101
|
Romaguera D, Fernández-Barrés S, Gracia-Lavedán E, Vendrell E, Azpiri M, Ruiz-Moreno E, Martín V, Gómez-Acebo I, Obón M, Molinuevo A, Fresán U, Molina-Barceló A, Olmedo-Requena R, Tardón A, Alguacil J, Solans M, Huerta JM, Ruiz-Dominguez JM, Aragonés N, Fernández-Villa T, Dierssen-Sotos T, Moreno V, Guevara M, Vanaclocha-Espi M, Lozano-Lorca M, Fernández-Tardón G, Castaño-Vinyals G, Pérez-Gómez B, Molina AJ, Llorca J, Gil L, Castilla J, Pollán M, Kogevinas M, Amiano P. Consumption of ultra-processed foods and drinks and colorectal, breast, and prostate cancer. Clin Nutr 2021; 40:1537-1545. [PMID: 33743289 DOI: 10.1016/j.clnu.2021.02.033] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 12/11/2022]
Abstract
AIMS To study whether the consumption of ultra-processed foods and drinks is associated with breast, colorectal, and prostate cancers. METHODS Multicentric population-based case-control study (MCC-Spain) conducted in 12 Spanish provinces. Participants were men and women between 20 and 85 years of age with diagnoses of colorectal (n = 1852), breast (n = 1486), or prostate cancer (n = 953), and population-based controls (n = 3543) frequency-matched by age, sex, and region. Dietary intake was collected using a validated food frequency questionnaire. Foods and drinks were categorized according to their degree of processing based on the NOVA classification. Unconditional multivariable logistic regression was used to evaluate the association between ultra-processed food and drink consumption and colorectal, breast, and prostate cancer. RESULTS In multiple adjusted models, consumption of ultra-processed foods and drinks was associated with a higher risk of colorectal cancer (OR for a 10% increase in consumption: 1.11; 95% CI 1.04-1.18). The corresponding odds for breast (OR 1.03; 95% CI 0.96-1.11) and prostate cancer (OR 1.02; 95% CI 0.93-1.12) were indicative of no association. CONCLUSIONS Results of this large population-based case-control study suggest an association between the consumption of ultra-processed foods and drinks and colorectal cancer. Food policy and public health should include a focus on food processing when formulating dietary guidelines.
Collapse
Affiliation(s)
- Dora Romaguera
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Instituto de Investigación Sanitaria Illes Balears (IdISBa), Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain.
| | - Sílvia Fernández-Barrés
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Esther Gracia-Lavedán
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Eva Vendrell
- Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018, Barcelona, Spain.
| | - Mikel Azpiri
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
| | - Emma Ruiz-Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
| | - Vicente Martín
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institut of Biomedicine (IBIOMED), Universidad de León, León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Spain.
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain.
| | - Mireia Obón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Amaia Molinuevo
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
| | - Ujué Fresán
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain.
| | - Ana Molina-Barceló
- Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain.
| | - Rocío Olmedo-Requena
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Spain; Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Spain.
| | - Adonina Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Medicine, University of Oviedo, Oviedo, Spain.
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain.
| | - Marta Solans
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.
| | - Jose M Huerta
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
| | | | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health, Madrid, Spain.
| | - Tania Fernández-Villa
- The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institut of Biomedicine (IBIOMED), Universidad de León, León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Spain.
| | - Trinidad Dierssen-Sotos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain.
| | - Victor Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
| | | | - Macarena Lozano-Lorca
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Spain.
| | - Guillermo Fernández-Tardón
- Department of Medicine, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain.
| | - Gemma Castaño-Vinyals
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Beatriz Pérez-Gómez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
| | - Antonio J Molina
- The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institut of Biomedicine (IBIOMED), Universidad de León, León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Spain.
| | - Javier Llorca
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain.
| | - Leire Gil
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
| | - Jesús Castilla
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
| | - Marina Pollán
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
| | - Manolis Kogevinas
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
| |
Collapse
|
102
|
Sung H, Park JM, Oh SU, Ha K, Joung H. Consumption of Ultra-Processed Foods Increases the Likelihood of Having Obesity in Korean Women. Nutrients 2021; 13:nu13020698. [PMID: 33671557 PMCID: PMC7926298 DOI: 10.3390/nu13020698] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Abstract
This study aimed to determine the association between consumption of ultra-processed foods and obesity among Korean adults. We used the data of 7364 participants (men 3219, women 4145) aged 19-64 years from the Korea National Health and Nutrition Examination Survey (KNHANES), 2016-2018. Food items were classified using the NOVA food classification system, depending on the extent and purpose of food processing: (1) unprocessed or minimally processed foods, (2) processed culinary ingredients, (3) processed foods, and (4) ultra-processed foods. Consumption of ultra-processed foods accounted for 26.8% of the total energy intake. After adjusting for potential confounders including sociodemographic and lifestyle characteristics, subjects with the highest consumption of ultra-processed foods (fourth quartile of % energy intake from ultra-processed foods) had 0.61 kg/m2 higher body mass index (BMI; 95% confidence interval [CI] 0.23-0.99, p-trend 0.0047), 1.34 cm higher waist circumference (WC; 95% CI 0.35-2.34, p-trend 0.0146), 51% higher odds of being obese (BMI > 25 kg/m2; odds ratio [OR] 1.51, 95% CI 1.14-1.99, p-trend 0.0037), and 64% higher odds of abdominal obesity (men: WC ≥ 90 cm, women: WC ≥ 85 cm; OR 1.64, 95% CI 1.24-2.16, p-trend 0.0004) than those with the lowest consumption (first quartile) among women. However, no association was found in men. These findings provide evidence that high consumption of ultra-processed foods is positively associated with obesity in Korean women. Further studies with a large-scale cohort or intervention trial are needed to identify the mechanism of associations between consumption of ultra-processed foods and health-related outcomes including obesity in Korea.
Collapse
Affiliation(s)
- Hyuni Sung
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (H.S.); (J.M.P.); (S.U.O.)
| | - Ji Min Park
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (H.S.); (J.M.P.); (S.U.O.)
| | - Se Uk Oh
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (H.S.); (J.M.P.); (S.U.O.)
| | - Kyungho Ha
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Korea;
| | - Hyojee Joung
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (H.S.); (J.M.P.); (S.U.O.)
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea
- Correspondence: ; Tel.: +82-2-880-2716
| |
Collapse
|
103
|
Mulligan C, Franco-Arellano B, Ahmed M, Vergeer L, Dickinson K, L'Abbé MR. Comparing how Canadian packaged food products align with the 2007 and 2019 versions of Canada's Food Guide. Appl Physiol Nutr Metab 2021; 46:934-944. [PMID: 33596121 DOI: 10.1139/apnm-2020-0620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In 2019, Canada's Food Guide (CFG) was updated from the 2007 version. This study developed a food-based nutrient profile model (NPM) to evaluate the alignment of packaged food and beverage products with CFG 2019 and compared it with CFG 2007. Packaged products from the University of Toronto's Food Label Information Program 2017 database were evaluated in terms of their alignment with CFG 2007 (using the Health Canada Surveillance Tool (HCST)) and CFG 2019 (using our newly developed CFG 2019 NPM). Agreement in alignment (e.g., products "in line" according to CFG 2019 NPM and in Tiers 1 or 2 according to the HCST) was calculated and differences in alignment and reasons for differences were quantified and described. Overall agreement in product alignment between CFG 2007 and 2019 was 81.9%, with fewer products aligned with CFG 2019: 16.4% vs. 31.8%, (χ2 = 189.12, p < 0.001). Differences in alignment varied across food categories (0.0-73.8%), explained by differences in CFG 2019, reflected in the CFG 2019 NPM (e.g., emphasis on avoiding processed foods, encouraging whole grains and low-fat dairy). This study presents a first step in assessing packaged foods' alignment with CFG 2019; future work is needed to evaluate broader dietary adherence to the updated recommendations. Novelty: A food-based nutrient profile model was developed based on the 2019 CFG and tested on packaged foods by comparing it with the nutrient-based HCST, based on CFG 2007. Most (82%) packaged products were "not in line" with either CFG version.
Collapse
Affiliation(s)
- Christine Mulligan
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Laura Vergeer
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Kacie Dickinson
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, Australia
| | - Mary R L'Abbé
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| |
Collapse
|
104
|
Pagliai G, Dinu M, Madarena MP, Bonaccio M, Iacoviello L, Sofi F. Consumption of ultra-processed foods and health status: a systematic review and meta-analysis. Br J Nutr 2021; 125:308-318. [PMID: 32792031 PMCID: PMC7844609 DOI: 10.1017/s0007114520002688] [Citation(s) in RCA: 460] [Impact Index Per Article: 153.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/30/2020] [Accepted: 07/09/2020] [Indexed: 01/08/2023]
Abstract
Increasing evidence suggests that high consumption of ultra-processed foods (UPF) is associated with an increase in non-communicable diseases, overweight and obesity. The present study systematically reviewed all observational studies that investigated the association between UPF consumption and health status. A comprehensive search of MEDLINE, Embase, Scopus, Web of Science and Google Scholar was conducted, and reference lists of included articles were checked. Only cross-sectional and prospective cohort studies were included. At the end of the selection process, twenty-three studies (ten cross-sectional and thirteen prospective cohort studies) were included in the systematic review. As regards the cross-sectional studies, the highest UPF consumption was associated with a significant increase in the risk of overweight/obesity (+39 %), high waist circumference (+39 %), low HDL-cholesterol levels (+102 %) and the metabolic syndrome (+79 %), while no significant associations with hypertension, hyperglycaemia or hypertriacylglycerolaemia were observed. For prospective cohort studies evaluating a total population of 183 491 participants followed for a period ranging from 3·5 to 19 years, highest UPF consumption was found to be associated with increased risk of all-cause mortality in five studies (risk ratio (RR) 1·25, 95 % CI 1·14, 1·37; P < 0·00001), increased risk of CVD in three studies (RR 1·29, 95 % CI 1·12, 1·48; P = 0·0003), cerebrovascular disease in two studies (RR 1·34, 95 % CI 1·07, 1·68; P = 0·01) and depression in two studies (RR 1·20, 95 % CI 1·03, 1·40; P = 0·02). In conclusion, increased UPF consumption was associated, although in a limited number of studies, with a worse cardiometabolic risk profile and a higher risk of CVD, cerebrovascular disease, depression and all-cause mortality.
