were included in the analysis, with a total of 334,114 participants and 10 health outcomes. In a narrative review, high UPFs consumption was obviously associated with an increased risk of all-cause mortality, overall cardiovascular diseases, coronary heart diseases, cerebrovascular diseases, hypertension, metabolic syndrome, overweight and obesity, depression, irritable bowel syndrome, overall cancer, postmenopausal breast cancer, gestational obesity, adolescent asthma and wheezing, and frailty. It showed no significant association with cardiovascular disease mortality, prostate and colorectal cancers, gestational diabetes mellitus and gestational overweight. Conclusions This study indicated a positive association between UPFs consumption and risk of several health outcomes. Large-scale prospective designed studies are needed to confirm our findings.
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Affiliation(s)
- Xiaojia Chen
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Zhang Zhang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Huijie Yang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Peishan Qiu
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Haizhou Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Fan Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Qiu Zhao
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China. .,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China.
| | - Jun Fang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China. .,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China.
| | - Jiayan Nie
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China. .,Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China.
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126
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Quintiliano Scarpelli D, Pinheiro Fernandes AC, Rodriguez Osiac L, Pizarro Quevedo T. Changes in Nutrient Declaration after the Food Labeling and Advertising Law in Chile: A Longitudinal Approach. Nutrients 2020; 12:E2371. [PMID: 32784370 PMCID: PMC7468860 DOI: 10.3390/nu12082371] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/02/2020] [Accepted: 08/06/2020] [Indexed: 01/07/2023] Open
Abstract
Chile has implemented several strategies to decrease the burden of obesity and chronic diseases. The Food Labeling and Advertising Law (Law 20.606) requires a front-of-package "high in" warning label when energy and nutrients of concern (ENC) (total sugar, saturated fats, sodium) exceed established limits. This study aims to evaluate the impact of Law 20.606 on the ENC declaration of packaged foods in Chile, before and after the law implementation. We analyzed food nutritional labeling declarations from 70% of the most consumed packaged foods in Chile. Data collection was conducted in 2013 and 2019 in Santiago. Pictures from all sides of the package were taken from 476 products, classified into 16 food groups. All food groups had changes in the ENC declaration during the study period. Total sugar content showed the highest reduction (-15.0%; p = 0.001). Dairy, confitures and similar and sugary beverages had the greatest reduction in energy and total sugar content (p < 0.01). Energy, total sugar and sodium front of package "high in" simulation was significantly reduced in dairy, sugary beverages, flour-based foods, confitures and similar, fish and seafoods, fats and oils, spices, condiments and sauces and sugars (p < 0.05). We observed that companies reformulated products to adapt to the new regulation.
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Affiliation(s)
- Daiana Quintiliano Scarpelli
- Carrera de Nutrición y Dietética, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile;
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Beslay M, Srour B, Méjean C, Allès B, Fiolet T, Debras C, Chazelas E, Deschasaux M, Wendeu-Foyet MG, Hercberg S, Galan P, Monteiro CA, Deschamps V, Calixto Andrade G, Kesse-Guyot E, Julia C, Touvier M. Ultra-processed food intake in association with BMI change and risk of overweight and obesity: A prospective analysis of the French NutriNet-Santé cohort. PLoS Med 2020; 17:e1003256. [PMID: 32853224 PMCID: PMC7451582 DOI: 10.1371/journal.pmed.1003256] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/22/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption has increased drastically worldwide and already represents 50%-60% of total daily energy intake in several high-income countries. In the meantime, the prevalence of overweight and obesity has risen continuously during the last century. The objective of this study was to investigate the associations between UPF consumption and the risk of overweight and obesity, as well as change in body mass index (BMI), in a large French cohort. METHODS AND FINDINGS A total of 110,260 adult participants (≥18 years old, mean baseline age = 43.1 [SD 14.6] years; 78.2% women) from the French prospective population-based NutriNet-Santé cohort (2009-2019) were included. Dietary intakes were collected at baseline using repeated and validated 24-hour dietary records linked to a food composition database that included >3,500 different food items, each categorized according to their degree of processing by the NOVA classification. Associations between the proportion of UPF in the diet and BMI change during follow-up were assessed using linear mixed models. Associations with risk of overweight and obesity were assessed using Cox proportional hazard models. After adjusting for age, sex, educational level, marital status, physical activity, smoking status, alcohol intake, number of 24-hour dietary records, and energy intake, we observed a positive association between UPF intake and gain in BMI (β Time × UPF = 0.02 for an absolute increment of 10 in the percentage of UPF in the diet, P < 0.001). UPF intake was associated with a higher risk of overweight (n = 7,063 overweight participants; hazard ratio (HR) for an absolute increase of 10% of UPFs in the diet = 1.11, 95% CI: 1.08-1.14; P < 0.001) and obesity (n = 3,066 incident obese participants; HR10% = 1.09 (1.05-1.13); P < 0.001). These results remained statistically significant after adjustment for the nutritional quality of the diet and energy intake. Study limitations include possible selection bias, potential residual confounding due to the observational design, and a possible item misclassification according to the level of processing. Nonetheless, robustness was tested and verified using a large panel of sensitivity analyses. CONCLUSIONS In this large observational prospective study, higher consumption of UPF was associated with gain in BMI and higher risks of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting UPF consumption. TRIAL REGISTRATION ClinicalTrials.gov NCT03335644 (https://clinicaltrials.gov/ct2/show/NCT03335644).
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Affiliation(s)
- Marie Beslay
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Caroline Méjean
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, Montpellier, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Thibault Fiolet
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Charlotte Debras
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Eloi Chazelas
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Mélanie Deschasaux
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Méyomo Gaelle Wendeu-Foyet
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Carlos A. Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Valérie Deschamps
- Santé Publique France (The French Public Health Agency), Nutritional Epidemiology Surveillance Team (ESEN)
| | - Giovanna Calixto Andrade
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
- Department of Preventive Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), Bobigny, France
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Martínez Arroyo A, Corvalán Aguilar C, Palma Molina X, Ceballos Sanchez X, Fisberg RM. Dietary Patterns of Adolescents from the Chilean Growth and Obesity Cohort Study Indicate Poor Dietary Quality. Nutrients 2020; 12:E2083. [PMID: 32674402 PMCID: PMC7400834 DOI: 10.3390/nu12072083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/29/2020] [Accepted: 07/12/2020] [Indexed: 11/16/2022] Open
Abstract
Diet during adolescence can have lasting effects on nutritional status, health, and development. We hypothesized that dietary patterns with low-quality nutrition are associated with overweightness. We collected data for 882 Chilean adolescents from the Growth and Obesity Cohort Study (mean age: 12 years). Dietary intake was assessed through 24-h recalls and weight status data were obtained during clinical visits. Dietary patterns were obtained through exploratory factor analysis. Multiple logistic regression models were used to examine cross-sectional associations between dietary patterns and overweight (BMI z-score ≥ 1SD). Four dietary patterns were identified: "Breakfast/Light dinner", "Natural foods", "Western", and "Snacking". "Breakfast/Light dinner", "Western", and "Snacking" patterns provided higher energy and excess nutrients (sodium, saturated fat, and added sugar). Moreover, adolescents with higher adherence to "Western" or " Snacking" patterns (third tertile) had higher odds of being classified as overweight (OR = 1.67; 95%CI: 1.103-2.522 and OR = 1.86; 95%CI: 1.235-2.792, respectively) than those with lower adherence (first tertile). "Natural foods" pattern was also associated with overweightness (OR = 1.83; 95%CI: 1.219-2.754). These dietary patterns were associated with overconsumption of nutrients of public health concern. Three of the four main dietary patterns were associated with overweightness. These results highlight the need of prioritizing adolescents on obesity prevention strategies.
