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Ferretti F, Mariani M. Sugar-sweetened beverage affordability and the prevalence of overweight and obesity in a cross section of countries. Global Health 2019; 15:30. [PMID: 30999931 PMCID: PMC6472017 DOI: 10.1186/s12992-019-0474-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/03/2019] [Indexed: 11/10/2022] Open
Abstract
Background A key component of ‘obesogenic environments’ is the ready availability of convenient, calorie-dense foods, in the form of hyper-palatable and relatively inexpensive ultra-processed products. Compelling evidence indicates that the regular consumption of soft drinks, specifically carbonated and non-carbonated sugar-sweetened beverages (SSBs), has a significant impact on the prevalence of overweight and obesity. However, to implement country-level effective prevention programmes we need to supplement this evidence with quantitative knowledge of the relationships between overweight/obesity and the main determinants of SSB consumption, notably SSB prices and consumers’ disposable income. Method Affordability considers the simultaneous effects of both price and disposable income on the buying decision. The purpose of this study was to investigate the effect of SSB affordability on the consumers’ purchasing behaviour and weight-related health outcomes. Our study was divided into three parts. First, we computed SSB consumption and affordability for approximately 150 countries worldwide. Second, we estimated a demand function for SSBs to assess the impact of affordability on consumption at the country level. Third, we used a multivariate regression model and country data on the prevalence of overweight and obesity to test the role of SSB affordability in the current obesity epidemic. Results The analysis reveals that SSB affordability: 1) showed both a large variability across countries and a clear tendency to increase substantially with the level of economic development; 2) played a key role in determining cross-country differences in the amount of soft drink consumed per capita; and 3) was significantly associated with the prevalence rates of both overweight and obesity. Specifically, we show that a 10 % increase in SSB affordability was associated, on average, with approximately 0.4 more overweight/obese adults per 100 inhabitants. Conclusions By controlling for the main possible confounding factors, our results clearly indicate that affordability is a major driver of purchasing behaviours and is significantly associated with the prevalence rates of both overweight and obesity. We thus suggest a fiscal approach to curb SSB consumption based on the effectiveness of ‘soda taxes’ to affect the long-term dynamic of SSB affordability. Electronic supplementary material The online version of this article (10.1186/s12992-019-0474-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fabrizio Ferretti
- School of Social Sciences, Department of Communication and Economics, University of Modena and Reggio Emilia, Palazzo Dossetti, Viale Allegri, 9, 42121, Reggio Emilia, Italy.
| | - Michele Mariani
- School of Social Sciences, Department of Communication and Economics, University of Modena and Reggio Emilia, Palazzo Dossetti, Viale Allegri, 9, 42121, Reggio Emilia, Italy
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352
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Adjibade M, Julia C, Allès B, Touvier M, Lemogne C, Srour B, Hercberg S, Galan P, Assmann KE, Kesse-Guyot E. Prospective association between ultra-processed food consumption and incident depressive symptoms in the French NutriNet-Santé cohort. BMC Med 2019; 17:78. [PMID: 30982472 PMCID: PMC6463641 DOI: 10.1186/s12916-019-1312-y] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 03/25/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption has increased over the last decades in Westernized countries. Our objective was to investigate for the first time the association between the proportion of UPF (%UPF) in the diet and incident depressive symptoms in the NutriNet-Santé cohort. METHODS The sample included 20,380 women and 6350 men (aged 18-86 years) without depressive symptoms at the first Center for Epidemiologic Studies Depression Scale (CES-D) measurement, using validated cut-offs (CES-D score ≥ 17 for men and ≥ 23 for women). The proportion of UPF in the diet was computed for each subject using the NOVA classification applied to dietary intakes collected by repeated 24-h records (mean = 8; SD = 2.3). The association between UPF and depressive symptoms was evaluated using multivariable Cox proportional hazards models. RESULTS Over a mean follow-up of 5.4 years, 2221 incident cases of depressive symptoms were identified. After accounting for a wide range of potential confounders, an increased risk of depressive symptoms was observed with an increased %UPF in the diet. In the main model adjusted for sociodemographic characteristics, body mass index, and lifestyle factors, the estimated hazard ratio for a 10% increase in UPF was 1.21 (95% confidence interval = 1.15-1.27). Considering %UPF in food groups, the association was significant only for beverages and sauces or added fats. CONCLUSION Overall, UPF consumption was positively associated with the risk of incident depressive symptoms, suggesting that accounting for this non-nutritional aspect of the diet could be important for mental health promotion.