Collapse
Affiliation(s)
- G. Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, 50134Florence, Italy
- Unit of Clinical Nutrition, Careggi University Hospital, 50134Florence, Italy
| | - M. Dinu
- Department of Experimental and Clinical Medicine, University of Florence, 50134Florence, Italy
- Unit of Clinical Nutrition, Careggi University Hospital, 50134Florence, Italy
| | - M. P. Madarena
- Department of Experimental and Clinical Medicine, University of Florence, 50134Florence, Italy
| | - M. Bonaccio
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, 86077Isernia, Italy
| | - L. Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, 86077Isernia, Italy
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100Varese, Italy
| | - F. Sofi
- Department of Experimental and Clinical Medicine, University of Florence, 50134Florence, Italy
- Unit of Clinical Nutrition, Careggi University Hospital, 50134Florence, Italy
| |
Collapse
|
105
|
Zhang Z, Jackson SL, Martinez E, Gillespie C, Yang Q. Association between ultraprocessed food intake and cardiovascular health in US adults: a cross-sectional analysis of the NHANES 2011-2016. Am J Clin Nutr 2021; 113:428-436. [PMID: 33021623 PMCID: PMC10097423 DOI: 10.1093/ajcn/nqaa276] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/04/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Higher intake of ultraprocessed foods (UPFs) might be associated with increased risk of cardiovascular disease. OBJECTIVES Our objective was to examine the association between usual percentage of calories (%kcal) from UPFs and the American Heart Association's "Life's Simple 7" cardiovascular health (CVH) metrics in US adults. METHODS We analyzed data from 11,246 adults aged ≥20 y from the NHANES 2011-2016 (a cross-sectional, nationally representative survey). UPF designation was assigned on the basis of the NOVA classification system, according to the extent and purpose of food processing. Each CVH metric was given a score of 0, 1, or 2 representing poor, intermediate, or ideal health, respectively. Scores of the 6 metrics (excluding diet) were summed, and CVH was categorized as inadequate (0-4), average (5-8), or optimum (9-12). We used the National Cancer Institute's methods to estimate the usual %kcal from UPFs, and multivariable linear and multinomial logistic regression to assess the association between UPFs and CVH, adjusted for age, sex, race and Hispanic origin, education, and poverty. RESULTS The weighted prevalence of inadequate, average, and optimum CVH was 8.0%, 51.7%, and 40.3%, respectively. The mean usual %kcal from UPFs was 55.4%, and midpoint of quartiles of intake ranged from 40.4% (quartile 1) to 70.5% (quartile 4). Every 5% increase in calories from UPFs was associated with 0.14 points lower CVH score (P < 0.001). The adjusted ORs for inadequate CVH were 1.40 (95% CI: 1.23, 1.60), 1.82 (1.45, 2.29), and 2.57 (1.79, 3.70), respectively, comparing quartiles 2, 3, and 4 with quartile 1 of UPF intake. The pattern of association was largely consistent across subgroups. CONCLUSIONS Usual %kcal from UPFs represented more than half of total calorie intake in US adults. A graded inverse association between %kcal from UPFs and CVH was observed.
Collapse
Affiliation(s)
- Zefeng Zhang
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sandra L Jackson
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Euridice Martinez
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Cathleen Gillespie
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Quanhe Yang
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
106
|
Abstract
PURPOSE OF REVIEW Ultra-processed foods (UPF) have been associated with poor diet quality and adverse health outcomes. Our aim in this review is to summarize recent research assessing the impact of UPF consumption, classified according to the NOVA system, on outcomes related to metabolic health. RECENT FINDINGS Thirty recent studies with different design, quality and target population have investigated the impact of UPF consumption on parameters related to metabolic health, which were organized into: metabolic syndrome; body weight change and obesity indicators; blood pressure and hypertension; glucose profile, insulin resistance and type 2 diabetes; other metabolic risks and cardiovascular diseases and mortality. Most of the studies demonstrated adverse associations between high UPF consumption and metabolic health, mainly those with robust design and involving adults. SUMMARY Most of the latest findings have revealed an adverse impact of high UPF consumption on metabolic health, including cardiovascular diseases and mortality. Scientific evidence is accumulating towards the necessity of curbing UPF consumption worldwide at different life stages. Nevertheless, other studies are needed to confirm the causality between UPF consumption and metabolic health in diverse scenarios and to better elucidate all likely mechanisms involved in this relationship.
Collapse
Affiliation(s)
- Renata Costa de Miranda
- Department of Preventive Medicine, School of Medicine
- Center for Epidemiological Research in Nutrition and Health
| | - Fernanda Rauber
- Department of Preventive Medicine, School of Medicine
- Center for Epidemiological Research in Nutrition and Health
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine
- Center for Epidemiological Research in Nutrition and Health
| |
Collapse
|
107
|
Konieczna J, Morey M, Abete I, Bes-Rastrollo M, Ruiz-Canela M, Vioque J, Gonzalez-Palacios S, Daimiel L, Salas-Salvadó J, Fiol M, Martín V, Estruch R, Vidal J, Martínez-González MA, Canudas S, Jover AJ, Fernández-Villa T, Casas R, Olbeyra R, Buil-Cosiales P, Babio N, Schröder H, Martínez JA, Romaguera D. Contribution of ultra-processed foods in visceral fat deposition and other adiposity indicators: Prospective analysis nested in the PREDIMED-Plus trial. Clin Nutr 2021; 40:4290-4300. [PMID: 33610419 DOI: 10.1016/j.clnu.2021.01.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/28/2020] [Accepted: 01/11/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Ultra-processed food and drink products (UPF) consumption has been associated with obesity and its-related comorbidities. Excess of visceral fat, which appears with increasing age, has been considered as the culprit contributing to adiposity-associated adverse health outcomes. However, none of previous studies elucidated the link between UPF and directly quantified adiposity and its distribution. We aimed to prospectively investigate the association between concurrent changes in UPF consumption and objectively assessed adiposity distribution. METHODS A subsample of 1485 PREDIMED-Plus participants (Spanish men and women aged 55-75 years with overweight/obesity and metabolic syndrome) underwent body composition measurements. Consumption of UPF at baseline, 6 and 12 months was evaluated using a validated 143-item semi-quantitative Food Frequency Questionnaire. Food items (g/day) were categorized according to their degree of processing using NOVA system. Regional adiposity (visceral fat (in g) and android-to-gynoid fat ratio) and total fat mass (in g) at three time points were measured with dual-energy X-ray absorptiometry (DXA) and were normalized using sex-specific z-scores. The association of changes in UPF consumption, expressed as the percentage of total daily intake (daily g of UPF/total daily g of food and beverage intake∗100), with adiposity changes was evaluated using linear mixed-effects models. RESULTS On average, the consumption of UPF accounted for 8.11% (SD 7.41%) of total daily intake (in grams) at baseline. In multivariable-adjusted model, 10% daily increment in consumption of UPF was associated with significantly (all p-values <0.05) greater accumulation of visceral fat (β 0.09 z-scores, 95% CI 0.05; 0.13), android-to-gynoid fat ratio (0.05, 0.00; 0.09) and total fat (0.09, 0.06; 0.13). CONCLUSION A higher consumption of UPF was associated with greater age-related visceral and overall adiposity accumulation. Further studies are warranted to confirm these results in other populations and settings. TRIAL REGISTRATION The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
Collapse
Affiliation(s)
- Jadwiga Konieczna
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Marga Morey
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Itziar Abete
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, Pamplona, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Maira Bes-Rastrollo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Miguel Ruiz-Canela
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Jesus Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, Alicante, Spain
| | - Sandra Gonzalez-Palacios
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, Alicante, Spain
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Hospital Universitari San Joan de Reus, Reus, Spain; Institut d'Investigació Pere Virgili (IISPV), Reus, Spain
| | - Miguel Fiol
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Grupo de Investigación en Interacciones Gen - Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Ramón Estruch
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Miguel A Martínez-González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Silvia Canudas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Hospital Universitari San Joan de Reus, Reus, Spain; Institut d'Investigació Pere Virgili (IISPV), Reus, Spain
| | - Antoni J Jover
- Atención Primaria Mallorca, Centro de Salud Arquitecte Bennàssar, Palma de Mallorca, Spain
| | - Tania Fernández-Villa
- Grupo de Investigación en Interacciones Gen - Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Rosa Casas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Romina Olbeyra
- Department of Endocrinology, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Pilar Buil-Cosiales
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Nancy Babio
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Hospital Universitari San Joan de Reus, Reus, Spain; Institut d'Investigació Pere Virgili (IISPV), Reus, Spain
| | - Helmut Schröder
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - J Alfredo Martínez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, Pamplona, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Dora Romaguera
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | |
Collapse
|
108
|
Wood B, Williams O, Nagarajan V, Sacks G. Market strategies used by processed food manufacturers to increase and consolidate their power: a systematic review and document analysis. Global Health 2021; 17:17. [PMID: 33499883 PMCID: PMC7836045 DOI: 10.1186/s12992-021-00667-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/18/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The public health community has become increasingly critical of the role that powerful corporations play in driving unhealthy diets, one of the leading contributors to the global burden of disease. While a substantial amount of work has examined the political strategies used by dominant processed food manufacturers that undermine public health, less attention has been paid to their use of market strategies to build and consolidate power. In this light, this paper aimed to systematically review and synthesise the market strategies deployed by dominant processed food manufacturers to increase and consolidate their power. METHODS A systematic review and document analysis of public health, business, legal and media content databases (Scopus, Medline, ABI Inform, Business Source Complete, Thomas Reuters Westlaw, Lexis Advance, Factiva, NewsBank), and grey literature were conducted. Data extracted were analysed thematically using an approach informed by Porter's 'Five Forces' framework. RESULTS 213 documents met inclusion criteria. The market strategies (n=21) and related practices of dominant processed food manufacturers identified in the documents were categorised into a typological framework consisting of six interconnected strategic objectives: i) reduce intense competition with equivalent sized rivals and maintaining dominance over smaller rivals; ii) raise barriers to market entry by new competitors; iii) counter the threat of market disruptors and drive dietary displacement in favour of their products; iv) increase firm buyer power over suppliers; v) increase firm seller power over retailers and distributors; and vi) leverage informational power asymmetries in relations with consumers. CONCLUSIONS The typological framework is well-placed to inform general and jurisdiction-specific market strategy analyses of dominant processed food manufacturers, and has the potential to assist in identifying countervailing public policies, such as those related to merger control, unfair trading practices, and public procurement, that could be used to address market-power imbalances as part of efforts to improve population diets.