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Affiliation(s)
- Angela Martínez Arroyo
- School of Nutrition and Dietetics, Faculty of Pharmacy, University of Valparaíso, Valparaíso 2360102, Chile; (A.M.A.); (X.P.M.); (X.C.S.)
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Camila Corvalán Aguilar
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7830420, Chile;
| | - Ximena Palma Molina
- School of Nutrition and Dietetics, Faculty of Pharmacy, University of Valparaíso, Valparaíso 2360102, Chile; (A.M.A.); (X.P.M.); (X.C.S.)
| | - Ximena Ceballos Sanchez
- School of Nutrition and Dietetics, Faculty of Pharmacy, University of Valparaíso, Valparaíso 2360102, Chile; (A.M.A.); (X.P.M.); (X.C.S.)
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
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129
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Venegas Hargous C, Reyes M, Smith Taillie L, González CG, Corvalán C. Consumption of non-nutritive sweeteners by pre-schoolers of the food and environment Chilean cohort (FECHIC) before the implementation of the Chilean food labelling and advertising law. Nutr J 2020; 19:69. [PMID: 32650775 PMCID: PMC7353755 DOI: 10.1186/s12937-020-00583-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 06/25/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Consumption of non-nutritive sweeteners (NNS) is becoming increasingly more frequent, particularly in the context of obesity prevention policies. The aim of this study was to describe the consumption of NNS in an ongoing cohort of pre-schoolers (4-6-year-old) before the implementation of the Chilean Food Labelling and Advertising Law, identify sociodemographic and anthropometric characteristics associated with their consumption, and describe the main dietary sources of each NNS sub-type. METHODS In 959 low-medium income pre-schoolers from the Food and Environment Chilean Cohort (FECHIC), dietary data from a single 24-h recall was linked to NNS content information obtained from packaged foods (n = 12,233). The prevalence of NNS consumption was estimated by food source and characterized by child and maternal sociodemographic and anthropometric variables. Intakes and main dietary sources were described for the six most prevalent NNS in Chile: Sodium Cyclamate, Saccharin, Aspartame, Acesulfame Potassium, Sucralose, and Steviol glycosides. RESULTS Sixty-eight percent of the pre-schoolers consumed at least one source of NNS on the day of the dietary recall; most of them consumed NNS from foods and beverages (n = 532), while only 12% (n = 119) also consumed table-top sweeteners. The prevalence of NNS consumption was significantly higher among children whose mothers had a high educational level compared to children whose mothers did not complete high school (p < 0.05); however, it did not differ by any other variable studied. The highest intakes of NNS were observed for Aspartame [2.5 (1.4-3.7) mg/kg per consumer], followed by Sodium Cyclamate [1.6 (1.3-2.6) mg/kg per consumer] and Steviol glycosides [1.2 (0.2-2.1) mg/kg per consumer]. Beverages were the only food group that contributed to the intake of the six NNS studied, accounting for 22% of the overall intake of Saccharine and up to 99% of Aspartame intake. CONCLUSIONS Before the implementation of the Food Labelling and Advertising Law, NNS consumption was highly prevalent among a cohort of low-middle income Chilean pre-schoolers. Continuous monitoring of NNS consumption is essential given potential food reformulation associated with the implementation of this set of obesity-prevention policies.
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Affiliation(s)
- Carolina Venegas Hargous
- Institute of Nutrition and Food Technology, University of Chile, Av. El Líbano 5524, Macul, Casilla 138-11, Santiago, Chile
| | - Marcela Reyes
- Institute of Nutrition and Food Technology, University of Chile, Av. El Líbano 5524, Macul, Casilla 138-11, Santiago, Chile
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 West Franklin St., Suite 210, Chapel Hill, 27516 NC United States
| | - Carmen Gloria González
- Institute of Nutrition and Food Technology, University of Chile, Av. El Líbano 5524, Macul, Casilla 138-11, Santiago, Chile
| | - Camila Corvalán
- Institute of Nutrition and Food Technology, University of Chile, Av. El Líbano 5524, Macul, Casilla 138-11, Santiago, Chile
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Reyes M, Smith Taillie L, Popkin B, Kanter R, Vandevijvere S, Corvalán C. Changes in the amount of nutrient of packaged foods and beverages after the initial implementation of the Chilean Law of Food Labelling and Advertising: A nonexperimental prospective study. PLoS Med 2020; 17:e1003220. [PMID: 32722710 PMCID: PMC7386631 DOI: 10.1371/journal.pmed.1003220] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/24/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND In June 2016, the first phase of the Chilean Food Labelling and Advertising Law that mandated front-of-package warning labels and marketing restrictions for unhealthy foods and beverages was implemented. We assess foods and beverages reformulation after this initial implementation. METHODS AND FINDINGS A data set with the 2015 to 2017 nutritional information was developed collecting the information at 2 time periods: preimplementation (T0: January-February 2015 or 2016; n = 4,055) and postimplementation (T1: January-February 2017; n = 3,025). Quartiles of energy and nutrients of concern (total sugars, saturated fats, and sodium, per 100 g/100 mL) and the proportion of products with energy and nutrients exceeding the cutoffs of the law (i.e., products "high in") were compared pre- and postimplementation of the law in cross-sectional samples of products with sales >1% of their specific food or beverage groups, according to the Euromonitor International Database; a longitudinal subsample (i.e., products collected in both the pre- and postimplementation periods, n = 1,915) was also analyzed. Chi-squared, McNemar tests, and quantile regressions (simple and multilevel) were used for comparing T0 and T1. Cross-sectional analysis showed a significant decrease (T0 versus T1) in the proportion of product with any "high in" (from 51% [95% confidence interval (CI) 49-52] to 44% [95% CI 42-45]), mostly in food and beverage groups in which regulatory cutoffs were below the 75th percentile of the nutrient or energy distribution. Most frequent reductions were in the proportion of "high in" sugars products (in beverages, milks and milk-based drinks, breakfast cereals, sweet baked products, and sweet and savory spreads; from 80% [95% CI 73-86] to 60% [95% CI 51-69]) and in "high in sodium" products (in savory spreads, cheeses, ready-to-eat meals, soups, and sausages; from 74% [95% CI 69-78] to 27% [95% CI 20-35]). Conversely, the proportion of products "high in" saturated fats only decreased in savory spreads (p < 0.01), and the proportion of "high in" energy products significantly decreased among breakfast cereals and savory spreads (both p < 0.01). Quantile analyses showed that most of the changes took place close to the cutoff values, with only few exceptions of overall left shifts in distribution. Longitudinal analyses showed similar results. However, it is important to note that the nonexperimental nature of this study does not allow to imply causality of these findings. CONCLUSIONS Our results show that, after initial implementation of the Chilean Law of Food Labelling and Advertising, there was a significant decrease in the amount of sugars and sodium in several groups of packaged foods and beverages. Further studies should clarify how food reformulation will impact dietary quality of the population.
