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Respective contribution of ultra-processing and nutritional quality of foods to the overall diet quality: results from the NutriNet-Santé study. Eur J Nutr 2023; 62:157-164. [PMID: 35925444 DOI: 10.1007/s00394-022-02970-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/18/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Both the nutritional quality of the foods consumed (as nutrient composition) and their ultra-processed nature have been linked to health risks. However, the respective contribution of each of these correlated dimensions or their synergy to the overall diet quality has been rarely explored. OBJECTIVE To identify the respective effects of the nutritional quality of the foods consumed, the ultra-processed nature of foods and their cross-effect contributing to the overall quality of the diet. DESIGN Cross-sectional observational study. SETTING Web-based French NutriNet-Santé cohort study. PARTICIPANTS Participants in the NutriNet-Santé cohort study with at least three available 24 h records as baseline dietary data (N = 98 454 participants). MAIN OUTCOME MEASURES The overall quality of the diet (qualified using the adherence to the 2017 French national nutrition and health dietary recommendations dietary score PNNS-GS2) was broken down into: (1) an effect of the nutritional quality of the foods consumed (qualified using the modified Foods Standards Agency nutrient profile model (underlying the Nutri-Score) dietary index FSAm-NPS DI); (2) an effect of the ultra-processed nature of the foods consumed (qualified using the proportion of ultra-processed foods consumed UPFp using the NOVA classification), and (3) a cross-effect of both dimensions. RESULTS The overall effect from the 'nutritional quality of the foods consumed' (FSAm-NPS DI) was 1.10, corresponding to 26% of the total effect; the overall effect from ultra-processed foods consumption was 1.29, corresponding to 30% of the total effect; and cross-effect between nutritional quality of the foods consumed and ultra-processing was at 1.91, corresponding to 44% of total effects. CONCLUSIONS Our study provides support to the postulate that nutritional quality and ultra-processing should be considered as two correlated but distinct and complementary dimensions of the diet.
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Park AH, Kulchar RJ, Susarla SM, Turton B, Sokal-Gutierrez K. Fewer Children in Families Associated with Lower Odds of Early Childhood Caries: A Sample from Three Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2195. [PMID: 36767562 PMCID: PMC9916343 DOI: 10.3390/ijerph20032195] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Childhood caries experience is influenced by family characteristics and oral health practices in the context of many social-commercial determinants. The aim of this study was to explore the relationship between families' number of children, oral health practices and child caries experience in a convenience sample of 1374 children aged 6 months through 6 years and their families from Ecuador, Nepal, and Vietnam. Data were collected by mother interviews and child dental exams. Multivariate logistic and Zero-Inflated-Poisson regression analyses assessed associations between number of children, oral health practices and decayed, missing or filled teeth (dmft). Families had a mean of 2.2 children (range 1-12); 72% of children had tooth decay, with mean dmft of 5.4. Adjusting for child age, sex, and urban/rural location, a greater number of children in the family was associated with significantly less likelihood of unhealthy bottle feeding practices, having a toothbrush/toothpaste and parent helping child brush, and being cavity-free; higher number of dmft, and greater likelihood of having a dental visit. Early childhood oral health promotion should include focus on oral hygiene and healthy feeding-particularly breastfeeding and healthy bottle feeding practices-as well as access to family planning services and support for childcare.
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Affiliation(s)
- Amy H. Park
- Rausser College of Natural Resources, University of California, Berkeley, CA 94704, USA
| | - Rachel J. Kulchar
- Department of Chemistry, Princeton University, Princeton, NJ 08544, USA
| | | | - Bathsheba Turton
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA
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Weinstein G, Vered S, Ivancovsky-Wajcman D, Ravona-Springer R, Heymann A, Zelber-Sagi S, Shahar DR, Beeri MS. Consumption of Ultra-Processed Food and Cognitive Decline among Older Adults With Type-2 Diabetes. J Gerontol A Biol Sci Med Sci 2023; 78:134-142. [PMID: 35305016 PMCID: PMC9879751 DOI: 10.1093/gerona/glac070] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption is related to increased morbidity and mortality. However, knowledge on its association with cognitive function is lacking. In this longitudinal study, we examined the associations between UPF intake and cognitive decline in older adults with type-2 diabetes (T2D). METHODS The sample included initially nondemented T2D older adults (≥65 years), from the Israel Diabetes and Cognitive Decline study, who had complete information on nutrition at baseline and at least 3 cognitive assessments (mean follow-up 5.3 ± 1.5 years). Nutritional intake was evaluated by a validated Food-Frequency Questionnaire, and foods were categorized as UPF based on NOVA classification. Percent of calories from UPF were calculated from total caloric consumption in total and specific food groups. Mixed effect models were used to examine the link between UPF intake (top vs bottom quartiles) and change in cognitive function overall and in specific domains, adjusting for potential confounders. RESULTS Of the total sample (N = 568; mean age 71.3 ± 4.5 years, 60% men), 141 consumed >31% kcal from UPF (top quartile). Greater intake of ultra-processed meat was associated with a faster decline in executive functions and global cognition (β = -0.041 ± 0.013; p = .002 and β = -0.026 ± 0.010; p = .011, respectively). Additionally, consumption of ultra-processed oils/spreads was associated with faster decline in executive functions and global cognition (β = -0.037 ± 0.014; p = .006 and β = -0.028 ± 0.010; p = .009, respectively). Total UPF consumption and UPF-derived from dairy products and bread/pastries/starch were not associated with cognitive change. CONCLUSION This study suggests that a high intake of ultra-processed meat and oils/spreads may be associated with accelerated cognitive decline in older individuals with T2D.
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Affiliation(s)
| | - Shiraz Vered
- School of Public Health, University of Haifa, Haifa, Israel
| | - Dana Ivancovsky-Wajcman
- Liver Unit, Department of Gastroenterology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Ramit Ravona-Springer
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Israel
| | - Anthony Heymann
- Sackler School of Medicine, Tel-Aviv University, Israel
- Maccabi Healthcare Services, Tel-Aviv, Israel
| | - Shira Zelber-Sagi
- School of Public Health, University of Haifa, Haifa, Israel
- Liver Unit, Department of Gastroenterology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Danit Rivka Shahar
- Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat-Gan, Israel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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204
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Maternal sociodemographic factors and their association with ultra-processed foods consumption among children. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-022-01809-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Interlinkages between Climate Change and Food Systems: The Impact on Child Malnutrition-Narrative Review. Nutrients 2023; 15:nu15020416. [PMID: 36678287 PMCID: PMC9865989 DOI: 10.3390/nu15020416] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023] Open
Abstract
The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning child diet and nutritional status, focusing on the interactions with climate and food systems. Inadequate infant and young child feeding practices, food insecurity, poverty, and limited access to health services are the leading causes of malnutrition across generations. Food system industrialization and globalization lead to a double burden of malnutrition, whereby undernutrition (i.e., stunting, wasting, and deficiencies in micronutrients) coexists with overweight and obesity, as well as to harmful effects on climate. Climate change and the COVID-19 pandemic are worsening child malnutrition, impacting the main underlying causes (i.e., household food security, dietary diversity, nutrient quality, and access to maternal and child health), as well as the social, economic, and political factors determining food security and nutrition (livelihoods, income, infrastructure resources, and political context). Existing interventions have the potential to be further scaled-up to concurrently address undernutrition, overnutrition, and climate change by cross-cutting education, agriculture, food systems, and social safety nets. Several stakeholders must work co-operatively to improve global sustainable nutrition.
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206
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Wood B, Sacks G. The influence of share buybacks on ill-health and health inequity: an exploratory analysis using a socio-ecological determinants of health lens. Global Health 2023; 19:3. [PMID: 36631805 PMCID: PMC9832402 DOI: 10.1186/s12992-023-00905-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Share buybacks, when a corporation buys back its own shares, are recognised as having potentially harmful impacts on society. This includes by contributing to economic inequalities, and by impeding investments with the potential to protect and promote the welfare of various stakeholders. Share buybacks, however, have received minimal analytical attention in the public health literature. This paper aimed to explore the potential influence of share buybacks on population health and health inequity using a socio-ecological determinants of health lens. METHODS We conducted a descriptive analysis of share buybacks made by corporations listed on United States (US) stock exchanges between 1982 and 2021, using quantitative data sourced from Compustat. We examined annual trends in share buyback expenditure, including comparisons to dividend, net income, capital expenditure, and research and development expenditure data. We then purposively sampled a set of corporations to provide illustrative examples of how share buybacks potentially influence key socio-ecological determinants of health. The examples were: i) three COVID-19 vaccine manufacturers; ii) five of the world's largest fossil fuel corporations; and iii) US car manufacturer General Motors. For these, we conducted an analysis of data from Compustat, company reports and grey literature materials, focusing on key sources of profits and their allocation to share buybacks and particular investments. RESULTS US-listed corporations spent an estimated US$9.2 trillion in real terms on share buybacks between 2012 and 2021 (nearly 12 times more than from 1982 to 1991). The contribution of share buybacks to total shareholder 'returns' increased from 11% in 1982 to 55% in 2021, with expenditure on shareholder returns increasing considerably relative to capital, research and development expenditure over this period. The three examples illustrated how some corporations have prioritised the short-term financial interests of their shareholders, including via implementing large share buyback programs, over investments with considerable potential to protect and promote the public's health. CONCLUSION The potentially substantial impacts of share buybacks on health warrant increased research and policy attention. Arguably, more must be done to regulate share buybacks as part of efforts to address the corporate drivers of ill-health and inequity.
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Affiliation(s)
- Benjamin Wood
- Global Centre for Preventive Health and Nutrition, Deakin University, Institute for Health Transformation, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Gary Sacks
- grid.1021.20000 0001 0526 7079Global Centre for Preventive Health and Nutrition, Deakin University, Institute for Health Transformation, 221 Burwood Highway, Burwood, VIC 3125 Australia
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Paula WO, Gonçalves VSS, Patriota ESO, Franceschini SCC, Pizato N. Impact of Ultra-Processed Food Consumption on Quality of Diet among Brazilian Pregnant Women Assisted in Primary Health Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1015. [PMID: 36673771 PMCID: PMC9859486 DOI: 10.3390/ijerph20021015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 05/14/2023]
Abstract
The quality of diet and nutritional status during pregnancy are crucial to optimize maternal and fetal health. Ultra-processed foods (UPFs) are increasingly prevalent in pregnancy groups despite being nutritionally unbalanced and associated with adverse perinatal outcomes. This cross-sectional study, conducted with data from 229 pregnant women, aimed to investigate the association between UPFs consumption and dietary nutrient intake of pregnant women assisted by Primary Health Care (PHC) in Federal District (DF), Brazil. Food consumption was assessed through two non-consecutive 24-h food records and categorized by the extent of processing using the NOVA classification. Multivariate linear regression models were used to analyze the association between the quintiles of UPF consumption and the total energy and nutrients intake. Mean daily energy intake was 1741 kcal, with 22.6% derived from UPFs. Greater UPF consumption was associated with reduced intake of unprocessed and minimally processed food. The highest quintile of UPFs was positively associated with higher total energy, trans fat, and sodium intake; and inversely associated with the diet content of protein, fiber, iron, magnesium, potassium, copper, zinc, selenium, and folate. Greater UPFs intake negatively impacts the nutritional quality of the diet and impoverishes the nutrient intake of pregnant women. Reducing UPF consumption may broadly improve dietary guidelines adherence in pregnant women and promote maternal and neonatal health.