Collapse
Affiliation(s)
- Benjamin Wood
- Global Obesity Centre, Deakin University, Melbourne, Australia.
| | - Owain Williams
- School of Political Science and International Studies, University of Leeds, Leeds, UK
| | | | - Gary Sacks
- Global Obesity Centre, Deakin University, Melbourne, Australia
| |
Collapse
|
109
|
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.
Collapse
|
110
|
Ultra-processed food consumption and obesity in the Australian adult population. Nutr Diabetes 2020; 10:39. [PMID: 33279939 PMCID: PMC7719194 DOI: 10.1038/s41387-020-00141-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/16/2020] [Accepted: 07/22/2020] [Indexed: 12/23/2022] Open
Abstract
Background Rapid simultaneous increases in ultra-processed food sales and obesity prevalence have been observed worldwide, including in Australia. Consumption of ultra-processed foods by the Australian population was previously shown to be systematically associated with increased risk of intakes of nutrients outside levels recommended for the prevention of obesity. This study aims to explore the association between ultra-processed food consumption and obesity among the Australian adult population and stratifying by age group, sex and physical activity level. Methods A cross-sectional analysis of anthropometric and dietary data from 7411 Australians aged ≥20 years from the National Nutrition and Physical Activity Survey 2011–2012 was performed. Food consumption was evaluated through 24-h recall. The NOVA system was used to identify ultra-processed foods, i.e. industrial formulations manufactured from substances derived from foods and typically added of flavours, colours and other cosmetic additives, such as soft drinks, confectionery, sweet or savoury packaged snacks, microwaveable frozen meals and fast food dishes. Measured weight, height and waist circumference (WC) data were used to calculate the body mass index (BMI) and diagnosis of obesity and abdominal obesity. Regression models were used to evaluate the association of dietary share of ultra-processed foods (quintiles) and obesity indicators, adjusting for socio-demographic variables, physical activity and smoking. Results Significant (P-trend ≤ 0.001) direct dose–response associations between the dietary share of ultra-processed foods and indicators of obesity were found after adjustment. In the multivariable regression analysis, those in the highest quintile of ultra-processed food consumption had significantly higher BMI (0.97 kg/m2; 95% CI 0.42, 1.51) and WC (1.92 cm; 95% CI 0.57, 3.27) and higher odds of having obesity (OR = 1.61; 95% CI 1.27, 2.04) and abdominal obesity (OR = 1.38; 95% CI 1.10, 1.72) compared with those in the lowest quintile of consumption. Subgroup analyses showed that the trend towards positive associations for all obesity indicators remained in all age groups, sex and physical activity level. Conclusion The findings add to the growing evidence that ultra-processed food consumption is associated with obesity and support the potential role of ultra-processed foods in contributing to obesity in Australia.
Collapse
|
111
|
Guillaumie L, Boiral O, Baghdadli A, Mercille G. Integrating sustainable nutrition into health-related institutions: a systematic review of the literature. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2020; 111:845-861. [PMID: 32959328 PMCID: PMC7728986 DOI: 10.17269/s41997-020-00394-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/20/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Sustainable nutrition is increasingly important, as the food system contributes one third of greenhouse gas emissions. Sustainable nutrition, or sustainable diet, refers to diets with low environmental impacts that contribute to food security and health. This systematic review aimed to identify factors that influence whether professionals in health-related institutions integrate sustainable nutrition into their practice. METHODS A mixed-methods systematic review was conducted using the MEDLINE, Embase, PsycINFO, and CINAHL databases. To be included, the studies had to document perspectives on sustainable nutrition from health professionals, including dietitians, students and educators in health sciences, public health officers, and hospital food service managers. Data extraction focused on perceived barriers, facilitating factors, and top recommendations for promoting sustainable nutrition. SYNTHESIS Twenty studies were included, most of which focused on dietitians. Data analysis revealed that 25 factors influenced the integration of sustainable nutrition into professional practice. The factors most reported in the included studies were perceived knowledge of sustainable nutrition, self-efficacy, awareness of environmental issues, and perceiving the promotion of sustainable nutrition to be part of one's professional role. Increasing societal support through awareness campaigns and increasing institutional support through guidelines, information tools, and financial support were also frequently mentioned. CONCLUSION Sustainable nutrition is a multifaceted concept; integrating it into already complex professional practices is therefore challenging. At the present time, dietitians seem to be the health professionals predominantly researched regarding their views on sustainable nutrition. Many concrete avenues to promote sustainable nutrition were identified through this review.
Collapse
Affiliation(s)
- Laurence Guillaumie
- Faculty of Nursing, Research Centre CHU de Québec-Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, QC, G1V 0A6, Canada.
| | - Olivier Boiral
- Canada Research Chair in Internalization of Sustainability Practices and Organizational Accountability, Department of Management, Université Laval, Québec, Canada
| | - Amel Baghdadli
- Department of Management, Université Laval, Pavillon Palasis-Prince, 2325 rue de la Terrasse, Québec, QC, G1V 0A6, Canada
| | - Geneviève Mercille
- Department of Nursing, Université de Montréal, Pavillon Liliane de Stewart, 2405, chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1A8, Canada
| |
Collapse
|
112
|
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: 409] [Impact Index Per Article: 102.3] [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.
Collapse
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
| |
Collapse
|
113
|
Consumers' Implicit and Explicit Recall, Understanding and Perceptions of Products with Nutrition-Related Messages: An Online Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218213. [PMID: 33172128 PMCID: PMC7664426 DOI: 10.3390/ijerph17218213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/29/2020] [Accepted: 11/03/2020] [Indexed: 11/17/2022]
Abstract
This study aimed to assess consumers' implicit and explicit recall, understanding and perceptions of products with a nutrition claim and a symbol depicting 'health,' and to determine whether these perceptions differed among Nutrition Facts table (NFt) users vs. nonusers. In an online survey, participants (n = 1997) were randomized to one of eight conditions in a 2 × 2 × 2 factorial design, consisting of a label with a claim (present/absent) a heart-shaped symbol depicting 'health' (present/absent) for a healthier or less healthy soup. Participants were shown a label for 10 s and asked whether they recalled seeing a claim. If participants answered yes, they were then asked to describe their response using open-ended questions. Participants also rated the product's perceived nutritional quality and purchase intentions using seven-point Likert scales. In the claim condition, most participants (75%) were able to recall the presence of a claim, while 12% incorrectly mentioned the presence of a claim when there was none. Claims likely attracted consumers' attention and increased perceived nutritional quality, although with limited influence among NFt users (23%). The symbol depicting 'health' did not enhance perceived nutritional quality or purchase intentions. Although most participants (77%) made their decisions implicitly using the front of labels, those who used the NFt had a better understanding of the nutritional quality of products.
Collapse
|
114
|
Pro-inflammatory diet is associated with a high number of cardiovascular events and ultra-processed foods consumption in patients in secondary care. Public Health Nutr 2020; 24:3331-3340. [DOI: 10.1017/s136898002000378x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractObjective:To evaluate the association of dietary inflammatory index (DII®) with the occurrence of cardiovascular events, cardiometabolic risk factors and with the consumption of processed, ultra-processed, unprocessed or minimally processed foods and culinary ingredients.Design:This was a cross-sectional study that analysed the baseline data from 2359 cardiac patients. Data on socio-demographic, anthropometric, clinical and food consumption were collected. Energy-adjusted food intake data were used to calculate DII, and the foods were classified according to the NOVA classification. Furthermore, the patients were grouped according to the number (1, 2 or ≥ 3) of manifested cardiovascular events. The data were analysed using linear and multinomial logistic regression.Settings:Multicentre study from Brazil.Participants:Patients with established cardiovascular events from the Brazilian Cardioprotective Nutritional Program Trial evaluated at baseline.Results:Most of the patients were male (58·8 %), older adults (64·2 %) and were overweight (68·8 %). Patients in the third tertile of DII (DII > 0·91) had were more likely to have 2 (OR 1·27, 95 % CI: 1·01–1·61) and ≥ 3 (OR 1·39, 95 % CI: 1·07–1·79) cardiovascular events, with poor cardiometabolic profile. They also were more likely to consume a higher percentage of processed, ultra-processed and culinary ingredients foods consumption compared with the patients in the first DII tertile (DII ≤ 0·91).Conclusion:A more pro-inflammatory diet is associated with a greater chance of having 2 and ≥ 3 cardiovascular events and cardiometabolic risk factors and were more likely to consume processed, ultra-processed and culinary ingredients compared to those with a more anti-inflammatory diet.