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Affiliation(s)
- Marcela Reyes
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Lindsey Smith Taillie
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Barry Popkin
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Rebecca Kanter
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Stefanie Vandevijvere
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
- Scientific Institute of Public Health (Sciensano), Department of Epidemiology and Public Health, Brussels, Belgium
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
- * E-mail:
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131
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Elizabeth L, Machado P, Zinöcker M, Baker P, Lawrence M. Ultra-Processed Foods and Health Outcomes: A Narrative Review. Nutrients 2020; 12:E1955. [PMID: 32630022 PMCID: PMC7399967 DOI: 10.3390/nu12071955] [Citation(s) in RCA: 314] [Impact Index Per Article: 78.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/16/2022] Open
Abstract
The nutrition literature and authoritative reports increasingly recognise the concept of ultra-processed foods (UPF), as a descriptor of unhealthy diets. UPFs are now prevalent in diets worldwide. This review aims to identify and appraise the studies on healthy participants that investigated associations between levels of UPF consumption and health outcomes. This involved a systematic search for extant literature; integration and interpretation of findings from diverse study types, populations, health outcomes and dietary assessments; and quality appraisal. Of 43 studies reviewed, 37 found dietary UPF exposure associated with at least one adverse health outcome. Among adults, these included overweight, obesity and cardio-metabolic risks; cancer, type-2 diabetes and cardiovascular diseases; irritable bowel syndrome, depression and frailty conditions; and all-cause mortality. Among children and adolescents, these included cardio-metabolic risks and asthma. No study reported an association between UPF and beneficial health outcomes. Most findings were derived from observational studies and evidence of plausible biological mechanisms to increase confidence in the veracity of these observed associations is steadily evolving. There is now a considerable body of evidence supporting the use of UPFs as a scientific concept to assess the 'healthiness' of foods within the context of dietary patterns and to help inform the development of dietary guidelines and nutrition policy actions.
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Affiliation(s)
- Leonie Elizabeth
- School of Exercise and Nutrition Science, Deakin University, Geelong 3217, Australia; (L.E.); (P.M.); (P.B.)
| | - Priscila Machado
- School of Exercise and Nutrition Science, Deakin University, Geelong 3217, Australia; (L.E.); (P.M.); (P.B.)
- Institute for Physical Activity and Nutrition, Deakin University, Geelong 3217, Australia
| | - Marit Zinöcker
- Department of Nutrition, Bjørknes University College, 0456 Oslo, Norway;
| | - Phillip Baker
- School of Exercise and Nutrition Science, Deakin University, Geelong 3217, Australia; (L.E.); (P.M.); (P.B.)
- Institute for Physical Activity and Nutrition, Deakin University, Geelong 3217, Australia
| | - Mark Lawrence
- School of Exercise and Nutrition Science, Deakin University, Geelong 3217, Australia; (L.E.); (P.M.); (P.B.)
- Institute for Physical Activity and Nutrition, Deakin University, Geelong 3217, Australia
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Sambra V, López-Arana S, Cáceres P, Abrigo K, Collinao J, Espinoza A, Valenzuela S, Carvajal B, Prado G, Peralta R, Gotteland M. Overuse of Non-caloric Sweeteners in Foods and Beverages in Chile: A Threat to Consumers' Free Choice? Front Nutr 2020; 7:68. [PMID: 32626722 PMCID: PMC7311776 DOI: 10.3389/fnut.2020.00068] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 04/22/2020] [Indexed: 12/14/2022] Open
Abstract
The prevalence of obesity among Chilean adults and children is one of the highest worldwide. To fight the constant increase of non-communicable diseases and the growing sales of sugar-sweetened beverages, the Chilean government recently enacted a new Law of Food Labeling and Advertising imposing the application of front-of-package warning labels in foodstuffs whose composition exceeds limits for critical nutrients including sugar. Accordingly, food companies have been reformulating their products, incorporating non-caloric sweeteners (NCSs) in partial or total replacement of sucrose. The number of NCS-containing foods and beverages, therefore, has been increasing in the last years. This study aims to identify the NCS-containing products from different food/beverage categories currently available on the Chilean market. Nineteen supermarkets and 13 food web pages were visited by trained dietitians to carry out a systematic search of ingredient information from the different food categories. Overall, 1,489 products were analyzed, of which 815 (55.5%) contained at least one NCS, being this proportion particularly high, compared to other countries. 67.1% of the dairy products, 31.5% of the cereal products, 49% of the processed fruits, 74.3% of the non-alcoholic beverages, and 46.2% of sweets and other desserts contained NCS. Considering the food categories more specifically oriented to children, NCSs were present in 98.8% of powder juices, 98.3% of the flavored milks, 91.2% of jellies, and 79% of the dairy desserts. Sucralose and steviol glycosides were the most widely used NCSs, these sweeteners being present, alone or mixed with other, in 73.5 and 39.7% of the NCS-containing products, respectively, while the use of saccharin and cyclamate was low. In addition, 80 tabletop NCSs were available in the local market, 91.2% of them being sucralose and steviol glycosides (alone or combined). The high number of food products containing steviol glycosides makes very plausible that the daily consumption of this NCS in the pediatric populations could exceed its acceptable daily intake (ADI). The fact that there are no NCS-free foods alternatives for certain food categories, especially for children, is worrying.
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Affiliation(s)
- Verónica Sambra
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Sandra López-Arana
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Paola Cáceres
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Karen Abrigo
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Javiera Collinao
- Faculty of Medicine, School of Nutrition and Dietetics, University of Chile, Santiago, Chile
| | - Alexandra Espinoza
- Faculty of Medicine, School of Nutrition and Dietetics, University of Chile, Santiago, Chile
| | - Sabrina Valenzuela
- Faculty of Medicine, School of Nutrition and Dietetics, University of Chile, Santiago, Chile
| | - Bielka Carvajal
- Department of Women and Newborn's Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Gabriel Prado
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Rebeca Peralta
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Martin Gotteland
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile.,Human Nutrition Unit, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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Martínez X, Zapata Y, Pinto V, Cornejo C, Elbers M, van der Graaf M, Villarroel L, Hodgson MI, Rigotti A, Echeverría G. Intake of Non-Nutritive Sweeteners in Chilean Children after Enforcement of a New Food Labeling Law that Regulates Added Sugar Content in Processed Foods. Nutrients 2020; 12:nu12061594. [PMID: 32485840 PMCID: PMC7352803 DOI: 10.3390/nu12061594] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/19/2020] [Accepted: 05/23/2020] [Indexed: 12/16/2022] Open
Abstract
After enforcement of a new food labeling law in 2016, Chile exhibits a greater offer to reduced sugar products with addition of non-nutritive sweeteners (NNS). Many of these products are consumed by children, who are at greater risk of reaching the acceptable daily intake (ADI) of these food additives. The objective of this study was to evaluate the intake levels of NNS in Chilean schoolchildren after the enactment of the aforementioned law. A total of 250 Chilean children 6-12 years old were surveyed. NNS intake was assessed through a food frequency questionnaire. All children evaluated consumed at least one NNS during the previous month. Sucralose had the highest consumption frequency reaching 99.2%, followed by acesulfame-K (92.8%), stevia (86.0%), and aspartame (85.2%). Aspartame showed the highest median intake, which came mainly from beverages (96%). No children exceeded the ADI of any NNS. Smaller children exhibited a higher body weight-adjusted intake of sucralose, acesulfame-K, stevia, and aspartame (p < 0.05). In Chile, a wide range of processed foods with NNSs is available and all schoolchildren evaluated consumed at least one product containing NNS. However, this consumption does not exceed defined ADIs for any of the six sweeteners authorized for food use in Chile.