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Affiliation(s)
- Walkyria O. Paula
- Graduate Program in Human Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
| | - Vivian S. S. Gonçalves
- Graduate Program in Public Health, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
| | - Erika S. O. Patriota
- Graduate Program in Public Health, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
| | | | - Nathalia Pizato
- Graduate Program in Human Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
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Pereyra González I, Farías-Antúnez S, Buffarini R, Gómez Ayora A, Fletcher AM, Rodrigues Domingues M, Freitas da Silveira M, Ferreira Umpiérrez AH. Ultra-processed food consumption and the incidence of obesity in two cohorts of Latin-American young children: A longitudinal study. J Pediatr Nurs 2023; 69:e120-e126. [PMID: 36604255 DOI: 10.1016/j.pedn.2022.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/03/2022] [Accepted: 12/19/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE We evaluated the potential associations between the consumption of ultra-processed food (UPF) and the incidence of obesity among Uruguayan and Brazilian preschoolers. DESIGN AND METHODS We conducted a longitudinal analysis using data from preschool children from Uruguay and Brazil. The "Health, child development and nutritional survey" (ENDIS) was conducted in Uruguay in 2013-2014 and 2015-2016. The Brazilian survey (Pelotas 2015 Birth Cohort) has measures from 2017 and 2019. The main outcome measure was obesity defined as body mass index (BMI) for age and sex ≥ +3 z-scores. The score of UPF consumption was the main exposure measured. Multilevel crude and adjusted Poisson regressions were performed to estimate risk ratios and the respective 95% Confidence Intervals (95% CI). RESULTS The overall incidence of obesity in this group of young Latin-American children with a mean age of 48 months was 4.1%. We observed a relationship between UPF and obesity with statistical significance (RR: 1.10 (95% CI, 1.02-1.18). Adjustment for weight at birth, age, sex, breastfeeding, country, and time between waves resulted in a similar relationship but lack of statistical significance. CONCLUSIONS Whilst in this study we did not find strong evidence of an association between the incidence of obesity and the intake at baseline and currently of UPF, results suggest that higher UPF consumption is more favorable than reduced consumption for the development of obesity. PRACTICE IMPLICATIONS The present study reinforces the importance of nutrition education and more effective public policies for promoting healthier food choices in early childhood.
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Affiliation(s)
- Isabel Pereyra González
- Faculty of Health Sciences, Catholic University of Uruguay, Uruguay; Faculty of Health Sciences, Catholic University of Maule, Chile.
| | | | - Romina Buffarini
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Andrea Gómez Ayora
- Faculty of Medicine, Center for Interdisciplinary Ethnography - Kaleidos, University of Cuenca, Ecuador
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209
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Fajardo VC, Barreto SM, Coelho CG, Haueisen Sander Diniz MDF, Bisi Molina MDC, Pinho Ribeiro AL, Telles RW. Ultra-processed foods: Cross-sectional and longitudinal association with uric acid and hyperuricemia in ELSA-Brasil. Nutr Metab Cardiovasc Dis 2023; 33:75-83. [PMID: 36411223 DOI: 10.1016/j.numecd.2022.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND AIMS Food intake influences uric acid (UA) levels and hyperuricemia (HU), but evidence on the role of ultra-processed foods (UPFs) are scarce. The association between UPFs consumption and (1) HU prevalence and UA levels; (2) HU cumulative incidence; and (3) UA level change over a 4-year period was investigated. METHODS AND RESULTS Cross-sectional and longitudinal analyses were performed using baseline (2008-2010, aged 35-74 years) and second visit (2012-2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants with glomerular filtration rate <60 mL/min/1.73 m2, bariatric surgery, implausible caloric intake, and using urate-lowering therapy (ULT) at baseline were excluded (all analyses). Participants with HU at baseline were excluded from longitudinal analyses. UPFs consumption was assessed using a food frequency questionnaire (FFQ) and categorized by the NOVA classification system (100 g/day). HU was defined as UA≥6.8 mg/dL. Linear, logistic, and mixed-effect linear regressions investigated the associations between UPFs consumption and UA/HU, adjusted for covariates. The final samples included 13,923 (cross-sectional) and 10,517 (longitudinal) individuals. The prevalence of HU was 18.7%, and the cumulative incidence was 4.9%. Greater UPFs consumption was associated with a greater prevalence of HU (OR:1.025 95%CI: 1.006; 1.044) and higher UA levels (β:0.024 95%CI: 0.016; 0.032). Every additional consumption of 100 g/day of UPFs raised the 4-year cumulative incidence of HU by 5.6% (95%CI: 1.021; 1.092). However, UPFs were not associated with the pace of UA level changes during the study period. CONCLUSION The present study shows that greater UPFs consumption is associated with another deleterious health consequence: higher UA levels and the risk of having HU.
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Affiliation(s)
- Virgínia Capistrano Fajardo
- Post-graduate Program in Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sandhi Maria Barreto
- Department of Preventive Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carolina Gomes Coelho
- Department of Preventive Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria de Fátima Haueisen Sander Diniz
- Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Antônio Luiz Pinho Ribeiro
- Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Telehealth Center, Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rosa Weiss Telles
- Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Rheumatology Service, Hospital das Clínicas da UFMG-Ebserh, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Characterization of Hypolipidemic Phenol Analogues from Fermented Tea by Eurotium cristatum. Foods 2022; 12:foods12010049. [PMID: 36613264 PMCID: PMC9818934 DOI: 10.3390/foods12010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Fuzhuan brick tea (FBT), a type of black tea, is a traditional beverage in China, especially popular among frontier ethnic groups. FBT is well-known for its health benefits, such as hypoglycemic, anti-hypertensive, anti-inflammatory, diuretic, and detoxification effects. Nevertheless, the underlying mechanisms on the molecular level are still elusive and the key compounds responsible for the health benefits are unidentified. Previous studies have mainly focused on functional studies of the water extract. However, FBT is typically cooked with butter or milk. Therefore, we hypothesized that some lipophilic components in FBT, which can be absorbed through the co-consumption of butter or milk, may play an important role in the health benefits. The present study aimed to investigate whether the liposoluble extract of FBT alleviates symptoms related to metabolic diseases and to identify the active compounds involved. By comparing the high-performance liquid chromatography (HPLC) profiles of water, milk and hexane extract, some low polarity peaks were observed in the milk and hexane extracts. Furthermore, the hexane extract treatment alleviated body weight gain, serum total cholesterol and triglyceride levels, and inhibited the accumulation of hepatic fat granules in a high-fat diet (HFD)-induced C57BL/6N mouse model. In order to identify the key functional lipophilic compounds in FBT, the hexane extract of FBT was subjected to chemical characterization. Four phenol analogs were characterized, namely, isodihydroauroglaucin (1), dihydroauroglaucin (2), tetrahydroauroglaucin (3), and flavoglaucin (4). Compounds 1 and 4 reduced the levels of total cholesterol and triglyceride in vivo. Both compounds also inhibited the high-fat diet-induced body weight gain and accumulation of fat granules in the liver of C57BL/6N mice. Isodihydroauroglaucin and flavoglaucin have therefore been identified as bioactive ingredients that contribute to the health benefits of FBT.
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211
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Monteiro CA, Astrup A. Does the concept of "ultra-processed foods" help inform dietary guidelines, beyond conventional classification systems? YES. Am J Clin Nutr 2022; 116:1476-1481. [PMID: 35670127 DOI: 10.1093/ajcn/nqac122] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The recommendation to prefer unprocessed/minimally processed foods and freshly made meals instead of ultra-processed foods (following the Nova food classification system) is being increasingly adopted in new official dietary guidelines issued by national governments and international health associations. This recommendation is supported by systematic reviews and meta-analyses of nationally representative dietary surveys and long-term cohort studies. These data show that increased intake of ultra-processed foods is associated with poor-quality diets and with increased morbidity and mortality from several chronic diseases. Various attributes of ultra-processed foods acting through known, plausible, or suggested physiologic and behavioral mechanisms relate them to ill health, and it is likely that different combinations of attributes and mechanisms affect different health outcomes. Although more research should be done to identify these mechanisms, existing evidence is sufficient to recommend the avoidance of ultra-processed foods to optimize health and policies to support and make feasible this recommendation.
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Affiliation(s)
- Carlos A Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Arne Astrup
- Obesity and Nutrition Science, Novo Nordisk Foundation, Hellerup, Denmark
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212
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Koenen MF, Balvert M, Fleuren H. Bi-objective goal programming for balancing costs vs. nutritional adequacy. Front Nutr 2022; 9:1056205. [PMID: 36590216 PMCID: PMC9798409 DOI: 10.3389/fnut.2022.1056205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Linear programming (LP) is often used within diet optimization to find, from a set of available food commodities, the most affordable diet that meets the nutritional requirements of an individual or (sub)population. It is, however, not always possible to create a feasible diet, as certain nutritional requirements are difficult to meet. In that case, goal programming (GP) can be used to minimize deviations from the nutritional requirements in order to obtain a near feasible diet. With GP the cost of the diet is often overlooked or taken into account using the ε-constraint method. This method does not guarantee to find all possible trade-offs between costs and nutritional deficiency without solving many uninformative LPs. Methods We present a method to find all trade-offs between any two linear objectives in a dietary LP context that is simple, does not solve uninformative LPs and does not need prior input from the decision maker (DM). This method is a bi-objective algorithm based on the NonInferior Set Estimation (NISE) method that finds all efficient trade-offs between two linear objectives. Results In order to show what type of insights can be gained from this approach, two analyses are presented that investigate the relation between cost and nutritional adequacy. In the first analysis a diet with a restriction on the exact energy intake is considered where all nutrient intakes except energy are allowed to deviate from their prescription. This analysis is especially helpful in case of a restrictive budget or when a nutritionally adequate diet is either unaffordable or unattainable. The second analysis only relaxes the exact energy intake, where the other nutrients are kept within their requirements, to investigate how the energy intake affects the cost of a diet. Here, we describe in what situations the so-called more-for-less paradox takes place, which can be induced by requiring an exact energy intake. Conclusion To the best of our knowledge, we are the first to address how to obtain all efficient trade-offs of two linear objectives in a dietary LP context and how this can be used for analyses.
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Affiliation(s)
- Melissa F. Koenen
- Zero Hunger Lab, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands,Department of Econometrics and Operations Research, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands,*Correspondence: Melissa F. Koenen
| | - Marleen Balvert
- Zero Hunger Lab, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands,Department of Econometrics and Operations Research, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands
| | - Hein Fleuren
- Zero Hunger Lab, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands,Department of Econometrics and Operations Research, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands
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Nel JH, Steyn NP. The Nutrition Transition and the Double Burden of Malnutrition in Sub-Saharan African Countries: How Do These Countries Compare with the Recommended LANCET COMMISSION Global Diet? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16791. [PMID: 36554669 PMCID: PMC9779835 DOI: 10.3390/ijerph192416791] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Over the last two decades, many sub-Saharan African (SSA) countries have undergone dietary and nutrition transitions fuelled by rapid urbanisation, economic development, and globalisation. The aim of the current study was to examine outcomes of the nutrition transition and the epidemiologic transition in SSA countries in terms of food intake, health, and socioeconomic and development factors. METHODS Food balance sheet data-specifically, per capita energy intake per day and per capita gram intake per day-from the CountrySTAT framework of the Food and Agricultural Organization (FAO) were analysed for major food commodities. Additionally, selected health and development indicators supplied by UNICEF, the WHO and the World Bank were analysed. RESULTS Four dietary patterns emerged. The diet of the southern African/island cluster (South Africa, Mauritius, Eswatini, Namibia, Cabo Verde, and the outlier Seychelles) resembles a Westernised diet, with median values high on sugar/sweeteners, alcohol, meat, animal fats, eggs, and dairy. On the other hand, the diet of countries in the other three clusters appears to be more traditional, with countries in the desert/semi-arid cluster consuming more cereals and pulses/tree nuts, countries in the tropical coastal cluster consuming more fish and vegetable oils, and countries in the equatorial cluster consuming more starchy roots and fruit and vegetables. The resulting median values of health indicators also indicate a higher prevalence of non-communicable diseases in the southern African/island cluster, whereas stunting and anaemia are higher in the other three clusters. CONCLUSIONS SSA countries are in different stages of the nutrition transition. By superimposing clusters generated using macronutrient intake values on a map of the climatic regions in Africa, one can clearly see the importance of climate on the availability of food and food intake patterns. Climate change presents a great challenge to healthy eating, as the link between climate regions and diets is illustrated.