Collapse
|
115
|
Yang Q, Zhang Z, Steele EM, Moore LV, Jackson SL. Ultra-Processed Foods and Excess Heart Age Among U.S. Adults. Am J Prev Med 2020; 59:e197-e206. [PMID: 33012621 PMCID: PMC10924299 DOI: 10.1016/j.amepre.2020.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION A high percentage of total calories from ultra-processed foods has been associated with several cardiovascular disease risk factors. No study has examined the association between ultra-processed foods and heart age. This study examines the association between ultra-processed foods and excess heart age (difference between estimated heart age and chronological age) among U.S. adults. METHODS The National Health and Nutrition Examination Survey (2009-2016) data for participants aged 30-74 years without cardiovascular disease or stroke (n=12,640) was used. Ultra-processed food was assigned based on NOVA classification of food processing, with ultra-processed food being the highest level. This study estimated the usual percentage of calories from ultra-processed foods and used sex-specific Framingham heart age algorithms to calculate heart age. The multivariable linear or logistic regression was used to examine the association between ultra-processed foods and excess heart age or likelihood of excess heart age being ≥10 years. Data analyses were conducted in 2020. RESULTS The median usual percentage of calories from ultra-processed foods was 54.5% (IQR=45.8%‒63.1%). Adjusted excess heart age increased from 7.0 years (95% CI=6.4, 7.6) in the lowest quintile (Q1) to 9.9 years (95% CI=9.2, 10.5) in the highest quintile (Q5) (p<0.001). Compared with Q1, AORs for excess heart age of ≥10 years were 1.16 (95% CI=1.08, 1.25) in Q2, 1.29 (95% CI=1.14, 1.46) in Q3, 1.43 (95% CI=1.20, 1.71) in Q4, and 1.66 (95% CI=1.29, 2.14) in Q5 (p<0.001). The pattern of association was largely consistent across subgroups. CONCLUSIONS U.S. adults consumed more than half of total daily calories from ultra-processed foods. A higher percentage of calories from ultra-processed foods was associated with higher excess heart age and likelihood of excess heart age of ≥10 years.
Collapse
Affiliation(s)
- Quanhe Yang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Zefeng Zhang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Euridice Martinez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Latetia V Moore
- Division of Nutrition Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sandra L Jackson
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
116
|
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.
Collapse
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
| | | | | | | |
Collapse
|
117
|
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.
Collapse
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
| |
Collapse
|
118
|
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.
Collapse
|
119
|
Ayton A, Ibrahim A, Dugan J, Galvin E, Wright OW. Ultra-processed foods and binge eating: A retrospective observational study. Nutrition 2020; 84:111023. [PMID: 33153827 DOI: 10.1016/j.nut.2020.111023] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/28/2020] [Accepted: 09/09/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES There is increasing evidence of the impact of ultra-processed foods on multiple metabolic and neurobiological pathways, including those involved in eating behaviors, both in animals and in humans. In this study we aimed to explore ultra-processed foods and their link with disordered eating in a clinical sample. METHODS This was a single site, retrospective observational study in a specialist eating disorder service using self-report on the electronic health records. Patients with a Diagnostic and Statistical Manual of Mental Disorders (fifth edition) diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) were randomly selected from the service database in Oxford from 2017 to 2019. The recently introduced NOVA classification was used to determine the degree of industrial food processing in each patient's diet. Frequencies of ultra-processed foods were analyzed for each diagnosis at each mealtime and during episodes of binging. RESULTS A total of 70 female and 3 male patients were included in the study; 22 had AN, 25 BN, and 26 BED. Patients with AN reported consuming 55% NOVA-4 foods, as opposed to approximately 70% in BN and BED patients. Foods that were consumed in a binge pattern were 100% ultra-processed. CONCLUSION Further research into the metabolic and neurobiological effects of ultra-processed food intake on disordered eating, particularly on binging, is needed.
Collapse
Affiliation(s)
- Agnes Ayton
- University of Oxford, Cotswold House Oxford, Warneford Hospital, Oxford Health Foundation Trust, Oxford, UK.
| | - Ali Ibrahim
- South London and Maudsley NHS Foundation Trust, Bethlem Adolescent Psychiatric Intensive Care Unit, Maudsley Hospital, London, UK
| | - James Dugan
- Department of Cardiology, Northern General Hospital, Sheffield, UK
| | - Eimear Galvin
- Oxford Health Foundation Trust, Cotswold House Oxford, Oxford, UK
| | | |
Collapse
|
120
|
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.
Collapse
|
121
|
Ayton A, Ibrahim A. The Western diet: a blind spot of eating disorder research?-a narrative review and recommendations for treatment and research. Nutr Rev 2020; 78:579-596. [PMID: 31846028 PMCID: PMC7682725 DOI: 10.1093/nutrit/nuz089] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Over the last 50 years, in parallel with the obesity epidemic, the prevalence of eating disorders has increased and presentations have changed. In this narrative review, we consider recent research exploring the implications of changing patterns of food consumption on metabolic and neurobiological pathways, a hitherto neglected area in eating disorder research. One of the major changes over this time has been the introduction of ultra-processed (NOVA-4) foods, which are gradually replacing unprocessed and minimally processed foods. This has resulted in the increased intake of various sugars and food additives worldwide, which has important metabolic consequences: triggering insulin and glucose response, stimulating appetite, and affecting multiple endocrine and neurobiological pathways, as well as the microbiome. A paradigm shift is needed in the conceptual framework by which the vulnerability to, and maintenance of, different eating disorders may be understood, by integrating recent knowledge of the individual metabolic responses to modern highly processed foods into existing psychological models. This could stimulate research and improve treatment outcomes.
Collapse
Affiliation(s)
- Agnes Ayton
- University of Oxford, Oxford, United Kingdom
| | - Ali Ibrahim
- South London and Maudsley NHS Foundation Trust, Snowsfields Adolescent Unit, Mapother House, Maudsley Hospital, London
| |
Collapse
|
122
|
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: 26] [Impact Index Per Article: 6.5] [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.
Collapse
|
123
|
Esteve M. Mechanisms Underlying Biological Effects of Cruciferous Glucosinolate-Derived Isothiocyanates/Indoles: A Focus on Metabolic Syndrome. Front Nutr 2020; 7:111. [PMID: 32984393 PMCID: PMC7492599 DOI: 10.3389/fnut.2020.00111] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/16/2020] [Indexed: 12/13/2022] Open
Abstract
An inverse correlation between vegetable consumption and the incidence of cancer has long been described. This protective effect is stronger when cruciferous vegetables are specifically consumed. The beneficial properties of vegetables are attributed to their bioactive components like fiber, antioxidants vitamins, antioxidants, minerals, and phenolic compounds. Cruciferous vegetables contain all these molecules; however, what makes them different are their sulfurous components, called glucosinolates, responsible for their special smell and taste. Glucosinolates are inactive biologically in the organism but are hydrolyzed by the enzyme myrosinase released as a result of chewing, leading to the formation of active derivatives such as isothiocyanates and indoles. A considerable number of in vitro and in vivo studies have reported that isothiocyanates and indoles elicit chemopreventive potency through multiple mechanisms that include modulation of phases I and II detoxification pathway enzymes, regulation of cell cycle arrest, and control of cell growth, induction of apoptosis, antioxidant activity, anti-angiogenic effects, and epigenetic regulation. Nuclear erythroid 2-related factor 2 (Nrf2) and Nuclear factor-κB (NF-κB) are key and central regulators in all these processes with a main role in oxidative stress and inflammation control. It has been described that isothiocyanates and indoles regulate their activity directly and indirectly. Today, the metabolic syndrome (central obesity, insulin resistance, hyperlipidemia, and hypertension) is responsible for a majority of deaths worldwide. All components of metabolic syndrome are characterized by chronic inflammation with deregulation of the PI3K/AKT/mTOR, MAPK/EKR/JNK, Nrf2, and NF-κB signaling pathways. The effects of GLSs derivatives controlling these pathways have been widely described in relation to cancer. Changes in food consumption patterns observed in the last decades to higher consumption of ultra-processed foods, with elevation in simple sugar and saturated fat contents and lower consumption of vegetables and fruits have been directly correlated with metabolic syndrome prevalence. In this review, it is summarized the knowledge regarding the mechanisms by which cruciferous glucosinolate derivatives (isothiocyanates and indoles) directly and indirectly regulate these pathways. However, the review places a special focus on the knowledge of the effects of glucosinolates derivatives in metabolic syndrome, since this has not been reviewed before.
Collapse
Affiliation(s)
- Montserrat Esteve
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Barcelona, Spain
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| |
Collapse
|
124
|
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: 238] [Impact Index Per Article: 59.5] [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.
Collapse
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.
| |
Collapse
|
125
|
Lower Postprandial Thermogenic Response to an Unprocessed Whole Food Meal Compared to an Iso-Energetic/Macronutrient Meal Replacement in Young Women: A Single-Blind Randomized Cross-Over Trial. Nutrients 2020; 12:nu12082469. [PMID: 32824408 PMCID: PMC7469013 DOI: 10.3390/nu12082469] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 12/22/2022] Open
Abstract
In contrast to ultra-processed foods that are associated with increased weight gain and obesity risk, nutritionally engineered dietary supplements, including meal replacement (MR) bars and shakes, are generally promoted as healthy. Limited data is available comparing the metabolic and hunger responses of whole food (WF) versus MR meals. The purpose of this study was to directly compare the thermic effect (TEM), respiratory exchange ratio (RER), hunger/taste ratings, and glucose response of two different breakfast meals containing MR and WF products in young healthy women. Eight volunteers completed two iso-caloric (529 kcals)/macronutrient (50% carbohydrates; 26% fat; 24% protein) test meals in a single-blind, randomized crossover design: (1) whole food meal; or (2) meal replacement. TEM was significantly higher following MR compared with WF (percent mean difference: 7.76 ± 3.78%; absolute mean difference: 0.053 ± 0.026 kcal/minute, p = 0.048), whereas WF substrate utilization demonstrated lower carbohydrate oxidation (RER) than MR (mean difference: -0.024 ± 0.008, p = 0.005). No differences existed for blood glucose response and feelings of hunger, desire to eat, and satiety among trials. Consumption of an MR meal increases postprandial thermogenesis and RER compared to a WF meal, which may impact weight control and obesity risk over the long-term.
Collapse
|
126
|
Askari M, Heshmati J, Shahinfar H, Tripathi N, Daneshzad E. Ultra-processed food and the risk of overweight and obesity: a systematic review and meta-analysis of observational studies. Int J Obes (Lond) 2020; 44:2080-2091. [PMID: 32796919 DOI: 10.1038/s41366-020-00650-z] [Citation(s) in RCA: 199] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 07/01/2020] [Accepted: 08/05/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Numerous studies have reported the association of ultra-processed foods with excess body weight; however, the nature and extent of this relation has not been clearly established. This systematic review was conducted to analyze the currently documented evidence regarding the association between ultra-processed food with overweight and obesity. METHODS A literature search was performed using multiple literature databases for relevant articles published prior to November 2019. Random effects model, namely the DerSimonian-Laird method, was applied to pool effect sizes. The potential sources of heterogeneity across studies were explored using the Cochrane Q test. RESULTS Fourteen studies (one cohort study and thirteen cross-sectional studies) were included in this review. A significant association was identified between ultra-processed food intake and overweight (pooled effect size: 1.02; 95% confidence interval (95% CI): 1.01, 1.03, p < 0.001) and obesity (pooled effect size: 1.26; 95% CI: 1.13, 1.41, p < 0.001). CONCLUSION Our findings revealed a positive association between ultra-processed foods and excess body weight. Future studies with longitudinal designs and adequate control for confounding factors are required to clarify whether ultra-processed food intake alters anthropometric parameters and leads to obesity.