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Affiliation(s)
- Ximena Martínez
- Center for Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins, Región Metropolitana, 340 Santiago, Chile; (X.M.); (Y.Z.); (V.P.); (C.C.); (M.E.); (M.v.d.G.); (A.R.)
| | - Yazmín Zapata
- Center for Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins, Región Metropolitana, 340 Santiago, Chile; (X.M.); (Y.Z.); (V.P.); (C.C.); (M.E.); (M.v.d.G.); (A.R.)
| | - Victoria Pinto
- Center for Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins, Región Metropolitana, 340 Santiago, Chile; (X.M.); (Y.Z.); (V.P.); (C.C.); (M.E.); (M.v.d.G.); (A.R.)
| | - Camila Cornejo
- Center for Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins, Región Metropolitana, 340 Santiago, Chile; (X.M.); (Y.Z.); (V.P.); (C.C.); (M.E.); (M.v.d.G.); (A.R.)
| | - Martje Elbers
- Center for Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins, Región Metropolitana, 340 Santiago, Chile; (X.M.); (Y.Z.); (V.P.); (C.C.); (M.E.); (M.v.d.G.); (A.R.)
- Hanzehogeschool Groningen, University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Maaike van der Graaf
- Center for Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins, Región Metropolitana, 340 Santiago, Chile; (X.M.); (Y.Z.); (V.P.); (C.C.); (M.E.); (M.v.d.G.); (A.R.)
- Hanzehogeschool Groningen, University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Luis Villarroel
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins 340, Santiago, Región Metropolitana, Chile;
| | - María Isabel Hodgson
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins 340, Santiago, Región Metropolitana, Chile;
| | - Attilio Rigotti
- Center for Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins, Región Metropolitana, 340 Santiago, Chile; (X.M.); (Y.Z.); (V.P.); (C.C.); (M.E.); (M.v.d.G.); (A.R.)
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins 340, Santiago, Región Metropolitana, Chile;
| | - Guadalupe Echeverría
- Center for Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins, Región Metropolitana, 340 Santiago, Chile; (X.M.); (Y.Z.); (V.P.); (C.C.); (M.E.); (M.v.d.G.); (A.R.)
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins 340, Santiago, Región Metropolitana, Chile;
- Correspondence: ; Tel.: +56-2-2354-2837
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Correa T, Reyes M, Taillie LS, Corvalán C, Dillman Carpentier FR. Food Advertising on Television Before and After a National Unhealthy Food Marketing Regulation in Chile, 2016-2017. Am J Public Health 2020; 110:1054-1059. [PMID: 32437274 DOI: 10.2105/ajph.2020.305658] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To study changes in food advertising on television after Chile's food marketing restriction was implemented in June 2016.Methods. Food advertisements shown between 6 am and 12 am on the 4 primary broadcast and 4 cable channels with the largest Chilean youth audiences during 2 random weeks in April and May 2016 and 2017 were analyzed for product nutrition and child-directed marketing.Results. The percentage of ads for foods high in energy, saturated fats, sugars, or sodium (HEFSS) decreased from 41.9% before the regulation to 14.8% after the regulation (P < .001). This decrease occurred in programs intended for children (from 49.7% to 12.7%; P < .001) as well as general audiences (from 38.5% to 15.7%; P < .001). The largest declines were seen for sodas, desserts, breakfast cereals and industrialized fruit- and vegetable-flavored drinks. Fewer HEFSS ads featured child-directed content (a decrease from 44.0% to 12.0%; P < .001), and the remaining child-directed HEFSS ads primarily aired on internationally owned cable channels.Conclusions. The significant postregulation decrease in the prevalence of HEFSS television ads suggests that children in Chile are now less exposed to unhealthy food advertising. However, television originating from national and international outlets should still be monitored for compliance.
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Affiliation(s)
- Teresa Correa
- Teresa Correa is with the School of Communication, Diego Portales University, Santiago, Chile. Marcela Reyes and Camila Corvalán are with the Institute of Nutrition and Food Technology, University of Chile, Santiago. Lindsey Smith Taillie is with the Carolina Population Center and the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Francesca R. Dillman Carpentier is with the Hussman School of Journalism and Media, University of North Carolina, Chapel Hill
| | - Marcela Reyes
- Teresa Correa is with the School of Communication, Diego Portales University, Santiago, Chile. Marcela Reyes and Camila Corvalán are with the Institute of Nutrition and Food Technology, University of Chile, Santiago. Lindsey Smith Taillie is with the Carolina Population Center and the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Francesca R. Dillman Carpentier is with the Hussman School of Journalism and Media, University of North Carolina, Chapel Hill
| | - Lindsey Smith Taillie
- Teresa Correa is with the School of Communication, Diego Portales University, Santiago, Chile. Marcela Reyes and Camila Corvalán are with the Institute of Nutrition and Food Technology, University of Chile, Santiago. Lindsey Smith Taillie is with the Carolina Population Center and the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Francesca R. Dillman Carpentier is with the Hussman School of Journalism and Media, University of North Carolina, Chapel Hill
| | - Camila Corvalán
- Teresa Correa is with the School of Communication, Diego Portales University, Santiago, Chile. Marcela Reyes and Camila Corvalán are with the Institute of Nutrition and Food Technology, University of Chile, Santiago. Lindsey Smith Taillie is with the Carolina Population Center and the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Francesca R. Dillman Carpentier is with the Hussman School of Journalism and Media, University of North Carolina, Chapel Hill
| | - Francesca R Dillman Carpentier
- Teresa Correa is with the School of Communication, Diego Portales University, Santiago, Chile. Marcela Reyes and Camila Corvalán are with the Institute of Nutrition and Food Technology, University of Chile, Santiago. Lindsey Smith Taillie is with the Carolina Population Center and the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Francesca R. Dillman Carpentier is with the Hussman School of Journalism and Media, University of North Carolina, Chapel Hill
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Association between Heat-Induced Chemical Markers and Ultra-Processed Foods: A Case Study on Breakfast Cereals. Nutrients 2020; 12:nu12051418. [PMID: 32423099 PMCID: PMC7285198 DOI: 10.3390/nu12051418] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/06/2020] [Accepted: 05/11/2020] [Indexed: 02/01/2023] Open
Abstract
Nutritional composition and neo-formed contaminant content in ultra-processed foods, amongst other factors, may contribute to increasing overall risk of non-communicable diseases and cancer. Commercial breakfast cereals (n = 53) were classified according to the NOVA approach as un-/minimally processed (NOVA-1, 11%), processed (NOVA-3, 30%), and ultra-processed (NOVA-4, 59%) foods. Acrylamide and hydroxymethylfurfural (HMF) content as heat-induced chemical markers was taken from our research team database. The NutriScore was used as the nutritional profiling system. Samples were distributed between groups A (19%), B (13%), C (38%), and D (30%). No statistically significant differences in acrylamide and HMF were found across the NutriScore groups. Sugar content was the only nutritional descriptor found to be significantly different between processed (11.6 g/100 g) and ultra-processed (23.1 g/100 g) breakfast cereal groups. Sugar content correlated with acrylamide (p < 0.001) and HMF (p < 0.0001). Acrylamide and HMF contents were not significantly higher in the NOVA-4 group when compared with the NOVA-3 group. However, trends towards higher acrylamide and HMF content are observed, amounting to a change of 75 µg/kg and 13.3 mg/kg in processed breakfast cereals, and 142 µg/kg and 32.1 mg/kg in ultra-processed breakfast cereals, respectively. Thus, the NOVA classification may not reflect the extent of the thermal treatment applied to the breakfast cereal but the type and amount of ingredients incorporated. Ultra-processed breakfast cereal does not predict significantly higher toxicological concern based on acrylamide content than processed breakfast cereals; a clear trend is seen whose contributing factors should be further studied.