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Affiliation(s)
- Moufidath Adjibade
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France.
| | - Chantal Julia
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne, F-93017, Bobigny, France
| | - Benjamin Allès
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France
| | - Mathilde Touvier
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France
| | - Cédric Lemogne
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Service de Psychiatrie et Addictologie de l'adulte et du sujet âgé, AP-HP, Hôpital européen Georges-Pompidou, Paris, France.,Institut Psychiatrie et Neurosciences, Inserm (U1266), UMR-S 1266, Paris, France
| | - Bernard Srour
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne, F-93017, Bobigny, France
| | - Pilar Galan
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France
| | - Karen E Assmann
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France
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353
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Schnabel L, Kesse-Guyot E, Allès B, Touvier M, Srour B, Hercberg S, Buscail C, Julia C. Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-aged Adults in France. JAMA Intern Med 2019; 179:490-498. [PMID: 30742202 PMCID: PMC6450295 DOI: 10.1001/jamainternmed.2018.7289] [Citation(s) in RCA: 221] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Growing evidence indicates that higher intake of ultraprocessed foods is associated with higher incidence of noncommunicable diseases. However, to date, the association between ultraprocessed foods consumption and mortality risk has never been investigated. OBJECTIVE To assess the association between ultraprocessed foods consumption and all-cause mortality risk. DESIGN, SETTING, AND PARTICIPANTS This observational prospective cohort study selected adults, 45 years or older, from the French NutriNet-Santé Study, an ongoing cohort study that launched on May 11, 2009, and performed a follow-up through December 15, 2017 (a median of 7.1 years). Participants were selected if they completed at least 1 set of 3 web-based 24-hour dietary records during their first 2 years of follow-up. Self-reported data were collected at baseline, including sociodemographic, lifestyle, physical activity, weight and height, and anthropometrics. EXPOSURES The ultraprocessed foods group (from the NOVA food classification system), characterized as ready-to-eat or -heat formulations made mostly from ingredients usually combined with additives. Proportion (in weight) of ultraprocessed foods in the diet was computed for each participant. MAIN OUTCOMES AND MEASURES The association between proportion of ultraprocessed foods and overall mortality was the main outcome. Mean dietary intakes from all of the 24-hour dietary records available during the first 2 years of follow-up were calculated and considered as the baseline usual food-and-drink intakes. Mortality was assessed using CépiDC, the French national registry of specific mortality causes. Hazard ratios (HRs) and 95% CIs were determined for all-cause mortality, using multivariable Cox proportional hazards regression models, with age as the underlying time metric. RESULTS A total of 44 551 participants were included, of whom 32 549 (73.1%) were women, with a mean (SD) age at baseline of 56.7 (7.5) years. Ultraprocessed foods accounted for a mean (SD) proportion of 14.4% (7.6%) of the weight of total food consumed, corresponding to a mean (SD) proportion of 29.1% (10.9%) of total energy intake. Ultraprocessed foods consumption was associated with younger age (45-64 years, mean [SE] proportion of food in weight, 14.50% [0.04%]; P < .001), lower income (<€1200/mo, 15.58% [0.11%]; P < .001), lower educational level (no diploma or primary school, 15.50% [0.16%]; P < .001), living alone (15.02% [0.07%]; P < .001), higher body mass index (calculated as weight in kilograms divided by height in meters squared; ≥30, 15.98% [0.11%]; P < .001), and lower physical activity level (15.56% [0.08%]; P < .001). A total of 602 deaths (1.4%) occurred during follow-up. After adjustment for a range of confounding factors, an increase in the proportion of ultraprocessed foods consumed was associated with a higher risk of all-cause mortality (HR per 10% increment, 1.14; 95% CI, 1.04-1.27; P = .008). CONCLUSIONS AND RELEVANCE An increase in ultraprocessed foods consumption appears to be associated with an overall higher mortality risk among this adult population; further prospective studies are needed to confirm these findings and to disentangle the various mechanisms by which ultraprocessed foods may affect health.