Collapse
Affiliation(s)
- Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Heshmati
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Shahinfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nishant Tripathi
- Department of Internal Medicine, University of Kentucky, Lexington, KY, USA
| | - Elnaz Daneshzad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. .,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| |
Collapse
|
127
|
Gardner C, Cole DC, Ryan L. Public health for the hunter-gatherer in us all. Canadian Journal of Public Health 2020; 111:701-704. [PMID: 32761544 PMCID: PMC7408970 DOI: 10.17269/s41997-020-00341-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/11/2020] [Indexed: 12/05/2022]
Abstract
In evolutionary terms, the transformations which humans have engendered in social, ecological and built environments are increasingly out of step with their biological makeup. We briefly review the evidence on health-relevant practices and status of our Paleolithic ancestors and contrast these with current food, transportation, work and governance systems with their associated impacts on human health. As public health and planning practitioners engaged in the EcoHealth Ontario Collaborative, we argue for recognition of our hunter-gatherer nature to promote joint efforts in building sustainable and equitable community infrastructures, both built and green. Although such efforts are underway at multiple jurisdictional levels across Canada, the pace is frustratingly slow for the burden of endemic chronic diseases and global environmental change which humans face. Reminding reluctant stakeholders of the hunter-gatherers in us all could bring about deeper reflection on the urgent work in redirecting community planning.
Collapse
Affiliation(s)
- Charles Gardner
- Simcoe Muskoka District Health Unit, 15 Sperling Drive, Barrie, Ontario, L4M 6K9, Canada.
| | - Donald C Cole
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Toronto, Ontario, M5T 3M7, Canada
| | - Loretta Ryan
- Association of Local Public Health Agencies (alPHa), 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada
| |
Collapse
|
128
|
Ultra-Processed Food Consumption Is Associated with Abdominal Obesity: A Prospective Cohort Study in Older Adults. Nutrients 2020; 12:nu12082368. [PMID: 32784758 PMCID: PMC7468731 DOI: 10.3390/nu12082368] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Ultra-processed food (UPF) consumption has been associated with increased incidence of cardiovascular disease and its risk factors. The aim of this study was to assess, for the first time in the literature, the prospective association between UPF consumption and the incidence of abdominal obesity (AO) in older adults. METHODS The study sample consists of 652 participants in the Seniors Study on Nutrition and Cardiovascular Risk in Spain: Seniors-ENRICA-1 study, (mean age 67, 44% women). At baseline, standardized anthropometric measurements were collected (including abdominal circumference). After a median follow-up of six years, the abdominal circumference was measured again, and the incidence of abdominal obesity (AO) was calculated, defined as an abdominal perimeter ≥102 cm in men and ≥88 cm in women. At baseline, dietary information was collected using a computerized and validated dietary history. Information was obtained on the usual diet in the previous year. A total number of 880 foods were classified according to their degree of processing following the NOVA classification. Foods or drinks formulated mostly or entirely from substances derived from foods, with little or no presence of the unaltered original food were classified as UPF. For each participant, the percentage of energy from UPF was derived and sex-specific tertiles were calculated. Logistic regression models were built and adjusted for sociodemographic, lifestyle, morbidity, and drug treatment variables. RESULTS Among those participants without AO at baseline, 177 developed AO during follow-up. The average consumption of UPF was 17% of total energy (7% in the first tertile; 29% in the third tertile). The odds ratio (95% confidence interval) for incident AO risk when compared to the lowest tertile was: 1.55 (0.99-2.44) for the second tertile of UPF consumption and 1.62 (1.04-2.54) for the third tertile; p for linear trend: 0.037. Results remained statistically significant after adjusting for potential dietary confounding factors such as fiber consumption, the intake of very long chain omega-3 fatty acids and adherence to the Mediterranean diet. CONCLUSIONS A higher UPF consumption is positively associated with incident AO in older adults in Spain. These findings extend the current evidence of the detrimental effect of UPF consumption on cardiometabolic health.
Collapse
|
129
|
How to protect both health and food system sustainability? A holistic 'global health'-based approach via the 3V rule proposal. Public Health Nutr 2020; 23:3028-3044. [PMID: 32758320 DOI: 10.1017/s136898002000227x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To define a generic diet to protect human health and food system sustainability based on three dimensions: animal:plant ratio, degree of food processing and food diversity. DESIGN/SETTING The percentages of maximum animal and ultra-processed energy content were evaluated from scientific papers (Web of Science database) and reports from international scientific institutions. Then, a weekly French standard diet, including these percentages and food diversity (≥42 different foods), was designed to calculate adequacy to nutritional needs. RESULTS Based on traditional and scientifically based healthy diets, and on foresight scenarios for sustainable diets at horizon 2050, a median daily animal energy content intake of 15 % was found to be protective towards both human health and environment. Based on epidemiological studies associating ultra-processed energy consumption with increased overweight/obesity risk, a precautionary threshold of approximately 15 % ultra-processed energy content was observed. The French diet allows addressing all nutritional needs and other nutritional indicators such as maximum salt and simple sugar consumption, α-linolenic acid:linoleic acid ratio and essential amino acids. This diet was named the '3V rule' for Végétal (plant), Vrai (real) and Varié (varied, if possible organic, local and seasonal). This generic diet can be adapted according to regional traditions and environmental characteristics. Excluding only one dimension of it would threaten both health and food system sustainability. CONCLUSIONS Tending towards a 3V-based diet, while respecting local constraints, should allow preserving human health, environment (greenhouse gas emissions, pollution, deforestation, etc.), small farmers, animal welfare and biodiversity, culinary traditions and socioeconomics (including an alleviation of public health cost).
Collapse
|
130
|
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: 146] [Impact Index Per Article: 36.5] [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).
Collapse
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
| |
Collapse
|
131
|
Le LKD, Hay P, Ananthapavan J, Lee YY, Mihalopoulos C. Assessing the Cost-Effectiveness of Interventions That Simultaneously Prevent High Body Mass Index and Eating Disorders. Nutrients 2020; 12:nu12082313. [PMID: 32752114 PMCID: PMC7468897 DOI: 10.3390/nu12082313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/24/2020] [Accepted: 07/29/2020] [Indexed: 01/25/2023] Open
Abstract
Eating disorders (ED) are among the top three most common debilitating illnesses in adolescent females, while high Body Mass Index (BMI) is one of the five leading modifiable risk factors for preventable disease burden. The high prevalence of eating and weight-related problems in adolescence is of great concern, particularly since this is a period of rapid growth and development. Here, we comment on the current evidence for the prevention of EDs and high BMI and the importance of assessing the cost-effectiveness of interventions that integrate the prevention of EDs and high BMI in this population. There is evidence that there are effective interventions targeted at children, adolescents and young adults that can reduce the prevalence of risk factors associated with the development of EDs and high BMI concurrently. However, optimal decision-making for the health of younger generations involves considering the value for money of these effective interventions. Further research investigating the cost-effectiveness of potent and sustainable integrated preventive interventions for EDs and high BMI will provide decision makers with the necessary information to inform investment choices.
Collapse
Affiliation(s)
- Long Khanh-Dao Le
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Victoria 3125, Australia; (J.A.); (Y.Y.L.); (C.M.)
- Correspondence: ; Tel.: +61-392468383
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia;
- Camden and Campbelltown Hospital, SWSLHD, Campbelltown, NSW 2560, Australia
| | - Jaithri Ananthapavan
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Victoria 3125, Australia; (J.A.); (Y.Y.L.); (C.M.)
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Victoria 3125, Australia
| | - Yong Yi Lee
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Victoria 3125, Australia; (J.A.); (Y.Y.L.); (C.M.)
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD 4076, Australia
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Victoria 3125, Australia; (J.A.); (Y.Y.L.); (C.M.)
| |
Collapse
|
132
|
Santos FSD, Dias MDS, Mintem GC, Oliveira IOD, Gigante DP. Food processing and cardiometabolic risk factors: a systematic review. Rev Saude Publica 2020; 54:70. [PMID: 32725096 PMCID: PMC7371411 DOI: 10.11606/s1518-8787.2020054001704] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 10/24/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.
Collapse
Affiliation(s)
- Francine Silva Dos Santos
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Mariane da Silva Dias
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Gicele Costa Mintem
- Departamento de Nutrição, Faculdade de Nutrição, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Isabel Oliveira de Oliveira
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Denise Petrucci Gigante
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| |
Collapse
|
133
|
A Gluten-Free Meal Produces a Lower Postprandial Thermogenic Response Compared to an Iso-Energetic/Macronutrient Whole Food or Processed Food Meal in Young Women: A Single-Blind Randomized Cross-Over Trial. Nutrients 2020; 12:nu12072035. [PMID: 32659919 PMCID: PMC7400113 DOI: 10.3390/nu12072035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 12/15/2022] Open
Abstract
Consumption of ultra-processed food (PF) is associated with obesity risk compared with whole food (WF) intake. Less is known regarding the intake of gluten-free (GF) food products. The purpose of this study was to directly compare the thermic effect (TEM), substrate utilization, hunger/taste ratings, and glucose response of three different meals containing PF, WF, and GF food products in young healthy women. Eleven volunteers completed all three iso-caloric/macronutrient test meals in a single-blind, randomized crossover design: (1) whole food meal (WF); (2) processed food meal (PF); or (3) gluten-free meal (GF). TEM was significantly lower following GF compared with WF (−20.94 kcal/meal, [95% CI, −35.92 to −5.96], p = 0.008) and PF (mean difference: −14.94 kcal/meal, [95% CI, −29.92 to 0.04], p = 0.04), respectively. WF consumption resulted in significantly higher feelings of fullness compared to GF (mean difference: +14.36%, [95% CI, 3.41 to 25.32%], p = 0.011) and PF (mean difference: +16.81%, [95% CI, 5.62 to 28.01%], p = 0.004), respectively, and enhanced palatability (taste of meal) compared to PF meal (mean Δ: +27.41%, [95% CI, 5.53 to 49.30%], p = 0.048). No differences existed for substrate utilization and blood glucose response among trials. Consumption of a GF meal lowers postprandial thermogenesis compared to WF and PF meals and fullness ratings compared to a WF meal which may impact weight control and obesity risk over the long-term.