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Abstract
OBJECTIVES To assess the consumption of ultra-processed foods and its association with the overall dietary content of nutrients related to non-communicable diseases (NCD) in the Chilean diet and to estimate the population attributable fraction of ultra-processed food consumption on the unhealthy nutrient content. DESIGN Cross-sectional analysis of dietary data collected through a national survey (2010). SETTING Chile. PARTICIPANTS Chilean population aged ≥2 years (n 4920). RESULTS In Chile, ultra-processed foods represented 28·6 % of the total energy intake. A significant positive association was found between the dietary share of ultra-processed foods and NCD-promoting nutrients such as dietary energy density (standardised regression coefficient (β) = 0·22), content of free sugars (β = 0·45), total fats (β = 0·26), saturated fats (β = 0·19), trans fats (β = 0·09) and Na:K ratio (β = 0·04), while a significant negative association was found with the content of NCD-protective nutrients such as K (β = -0·19) and fibre (β = -0·31). The content of Na (β = 0·02) presented no significant association. Except for Na, the prevalence of inadequate intake of all nutrients (WHO recommendations) increased across quintiles of the dietary share of ultra-processed foods. With the reduction of ultra-processed foods consumption to the level seen among the 20 % lowest consumers (3·8 % (0-9·3 %) of the total energy from ultra-processed foods), the prevalence of nutrient inadequacy would be reduced in almost three-fourths for trans fats; in half for energy density (foods); in around one-third for saturated fats, energy density (beverages), free sugars and total fats; in near 20 % for fibre and Na:K ratio and in 13 % for K. CONCLUSIONS In Chile, decreasing the consumption of ultra-processed foods is a potentially effective way to achieve the WHO nutrient goals for the prevention of diet-related NCD.
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Abstract
Emerging evidence suggests that the consumption of ultra-processed foods (UPF) plays a role in the development of chronic diseases, but evidence of their influence in children is limited. Our objective was to study longitudinal trends of UPF intake and determine their impact on blood lipids in young children. The present study was a follow-up of a randomised field trial of children (n 308) from Porto Alegre, Brazil. Dietary intake was collected using two 24-h recalls at 3 and 6 years of age, and consumption of UPF was classified according to the NOVA system, a food classification based on the extent and purpose of industrial food processing. At age 6 years, blood tests were performed to measure lipid profile. Contribution of UPF to total energy intake increased by 10 % during the follow-up period, from 43·4 % at 3 years to 47·7 % at 6 years of age. Linear regression models showed that children in the highest tertile of UPF consumption at age 3 years had higher levels of total cholesterol (TC; β 0·22 mmol/l; 95 % CI 0·04, 0·39) and TAG at age 6 years (β 0·11 mmol/l, 95 % CI 0·01, 0·20) compared with those in the lowest tertile. A positive dose-response was observed for an absolute increment of 10 % of UPF on TC (β 0·07 mmol/l, 95 % CI 0·00, 0·14) and TAG (β 0·04 mmol/l, 95 % CI 0·01, 0·07). Based on our data, consumption of UPF increased significantly over time and was associated with higher blood lipid levels in children from a low-income community. Our findings highlight the need for effective strategies to minimise the consumption of UPF in early life.
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Consumption of ultra-processed foods at 11, 22 and 30 years at the 2004, 1993 and 1982 Pelotas Birth Cohorts. Public Health Nutr 2020; 24:299-308. [PMID: 32204744 DOI: 10.1017/s1368980019004245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe the consumption of ultra-processed foods according to demographic and socioeconomic characteristics in three birth cohorts. DESIGN Cross-sectional analysis. SETTING Data from the 2004, 1993 and 1982 Pelotas Birth Cohorts were used at 11, 22 and 30 years, respectively, collected between 2012 and 2015. Outcome was the relative contribution of ultra-processed foods from the total daily energy intake. Maternal-independent variables were self-reported skin colour, schooling, age and family income (obtained in the perinatal study), and variables of the cohort member, sex, skin colour, schooling and current family income (the last two obtained at the 11-, 22- and 30-year follow-ups of the respective cohorts). We calculated crude and adjusted means of the outcome for the whole cohorts and according to the independent variables. PARTICIPANTS 11-, 22- and 30-year-old individuals. RESULTS Daily energetic contribution from ultra-processed foods was higher in the younger cohort (33·7, 29·8 and 25·1 % at 11, 22 and 30 years, respectively). Maternal schooling and family income at birth showed an inverse dose-response relationship at 11 and 22 years, but a positive dose-response at 30 years. Female sex, lower schooling and family income at 22 years and higher schooling at 30 years were associated to a higher contribution from ultra-processed foods in the daily energy intake. CONCLUSIONS Information from food and nutrition policies needs a higher dissemination, mostly among women and population groups of lower income and schooling, including its promotion in media and health services, aiming for a decreased consumption of ultra-processed foods.
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Khandpur N, Cediel G, Obando DA, Jaime PC, Parra DC. Sociodemographic factors associated with the consumption of ultra-processed foods in Colombia. Rev Saude Publica 2020; 54:19. [PMID: 32049210 PMCID: PMC7006913 DOI: 10.11606/s1518-8787.2020054001176] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 06/17/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the consumption of ultra-processed foods in the Colombian population across sociodemographic factors. METHODS We used data from the 2005 National Survey of the Nutritional Status in Colombia. Food consumption was assessed using a 24-hour food recall in 38,643 individuals. The food items were classified according to the degree and extent of industrial processing using the NOVA classification. RESULTS The mean calorie contribution of ultra-processed foods ranged from 0.2% in the lowest quintile of consumers to 41.1% in the highest quintile of consumers. The greatest increases were due to the consumption of industrialized breads, sweet and savory snacks, sugary drinks, processed meats, and confectionery. No major differences were found in the consumption of ultra-processed foods between men and women. We observed significant differences by age, socioeconomic status, area of residence, and geographic region. Children and adolescents showed a higher intake of ultra-processed foods, almost double that of participants over 50 years of age. Children consumed significantly more snacks, confectionery products, processed cereals, milk-based drinks and desserts. Participants over 50 years consumed fewer products from these sub-groups of ultra-processed foods but had the highest consumption of industrialized bread. Individuals from urban areas, those with high socioeconomic status, participants residing in the Bogotá region had 1.5 to 1.7 times higher calorie intake from ultra-processed foods compared with those from a lower socioeconomic status and those residing in rural regions. CONCLUSION In Colombia, industrialized bread is the ultra-processed product that is most easily assimilated into the traditional diet, along with snacks and sugary drinks. Children and adolescents residing in urban areas and households with greater purchasing power have some of the highest intakes of ultra-processed foods in the country.