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Affiliation(s)
- Laure Schnabel
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Epidémiologie et Statistique, Sorbonne Paris Cité, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Epidémiologie et Statistique, Sorbonne Paris Cité, Bobigny, France
| | - Benjamin Allès
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Epidémiologie et Statistique, Sorbonne Paris Cité, Bobigny, France
| | - Mathilde Touvier
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Epidémiologie et Statistique, Sorbonne Paris Cité, Bobigny, France
| | - Bernard Srour
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Epidémiologie et Statistique, Sorbonne Paris Cité, Bobigny, France
| | - Serge Hercberg
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Epidémiologie et Statistique, Sorbonne Paris Cité, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France
| | - Camille Buscail
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Epidémiologie et Statistique, Sorbonne Paris Cité, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France
| | - Chantal Julia
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Epidémiologie et Statistique, Sorbonne Paris Cité, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France
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354
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Karlsen MC, Rogers G, Miki A, Lichtenstein AH, Folta SC, Economos CD, Jacques PF, Livingston KA, McKeown NM. Theoretical Food and Nutrient Composition of Whole-Food Plant-Based and Vegan Diets Compared to Current Dietary Recommendations. Nutrients 2019; 11:nu11030625. [PMID: 30875784 PMCID: PMC6471973 DOI: 10.3390/nu11030625] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 12/16/2022] Open
Abstract
Public interest in popular diets is increasing, in particular whole-food plant-based (WFPB) and vegan diets. Whether these diets, as theoretically implemented, meet current food-based and nutrient-based recommendations has not been evaluated in detail. Self-identified WFPB and vegan diet followers in the Adhering to Dietary Approaches for Personal Taste (ADAPT) Feasibility Survey reported their most frequently used sources of information on nutrition and cooking. Thirty representative days of meal plans were created for each diet. Weighted mean food group and nutrient levels were calculated using the Nutrition Data System for Research (NDSR) and data were compared to DRIs and/or USDA Dietary Guidelines/MyPlate meal plan recommendations. The calculated HEI-2015 scores were 88 out of 100 for both WFPB and vegan meal plans. Because of similar nutrient composition, only WFPB results are presented. In comparison to MyPlate, WFPB meal plans provide more total vegetables (180%), green leafy vegetables (238%), legumes (460%), whole fruit (100%), whole grains (132%), and less refined grains (−74%). Fiber level exceeds the adequate intakes (AI) across all age groups. WFPB meal plans failed to meet the Recommended Dietary Allowances (RDA)s for vitamin B12 and D without supplementation, as well as the RDA for calcium for women aged 51–70. Individuals who adhere to WFBP meal plans would have higher overall dietary quality as defined by the HEI-2015 score as compared to typical US intakes with the exceptions of calcium for older women and vitamins B12 and D without supplementation. Future research should compare actual self-reported dietary intakes to theoretical targets.
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Affiliation(s)
- Micaela C Karlsen
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
| | - Gail Rogers
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
| | - Akari Miki
- Nutritional Epidemiology Program at Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.
| | - Alice H Lichtenstein
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
- Department of Medicine, Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA.
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
- Department of Medicine, Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA.
| | - Paul F Jacques
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
- Nutritional Epidemiology Program at Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.
| | - Kara A Livingston
- Nutritional Epidemiology Program at Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.
| | - Nicola M McKeown
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
- Nutritional Epidemiology Program at Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.