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Affiliation(s)
- Johanna H. Nel
- Department of Logistics, Stellenbosch University, Stellenbosch 7600, South Africa
| | - Nelia P. Steyn
- Department of Human Biology, University of Cape Town, UCT Medical Campus, Anzio Road, Anatomy Building, Observatory, Cape Town 7925, South Africa
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Jacobs I, Taljaard-Krugell C, Wicks M, Cubasch H, Joffe M, Laubscher R, Romieu I, Levy RB, Rauber F, Biessy C, Rinaldi S, Huybrechts I. Degree of food processing and breast cancer risk in black urban women from Soweto, South African: the South African Breast Cancer study. Br J Nutr 2022; 128:2278-2289. [PMID: 35109954 PMCID: PMC9346100 DOI: 10.1017/s0007114522000423] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/14/2022] [Accepted: 01/31/2022] [Indexed: 12/30/2022]
Abstract
This study aimed to investigate the association between consumption of ultra-processed foods, whole foods and breast cancer risk in black women from Soweto, South Africa. A population-based case (n 396)-control (n 396) study matched on age and residence, using data from the South African Breast Cancer study. Dietary intake was assessed using a validated quantified FFQ. Food items were categorised using the NOVA system ((1) unprocessed/minimally processed foods, (2) culinary ingredients, (3) processed foods and (4) ultra-processed foods). Conditional logistic regression models were used to estimate OR and 95 % CI of dietary contributions from each NOVA food group (as a percentage of total energy intake (EI)) and adjusting for potential confounders. Considering contributions to total EI per day, ultra-processed food consumption contributed to 44·8 % in cases and 47·9 % in controls, while unprocessed/minimally processed foods contributed to 38·8 % in cases and 35·2 % in controls. Unprocessed/minimally processed food consumption showed an inverse association with breast cancer risk overall (OR = 0·52, 95 % CI 0·35, 0·78), as well as in pre- and postmenopausal women separately (OR = 0·52, 95 % CI 0·27, 0·95 and OR = 0·55, 95 % CI 0·35, 0·89, respectively) and in women with progesterone positive breast cancer (OR = 0·23, 95 % CI 0·06, 0·86). There was no heterogeneity in association with breast cancer when analyses were stratified according to BMI. No significant associations were observed for the consumption of other NOVA food groups. Intake of unprocessed/minimally processed foods may reduce the risk of developing breast cancer in black women from Soweto, South Africa.
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Affiliation(s)
- Inarie Jacobs
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Christine Taljaard-Krugell
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Mariaan Wicks
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Herbert Cubasch
- Department of Surgery, Faculty of Health Sciences, University of Witwatersrand, Private Bag X2600, Houghton, Johannesburg2041, South Africa
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Parktown, Johannesburg2193, South Africa
| | - Maureen Joffe
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Parktown, Johannesburg2193, South Africa
- MRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Private Bag X3, Johannesburg2050, South Africa
| | - Ria Laubscher
- South African Medical Research Council, PO Box 19070, Tygerberg, Cape Town, 7505South Africa
| | - Isabelle Romieu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, CP 62100, Cuernavaca, Morelos, México
- Hubert Department of Global Health, Emory University, Atlanta, GA30329, USA
| | - Renata B. Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo (FMUSP), São Paulo, SP01246-903, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo, SP01246-904, Brazil
| | - Fernanda Rauber
- Department of Preventive Medicine, School of Medicine, University of São Paulo (FMUSP), São Paulo, SP01246-903, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo, SP01246-904, Brazil
| | - Carine Biessy
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, IARC-WHO 150 cours Albert Thomas, 69372Lyon, France
| | - Sabina Rinaldi
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, IARC-WHO 150 cours Albert Thomas, 69372Lyon, France
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, IARC-WHO 150 cours Albert Thomas, 69372Lyon, France
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Lawrence M. Ultra-processed foods: a fit-for-purpose concept for nutrition policy activities to tackle unhealthy and unsustainable diets. Br J Nutr 2022; 129:1-4. [PMID: 36514813 PMCID: PMC10197079 DOI: 10.1017/s000711452200280x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 12/15/2022]
Abstract
Modern nutrition science began approximately 100 years ago in the context of nutrient deficiency diseases. Nutrition research and policy activities were framed mostly within a reductionist paradigm in which foods were analysed as being a collection of their constituent nutrients. Today, nutrition problems extend to all forms of malnutrition as well as environmental sustainability considerations and are associated with food and dietary pattern exposures. In 2009, researchers investigating the nutrition transition in Brazil proposed that industrial food processing was a key determinant of nutrition problems. The NOVA food classification system which is based on the nature, extent and purposes of food processing was developed to operationalise this proposition. The ultra-processed food (UPF) concept within NOVA is receiving much attention in relation to nutrition research and policy activities. This commentary describes the UPF concept as being fit-for-purpose in providing guidance to inform policy activities to tackle unhealthy and unsustainable diets. There is now a substantial body of evidence linking UPF exposure with adverse population and planetary health outcomes. The UPF concept is increasingly being used in the development of food-based dietary guidelines and nutrition policy actions. It challenges many conventional nutrition research and policy activities as well as the political economy of the industrial food system. Inevitably, there are politicised debates associated with UPF and it is apparent a disproportionate number of articles claiming the concept is controversial originate from a small number of researchers with declared associations with UPF manufacturers. Prominent examples of these claims are assessed.
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Affiliation(s)
- Mark Lawrence
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia email
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Coyle DH, Huang L, Shahid M, Gaines A, Di Tanna GL, Louie JCY, Pan X, Marklund M, Neal B, Wu JHY. Socio-economic difference in purchases of ultra-processed foods in Australia: an analysis of a nationally representative household grocery purchasing panel. Int J Behav Nutr Phys Act 2022; 19:148. [PMID: 36503612 PMCID: PMC9742014 DOI: 10.1186/s12966-022-01389-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Consumption of ultra-processed foods is associated with increased risk of obesity and non-communicable diseases. Little is known about current patterns of ultra-processed foods intake in Australia. The aim of this study was to examine the amount and type of ultra-processed foods purchased by Australian households in 2019 and determine whether purchases differed by socio-economic status (SES). We also assessed whether purchases of ultra-processed foods changed between 2015 and 2019. METHODS: We used grocery purchase data from a nationally representative consumer panel in Australia to assess packaged and unpackaged grocery purchases that were brought home between 2015 to 2019. Ultra-processed foods were identified according to the NOVA system, which classifies foods according to the nature, extent and purpose of industrial food processing. Purchases of ultra-processed foods were calculated per capita, using two outcomes: grams/day and percent of total energy. The top food categories contributing to purchases of ultra-processed foods in 2019 were identified, and differences in ultra-processed food purchases by SES (Index of Relative Social Advantage and Disadvantage) were assessed using survey-weighted linear regression. Changes in purchases of ultra-processed foods between 2015 to 2019 were examined overall and by SES using mixed linear models. RESULTS In 2019, the mean ± SD total grocery purchases made by Australian households was 881.1 ± 511.9 g/d per capita. Of this, 424.2 ± 319.0 g/d per capita was attributable to purchases of ultra-processed foods, which represented 56.4% of total energy purchased. The largest food categories contributing to total energy purchased included mass-produced, packaged breads (8.2% of total energy purchased), chocolate and sweets (5.7%), biscuits and crackers (5.7%) and ice-cream and edible ices (4.3%). In 2019, purchases of ultra-processed foods were significantly higher for the lowest SES households compared to all other SES quintiles (P < 0.001). There were no major changes in purchases of ultra-processed foods overall or by SES over the five-year period. CONCLUSIONS Between 2015 and 2019, ultra-processed foods have consistently made up the majority of groceries purchased by Australians, particularly for the lowest SES households. Policies that reduce ultra-processed food consumption may reduce diet-related health inequalities.
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Affiliation(s)
- Daisy H. Coyle
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Liping Huang
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Maria Shahid
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Allison Gaines
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia ,grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, SW7 2AZ UK
| | - Gian Luca Di Tanna
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Jimmy Chun Yu Louie
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia ,grid.194645.b0000000121742757School of Biological Science, Faculty of Science, The University of Hong Kong, Hong Kong, 999077 China
| | - Xiongfei Pan
- grid.461863.e0000 0004 1757 9397Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Matti Marklund
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Bruce Neal
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia ,grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, SW7 2AZ UK
| | - Jason H. Y. Wu
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
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Huse O, Reeve E, Bell C, Sacks G, Baker P, Wood B, Backholer K. Strategies used by the soft drink industry to grow and sustain sales: a case-study of The Coca-Cola Company in East Asia. BMJ Glob Health 2022; 7:bmjgh-2022-010386. [PMID: 36593644 PMCID: PMC9730366 DOI: 10.1136/bmjgh-2022-010386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The market and non-market activities of the food and beverage industry contribute to unhealthy and unsustainable dietary patterns, increasingly in low-income and middle-income countries (LMICs). We aimed to describe how The Coca-Cola Company (TCCC), as the world market leader in the sugar-sweetened beverage sector, operationalises their activities in LMICs in East Asia, among the world's most highly populated yet under-researched countries, to illustrate the ways in which these activities may negatively influence health outcomes. METHODS We adopted a theoretically-guided qualitative research design and documentary analysis method. Data sources included: industry documents and web pages, marketing case studies obtained from the World Advertising Research Centre, media reports, global trade summaries and websites of industry associations. To guide data analysis, we synthesised a conceptual framework from existing commercial determinants of health literature, to describe ways in which the market and non-market activities of TCCC influence health. RESULTS TCCC leverages subsidiary companies and investments in international networks to expand its supply chains. The company engages in frequent political activities to minimise the implementation of nutrition policies that may impact profits. The company markets products, particularly on digital and mobile devices, often targeting children, adolescents and mothers, and undertakes public relations activities related to human rights, environmental sustainability and community and economic supports, and these public relations activities are often integrated into marketing campaigns. The identified activities of TCCC are frequently in direct contrast to efforts to improve the healthfulness of population diets in East Asia LMICs. CONCLUSIONS A public health analysis of the market and non-market activities of corporations active in unhealthy commodity industries needs to be broad in scope to cover the diverse set of strategies used to increase their market power and influence. Governments should consider a suite of policy options to attenuate these commercial determinants of unhealthy diets.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Erica Reeve
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Colin Bell
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - Benjamin Wood
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
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218
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Koios D, Machado P, Lacy-Nichols J. Representations of Ultra-Processed Foods: A Global Analysis of How Dietary Guidelines Refer to Levels of Food Processing. Int J Health Policy Manag 2022; 11:2588-2599. [PMID: 35184508 PMCID: PMC9818109 DOI: 10.34172/ijhpm.2022.6443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 01/15/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND As evidence grows about negative health impacts of ultra-processed foods (UPFs), nutrient-centred advice is contested, and food-based dietary guidelines are increasingly utilised. Previous analyses of dietary guidelines evaluated their potential impact on health and sustainability, but little research has been conducted to examine how the concept of UPFs is reflected in dietary advice for consumers. This paper systematically analyses whether and how UPFs are represented in dietary guidelines internationally. METHODS Based on a systematic online search, the consumer-targeted key messages of 106 dietary guidelines were identified and a qualitative content analysis was conducted. A coding framework was developed to classify messages as 'eat more' or 'eat less' according to the language used (eg, 'choose' vs 'avoid') and to differentiate between a focus on nutrients or food processing. Specific foods mentioned in 'eat less' guidelines were classified according to their level of processing using the NOVA framework. RESULTS 99% of guidelines utilised some type of nutrient-based message, either promoting 'positive' nutrients (eg, vitamins) or discouraging the consumption of 'negative' nutrients (mainly salt, sugar and fat). Explicit references to food processing were present in 45% of 'eat less' guidelines and 5% of 'eat more' guidelines. Implicit references (eg, promoting 'raw' or discouraging 'packaged' foods) were found in 43% of 'eat less' and 75% of 'eat more' guidelines. 53% of the specific foods referred to in 'eat less' advice were UPFs. CONCLUSION Overall, nutrient-based messages were more common than messages about processing levels. The majority of discouraged foods were UPFs, however some minimally processed foods were discouraged, which points to tensions and contradictions between nutrient- and processing-based dietary advice. As dietary guidelines begin to include advice about food processing, it is important to consider both consumer understanding of the terms used and their capacity to act on the advice.