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Affiliation(s)
- Neha Khandpur
- University of São PauloFaculty of Public HealthDepartment of NutritionSão PauloSPBrazilUniversity of São Paulo. Faculty of Public Health. Department of Nutrition. Center for Epidemiological Research in Nutrition and Health. São Paulo, SP, Brazil
- Harvard UniversityHarvard T.H. Chan School of Public HealthDepartment of NutritionCambridgeMAUSAHarvard University. Harvard T.H. Chan School of Public Health. Department of Nutrition. Cambridge, MA, USA
| | - Gustavo Cediel
- University of São PauloFaculty of Public HealthDepartment of NutritionSão PauloSPBrazilUniversity of São Paulo. Faculty of Public Health. Department of Nutrition. Center for Epidemiological Research in Nutrition and Health. São Paulo, SP, Brazil
- University of AntioquiaSchool of Nutrition and DieteticsMedellínANTColombiaUniversity of Antioquia. School of Nutrition and Dietetics. Medellín, ANT, Colombia
| | - Daniel Ayala Obando
- Catholic University of ChileDepartment of StatisticsSantiagoRMChileCatholic University of Chile. Department of Statistics. Santiago, RM, Chile
| | - Patrícia Constante Jaime
- University of São PauloFaculty of Public HealthDepartment of NutritionSão PauloSPBrazilUniversity of São Paulo. Faculty of Public Health. Department of Nutrition. Center for Epidemiological Research in Nutrition and Health. São Paulo, SP, Brazil
| | - Diana C. Parra
- Washington University in St. LouisSchool of MedicineProgram in PhysiotherapySt. LouisMOUSAWashington University in St. Louis. School of Medicine. Program in Physiotherapy. St. Louis, MO, USA
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Bambs C, Bravo-Sagua R, Margozzini P, Lavandero S. Science and Health Policies to Tackle Chronic Diseases in Chile. Trends Endocrinol Metab 2020; 31:67-70. [PMID: 31859214 DOI: 10.1016/j.tem.2019.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 11/14/2019] [Accepted: 11/19/2019] [Indexed: 12/13/2022]
Abstract
Chile has experienced rapid epidemiological transitions characterized by decreasing infant mortality, population aging, and a shift towards obesity with an increase in noncommunicable diseases (NCDs). Today, tobacco, alcohol, and ultraprocessed foods are the main risk factors for these diseases. Based on Chile's experience in tobacco control, we discuss paths to make progress in population evidence-based strategies to improve overall community health.
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Affiliation(s)
- Claudia Bambs
- Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Departamento de Salud Pública, Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Roberto Bravo-Sagua
- Advanced Center for Chronic Diseases (ACCDiS), Facultad Ciencias Químicas y Farmacéuticas and Facultad Medicina, Santiago, Chile; Instituto de Nutrición y Tecnología de los Alimentos (INTA), Santiago, Chile
| | - Paula Margozzini
- Departamento de Salud Pública, Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sergio Lavandero
- Advanced Center for Chronic Diseases (ACCDiS), Facultad Ciencias Químicas y Farmacéuticas and Facultad Medicina, Santiago, Chile; Corporación Centro de Estudios Científicos de las Enfermedades Cronicas (CECEC), Santiago, Chile; Cardiology Division, Department of Internal Medicine. University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Srour B, Fezeu LK, Kesse-Guyot E, Allès B, Debras C, Druesne-Pecollo N, Chazelas E, Deschasaux M, Hercberg S, Galan P, Monteiro CA, Julia C, Touvier M. Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort. JAMA Intern Med 2020; 180:283-291. [PMID: 31841598 PMCID: PMC6990737 DOI: 10.1001/jamainternmed.2019.5942] [Citation(s) in RCA: 241] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/10/2019] [Indexed: 12/11/2022]
Abstract
Importance Ultraprocessed foods (UPF) are widespread in Western diets. Their consumption has been associated in recent prospective studies with increased risks of all-cause mortality and chronic diseases such as cancer, cardiovascular diseases, hypertension, and dyslipidemia; however, data regarding diabetes are lacking. Objective To assess the associations between consumption of UPF and risk of type 2 diabetes (T2D). Design, Setting, and Participants In this population-based prospective cohort study, 104 707 participants aged 18 years or older from the French NutriNet-Santé cohort (2009-2019) were included. Dietary intake data were collected using repeated 24-hour dietary records (5.7 per participant on average), designed to register participants' usual consumption for more than 3500 different food items. These were categorized according to their degree of processing by the NOVA classification system. Main Outcomes and Measures Associations between UPF consumption and risk of T2D were assessed using cause-specific multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). Results A total of 104 707 participants (21 800 [20.8%] men and 82 907 [79.2%] women) were included. Mean (SD) baseline age of participants was 42.7 (14.5) years. Absolute T2D rates in the lowest and highest UPF consumers were 113 and 166 per 100 000 person-years, respectively. Consumption of UPF was associated with a higher risk of T2D (multi-adjusted hazard ratio [HR] for an absolute increment of 10 in the percentage of UPF in the diet, 1.15; 95% CI, 1.06-1.25; median follow-up, 6.0 years; 582 252 person-years; 821 incident cases). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet, for other metabolic comorbidities (HR, 1.13; 95% CI, 1.03-1.23), and for weight change (HR, 1.13; 95% CI, 1.01-1.27). The absolute amount of UPF consumption (grams per day) was consistently associated with T2D risk, even when adjusting for unprocessed or minimally processed food intake (HR for a 100 g/d increase, 1.05; 95% CI, 1.02-1.08). Conclusions and Relevance In this large observational prospective study, a higher proportion of UPF in the diet was associated with a higher risk of T2D. Even though these results need to be confirmed in other populations and settings, they provide evidence to support efforts by public health authorities to recommend limiting UPF consumption. Trial Registration ClinicalTrials.gov Identifier: NCT03335644.