Collapse
|
134
|
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: 324] [Impact Index Per Article: 81.0] [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.
Collapse
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
| |
Collapse
|
135
|
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.
Collapse
|
136
|
Rauber F, Steele EM, Louzada MLDC, Millett C, Monteiro CA, Levy RB. Ultra-processed food consumption and indicators of obesity in the United Kingdom population (2008-2016). PLoS One 2020; 15:e0232676. [PMID: 32357191 PMCID: PMC7194406 DOI: 10.1371/journal.pone.0232676] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/20/2020] [Indexed: 02/01/2023] Open
Abstract
We examined the association between the consumption of ultra-processed foods and adiposity in a nationally representative sample of the UK adult population. We studied 6,143 participants (19 to 96 years, 51.6% female) sampled by the UK National Diet and Nutrition Survey (2008-16). Food items reported in four-day food diary were classified according to the NOVA system. Multiple linear and logistic regressions were used to evaluate associations between the dietary contribution of ultra-processed foods (sex-specific quartile and continuous) and Body Mass Index (BMI), Waist Circumference (WC) and obesity (BMI>30kg/m2) and abdominal obesity (men: WC≥102cm, women: WC≥88cm) status. Models were adjusted for sociodemographic and lifestyle characteristics. In multivariable analyses, the highest consumption of ultra-processed food was associated with 1.66 kg/m2 higher BMI (95%CI 0.96-2.36), 3.56 cm greater WC (95%CI 1.79-5.33) and 90% higher odds for being obese (OR = 1.90, 95%CI 1.39-2.61), compared with the lowest consumption. A 10% increase in the consumption of ultra-processed foods was associated with an increase of 0.38 kg/m2 in BMI (95%CI 0.20-0.55), 0.87 cm in WC (95%CI 0.40-1.33) and 18% higher odds of being obese (OR = 1.18, 95%CI 1.08-1.28). The consumption of ultra-processed food was associated with an increase in BMI, WC and prevalence of obesity in both sexes. A dose response relationship was observed in both sexes, with a 10% increase in the consumption of ultra-processed foods being associated with a 18% increase in the prevalence of obesity in men and a 17% increase in women. Higher consumption of ultra-processed food is associated with greater adiposity in the UK adult population. Policy makers should consider actions that promote consumption of unprocessed or minimally processed foods and reduce consumption of ultra-processed foods.
Collapse
Affiliation(s)
- Fernanda Rauber
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
- * E-mail:
| | - Eurídice Martínez Steele
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - Maria Laura da Costa Louzada
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - Christopher Millett
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brazil
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, England, United Kingdom
| | - Carlos Augusto Monteiro
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
137
|
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.
Collapse
|
138
|
Microbiological Stability and Overall Quality of Ready-To-Heat Meals Based on Traditional Recipes of the Basilicata Region. Foods 2020; 9:foods9040406. [PMID: 32244691 PMCID: PMC7230950 DOI: 10.3390/foods9040406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/24/2020] [Accepted: 03/30/2020] [Indexed: 11/16/2022] Open
Abstract
The quality of ready meals is affected by several factors that may impair stability and nutritional value. In this work, we evaluated the overall quality of four traditional meals (Basilicata region) prepared according to the cook&chill method, packaged in air or modified atmosphere packaging (MAP; 70% N2 and 30% CO2), and stored at 4 °C for seven days. The shelf-life was determined by Listeria monocytogenes challenge testing and inactivation by microwave (MW) heating was assessed. The counts at the production day were excellent in three meals out of four, whereas one had high levels of spoilage and pathogens both as soon as the preparation and after seven days. MAP was partially effective only against the growth of the aerobic mesophilic species, whereas sensory analysis revealed that MAP may preserve many of sensory attributes. The average shelf-life of the meals ranged from 11 to 13 days, however, the potential shelf-life was undetectable in one out four meals, as L. monocytogenes growth was inhibited two days after the inoculum. In the inoculated meals, MW heating provided a partial inactivation (25%) of the pathogen. The overall quality of type the meals was partially satisfactory; post-cooking contaminations may affect the microbial load and reduce the palatability over the storage period and, above all, may involve biological hazards which consumers' habits may not be able to eliminate.
Collapse
|
139
|
Blanchet R, Willows N, Johnson S, Salmon Reintroduction Initiatives ON, Batal M. Traditional Food, Health, and Diet Quality in Syilx Okanagan Adults in British Columbia, Canada. Nutrients 2020; 12:nu12040927. [PMID: 32230797 PMCID: PMC7230592 DOI: 10.3390/nu12040927] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 11/16/2022] Open
Abstract
In Canada, store-bought food constitutes the majority of First Nations (FN) people’s diets; however, their traditional foods (TF; wild fish, game, fowl, and plants) remains vital for their health. This study compares health indicators and diet quality among 265 Syilx Okanagan adults according to whether or not they reported eating TF during a 24-h dietary recall. Three methods assessed diet quality: nutrient intakes and adequacy, Healthy Eating Index (HEI-C), and contributions of ultra-processed products (UPP) to %energy using the NOVA classification. Fifty-nine participants (22%) reported eating TF during the dietary recall; TF contributed to 13% of their energy intake. There were no significant differences in weight status or prevalence of chronic disease between TF eaters and non-eaters. TF eaters had significantly higher intakes of protein; omega-3 fatty acids; dietary fibre; copper; magnesium; manganese; phosphorus; potassium; zinc; niacin; riboflavin; and vitamins B6, B12, D, and E than non-eaters. TF eaters also had significantly better diet quality based on the HEI-C and the %energy from UPP. Findings support that TF are critical contributors to the diet quality of FN individuals. Strength-based FN-led interventions, such as Indigenous food sovereignty initiatives, should be promoted to improve access to TF and to foster TF consumption.
Collapse
Affiliation(s)
- Rosanne Blanchet
- Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Correspondence: (R.B.); (N.W.); Tel.: +1-780-492-3989 (N.W.)
| | - Noreen Willows
- Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Correspondence: (R.B.); (N.W.); Tel.: +1-780-492-3989 (N.W.)
| | | | | | - Malek Batal
- Department of Nutrition, Faculty of Medicine, University of Montreal, P.O. Box 6128, succ. Centre-ville, Montreal, QC H3C 3J7, Canada;
- Centre de recherche en santé publique du Québec (CReSP), Montreal, QC H3C 3J7, Canada
| |
Collapse
|
140
|
Seale E, Greene-Finestone LS, de Groh M. Examining the diversity of ultra-processed food consumption and associated factors in Canadian adults. Appl Physiol Nutr Metab 2020; 45:857-864. [PMID: 32073881 DOI: 10.1139/apnm-2019-0518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Ultra-processed food (UPF) consumption is increasing globally at an unprecedented rate. We investigated UPF consumption among Canadian adults and associated sociodemographic and health-related factors. This study was a secondary analysis of the Foodbook study (2014-2015), which collected self-reported data on foods consumed by Canadians during a 7-day period. UPF diversity was assessed by summing the different types of UPFs consumed in the previous week to produce a diversity score. Descriptive statistics summarized UPF diversity among subgroups in Canada. Regression models identified significant associations between UPF diversity, body mass index (BMI), and sociodemographic variables. This study included 6062 participants, aged 18 years and older, representing 24.7 million Canadian adults. Almost all Canadian adults (99.0%) consumed UPFs at least once weekly. The most common UPFs consumed were chocolate, chips/pretzels, cold breakfast cereal, and fast foods. UPF diversity was greatest among men, young respondents, those with high income, and those with obesity. When controlling for potential confounders, UPF diversity for men and women was significantly associated with younger age and higher BMI; it was also associated with region for women. This study suggests UPF consumption in Canada varies across sociodemographic subgroups, but ultimately is pervasive. Further research examining potential health risks associated with UPF consumption is encouraged to inform Canadian interventions. Novelty: Almost all Canadians consume at least one type of ultra-processed food weekly. Nearly half or more Canadians consume chocolate, chips/pretzels, cold breakfast cereal, or fast food at least once weekly. Gender, age, and BMI are consistently associated with ultra-processed food diversity.