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Affiliation(s)
- Daniela Koios
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Priscila Machado
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Liu S, Yi M, Qin J, Lei F, Lin L, Li Y, Zhuo M, Liu W, Huang X, Cai J, Zhang X, Zhang P, Ji Y, Ye J, Li H. The increasing incidence and high body mass index-related burden of gallbladder and biliary diseases-A results from global burden of disease study 2019. Front Med (Lausanne) 2022; 9:1002325. [PMID: 36530914 PMCID: PMC9757069 DOI: 10.3389/fmed.2022.1002325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/11/2022] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Gallbladder and biliary diseases are common gastrointestinal conditions associated with huge socioeconomic costs and are considered risk factors for cardiovascular diseases and digestive system cancers. The prevalence and incidence of gallbladder and biliary diseases have not received enough attention from 1990 to 2019. Several non-communicable diseases were associated with the incidence of gallbladder and biliary diseases. It is necessary to clarify the change in the incidence and disability burden of gallbladder and biliary diseases worldwide. METHODS Data on high body mass index (BMI)-related disease burden and incidence, years of life lost prematurely, and years lived with disability (YLDs) due to gallbladder and biliary diseases were obtained from the Global Burden of Disease 2019. The estimated annual percentage change was calculated to qualify the gallbladder and biliary disease burden change. RESULTS The global age-standardized incidence rate has increased from 585.35 per 100,000 (95% UI: 506.05-679.86) in 1990 to 634.32 per 100,000 (95% UI: 540.21-742.93) in 2019. And the increase in incidence was positively correlated with rising high BMI-related summary exposure value. The high BMI-related YLDs of gallbladder and biliary diseases have increased worldwide over time. Globally, the 25-49 age group suffered a rapid rise in incidence and high BMI attributable to the YLDs rate of gallbladder and biliary diseases. CONCLUSION The global incidence and high BMI-related YLDs of gallbladder and biliary diseases remain prominent to increase over the past 30 years. Notably, the incidence and high BMI-related YLDs among people aged 25-49 years have rapidly increased over time. Therefore, high BMI should be emphasized in strategic priorities for controlling gallbladder and biliary diseases.
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Affiliation(s)
- Shuhua Liu
- Department of Anesthesiology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Maolin Yi
- Department of Mammary Gland and Thyroid Gland, Huanggang Central Hospital of Yangtze University, Huanggang, China
| | - Juanjuan Qin
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Fang Lei
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Lijin Lin
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Yi Li
- Department of Anesthesiology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Ming Zhuo
- Department of Anesthesiology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Weifang Liu
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xuewei Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Jingjing Cai
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiaojing Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Peng Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Yanxiao Ji
- Institute of Model Animal, Wuhan University, Wuhan, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Junming Ye
- Department of Anesthesiology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
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Martinez Steele E, Marrón Ponce JA, Cediel G, Louzada MLC, Khandpur N, Machado P, Moubarac JC, Rauber F, Corvalán C, Levy RB, Monteiro CA. Potential reductions in ultra-processed food consumption substantially improve population cardiometabolic-related dietary nutrient profiles in eight countries. Nutr Metab Cardiovasc Dis 2022; 32:2739-2750. [PMID: 36163210 DOI: 10.1016/j.numecd.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The negative effect on dietary nutrient profiles is the most obvious mechanism explaining the higher risk of cardiometabolic diseases associated with increased dietary share of UPF observed in large cohort studies. We estimate the proportion of diets with excessive energy density, excessive free sugars or saturated fat contents and insufficient fiber that could be avoided, if UPF consumption was reduced to levels among lowest consumers across eight countries, as well as the proportion of diets with multiple inadequacies. METHODS AND RESULTS Using nationally-representative cross-sectional surveys from Brazil (2008-09), Chile (2010), Colombia (2005), Mexico (2012), Australia (2011-12), the UK (2008-16), Canada (2015), and the US (2015-16), inadequate energy density (≥2.25 kcal/g) or contents of free sugars (>10% of total energy intake), saturated fats (>10% of total energy intake) and fiber (<25 g/2000 kcal) population attributable fractions were quantified. Substantial reductions in nutrient inadequacies would be observed ranging from 50.4% in Chile to 76.8% in US for dietary energy density, from 15.5% in Colombia to 68.4% in Australia for free sugars, from 9.5% in Canada to 35.0% in Mexico for saturated fats, and from 10.3% in UK to 37.9% in Mexico for fiber. Higher reductions would be observed for diets with multiple nutrient inadequacies: from 27.3% in UK to 77.7% in Australia for ≥3 and from 69.4% in Canada to 92.1% in US, for 4 inadequacies. CONCLUSIONS Lowering dietary contribution of UPF to levels among country-specific lowest consumers is a way to improve population cardiometabolic-related dietary nutrient profiles.
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Affiliation(s)
- E 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.
| | - J A Marrón Ponce
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico.
| | - G Cediel
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil; School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia.
| | - M L C Louzada
- 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.
| | - N Khandpur
- 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; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA.
| | - P Machado
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia.
| | - J-C Moubarac
- Département de Nutrition, Université de Montréal, Montréal, Canada.
| | - F Rauber
- 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; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - C Corvalán
- CIAPEC, Unidad de Nutrición Pública, INTA, Universidad de Chile, Chile.
| | - R B Levy
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - C A Monteiro
- 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.
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221
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Lacy-Nichols J, Freudenberg N. Opportunities and limitations of the ultra-processed food framing. NATURE FOOD 2022; 3:975-977. [PMID: 37118311 DOI: 10.1038/s43016-022-00670-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Jennifer Lacy-Nichols
- The University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.
| | - Nick Freudenberg
- City University of New York School of Public Health, New York, NY, USA
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Li X, Man J, Chen H, Yang X. Spatiotemporal trends of disease burden of edentulism from 1990 to 2019: A global, regional, and national analysis. Front Public Health 2022; 10:940355. [PMID: 36518579 PMCID: PMC9742533 DOI: 10.3389/fpubh.2022.940355] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
Background Understanding the spatiotemporal trends in disease burden of edentulism is critical to reducing disease burden of edentulism and deploying medical resources. We assessed the changing patterns of disease burden of edentulism at global, regional, and national levels from 1990 to 2019. Methods Data on incident cases, prevalent cases, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of edentulism were extracted from the Global Burden of Disease 2019 Study. We calculated the estimated annual percentage change (EAPC) to quantify spatiotemporal trends in the ASRs of edentulism. Results In 2019, the number of prevalent cases and DALYs of edentulism were 35.2 and 9.6 million, and the ASPR and ASDR were 43.12/1,000 and 1.18/1,000, with EAPCs of -0.18 [95% confidence interval (CI): -0.28, -0.09] and -0.16[95% CI: -0.26, -0.07] from 1990 to 2019, respectively. Females and the elderly had a higher burden of edentulism. Although the ASPR, ASDR, and ASIR in the high SDI, high-middle SDI, and middle SDI regions showed a decreasing or stable trend, the absolute disease burdens of edentulism in these regions were still high. Although the absolute disease burdens of low SDI and low-middle SDI were low, their ASPR and ASDR showed an upward trend. In countries with high initial disease burden or high SDI, ASPR, ASDR, and ASIR showed stable or declining trends. Conclusion The absolute disease burden due to edentulism was increasing in many countries and regions. Countries should reduce the disease burden caused by edentulism by adopting measures including the prevention and treatment of dental caries and periodontal disease.
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Affiliation(s)
- Xiao Li
- Department of Special Treatment, Jinan Stomatological Hospital, Jinan, China
| | - Jinyu Man
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China,Clinical Research Center of Shandong University, Jinan, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China,Clinical Research Center of Shandong University, Jinan, China,*Correspondence: Xiaorong Yang
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223
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Simple solutions for complex problems? What is missing in agriculture for nutrition interventions. Food Secur 2022. [DOI: 10.1007/s12571-022-01324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Abstract
Within the nutritionism paradigm, in this article we critically review the marketization and medicalization logics which aim to address the pressing issue of malnutrition in low- and middle-income countries. Drawing from political economy and food system transformation discourses, we are using the popular intervention types of nutrition-sensitive value chains (marketization logic) and biofortification exemplified through orange-fleshed sweet potato (medicalization logic) to assess their outcomes and underlying logics. We demonstrate that there is insufficient evidence of the positive impact of these interventions on nutritional outcomes, and that their underlying theories of change and impact logics do not deal with the inherent complexity of nutritional challenges. We show that nutrition-sensitive value chain approaches are unable to leverage or enhance the functioning of value chains to improve nutritional outcomes, especially in light of the disproportionate power of some food companies. We further demonstrate that orange-fleshed sweet potato interventions and biofortification more broadly adopt a narrow approach to malnutrition, disregarding the interactions between food components and broader value chain and food system dynamics. We argue that both intervention types focus solely on increasing the intake of specific nutrients without incorporating their embeddedness in the wider food systems and the relevant political-economic and social relations that influence the production and consumption of food. We conclude that the systemic nature of malnutrition requires to be understood and addressed as part of the food system transformation challenge in order to move towards solving it. To do so, new evaluation frameworks along with new approaches to solutions are necessary that support multiple and diverse development pathways, which are able to acknowledge the social, political-economic, and environmental factors and drivers of malnutrition and poverty.