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Affiliation(s)
- Bernard Srour
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Léopold K. Fezeu
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Benjamin Allès
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Charlotte Debras
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Nathalie Druesne-Pecollo
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Eloi Chazelas
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Mélanie Deschasaux
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Serge Hercberg
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Pilar Galan
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
| | - Carlos A. Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr Arnaldo 715, São Paulo 01246-904, Brazil
| | - Chantal Julia
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Mathilde Touvier
- Paris 13 University, Inserm, Inra, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France
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142
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A Multicenter Study Evaluating the Stages of Change in Food Consumption with Warning Labels among Chilean University Students. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2317929. [PMID: 32461968 PMCID: PMC7212336 DOI: 10.1155/2020/2317929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 06/24/2019] [Accepted: 07/16/2019] [Indexed: 11/18/2022]
Abstract
Objective To analyze the stage of change in food consumption with warning labels among Chilean university students. Materials and Methods Cross-sectional study which applied surveys in universities from all over the country. Study included 4807 participants of 18 to 40 years of both sexes who were asked about the level of knowledge of the new food law and food consumption with warning signals, including questions regarding their willingness to behavior change according to Prochaska's transtheoretical model. To compare continuous variables, Student's t-test was used in the statistical package SPSS 22.0, and p <0.05 was considered a significant difference. Results Of the total number of respondents, 99.3% of the students indicated that they know about the food law, classifying foods with signals in the precontemplation stage. Compared by sex, we observed that women give greater importance to behavior change in all of foods (p <0.001). Underweight students give less importance to change in unhealthy foods, while obesity students give more importance but do not show more confidence in behavior change (p <0.05). Conclusion The university students show a low importance and confidence to make behavior change, aspects associated with sex and nutritional status. It is necessary to strengthen nutritional food education and not just talk about structural measures.
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143
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Sato PDM, Couto MT, Wells J, Cardoso MA, Devakumar D, Scagliusi FB. Mothers' food choices and consumption of ultra-processed foods in the Brazilian Amazon: A grounded theory study. Appetite 2020; 148:104602. [PMID: 31953143 DOI: 10.1016/j.appet.2020.104602] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
In recent decades, an increase in consumption of ultra-processed foods (UPF), a type of product frequently associated with diet-related obesity, chronic diseases, decrease of eating traditions and loss of culinary diversity, has been observed in middle-income countries. However, there is lack of information on factors related to choosing UPF. In this study, we aimed to understand the factors promoting UPF choices and consumption among mothers living in an urban context in the Brazilian Amazon, and to present a conceptual model grounded on their experiences that illustrates the dynamics between the observed factors. For this qualitative study, we used a constructive grounded theory approach, with a theoretical sampling of 40 women, to choose mothers with high and low consumption of ultra-processed foods. Data production and the first steps of analysis were performed concomitantly, followed by four steps of coding focused on creating conceptual categories and explaining the interactions between them. Our findings highlighted the importance of context in promoting UPF choice and consumption, particularly the "food environment", physical and virtual, and the "sociocultural environment". These contextual aspects interacted with the two main personal aspects influencing participants' UPF consumption, one concerning practices, "cooking behaviors", and the other concerning preferences, "food tastes". Factors such as economic and time constraints were also important and competed to shape eating practices through interactions with participants' health valorization. Findings are discussed in relation to food choice theories, social roles and the food environment. Implications for public health initiatives include the importance of considering environmental changes, sociocultural and economic influences, the reliance on UPF, and the role of women in the home, when promoting healthy diets.
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Affiliation(s)
- Priscila de Morais Sato
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, 01246-904, São Paulo, Brazil.
| | - Marcia Thereza Couto
- Department of Preventive Medicine, Medical School, University of São Paulo, Avenida Doutor Arnaldo 455, 01246-903, São Paulo, Brazil.
| | - Jonathan Wells
- Pop, Policy & Practice Program, UCL Great Ormond Street Institute of Child Health, London, WC1N1EH, United Kingdom.
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, 01246-904, São Paulo, Brazil.
| | - Delanjathan Devakumar
- Institute for Global Health, University College of London, London, WC1N1EH, United Kingdom.
| | - Fernanda Baeza Scagliusi
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, 01246-904, São Paulo, Brazil.
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144
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Davidou S, Christodoulou A, Fardet A, Frank K. The holistico-reductionist Siga classification according to the degree of food processing: an evaluation of ultra-processed foods in French supermarkets. Food Funct 2020; 11:2026-2039. [DOI: 10.1039/c9fo02271f] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The Siga classification of foods according to degree of processing showed that two-thirds of 24 932 packaged foods collected in French supermarkets are ultra-processed at various degrees.
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145
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Zorbas C, Eyles H, Orellana L, Peeters A, Mhurchu CN, Riesenberg D, Backholer K. Do purchases of price promoted and generic branded foods and beverages vary according to food category and income level? Evidence from a consumer research panel. Appetite 2020; 144:104481. [DOI: 10.1016/j.appet.2019.104481] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/11/2019] [Accepted: 10/03/2019] [Indexed: 11/25/2022]
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146
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Evaluating the impact of Chile's marketing regulation of unhealthy foods and beverages: pre-school and adolescent children's changes in exposure to food advertising on television. Public Health Nutr 2019; 23:747-755. [PMID: 31822317 DOI: 10.1017/s1368980019003355] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the effects of Chile's 2016 regulation restricting child-directed marketing of products high in energy, saturated fats, sodium and sugars on reducing children's exposure to 'high-in' television food advertising. DESIGN Television use by pre-schoolers and adolescents was assessed via surveys in the months prior to implementation and a year after implementation. Hours and channels of television use were linked with the amount of high-in food advertising observed in corresponding content analyses of food advertisements (ads) from popular broadcast and cable channels to estimate changes in exposure to food ads from these channels. SETTING Middle-lower and lower-income neighbourhoods in Santiago, Chile. PARTICIPANTS Pre-schoolers (n 879; mothers reporting) and adolescents (n 753; self-reporting). RESULTS Pre-schoolers' and adolescents' exposure to high-in food advertising in total decreased significantly by an average of 44 and 58 %, respectively. Exposure to high-in food advertising with child-directed appeals, such as cartoon characters, decreased by 35 and 52 % for pre-schoolers and adolescents, respectively. Decreases were more pronounced for children who viewed more television. Products high in sugars were the most prevalent among the high-in ads seen by children after implementation. CONCLUSIONS Following Chile's 2016 child-directed marketing regulation, children's exposure to high-in food advertising on popular broadcast and cable television decreased significantly but was not eliminated from their viewing. Later stages of the regulation are expected to eliminate the majority of children's exposure to high-in food advertising from television.
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147
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Nazmi A, Tseng M, Robinson D, Neill D, Walker J. A Nutrition Education Intervention Using NOVA Is More Effective Than MyPlate Alone: A Proof-of-Concept Randomized Controlled Trial. Nutrients 2019; 11:E2965. [PMID: 31817564 PMCID: PMC6950011 DOI: 10.3390/nu11122965] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 11/29/2022] Open
Abstract
The ability to classify foods based on level of processing, not only conventional MyPlate food groups, might be a useful tool for consumers faced with a wide array of highly processed food products of varying nutritional value. The objective of this study was to assess the impact of a proof-of-concept nutrition education intervention on nutrition knowledge, assessed by correct classification of foods according to MyPlate food groups, MyPlate 'limit' status (for fat, sugar, sodium), and level of processing (NOVA categories). We utilized a randomized, controlled design to examine the impact of a MyPlate vs. combined MyPlate + NOVA intervention vs. control group. Intervention groups received educational flyers via email and participants were assessed using electronic baseline and follow-up surveys. The MyPlate + NOVA intervention group performed at least as well as the MyPlate group on classifying conventional food groups and 'limit' status. Moreover, the MyPlate + NOVA group far outperformed the other groups on classifying NOVA categories. Longer-term trials are needed, but our results suggest that NOVA principles may be more easily understood and applied than those of MyPlate. Education strategies focusing on level of food processing may be effective in the context of the modern food environment.