Collapse
Affiliation(s)
- Emily Seale
- Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada
| | - Linda S Greene-Finestone
- Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada.,Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada
| | - Margaret de Groh
- Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada.,Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada
| |
Collapse
|
141
|
Sartorelli DS, Crivellenti LC, Manochio-Pina MG, Baroni NF, Carvalho MR, Diez-Garcia RW, Franco LJ. Study Protocol effectiveness of a nutritional intervention based on encouraging the consumption of unprocessed and minimally processed foods and the practice of physical activities for appropriate weight gain in overweight, adult, pregnant women: a randomized controlled trial. BMC Pregnancy Childbirth 2020; 20:24. [PMID: 31910819 PMCID: PMC6947817 DOI: 10.1186/s12884-019-2672-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/11/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Evidence from observational studies suggests that a greater intake of ultra-processed foods during pregnancy is associated with a higher chance of obesity, increased gestational weight gain, and neonatal adiposity. The aim of the present study is to evaluate the effectiveness of a nutritional intervention based on encouraging the consumption of unprocessed and minimally processed foods and the practice of physical activities for appropriate weight gain in overweight, adult, pregnant women. Additionally, the effect of the intervention on pregnancy outcomes, neonatal adiposity, and the child's weight and height will be investigated. METHODS This is a two-armed parallel randomized controlled trial that will be conducted at primary health units in Ribeirão Preto, SP, Brazil. Adult pregnant women who are overweight and receiving prenatal care in the public health system will be included. The women will be randomly allocated into control (standard care) or intervention groups. Those enrolled in the intervention group will participate in three individualized nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods and the practice of physical activities. The recruitment of the participants will be carried out at seven health facilities over 12 months, with a sample of 300 women expected. Maternal anthropometric, sociodemographic, blood pressure, biochemical, and lifestyle data will be obtained at baseline (up to the 16th week of gestation), and during a second assessment (34th to 36th gestational week). The neonate body composition will be estimated after birth, and data on pregnancy outcomes, weight and height of children at 6, 12 and 24 months of age will be further obtained from medical records. DISCUSSION This will be the first randomized controlled trial to test the effectiveness of a nutritional intervention based on encouraging the consumption of unprocessed and minimally processed foods and the practice of physical activities for appropriate weight gain in adult, overweight, pregnant women. Furthermore, the effect of the intervention on pregnancy outcomes, neonatal adiposity and the child's weight and height will be evaluated. TRIAL REGISTRATION Registro Brasileiro de Ensaios Clínicos (Rebec) RBR-2w9bhc July 30th 2018 (http://www.ensaiosclinicos.gov.br/rg/?q=RBR-2w9bhc+), and RBR-7yx36h June 4th 2019 (http://www.ensaiosclinicos.gov.br/rg/?q=RBR-7yx36h+0.
Collapse
Affiliation(s)
- Daniela Saes Sartorelli
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Brazil, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
| | - Lívia Castro Crivellenti
- Graduate Program of Public Health, Ribeirão Preto Medical School, University of São Paulo, Brazil, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Marina Garcia Manochio-Pina
- Program in Health Promotion, University of Franca, Avenida Dr. Armando Salles Oliveira, 201, Franca, SP, 14404-600, Brazil
| | - Naiara Franco Baroni
- Graduate Program of Public Health, Ribeirão Preto Medical School, University of São Paulo, Brazil, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Mariana Rinaldi Carvalho
- Graduate Program of Public Health, Ribeirão Preto Medical School, University of São Paulo, Brazil, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Rosa Wanda Diez-Garcia
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Laércio Joel Franco
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Brazil, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| |
Collapse
|
142
|
Bortolini GA, Moura ALDP, de Lima AMC, Moreira HDOM, Medeiros O, Diefenthaler ICM, de Oliveira ML. [Food guides: a strategy to reduce the consumption of ultra-processed foods and prevent obesityGuías alimentarias: estrategia para reducir el consumo de alimentos ultraprocesados y prevenir la obesidad]. Rev Panam Salud Publica 2020; 43:e59. [PMID: 31892922 PMCID: PMC6913219 DOI: 10.26633/rpsp.2019.59] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/22/2019] [Indexed: 12/20/2022] Open
Abstract
A obesidade é um grave problema de saúde pública e seu aumento tem sido associado ao crescimento do consumo de ultraprocessados em diversas regiões, incluindo a América Latina. Os guias alimentares são diretrizes oficiais para a promoção da alimentação saudável e podem servir como ferramentas para a prevenção da obesidade. O Brasil foi o primeiro país a adotar o nível de processamento para classificar os alimentos e fazer recomendações a partir dessa classificação em seus guias alimentares. Assim, o objetivo deste artigo é compartilhar a experiência brasileira na incorporação de tais recomendações como diretrizes oficiais e na elaboração de guias alimentares. Para o desenvolvimento dos guias alimentares brasileiros, o Ministério da Saúde buscou valorizar a construção coletiva, com participação e discussão do conteúdo por atores estratégicos. No Guia Alimentar para Crianças Brasileiras Menores de 2 Anos houve aprimoramento do processo, com formação de um comitê gestor e um comitê de monitoramento político, chamada pública de pesquisadores e profissionais de saúde e oficinas de escuta com atores-chave para a definição do escopo do guia. O processo de validação contou com oficinas adicionais, com presença de atores estratégicos, além de oficinas em todos os estados para debate e mobilização para participação na consulta pública on-line. Como resultado do aprendizado, destacamos a importância da participação de atores estratégicos e a necessidade de dar ampla transparência ao processo de elaboração e validação de guias alimentares.
Collapse
Affiliation(s)
- Gisele Ane Bortolini
- Ministério da Saúde Coordenação Geral de Alimentação e Nutrição BrasíliaDF Brasil Ministério da Saúde, Coordenação Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| | - Ana Luisa de Paiva Moura
- Ministério da Saúde Coordenação Geral de Alimentação e Nutrição BrasíliaDF Brasil Ministério da Saúde, Coordenação Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| | - Ana Maria Cavalcante de Lima
- Ministério da Saúde Coordenação Geral de Alimentação e Nutrição BrasíliaDF Brasil Ministério da Saúde, Coordenação Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| | - Helissa de Oliveira Mendonça Moreira
- Ministério da Saúde Coordenação Geral de Alimentação e Nutrição BrasíliaDF Brasil Ministério da Saúde, Coordenação Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| | - Olivia Medeiros
- Ministério da Saúde Coordenação Geral de Alimentação e Nutrição BrasíliaDF Brasil Ministério da Saúde, Coordenação Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| | - Isabel Cristina Moutinho Diefenthaler
- Ministério da Saúde Coordenação Geral de Alimentação e Nutrição BrasíliaDF Brasil Ministério da Saúde, Coordenação Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| | - Michele Lessa de Oliveira
- Ministério da Saúde Coordenação Geral de Alimentação e Nutrição BrasíliaDF Brasil Ministério da Saúde, Coordenação Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| |
Collapse
|
143
|
Abstract
Introduction A number of studies suggest a relationship between the intake of ultra-processed foods and the prevalence of obesity. Specifically, this type of food provides large amounts of free sugars and saturated fats, which contribute to a high energy intake. In the last few decades the consumption of these products has increased to the point of representing an important amount of calories in the daily diet of several populations. As a result, foods that are usually consumed in healthy eating patterns, containing fiber, complex carbohydrates, and good fats, have been displaced. This systematic review aims to compile the information available in the literature, and to examine the scientific evidence about the relationship between ultra-processed food and obesity. Nevertheless, there are a number of limitations due to the heterogeneity of the methodologies or food classification systems used in the different studies, which makes it difficult to draw definitive conclusions on the relationship between consumption of ultra-processed food and development of obesity.
Collapse
|
144
|
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.
Collapse
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
| |
Collapse
|
145
|
Liem DG, Russell CG. The Influence of Taste Liking on the Consumption of Nutrient Rich and Nutrient Poor Foods. Front Nutr 2019; 6:174. [PMID: 31803750 PMCID: PMC6872500 DOI: 10.3389/fnut.2019.00174] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/25/2019] [Indexed: 12/27/2022] Open
Abstract
Repeated consumption of high-energy nutrient poor foods can lead to undesirable health outcomes such as obesity. Taste plays an important role in food choice, and a better understanding of the links between the taste of foods, individual taste preferences, food choices, and intakes will aid in our understanding of why some people might select and consume unhealthy foods. The present review focuses on three main questions: (1) do nutrient poor and nutrient rich foods significantly differ in taste profile? (2) are humans predisposed toward developing a liking or preference for certain taste profiles? (3) how are individual variations in liking of the basic taste qualities related to long term food intake and adverse health outcomes such as obesity? Results indicated that nutrient poor foods were likely to be sweet, salty and fatty mouthfeel, while the taste profiles of nutrient rich foods were diverse. Although humans are born with a universal liking for sweet and aversion for bitter taste, large individual differences exist in liking of all the basic taste qualities. These individual differences partly explain differences in short term intakes of foods varying in taste profiles. However they fail to sufficiently explain long term food choices and negative health outcomes such as obesity. Future studies should focus on how the full sensory profile of food which includes taste, smell and texture interacts with individual characteristics (e.g., taste or health motivations, taste preferences) to affect consumption of nutrient rich and nutrient poor foods.
Collapse
Affiliation(s)
- Djin Gie Liem
- Deakin University, Geelong VIC, Australia
- Centre for Advanced Sensory Science, School of Exercise and Nutrition Sciences, Deakin University, Geelong VIC, Australia
| | - Catherine Georgina Russell
- Deakin University, Geelong VIC, Australia
- Centre for Advanced Sensory Science, School of Exercise and Nutrition Sciences, Deakin University, Geelong VIC, Australia
| |
Collapse
|
146
|
Zupanič N, Hribar M, Fidler Mis N, Pravst I. Free Sugar Content in Pre-Packaged Products: Does Voluntary Product Reformulation Work in Practice? Nutrients 2019; 11:nu11112577. [PMID: 31717724 PMCID: PMC6893660 DOI: 10.3390/nu11112577] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 11/16/2022] Open
Abstract
Ultra-processed, pre-packaged foods are becoming a growing part of our diet, while displacing whole and minimally processed foods. This results in an increased intake of free sugar, salt, and saturated fats, that have a profoundly negative effect on health. We aimed to assess the trend in free sugar content in pre-packaged foods in Slovenia and evaluate the efficacy of industry self-regulations designed to combat the excess consumption of free sugar. A nation-wide data collection of the Slovenian food supply was performed in 2015 and repeated in 2017. In 2017, 54.5% of all products (n = 21,115) contained free sugars (median: 0.26 g free sugar/100 g). Soft drinks became the main free sugar source among pre-packaged goods (28% of all free sugar sold on the market) in place of chocolates and sweets, of which relative share decreased by 4.4%. In the categories with the highest free sugar share, market-leading brands were often sweeter than the average free sugar value of the category. This indicates that changes in on-shelf availability towards a greater number of healthier, less sweet products are not necessarily reflected in healthier consumers’ choices. Relying solely on voluntary industrial commitments to reduce free sugar consumption will likely not be sufficient to considerably improve public health. While some further improvements might be expected over the longer term, voluntarily commitments are more successful in increasing the availability of healthier alternatives, rather than improving the nutritional composition of the market-leading products. Additional activities are, therefore, needed to stimulate reformulation of the existing market-leading foods and drinks, and to stimulate the consumption of healthier alternatives.