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Nilson EAF, Ferrari G, Louzada MLDC, Levy RB, Monteiro CA, Rezende LFM. The estimated burden of ultra-processed foods on cardiovascular disease outcomes in Brazil: A modeling study. Front Nutr 2022; 9:1043620. [PMID: 36466395 PMCID: PMC9712187 DOI: 10.3389/fnut.2022.1043620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2023] Open
Abstract
Introduction Ultra-processed foods (UPF) have been associated with an increased risk of cardiovascular diseases (CVD). This study aimed to estimate CVD premature deaths, incident cases, and disability adjusted life-years (DALYs) attributable to the consumption of UPF in Brazilian adults in 2019. Methods A validated a comparative risk assessment model was adapted to estimate the burden of major CVD outcomes (coronary heart disease and stroke) attributable to the consumption of UPF in Brazilian adults aged 30 to 69 years. The model inputs included nationally representative data of the UPF contribution to the total energy of the diet, national official demographic records, CVD outcomes (incidence, deaths and DALYs) from the Global Burden of Disease study for 2019, and relative risks from meta-analysis studies. Results We estimated that approximately 19,200 premature deaths (95% uncertainty intervals - UI, 7,097 to 32,353), 74,900 new cases (95% UI, 25,983 to 128,725), and 883,000 DALYs/year (95% UI, 324,279 to 1,492,593) from CVD were attributable to the consumption of UPF in Brazil, corresponding to about 22% of the premature deaths from CVD and to 33% of the total premature all-cause deaths attributable to UPF intake among Brazilian adults. Reducing UPF consumption by 10% in the adult population would avert approximately 11% of the premature CVD deaths, equivalent to 2,100 deaths/year (95% UI, 697 to 4,511). A 20% reduction in UPF intake would avert approximately 21% of the premature CVD deaths or 4,100 deaths (95% UI, 1,413 to 8,047), and a 50% reduction in UPF intake would avert about 52% of the premature CVD deaths, corresponding to 9,900 deaths/year (95% UI, 3,682 to 17,820). If UPF consumption among adults was reduced to that of the first quintile of UPF intake in the baseline scenario, approximately 81% of the premature CVD deaths would be averted, corresponding to some 15,600 deaths/year (95% UI, 5,229 to 27,519). Conclusion Our study estimated a high burden of premature CVD outcomes attributable to the consumption of UPF in Brazil. Our findings support food policies aimed at reducing the consumption of UPF, such as fiscal and regulatory policies, which are imperative to prevent CVD in Brazil.
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Affiliation(s)
- Eduardo Augusto Fernandes Nilson
- Center for Epidemiological Research in Nutrition and Public Health, University of São Paulo, São Paulo, Brazil
- Oswaldo Cruz Foundation-Fiocruz, Brasília, Brazil
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile
| | | | - Renata Bertazzi Levy
- Department of Preventive Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Carlos Augusto Monteiro
- Center for Epidemiological Research in Nutrition and Public Health, University of São Paulo, São Paulo, Brazil
| | - Leandro F. M. Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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225
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Vissers E, Wellens J, Sabino J. Ultra-processed foods as a possible culprit for the rising prevalence of inflammatory bowel diseases. Front Med (Lausanne) 2022; 9:1058373. [PMID: 36419796 PMCID: PMC9676654 DOI: 10.3389/fmed.2022.1058373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
Inflammatory bowel diseases (IBD) are chronic inflammatory disorders of the gastrointestinal tract, and the exact pathogenesis is still unclear. It is believed that IBD develops in response to a complex interaction between the microbiota, environmental factors, and the immune system, in genetically predisposed individuals. Identifying these environmental factors will offer more insight in the development of the disease, and reveal new therapeutic targets for IBD patients. One of the environmental factors that has gained more interest over the last years is our diet. The prevalence of IBD has increased significantly and this increase is thought to be associated with a ‘Western diet', characterized by high intake of fats, added sugar, meat, and ultra-processed foods (UPFs). The UPFs now account for almost 50% of the energy intake in Westernized countries and are therefore an important characteristic of this Western diet. UPFs are characterized by higher amounts of salt, fat, sugar and the presence of different food additives. Epidemiological studies have found associations between UPF intake and a range of non-communicable diseases, including inflammatory bowel disease (IBD). Preclinical and clinical evidence suggest that non-nutritive ingredients and additives, present in UPFs, can negatively affect different components of the intestinal barrier, such as the microbiota, the mucus layer, the epithelium, and the immune cells in the lamina propria. Disruption of this barrier can cause the immune system to encounter an increased bacterial exposure, leading to an aberrant immune response. In this article, the available evidence on the possible role of UPFs and their components in the increasing incidence and prevalence of IBD is reviewed. These findings can be translated to the clinic and may be helpful to consider when giving dietary advice to IBD patients. A better understanding of the role of UPFs may lead to less restrictive diets for patients with IBD, hence increasing the dietary compliance and efficacy of exclusion diets.
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Affiliation(s)
- Eva Vissers
- Department of Chronic Diseases, Metabolism and Aging, Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
| | - Judith Wellens
- Department of Chronic Diseases, Metabolism and Aging, Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - João Sabino
- Department of Chronic Diseases, Metabolism and Aging, Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- *Correspondence: João Sabino
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Grech A, Sui Z, Rangan A, Simpson SJ, Coogan SCP, Raubenheimer D. Macronutrient (im)balance drives energy intake in an obesogenic food environment: An ecological analysis. Obesity (Silver Spring) 2022; 30:2156-2166. [PMID: 36321270 PMCID: PMC9828743 DOI: 10.1002/oby.23578] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The protein leverage hypothesis (PLH) postulates that strong regulation of protein intake drives energy overconsumption and obesity when human diets are diluted by fat and carbohydrates. The two predictions of the PLH are that humans (i) regulate intake to maintain protein within a narrow range and that (ii) energy intake is an inverse function of percentage energy from protein because absolute protein intake is maintained within narrow limits. METHODS Multidimensional nutritional geometry was used to test the predictions of the PLH using dietary data from the Australian National Nutrition and Physical Activity Survey. RESULTS Both predictions of the PLH were confirmed in a population setting: the mean protein intake was 18.4%, and energy intake decreased with increasing energy from protein (L = -0.18, p < 0.0001). It was demonstrated that highly processed discretionary foods are a significant diluent of protein and associated with increased energy but not increased protein intake. CONCLUSIONS These results support an integrated ecological and mechanistic explanation for obesity, in which low-protein highly processed foods lead to higher energy intake because of the biological response to macronutrient imbalance driven by a dominant appetite for protein. This study supports a central role for protein in the obesity epidemic, with significant implications for global health.
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Affiliation(s)
- Amanda Grech
- Charles Perkins CentreUniversity of SydneySydneyNew South WalesAustralia
- School of Life and Environmental ScienceUniversity of SydneySydneyNew South WalesAustralia
| | - Zhixian Sui
- Charles Perkins CentreUniversity of SydneySydneyNew South WalesAustralia
- School of Life and Environmental ScienceUniversity of SydneySydneyNew South WalesAustralia
| | - Anna Rangan
- Charles Perkins CentreUniversity of SydneySydneyNew South WalesAustralia
- School of Life and Environmental ScienceUniversity of SydneySydneyNew South WalesAustralia
| | - Stephen J. Simpson
- Charles Perkins CentreUniversity of SydneySydneyNew South WalesAustralia
- School of Life and Environmental ScienceUniversity of SydneySydneyNew South WalesAustralia
| | - Sean C. P. Coogan
- Charles Perkins CentreUniversity of SydneySydneyNew South WalesAustralia
- School of Life and Environmental ScienceUniversity of SydneySydneyNew South WalesAustralia
| | - David Raubenheimer
- Charles Perkins CentreUniversity of SydneySydneyNew South WalesAustralia
- School of Life and Environmental ScienceUniversity of SydneySydneyNew South WalesAustralia
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Market concentration and the healthiness of packaged food and non-alcoholic beverage sales across the European single market. Public Health Nutr 2022; 25:3131-3136. [PMID: 36073156 PMCID: PMC9991654 DOI: 10.1017/s1368980022001926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the relationship between market concentration and diversity, as indicators of market structure, and the healthiness of food and beverage sales across Europe. DESIGN Market share (MS) data per country were used to calculate market concentration, assessed by the four-firm concentration ratio and market diversity, and by the number of companies with ≥1 % MS and the number of companies uniquely present in one European country. The healthiness of food sales was assessed by applying the NOVA classification (level of processing). Simple and multiple linear regressions were performed to assess the relationship between market concentration, diversity and the healthiness of food and beverage sales. SETTING The European single market. PARTICIPANTS The twenty-seven European single market member states for which Euromonitor sales data were available at the most fine-grained Euromonitor packaged food and non-alcoholic beverage product subcategory level. RESULTS Increased market concentration with a country and a product category fixed effect significantly predicted increased sales of ultra-processed packaged food products. There was insufficient data variability in the level of processing of non-alcoholic beverage product categories to formulate conclusions for non-alcoholic beverages. Increased market diversity in turn significantly predicted reduced country-level sales of ultra-processed products. CONCLUSIONS The results indicated a relationship between market structure and the healthiness of packed food products sold on the European market. However, more research with detailed nutritional data is warranted to document and quantify this interaction.
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228
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Nix E. Proposed Changes to Nutrition Curricula in Higher Education. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:1042-1046. [PMID: 36184353 DOI: 10.1016/j.jneb.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 06/16/2023]
Abstract
Although the field of nutrition has shifted to holistic approaches to dietary health, introductory nutrition courses have primarily focused on a reductionist approach. From my perspective, there is a need for radical changes in nutrition curricula to emphasize the importance of whole foods, complex dietary behavior, and food systems that align with the progress made within the field of nutrition. This holistic perspective of food and dietary patterns can help future dietitians and those not pursuing dietetics to understand the complex realities of nutrition while also learning transferable skills, such as systems-thinking, communication, and evaluation and critique of current research.
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Affiliation(s)
- Elizabeth Nix
- Health and Human Kinetics Department, Ohio Wesleyan University, Delaware, OH.
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229
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Lv JL, Wu QJ, Wang XB, Du Q, Liu FH, Guo RH, Leng X, Pan BC, Zhao YH. Intake of ultra-processed foods and asthenozoospermia odds: A hospital-based case-control study. Front Nutr 2022; 9:941745. [PMID: 36337657 PMCID: PMC9630735 DOI: 10.3389/fnut.2022.941745] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background The intake of ultra-processed foods (UPFs) has increased rapidly in recent years. Evidence has suggested that UPFs has adverse effects on several health outcomes. This study aimed to first evaluate the association between the intake of UPFs and asthenozoospermia odds. Methods A hospital-based case-control study including 549 cases and 581 controls was performed in the infertility clinics of Shengjing Hospital of China Medical University from June 2020 to December 2020. Dietary intake was assessed using a validated food frequency questionnaire. Food items were categorized by the NOVA classification system based on the degree of processing. Semen parameters were analyzed according to the World Health Organization guidelines. Results The highest tertile of UPFs intake (% of total energy intake) was positively associated with the odds of asthenozoospermia (odds ratio [OR] = 1.53; 95% confidence interval [CI]: 1.12, 2.10; P for trend < 0.05), compared with the lowest tertile. Similar patterns were also found in subgroup analyses among participants with age ≥32 years (OR = 1.58; 95% CI: 1.04, 2.40), BMI ≥ 24 kg/m2 (OR = 1.52; 95% CI: 1.04, 2.22), ever cigarette smoking (OR = 1.78; 95% CI: 1.14, 2.79), and ever alcohol drinking (OR = 1.65; 95% CI: 1.01, 2.72), and in sensitivity analyses by using absolute amount (g/day) to calculate the intake of UPFs. Conclusion Higher consumption of UPFs was positively associated with the odds of asthenozoospermia. More studies are needed to confirm our findings.