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Affiliation(s)
- Aydin Nazmi
- Food Science and Nutrition Department, California Polytechnic State University, San Luis Obispo, CA 93407, USA
| | - Marilyn Tseng
- Kinesiology and Public Health Department, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
| | - Derrick Robinson
- University of California, Division of Agriculture and Natural Resources, Davis, CA 95618, USA
| | - Dawn Neill
- Interdisciplinary Studies in the Liberal Arts, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
| | - John Walker
- Statistics Department, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
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148
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Partridge D, Lloyd KA, Rhodes JM, Walker AW, Johnstone AM, Campbell BJ. Food additives: Assessing the impact of exposure to permitted emulsifiers on bowel and metabolic health - introducing the FADiets study. NUTR BULL 2019; 44:329-349. [PMID: 31866761 PMCID: PMC6899614 DOI: 10.1111/nbu.12408] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Emulsifiers are common components of processed foods consumed as part of a Western diet. Emerging in vitro cell-line culture, mouse model and human intestinal tissue explant studies have all suggested that very low concentrations of the food emulsifier polysorbate 80 may cause bacterial translocation across the intestinal epithelium, intestinal inflammation and metabolic syndrome. This raises the possibility that dietary emulsifiers might be factors in conditions such as coronary artery disease, type 2 diabetes and Crohn's disease. The potential mechanism behind the observed effects of this emulsifier is uncertain but may be mediated via changes in the gut microbiota or by increased bacterial translocation, or both. It is also unknown whether these effects are generalisable across all emulsifiers and detergents, including perhaps the natural emulsifier lecithin or even conjugated bile acids, particularly if the latter escape reabsorption and pass through to the distal ileum or colon. A major objective of the Medical Research Council (MRC)-funded Mechanistic Nutrition in Health (MECNUT) Emulsifier project is therefore to investigate the underlying mechanisms and effects of a range of synthetic and natural emulsifiers and detergents in vitro and in vivo, and to determine the effects of a commonly consumed emulsifier (soya lecithin) on gut and metabolic health through a controlled dietary intervention study in healthy human volunteers - the FADiets study. This report provides an overview of the relevant literature, discussing the impact of emulsifiers and other additives on intestinal and metabolic health, and gives an overview of the studies being undertaken as part of the MECNUT Emulsifier project.
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Affiliation(s)
- D. Partridge
- The Rowett InstituteUniversity of AberdeenAberdeenUK
| | - K. A. Lloyd
- Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | - J. M. Rhodes
- Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | - A. W. Walker
- The Rowett InstituteUniversity of AberdeenAberdeenUK
| | | | - B. J. Campbell
- Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
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149
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Neri D, Martinez-Steele E, Monteiro CA, Levy RB. Consumption of ultra-processed foods and its association with added sugar content in the diets of US children, NHANES 2009-2014. Pediatr Obes 2019; 14:e12563. [PMID: 31364315 DOI: 10.1111/ijpo.12563] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/11/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is cumulative recognition that increases in the dietary share of ultra-processed foods result in deterioration of the nutritional quality of the overall diet and adverse health outcomes. OBJECTIVE The purpose of this study was to assess the consumption of ultra-processed foods and to examine its association with added sugar content in the diet of US children aged 2 to 19 years. METHODS We classified all food items according to the NOVA food classification system and looked at the consumption of ultra-processed foods, measured as percentage of total energy intake. We assessed dietary added sugar content by estimating its contribution to total energy intake and the proportion of individuals with diets exceeding the recommended limit of 10% of total energy intake from added sugars. We also examined the proportion of those who surpassed twice that limit. Gaussian and Poisson regressions estimated the association between consumption of ultra-processed foods and estimates of added sugar content. RESULTS Ultra-processed foods contributed to 65% of total energy intake and to 92% of energy from added sugars in the diet of US children. The mean percent energy provided by added sugars in the observed period was 14.3%. Most individuals (70.9%) had diets exceeding the recommended limit of added sugar (<10% of total energy intake), and 18.4% of the population had diets surpassing twice the recommended level (20% of total energy intake). A 5.5% point increase in the dietary share of ultra-processed foods determined a 1 percentage point increase in the dietary content of added sugars, with stronger adjusted associations among younger children. CONCLUSIONS Public health efforts to reduce added sugars in the diet of US children must put greater emphasis on decreasing the consumption of ultra-processed foods.
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Affiliation(s)
- Daniela Neri
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Euridice Martinez-Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Carlos Augusto Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil.,Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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150
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Blanco-Rojo R, Sandoval-Insausti H, López-Garcia E, Graciani A, Ordovás JM, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P. Consumption of Ultra-Processed Foods and Mortality: A National Prospective Cohort in Spain. Mayo Clin Proc 2019; 94:2178-2188. [PMID: 31623843 DOI: 10.1016/j.mayocp.2019.03.035] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/19/2019] [Accepted: 03/27/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess the prospective association between ultra-processed food consumption and all-cause mortality and to examine the effect of theoretical iso-caloric non-processed foods substitution. PATIENTS AND METHODS A population-based cohort of 11,898 individuals (mean age 46.9 years, and 50.5% women) were selected from the ENRICA study, a representative sample of the noninstitutionalized Spanish population. Dietary information was collected by a validated computer-based dietary history and categorized according to their degree of processing using NOVA classification. Total mortality was obtained from the National Death Index. Follow-up lasted from baseline (2008-2010) to mortality date or December 31th, 2016, whichever was first. The association between quartiles of consumption of ultra-processed food and mortality was analyzed by Cox models adjusted for the main confounders. Restricted cubic-splines were used to assess dose-response relationships when using iso-caloric substitutions. RESULTS Average consumption of ultra-processed food was 385 g/d (24.4% of the total energy intake). After a mean follow-up of 7.7 years (93,599 person-years), 440 deaths occurred. The hazard ratio (and 95% CI) for mortality in the highest versus the lowest quartile of ultra-processed food consumption was 1.44 (95% CI, 1.01-2.07; P trend=.03) in percent of energy and 1.46 (95% CI, 1.04-2.05; P trend=.03) in grams per day per kilogram. Isocaloric substitution of ultra-processed food with unprocessed or minimally processed foods was associated with a significant nonlinear decrease in mortality. CONCLUSION A higher consumption of ultra-processed food was associated with higher mortality in the general population. Furthermore, the theoretical iso-caloric substitution ultra-processed food by unprocessed or minimally processed foods would suppose a reduction of the mortality risk. If confirmed, these findings support the necessity of the development of new nutritional policies and guides at the national and international level. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01133093.
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Affiliation(s)
- Ruth Blanco-Rojo
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain
| | - Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Esther López-Garcia
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Auxiliadora Graciani
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Jose M Ordovás
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Jose R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Pilar Guallar-Castillón
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD.
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