Collapse
Affiliation(s)
- Nina Zupanič
- Nutrition Institute, Tržaška cesta 40, SI-1000 Ljubljana, Slovenia; (N.Z.); (M.H.)
| | - Maša Hribar
- Nutrition Institute, Tržaška cesta 40, SI-1000 Ljubljana, Slovenia; (N.Z.); (M.H.)
| | - Nataša Fidler Mis
- Department of Gastroenterology, Hepatology and Nutrition, University Children’s Hospital, University Medical Centre Ljubljana, Bohoričeva 20, SI-1000 Ljubljana, Slovenia;
| | - Igor Pravst
- Nutrition Institute, Tržaška cesta 40, SI-1000 Ljubljana, Slovenia; (N.Z.); (M.H.)
- Correspondence: ; Tel.: +386-590-68871; Fax: +386-310-07981
| |
Collapse
|
147
|
Martínez Leo EE, Segura Campos MR. Effect of ultra-processed diet on gut microbiota and thus its role in neurodegenerative diseases. Nutrition 2019; 71:110609. [PMID: 31837645 DOI: 10.1016/j.nut.2019.110609] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/06/2019] [Accepted: 09/23/2019] [Indexed: 02/06/2023]
Abstract
The current dietary pattern is characterized by high consumption of ultra-processed foods and lower consumption of fiber and vegetables, environmental factors that are associated directly with the current incidence of chronic metabolic diseases. Diet is an environmental factor that influences the diversity and functionality of the gut microbiota, where dietary changes have a direct action on their homeostasis. The environment created in the gut by ultra-processed foods, a hallmark of the Western diet that are recognized as trigger factors for low-grade systemic inflammatory and oxidative changes, favor the development of neurodegenerative diseases (NDs). From a systematic search, the present review analyzes the relationship and effect of the current feeding pattern, with the dysregulation of the microbiota and its influence on the development of cognitive decline. Because diagnosis of NDs is usually at late stages, this review highlights the importance of a search for stricter public health strategies regarding access to and development of ultra-processed foods.
Collapse
Affiliation(s)
- Edwin E Martínez Leo
- Facultad de Ingeniería Química, Universidad Autónoma de Yucatán, Periférico Norte Yucatán, México
| | - Maira R Segura Campos
- Facultad de Ingeniería Química, Universidad Autónoma de Yucatán, Periférico Norte Yucatán, México.
| |
Collapse
|
148
|
Vegetarianism and other eating practices among youth and young adults in major Canadian cities. Public Health Nutr 2019; 23:609-619. [DOI: 10.1017/s136898001900288x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AbstractObjective:To estimate the prevalence and sociodemographic characteristics of youth and young adults in major Canadian cities with self-reported vegetarian dietary practices and examine efforts to alter their diets.Design:Data were collected in autumn 2016 via web-based surveys. Respondents reported vegetarian dietary practices (vegan, vegetarian or pescatarian) and efforts in the preceding year to consume more or less of several nutrients, food groups and/or foods with particular attributes. Logistic regression models examined sociodemographic correlates of each vegetarian dietary practice and differences in other eating practices by diet type.Setting:Participants were recruited from five major Canadian cities.Participants:Youth and young adults, aged 16–30 years (n 2566).Results:Overall, 13·6 % of respondents reported vegetarian dietary practices: 6·6 % vegetarian, 4·5 % pescatarian and 2·5 % vegan. Sex, race/ethnicity, self-reported frequency of using the Nutrition Facts table and health literacy were significantly correlated with self-reported vegetarian dietary practice (P < 0·01 for all). Efforts to consume more fruits and vegetables (66·8 %) and protein (54·8 %), and less sugar (61·3 %) and processed foods (54·7 %), were prevalent overall. Respondents with vegetarian dietary practices were more likely to report efforts to consume fewer carbohydrates and animal products, and more organic, locally produced, ethically sourced/sustainably sourced/fair trade and non-GM foods (P < 0·01 for all), compared with those without these reported dietary practices.Conclusions:Nearly 14 % of the sampled youth and young adults in major Canadian cities reported vegetarian dietary practices and may be especially likely to value and engage in behaviours related to health-conscious diets and sustainable food production.
Collapse
|
149
|
Brassard D, Laramée C, Provencher V, Vohl MC, Robitaille J, Lemieux S, Lamarche B. Consumption of low nutritive value foods and cardiometabolic risk factors among French-speaking adults from Quebec, Canada: the PREDISE study. Nutr J 2019; 18:49. [PMID: 31466524 PMCID: PMC6716857 DOI: 10.1186/s12937-019-0474-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/15/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND There is very limited knowledge on the magnitude to which foods with low nutritive value constitute the diet of adults from the province of Quebec. The extent to which these foods impact cardiometabolic risk is also poorly documented. The objective was to assess the contribution of low nutritive value foods to total energy intake (E) and to examine associations with cardiometabolic risk factors among French-speaking adults from 5 administrative regions of the Province of Quebec. METHODS As part of the cross-sectional PREDISE Study, 1147 adults (50.2% women; mean [SD] age, 43.2 [4.6] years) participated in a web-based investigation. Dietary intake data were obtained using a validated web-based self-administered 24-h recall, the R24W, completed on three occasions. Foods with low nutritive value were defined as foods exceeding predetermined thresholds for the following nutrients: saturated fat, sugar or sodium as well as beverages and ingredients not recommended in Canada's Food Guide 2019. A total of 1019 participants underwent on-site clinical assessment of cardiometabolic risk factors. RESULTS Participants consumed on average 29.0%E (95%CI, 28.2-29.7) as low nutritive value foods, to which pastries (18%), alcohol (15%), sweets (13%), chips/popcorn (6%) and sugar-sweetened beverages (6%) contributed the most. Low nutritive value foods contributed more to total E in men than in women (30.7%E vs. 27.5%E, respectively; P < 0.0001). In fully-adjusted linear regression models, increments of 250 kcal/d from low nutritive value foods were associated with higher body mass index (+ 1.7 kg/m2; 95%CI 1.2 to 2.2), higher waist circumference (+ 0.6 cm; 95%CI, 0.1 to 1.1), cholesterol: HDL cholesterol ratio (+ 0.12 mmol/L; 95%CI, 0.01 to 0.24 and triglycerides (+ 7.8%; 95%CI, 3.0 to 12.8). CONCLUSIONS Low nutritive value foods contribute near 30% of total daily energy intake of French-speaking adults of the Province of Quebec and are associated with increased waist circumference and an unfavourable lipid profile. Addressing consumption of low nutritive value foods at the population level is a potential strategy to attenuate the burden of chronic diseases.
Collapse
Affiliation(s)
- Didier Brassard
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Université Laval, Quebec City, Canada
- School of Nutrition, Université Laval, Quebec City, Canada
| | - Catherine Laramée
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Université Laval, Quebec City, Canada
| | - Véronique Provencher
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Université Laval, Quebec City, Canada
- School of Nutrition, Université Laval, Quebec City, Canada
| | - Marie-Claude Vohl
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Université Laval, Quebec City, Canada
- School of Nutrition, Université Laval, Quebec City, Canada
| | - Julie Robitaille
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Université Laval, Quebec City, Canada
- School of Nutrition, Université Laval, Quebec City, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Université Laval, Quebec City, Canada
- School of Nutrition, Université Laval, Quebec City, Canada
| | - Benoît Lamarche
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Université Laval, Quebec City, Canada
- School of Nutrition, Université Laval, Quebec City, Canada
| |
Collapse
|
150
|
Machado PP, Steele EM, Levy RB, Sui Z, Rangan A, Woods J, Gill T, Scrinis G, Monteiro CA. Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study. BMJ Open 2019; 9:e029544. [PMID: 31462476 PMCID: PMC6720475 DOI: 10.1136/bmjopen-2019-029544] [Citation(s) in RCA: 139] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/27/2019] [Accepted: 07/10/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE This study aimed to describe the consumption of ultra-processed foods in Australia and its association with the intake of nutrients linked to non-communicable diseases (NCDs). DESIGN Cross-sectional study. SETTING National Nutrition and Physical Activity Survey (2011-2012). PARTICIPANTS 12,153 participants aged 2+ years. MAIN OUTCOME MEASURES Average dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs. DATA ANALYSIS Food items were classified according to the NOVA system, a classification based on the nature, extent and purpose of industrial food processing. The contribution of each NOVA food group and their subgroups to total energy intake was calculated. Mean nutrient content of ultra-processed food and non-ultra-processed food fractions of the diet were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of nutrients linked to NCDs as well as in the prevalence of intakes outside levels recommended for the prevention of NCDs were examined. RESULTS Ultra-processed foods had the highest dietary contribution (42.0% of energy intake), followed by unprocessed or minimally processed foods (35.4%), processed foods (15.8%) and processed culinary ingredients (6.8%). A positive and statistically significant linear trend was found between quintiles of ultra-processed food consumption and intake levels of free sugars (standardised β 0.43, p<0.001); total (β 0.08, p<0.001), saturated (β 0.18, p<0.001) and trans fats (β 0.10, p<0.001); sodium (β 0.21, p<0.001) and diet energy density (β 0.41, p<0.001), while an inverse relationship was observed for dietary fibre (β -0.21, p<0.001) and potassium (β -0.27, p<0.001). The prevalence of non-recommended intake levels of all studied nutrients increased linearly across quintiles of ultra-processed food intake, notably from 22% to 82% for free sugars, from 6% to 11% for trans fat and from 2% to 25% for dietary energy density, from the lowest to the highest ultra-processed food quintile. CONCLUSION The high energy contribution of ultra-processed foods impacted negatively on the intake of non-ultra-processed foods and on all nutrients linked to NCDs in Australia. Decreasing the dietary share of ultra-processed foods would substantially improve the diet quality in the country and help the population achieve recommendations on critical nutrients linked to NCDs.
Collapse
Affiliation(s)
- Priscila P Machado
- Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Euridice M Steele
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Renata B Levy
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Zhixian Sui
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Anna Rangan
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Julie Woods
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Tim Gill
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Gyorgy Scrinis
- School of Agriculture and Food, The University of Melbourne, Melbourne, Victoria, Australia
| | - Carlos A Monteiro
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|