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Affiliation(s)
- Jia-Le Lv
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao-Bin Wang
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qiang Du
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ren-Hao Guo
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xu Leng
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bo-Chen Pan
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Bo-Chen Pan
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- Yu-Hong Zhao
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Tak M, Law C, Green R, Shankar B, Cornelsen L. Processed foods purchase profiles in urban India in 2013 and 2016: a cluster and multivariate analysis. BMJ Open 2022; 12:e062254. [PMID: 36207045 PMCID: PMC9558783 DOI: 10.1136/bmjopen-2022-062254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Sales of ultraprocessed foods (UPFs) and beverages are rising in low-income and middle-income countries. Such foods are often linked with weight gain, obesity, type 2 diabetes and hypertension-diseases that are on the rise in India. This paper analysed patterns in purchases of processed and UPF by urban Indian households. SETTING Panel data from Kantar -Worldpanel Division, India for 2013 and 2016. PARTICIPANTS 58 878 urban Indian households. METHODS We used K-mean partition clustering and multivariate regression to analyse patterns in processed food (PF) and UPF purchase for urban India. RESULTS Three-quarters of urban Indian households purchased over ten PF groups. Mean per person annual PF purchase was 150 kg. UPF purchase was low at 6.4 kg in 2016 but had grown by 6% since 2013. Cluster analysis identified three patterns of consumption, characterised by low (54% of the households in 2016), medium (36%) and high (10%) PF purchase quantities. High cluster households purchased over three times as much PFs and UPF as the low cluster households. Notably, salt purchases were persistently high across clusters in both years (>3.3 kg), while sweet snack and ready-to-eat food purchases grew consistently in all clusters between 2013 and 2016. A positive and significant association was found between household purchases of UPF and their socioeconomic status as well as ownership of durables, such as refrigerator, colour television and washing machine (all p<0.001). Spatial characteristics including size of town (p<0.05) in which the household is located were also positively associated with the purchase of UPF. CONCLUSION Results suggest the need for tailored regional and city level interventions to curb the low but growing purchase of UPF. New data on obesity and rise of non-communicable diseases, the results are concerning given the links between lifestyle changes and the speed of urbanisation in Indian cities.
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Affiliation(s)
- Mehroosh Tak
- Veterinary Epidemiology, Economics and Public Health, The Royal Veterinary College, London, UK
| | - Cherry Law
- Department of Agri-Food Economics and Marketing, School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - Rosemary Green
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Bhavani Shankar
- Institute for Sustainable Food, University of Sheffield, Sheffield, UK
| | - Laura Cornelsen
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Gustafson DI, Decker EA, Drewnowski A, Hamm MW, Hwang J, Merrigan KA. Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods. Curr Dev Nutr 2022; 6:nzac136. [PMID: 36204327 PMCID: PMC9529222 DOI: 10.1093/cdn/nzac136] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/15/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022] Open
Abstract
There is a growing global consensus among food system experts that diets and how we source our foods must change. The sustainable nutrition community continues exploring the environmental impact and dietary value of foods. Packaged foods have been largely ignored within the dialogue, and if they are addressed, existing frameworks tend to label them all as "ultraprocessed" and uniformly discourage their consumption. This approach lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health. This article summarizes the meeting discussion, which informed the development of a proposed framework based on guiding principles for defining sustainable, nutritious packaged foods across key nutrition, environmental, economic, and sociocultural well-being indicators. Although additional research is needed to substantiate specific metrics in order to operationalize the framework, it is intended to be a foundation from which to build and refine as science and measurement capabilities advance, and an important step toward broader adoption of healthy, sustainable diets.
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Affiliation(s)
- David I Gustafson
- Adjunct Research Faculty, Biological Systems Engineering, Washington State University, Pullman, WA, USA
| | - Eric A Decker
- Department of Food Science, University of Massachusetts, Amherst, MA, USA
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA; USA
| | - Michael W Hamm
- Department of Community Sustainability, Michigan State University, Lansing, MI, USA
| | - Jane Hwang
- Social Accountability International, New York, NY, USA
| | - Kathleen A Merrigan
- Swette Center for Sustainable Food Systems, Arizona State University, Tempe, AZ, USA
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232
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Matos JDP, Rodrigues MB, Vandevijvere S, Claro RM, Horta PM. Global case study of digital marketing on social media by a top soda brand. Health Promot Int 2022; 37:6722723. [PMID: 36166269 DOI: 10.1093/heapro/daac133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Big Soda segment is central in modern food systems, and they invest heavily in digital marketing, but little is known about it. We aimed to analyze the digital marketing on Facebook of the soda brand with a major worldwide reach. Countries were described in terms of soda brand presence and popularity on Facebook according to countries' socio-demographic index (SDI) and the market share of soda brand (%MS). From 149 countries, 57.0% had soda brand's Facebook page among the top five in the number of followers within the beverage segment. Among them, digital marketing was described by the number of the page followers, the number of posts, and the number of interactions (likes, comments and shares) that each post received by Facebook users. Also, we analyzed the characteristics, and the use of marketing strategies on posts in a random sample of 10% (n = 1217) of all posts. We found that soda brand's popularity on Facebook was higher among countries with higher SDI and higher %MS. Also, the number of users that engaged with soda brand's posts was higher among countries with lower SDI and higher brand's %MS. The brand's posts focus on young adults, display of brand's products and glorification of its attributes. Other identified features include sport-related thematic and appeals to socialization and healthy eating. In addition, posts' characteristics differed with countries' characteristics. Soda brand digital marketing varies according to countries' characterization and maintains the brand position on the global marketing of beverages.
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Affiliation(s)
| | | | | | - Rafael Moreira Claro
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paula Martins Horta
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Liguori J, Pradeilles R, Laar A, Zotor F, Tandoh A, Klomegah S, Osei‐Kwasi HA, Le Port A, Bricas N, Aryeetey R, Akparibo R, Griffiths P, Holdsworth M. Individual‐level drivers of dietary behaviour in adolescents and women through the reproductive life course in urban Ghana: A Photovoice study. MATERNAL & CHILD NUTRITION 2022; 18:e13412. [PMID: 35938776 PMCID: PMC9480960 DOI: 10.1111/mcn.13412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
Evidence on the individual‐level drivers of dietary behaviours in deprived urban contexts in Africa is limited. Understanding how to best inform the development and delivery of interventions to promote healthy dietary behaviours is needed. As noncommunicable diseases account for over 40% of deaths in Ghana, the country has reached an advanced stage of nutrition transition. The aim of this study was to identify individual‐level factors (biological, demographic, cognitive, practices) influencing dietary behaviours among adolescent girls and women at different stages of the reproductive life course in urban Ghana with the goal of building evidence to improve targeted interventions. Qualitative Photovoice interviews (n = 64) were conducted in two urban neighbourhoods in Accra and Ho with adolescent girls (13–14 years) and women of reproductive age (15–49 years). Data analysis was both theory‐ and data‐driven to allow for emerging themes. Thirty‐seven factors, across four domains within the individual‐level, were identified as having an influence on dietary behaviours: biological (n = 5), demographic (n = 8), cognitions (n = 13) and practices (n = 11). Several factors emerged as facilitators or barriers to healthy eating, with income/wealth (demographic); nutrition knowledge/preferences/risk perception (cognitions); and cooking skills/eating at home/time constraints (practices) emerging most frequently. Pregnancy/lactating status (biological) influenced dietary behaviours mainly through medical advice, awareness and willingness to eat foods to support foetal/infant growth and development. Many of these factors were intertwined with the wider food environment, especially concerns about the cost of food and food safety, suggesting that interventions need to account for individual‐level as well as wider environmental drivers of dietary behaviours. Time constraints, eating at home, eating out, cooking skills, food preferences and food safety concerns were identified as key factors influencing dietary behaviours at the individual level in urban Ghana. Ability to eat nutritious, safe food was largely mediated by income and wealth. Biological factors, such as pregnancy/lactating status influenced behaviours through medical advice, nutrition knowledge and willingness to promote foetal/infant development. Many individual‐level factors were intertwined with the wider food environment. Factors influencing dietary behaviour at different levels need to be considered together when developing interventions/policies for healthier diets.
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Affiliation(s)
- Julia Liguori
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri‐Food Systems) CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro Montpellier, IRD Montpellier France
| | - Rebecca Pradeilles
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
| | - Amos Laar
- Department of Population, Family & Reproductive Health, School of Public Health University of Ghana Accra Ghana
| | - Francis Zotor
- Department of Family and Community Health, School of Public Health University of Health and Allied Sciences Ho Ghana
| | - Akua Tandoh
- Department of Population, Family & Reproductive Health, School of Public Health University of Ghana Accra Ghana
| | - Senam Klomegah
- Department of Family and Community Health, School of Public Health University of Health and Allied Sciences Ho Ghana
| | | | - Agnès Le Port
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri‐Food Systems) CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro Montpellier, IRD Montpellier France
| | - Nicolas Bricas
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri‐Food Systems) CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro Montpellier, IRD Montpellier France
| | - Richmond Aryeetey
- Department of Population, Family & Reproductive Health, School of Public Health University of Ghana Accra Ghana
| | - Robert Akparibo
- School of Health and Related Research University of Sheffield Sheffield UK
| | - Paula Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri‐Food Systems) CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro Montpellier, IRD Montpellier France
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Dereje R, Girma A, Molla A, Simieneh A. Mid upper arm circumference as screening tool of overweight or obesity among adult employees of Mizan Tepi University, Southwest Ethiopia. Heliyon 2022; 8:e10793. [PMID: 36211995 PMCID: PMC9535271 DOI: 10.1016/j.heliyon.2022.e10793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/14/2022] [Accepted: 09/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background Overweight or obesity is an excessive fat accumulation that impairs the health and wellbeing of the adult population throughout the world. Recently Mid upper arm circumference (MUAC) was suggested as a screening index for overweight or obesity among adolescents, but its utilization for the assessment of overweight or obesity in the adult population is not clear yet. In addition, little is known about the screening ability of MUAC for overweight or obesity in the adult population of Ethiopia. Therefore, this study aimed to evaluate the utility of MUAC for screening overweight or obesity among adult employees of Mizan Tepi University, Southwest Ethiopia. Method A Facility -based cross-sectional study was carried out from February 21 to March 20, 2020, at Mizan Tepi University. About 585 study participants were selected by gender-based stratified sampling technique. Anthropometric data like weight, height, and MUAC were collected. Pearson's correlation between MUAC, body mass index (BMI), and age was calculated to see a relationship between them. The Receiver operating characteristics (ROC) curve was calculated to identify the screening ability of MUAC for overweight or obesity. The appropriate MUAC cutoff point for both men and women established using the Youden index. Additionally, sensitivity, specificity, positive, and negative predictive values were calculated. Result The prevalence of overweight and obesity among the study participants was 18.1% and 4.8%, respectively. MUAC had a strong positive correlation with BMI, r = 0.65 (95% CI; 0.56–0.69). According to ROC analysis, MUAC is an excellent screening tool for male and female employees with excellent accuracy (AUC = 0.9 with 91.4% sensitivity and 76.4% specificity) and good accuracy (AUC = 0.83 with 67.2% sensitivity and 83.5% specificity), respectively. Based on the youden index, the cutoff point of MUAC to screen overweight or obesity among male and female employees was 26.91cm. Conclusion Mid-upper arm circumference (MUAC) has an equal ability with BMI to screen overweight or obesity among adults. Therefore, MUAC can be utilized as an alternative index to screen overweight and obesity in resource-limited setups.
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Dicken SJ, Batterham RL. Ultra-processed food: a global problem requiring a global solution. Lancet Diabetes Endocrinol 2022; 10:691-694. [PMID: 36037821 DOI: 10.1016/s2213-8587(22)00248-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Samuel J Dicken
- Centre for Obesity Research, Department of Medicine, University College London, London WC1E 6JF, UK
| | - Rachel L Batterham
- Centre for Obesity Research, Department of Medicine, University College London, London WC1E 6JF, UK; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, London, UK; National Institute for Health and Care Research, Biomedical Research Centre, University College London Hospital, London, UK.
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Wiles NL. The battle against ultra-processed food consumption in a post-COVID-19 era. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2022. [DOI: 10.1080/16070658.2022.2105492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Nicola Laurelle Wiles
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Science, College of Agricultural, Engineering, and Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
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Grech A, Rangan A, Allman-Farinelli M, Simpson SJ, Gill T, Raubenheimer D. A Comparison of the Australian Dietary Guidelines to the NOVA Classification System in Classifying Foods to Predict Energy Intakes and Body Mass Index. Nutrients 2022; 14:nu14193942. [PMID: 36235595 PMCID: PMC9571644 DOI: 10.3390/nu14193942] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
NOVA classification distinguishes foods by level of processing, with evidence suggesting that a high intake of ultra-processed foods (UPFs, NOVA category 4) leads to obesity. The Australian Dietary Guidelines, in contrast, discourage excess consumption of “discretionary foods” (DFs), defined according to their composition. Here, we (i) compare the classification of Australian foods under the two systems, (ii) evaluate their performance in predicting energy intakes and body mass index (BMI) in free-living Australians, and (iii) relate these outcomes to the protein leverage hypothesis of obesity. Secondary analysis of the Australian National Nutrition and Physical Activity Survey was conducted. Non-protein energy intake increased by 2.1 MJ (p < 0.001) between lowest and highest tertiles of DF intake, which was significantly higher than UPF (0.6 MJ, p < 0.001). This demonstrates that, for Australia, the DF classification better distinguishes foods associated with high energy intakes than does the NOVA system. BMI was positively associated with both DFs (−1. 0, p = 0.0001) and UPFs (−1.1, p = 0.0001) consumption, with no difference in strength of association. For both classifications, macronutrient and energy intakes conformed closely to the predictions of protein leverage. We account for the similarities and differences in performance of the two systems in an analysis of Australian foods.
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Affiliation(s)
- Amanda Grech
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
- School of Life and Environmental Science, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
- Correspondence: (A.G.); (D.R.)
| | - Anna Rangan
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
- School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
- School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Stephen J. Simpson
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
- School of Life and Environmental Science, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Tim Gill
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
- School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - David Raubenheimer
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
- School of Life and Environmental Science, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
- Correspondence: (A.G.); (D.R.)
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Ambikapathi R, Schneider KR, Davis B, Herrero M, Winters P, Fanzo JC. Global food systems transitions have enabled affordable diets but had less favourable outcomes for nutrition, environmental health, inclusion and equity. NATURE FOOD 2022; 3:764-779. [PMID: 37118149 DOI: 10.1038/s43016-022-00588-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 08/11/2022] [Indexed: 11/09/2022]
Abstract
AbstractOver the past 50 years, food systems worldwide have shifted from predominantly rural to industrialized and consolidated systems, with impacts on diets, nutrition and health, livelihoods, and environmental sustainability. We explore the potential for sustainable and equitable food system transformation (ideal state of change) by comparing countries at different stages of food system transition (changes) using food system typologies. Historically, incomes have risen faster than food prices as countries have industrialized, enabling a simultaneous increase in the supply and affordability of many nutritious foods. These shifts are illustrated across five food system typologies, from rural and traditional to industrial and consolidated. Evolving rural economies, urbanization and changes in food value chains have accompanied these transitions, leading to changes in land distribution, a smaller share of agri-food system workers in the economy and changes in diets. We show that the affordability of a recommended diet has improved over time, but food systems of all types are falling short of delivering optimal nutrition and health outcomes, environmental sustainability, and inclusion and equity for all. Six ‘outlier’ case studies (Tajikistan, Egypt, Albania, Ecuador, Bolivia and the United States of America) illustrate broad trends, trade-offs and deviations. With the integrated view afforded by typologies, we consider how sustainable transitions can be achieved going forward.
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Costa CDS, Buffarini R, Flores TR, Neri D, Freitas Silveira M, Monteiro CA. Consumption of ultra-processed foods and growth outcomes in early childhood: 2015 Pelotas Birth Cohort. Br J Nutr 2022; 129:1-8. [PMID: 36093936 DOI: 10.1017/s0007114522002926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The current study aims to describe the consumption of ultra-processed foods, from 2 to 4 years old, and evaluate its association with growth outcomes during the same period. It is a prospective cohort study using data from the 2015 Pelotas-Brazil Birth Cohort. Outcomes assessed at the 2- and 4-year-old follow-ups were BMI-for-age Z-score and length/height-for-age Z-score. The exposure was a score of ultra-processed food consumption calculated at each follow-up by summing up the positive answers for the consumption of nine specific items/subgroups of ultra-processed foods: (i) instant noodles; (ii) soft drink; (iii) chocolate powder in milk; (iv) nuggets, hamburger or sausages; (v) packaged salty snacks; (vi) candies, lollipops, chewing gum, chocolate or jelly; (vii) sandwich cookie or sweet biscuit; (viii) juice in can or box or prepared from a powdered mix and (ix) yogurt. Crude and adjusted analyses between the score of ultra-processed foods and the outcomes were run using generalised estimating equations. Prevalence of consumption of ultra-processed foods increased from 2 to 4 years old, for all evaluated items/subgroups, except yogurt. In prospective analyses, higher scores of ultra-processed food consumption were associated with higher BMI-for-age Z-score and lower length/height-for-age Z-score, after adjustment for confounders. Ultra-processed food consumption, measured using a short questionnaire with low research burden, increased from 2 to 4 years old and was related to deleterious growth outcomes in early childhood. These results reinforce the importance of avoiding the consumption of these products in childhood to prevent the double burden of malnutrition and non-communicable chronic diseases throughout the life.
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Affiliation(s)
- Caroline Dos Santos Costa
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP01246-904, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Romina Buffarini
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Thaynã Ramos Flores
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Daniela Neri
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP01246-904, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | | | - Carlos Augusto Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP01246-904, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
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de Oliveira MFB, Martins CA, de Castro IRR. The (scarce and circumscribed) culinary content in food-based dietary guidelines around the world: 1991-2021. Public Health Nutr 2022; 25:1-9. [PMID: 36073171 PMCID: PMC9991562 DOI: 10.1017/s1368980022001938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 07/14/2022] [Accepted: 08/09/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the culinary content of key messages contained in food-based dietary guidelines (FBDG) available at the global online repository of the FAO of the UN. DESIGN Document analysis was conducted in August 2021 with data extraction of key messages explicitly related to cooking present in FBDG. Data were analysed inductively using thematic analysis. SETTING The FAO's global repository of FBDG. PARTICIPANTS Not applicable. RESULTS Just over half (n 39; 53·4 %) of the seventy-three FBDG analysed included at least one key message about cooking. The Latin American and Caribbean FBDG presented the greatest amount and variety of content about cooking in the key messages, whereas the Near East and North America placed less emphasis on cooking. We identified three themes: (i) healthy food preparation (n 35; 61·4 % of the fifty-seven culinary key messages identified); (ii) food hygiene (n 14; 24·6 %) and (iii) the promotion of culinary practices (n 7; 12·3 %). Albania's key message covered two themes (food hygiene and healthy food preparation) (n 1; 1·8 %). CONCLUSION FBDG are official documents that express recommendations for a healthy diet. As most of these recommendations throughout the world include foods that must be cooked prior to consumption, culinary content should gain more visibility and be presented more broadly in these official documents.
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Affiliation(s)
- Mariana Fernandes Brito de Oliveira
- Institute of Food and Nutrition, Multidisciplinary Center of Federal University of Rio de Janeiro-Macaé, Av. Aluizio da Silva Gomes, 50, Novo Cavaleiros, Macaé, RJ, Brazil
| | - Carla Adriano Martins
- Institute of Food and Nutrition, Multidisciplinary Center of Federal University of Rio de Janeiro-Macaé, Av. Aluizio da Silva Gomes, 50, Novo Cavaleiros, Macaé, RJ, Brazil
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, São Paulo, SP, Brazil
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Rodríguez‐García C, Sánchez‐Quesada C, Algarra I, Gaforio JJ. Differential Immunometabolic Effects of High-Fat Diets Containing Coconut, Sunflower, and Extra Virgin Olive Oils in Female Mice. Mol Nutr Food Res 2022; 66:e2200082. [PMID: 35848367 PMCID: PMC9787653 DOI: 10.1002/mnfr.202200082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/06/2022] [Indexed: 12/30/2022]
Abstract
SCOPE To compare the effects of three high-fat diets (HFDs) based on coconut, sunflower, or extra virgin olive oils (EVOOs) on adipose tissue, metabolism, and inflammation. METHODS AND RESULTS Mice are fed for 16 weeks on their respective HFD. HFD based on coconut oil produces significantly lower body weight than EVOO- or sunflower oil-based HFDs. Furthermore, the coconut oil HFD leads to metabolic disturbances such as reduction of circulating leptin and adiponectin concentrations, hypertriglyceridemia, hepatomegaly, and liver triglyceride accumulation. Likewise, this diet produces an increase in serum pro-inflammatory cytokines (interleukin 6 [IL-6] and tumor necrosis factor-α [TNF-α]). In white (WAT) and brown (BAT) adipose tissue, the HFD based on coconut oil does not cause significant changes in the expression of studied proteins related to thermogenesis (uncoupling protein 1 [UCP-1]), mitochondrial biogenesis, and browning (peroxisome proliferator-activated receptor-γ coactivator 1α [PGC-1α] and nuclear factor E2-related factor 2 [Nrf2]). However, the HFD based on EVOO induces upregulation of UCP-1, PGC-1α, and Nrf2 expression in BAT, increases the expression of UCP-1 and PGC-1α in inguinal WAT, and enhances the expression of PGC-1α in epididymal WAT. CONCLUSIONS An HFD based on coconut oil could reduce circulating leptin and adiponectin concentrations, increase the liver fat content, raise serum triglycerides, and promote inflammation by increasing circulating pro-inflammatory cytokines, while an EVOO-based HFD could increase thermogenic activity.
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Affiliation(s)
- Carmen Rodríguez‐García
- Department of Health Sciences, Faculty of Experimental SciencesUniversity of JaénJaén23071Spain,University Institute of Research in Olive Groves and Olive Oils University of JaenCampus las Lagunillas, s/nJaén23071Spain
| | - Cristina Sánchez‐Quesada
- Department of Health Sciences, Faculty of Experimental SciencesUniversity of JaénJaén23071Spain,University Institute of Research in Olive Groves and Olive Oils University of JaenCampus las Lagunillas, s/nJaén23071Spain,Agri‐food Campus of International Excellence (ceiA3)Córdoba14071Spain
| | - Ignacio Algarra
- Department of Health Sciences, Faculty of Experimental SciencesUniversity of JaénJaén23071Spain
| | - José J. Gaforio
- Department of Health Sciences, Faculty of Experimental SciencesUniversity of JaénJaén23071Spain,University Institute of Research in Olive Groves and Olive Oils University of JaenCampus las Lagunillas, s/nJaén23071Spain,Agri‐food Campus of International Excellence (ceiA3)Córdoba14071Spain,CIBER Epidemiología y Salud Pública (CIBER‐ESP)Instituto de Salud Carlos IIIMadrid28029Spain
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Prospective association between ultra-processed food consumption and incidence of elevated symptoms of common mental disorders. J Affect Disord 2022; 312:78-85. [PMID: 35691417 DOI: 10.1016/j.jad.2022.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Our aim was to investigate the association between ultra-processed food (UPF) consumption and the incidence of elevated symptoms of common mental disorders (CMD) in two Brazilian birth cohorts. METHODS We analyzed data from the 1993 (n = 3130) and 1982 (n = 3165) Pelotas Birth Cohorts. In the 1993 cohort, the 18y wave provided the first wave data and the 22y wave the second wave data. In the 1982 cohort, the first and the second waves data came from the 22y and the 30y waves, respectively. The self-reporting questionnaire (SRQ-20) was used to assess CMD symptoms and determine the incidence of elevated symptoms of CMD over time. UPF consumption was assessed using food frequency questionnaires, and it was expressed as % of the total energy and % of g/d intake and coded into quartiles according to sex. Poisson and Cox regression models were used to estimate the association between UPF consumption and incidence of elevated symptoms of CMD. RESULTS There were no associations between first wave quartiles of UPF consumption and incidence of elevated symptoms of CMD (quartiles based on % of total energy:Q2: HR = 1.15, 95%CI: 0.93-1.42; Q3 = 0.91, 0.73-1.14; Q4 = 0.97, 0.77-1.21. Quartiles based on % of g/d: Q2 = 1.03, 0.83-1.27; Q3 = 1.05, 0.85-1.31; Q4 = 0.97, 0.78-1.21). LIMITATIONS Recall bias and only two time-points in each cohort study. CONCLUSIONS The consumption of ultra-processed food was not associated with the incidence of elevated CMD symptoms over time.
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Scrinis G, Monteiro C. From ultra-processed foods to ultra-processed dietary patterns. NATURE FOOD 2022; 3:671-673. [PMID: 37118150 DOI: 10.1038/s43016-022-00599-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Gyorgy Scrinis
- School of Agriculture and Food, University of Melbourne, Melbourne, Victoria, Australia.
| | - Carlos Monteiro
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
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Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and possible underlying mechanisms relating UPF consumption to weight gain and co-morbidities. RECENT FINDINGS In primarily observational studies, UPF consumption is consistently associated with an increased risk for weight gain among adults and children and increased risk for adiposity-related co-morbidities in adults. In a single mechanistic study, consumption of UPFs led to increased energy intake and weight gain relative to whole foods. UPFs tend to be more energy-dense than nutrient-dense, and UPF consumption is associated with increased adiposity and co-morbidity risk. These data suggest that recommendations to limit UPF consumption may be beneficial to health - though further mechanistic studies are needed.
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Affiliation(s)
- Anthony Crimarco
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Matthew J Landry
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Christopher D Gardner
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA.
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Abstract
Nutrition is a corner stone of diabetes management, and should be regarded as fundamental to achieving blood glucose control. The current advice for nutrition in diabetes management is discussed, with a focus on body weight, macro and micro nutrients, foods and food groups, dietary patterns, and the lifestyle context. More recent evidence on topics such as body weight and dietary patterns indicate flexibility in what can be recommended, which enables patient preference and may aid adherence. Importantly, a healthy diet for those with diabetes is also appropriate to recommend for their families and the general population.
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Affiliation(s)
- Andrew Reynolds
- Department of Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Jim Mann
- Department of Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand
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IUNS sustainable diets task force. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bopape M, De Man J, Taillie LS, Ng SW, Murukutla N, Swart R. Effect of different front-of-package food labels on healthfulness perception of ultraprocessed food and intention to purchase the products- A randomised controlled trial. Appetite 2022; 179:106283. [PMID: 36027994 DOI: 10.1016/j.appet.2022.106283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/10/2022] [Accepted: 08/18/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to evaluate the effect of different labels on participants: identifying products high in nutrients of concern; identifying unhealthy products, and intention to purchase unhealthy products. This blinded randomised controlled trial included a representative sample of South African households (n = 1951). Per household we selected a member primarily responsible for food purchases. Participants were randomised into the Warning Label (WL), Guideline Dietary Amounts (GDA) or Multiple Traffic Light (MTL) arms. Each participant answered questions in a no label condition (control) followed by same questions in the label condition (experiment). Complete data were collected and analysed for 1948 participants (WL = 33.7%, GDA = 32.1% and MTL = 34.2%). The probability of correctly identifying products high in nutrients of concern and identifying products as being unhealthy was higher with the WL compared to the GDA or MTL for most items. There was no difference in performance between the GDA and the MTL when considering all items together. A higher percentage of participants reported a lower intention to purchase an unhealthy product after exposure to the WL compared to MTL for 5 out of 6 products; 2 out of 6 products for the WL compared to GDA and 2 out of 6 products for GDA compared to MTL. Compared to the control condition, exposure to each of the labels resulted in better identification of nutrients of concerns, unhealthy products and a lower intention to purchase when considering all specific outcome items together. The WL showed a higher potential to enable South African consumers to identify products high in nutrients of concern, identify unhealthy products and discourage purchasing of unhealthy products.
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Affiliation(s)
- Makoma Bopape
- Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Limpopo, South Africa; Faculty of Community and Health Sciences, School of Public Health, University of the Western Cape, South Africa.
| | - Jeroen De Man
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.
| | - Lindsey Smith Taillie
- Carolina Population Center and Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA.
| | - Shu Wen Ng
- Carolina Population Center and Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA.
| | | | - Rina Swart
- Department of Dietetics and Nutrition, Faculty of Community and Health Sciences, University of the Western Cape, South Africa.
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Ngigi PB, Mouquet-Rivier C, Amiot MJ, Termote C, Pallet D. Increasing pulse agrobiodiversity to improve food security and sustainable agriculture in Sub-Saharan Africa. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.948808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Long-life cycle pulses have significant food security potential, however, there is little evidence to explain why they are not more widely produced and consumed in sub-Saharan Africa (SSA). This study aimed at exploring existing knowledge to inform on future research priorities in mainstreaming superior species. As staple food along with cereals, pulses are an important source of nutrients whose intake is often inadequate in SSA, however, pulse consumption remain inadequate in SSA. Depending on the crop's life cycle, pulses have multiple functions that can support food systems and ecosystem resilience. Compared to short-life cycle pulses, long-life cycle pulses rank higher in multipurpose role. However, prior research has focused primarily on short-life cycle pulses due to rapid grain production. Long-life cycle pulses remain underutilized and neglected despite showing steady but modest yield increases and adaptation to environments, suggesting that they are better positioned to respond to the diverse needs of smallholder farmers in SSA. In the context of climate change, rain-fed agriculture, depleted agricultural soils, and lack of subsidized fertilizers, there is need to transform existing food systems toward sustainable food production and improved resilience. Increasing pulse agrobiodiversity by integrating long-life cycle pulses in existing farming systems could not only contribute in alleviating malnutrition, but also poverty and inequalities. In addition, representative and accurate data are needed based on the correct use of accepted scientific names for all data across the food system. This is a prerequisite for assessing pulse consumption adequacy and quantifying production and consumption trends.
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249
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Aminde LN, Cobiac LJ, Phung D, Phung HN, Veerman JL. Avoidable burden of stomach cancer and potential gains in healthy life years from gradual reductions in salt consumption in Vietnam, 2019-2030: a modelling study. Public Health Nutr 2022; 26:1-12. [PMID: 35983611 PMCID: PMC9989714 DOI: 10.1017/s136898002200177x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/29/2022] [Accepted: 08/05/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Excess salt consumption is causally linked with stomach cancer, and salt intake among adults in Vietnam is about twice the recommended levels. The aim of this study was to quantify the future burden of stomach cancer that could be avoided from population-wide salt reduction in Vietnam. DESIGN A dynamic simulation model was developed to quantify the impacts of achieving the 2018 National Vietnam Health Program (8 g/d by 2025 and 7 g/d by 2030) and the WHO (5 g/d) salt reduction policy targets. Data on salt consumption were obtained from the Vietnam 2015 WHO STEPS survey. Health outcomes were estimated over 6-year (2019-2025), 11-year (2019-2030) and lifetime horizons. We conducted one-way and probabilistic sensitivity analyses. SETTING Vietnam. PARTICIPANTS All adults aged ≥ 25 years (61 million people, 48·4 % men) alive in 2019. RESULTS Achieving the 2025 and 2030 national salt targets could result in 3400 and 7200 fewer incident cases of stomach cancer, respectively, and avert 1900 and 4800 stomach cancer deaths, respectively. Achieving the WHO target by 2030 could prevent 8400 incident cases and 5900 deaths from stomach cancer. Over the lifespan, this translated to 344 660 (8 g/d), 411 060 (7 g/d) and 493 633 (5 g/d) health-adjusted life years gained, respectively. CONCLUSIONS A sizeable burden of stomach cancer could be avoided, with gains in healthy life years if national and WHO salt targets were attained. Our findings provide impetus for policy makers in Vietnam and Asia to intensify salt reduction strategies to combat stomach cancer and mitigate pressure on the health systems.
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Affiliation(s)
- Leopold Ndemnge Aminde
- School of Medicine and Dentistry, Griffith University, Ian O’Connor Building (G40), Gold Coast Campus, 1 Parklands Drive, Gold Coast, QLD4215, Australia
| | - Linda J Cobiac
- School of Medicine and Dentistry, Griffith University, Ian O’Connor Building (G40), Gold Coast Campus, 1 Parklands Drive, Gold Coast, QLD4215, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Hai N Phung
- School of Medicine and Dentistry, Griffith University, Ian O’Connor Building (G40), Gold Coast Campus, 1 Parklands Drive, Gold Coast, QLD4215, Australia
| | - J Lennert Veerman
- School of Medicine and Dentistry, Griffith University, Ian O’Connor Building (G40), Gold Coast Campus, 1 Parklands Drive, Gold Coast, QLD4215, Australia
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Trübswasser U, Candel J, Genye T, Bossuyt A, Holdsworth M, Baye K, Talsma E. Benchmarking policy goals and actions for healthy food environments in Ethiopia to prevent malnutrition in all its forms using document analysis. BMJ Open 2022; 12:e058480. [PMID: 35985782 PMCID: PMC9396152 DOI: 10.1136/bmjopen-2021-058480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE Unhealthy diets resulting in overweight and obesity and diet-related non-communicable diseases are of increasing concern in Ethiopia, alongside persistent undernutrition, and have been linked to unhealthy food environments. Little is known about the policy response to unhealthy food environments in Ethiopia. The objective of this study was to assess how different food environment domains have been addressed in Ethiopian policy goals and action over time and how this compares with global good practice benchmarks. SETTING Ethiopia. PRIMARY AND SECONDARY OUTCOME MEASURES We analysed intentions and plans of the government to act, using policy documents (outputs of decision-making in the form of published strategies, plans or policies) related to improving diets and nutritional status through healthy food environments in Ethiopia between 2008 and 2020. Our coding framework was guided by the policy component (n=7 domains) of the Healthy Food-Environment Policy Index, which was modified to include food quality and safety as an eighth domain. RESULTS From the 127 policy outputs identified, 38 were retained, published by 9 different government ministries and institutions. Our results show that eight food environment domains have been addressed to some extent, but gaps remain compared with global best practice, especially in food promotion, processing, retail, price and trade. From 2018, policy began to embrace the wider food system, with more explicit food environment interventions becoming apparent. CONCLUSIONS Policy efforts achieved in food safety, food processing, marketing and labelling are important stepping stones to building future policy actions addressing the food environment domains of food retail, food provision and food trade. Benchmarking of food environment policy actions should also consider actions on food fortification, agro-processing and informal markets in the context of multiple forms of malnutrition.
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Affiliation(s)
- Ursula Trübswasser
- Division of Human Nutrition and Health, Chair Group Global Nutrition, Wageningen University & Research, Wageningen, The Netherlands
| | - Jeroen Candel
- Public Administration and Policy Group, Department of Social Sciences, Wageningen University & Research, Wageningen, The Netherlands
| | - Tirsit Genye
- Ethiopia NIPN Technical Assistance Project (ENTAP), International Food Policy Research Institute, Addis Ababa, Ethiopia
| | - Anne Bossuyt
- Ethiopia NIPN Technical Assistance Project (ENTAP), International Food Policy Research Institute, Addis Ababa, Ethiopia
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Center on Sustainable Agri-Food Systems), (Univ. Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Kaleab Baye
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Elise Talsma
- Division of Human Nutrition and Health, Chair Group Global Nutrition, Wageningen University & Research, Wageningen, The Netherlands
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