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355
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Pereira GS, Honorio AR, Gasparetto BR, Lopes CMA, Lima DCND, Tribst AAL. Influence of information received by the consumer on the sensory perception of processed orange juice. J SENS STUD 2019. [DOI: 10.1111/joss.12497] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Geovanna S. Pereira
- The Center for Food Studies (NEPA)University of Campinas (UNICAMP) Campinas São Paulo Brazil
| | - Alice R. Honorio
- The Center for Food Studies (NEPA)University of Campinas (UNICAMP) Campinas São Paulo Brazil
| | - Bruna R. Gasparetto
- Food Engineering, Federal Center for Technological Education Celso Suckow da Fonseca (CEFET‐RJ) Valença Rio de Janeiro Brazil
| | - Carla M. A. Lopes
- Food Engineering, Federal Center for Technological Education Celso Suckow da Fonseca (CEFET‐RJ) Valença Rio de Janeiro Brazil
| | - Diana C. N. d. Lima
- Food Engineering, Federal Center for Technological Education Celso Suckow da Fonseca (CEFET‐RJ) Valença Rio de Janeiro Brazil
| | - Alline A. L. Tribst
- The Center for Food Studies (NEPA)University of Campinas (UNICAMP) Campinas São Paulo Brazil
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356
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Moran AJ, Khandpur N, Polacsek M, Rimm EB. What factors influence ultra-processed food purchases and consumption in households with children? A comparison between participants and non-participants in the Supplemental Nutrition Assistance Program (SNAP). Appetite 2019; 134:1-8. [DOI: 10.1016/j.appet.2018.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 11/02/2018] [Accepted: 12/10/2018] [Indexed: 01/14/2023]
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357
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Food loves company: Risky eating with friends increases interpersonal closeness. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2019. [DOI: 10.1016/j.jesp.2018.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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358
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Ultra-processed food intake and mortality in the USA: results from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). Public Health Nutr 2019; 22:1777-1785. [PMID: 30789115 DOI: 10.1017/s1368980018003890] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the association between ultra-processed food intake and all-cause mortality and CVD mortality in a nationally representative sample of US adults. DESIGN Prospective analyses of reported frequency of ultra-processed food intake in 1988-1994 and all-cause mortality and CVD mortality through 2011. SETTING The Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994).ParticipantsAdults aged ≥20 years (n 11898). RESULTS Over a median follow-up of 19 years, individuals in the highest quartile of frequency of ultra-processed food intake (e.g. sugar-sweetened or artificially sweetened beverages, sweetened milk, sausage or other reconstructed meats, sweetened cereals, confectionery, desserts) had a 31% higher risk of all-cause mortality, after adjusting for demographic and socio-economic confounders and health behaviours (adjusted hazard ratio=1·31; 95% CI 1·09, 1·58; P-trend = 0·001). No association with CVD mortality was observed (P-trend=0·86). CONCLUSIONS Higher frequency of ultra-processed food intake was associated with higher risk of all-cause mortality in a representative sample of US adults. More longitudinal studies with dietary data reflecting the modern food supply are needed to confirm our results.
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359
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Abstract
AbstractThe present commentary contains a clear and simple guide designed to identify ultra-processed foods. It responds to the growing interest in ultra-processed foods among policy makers, academic researchers, health professionals, journalists and consumers concerned to devise policies, investigate dietary patterns, advise people, prepare media coverage, and when buying food and checking labels in shops or at home. Ultra-processed foods are defined within the NOVA classification system, which groups foods according to the extent and purpose of industrial processing. Processes enabling the manufacture of ultra-processed foods include the fractioning of whole foods into substances, chemical modifications of these substances, assembly of unmodified and modified food substances, frequent use of cosmetic additives and sophisticated packaging. Processes and ingredients used to manufacture ultra-processed foods are designed to create highly profitable (low-cost ingredients, long shelf-life, emphatic branding), convenient (ready-to-consume), hyper-palatable products liable to displace all other NOVA food groups, notably unprocessed or minimally processed foods. A practical way to identify an ultra-processed product is to check to see if its list of ingredients contains at least one item characteristic of the NOVA ultra-processed food group, which is to say, either food substances never or rarely used in kitchens (such as high-fructose corn syrup, hydrogenated or interesterified oils, and hydrolysed proteins), or classes of additives designed to make the final product palatable or more appealing (such as flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners, and anti-foaming, bulking, carbonating, foaming, gelling and glazing agents).
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360
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Variation of Adolescent Snack Food Choices and Preferences along a Continuum of Processing Levels: The Case of Apples. Foods 2019; 8:foods8020050. [PMID: 30717139 PMCID: PMC6406983 DOI: 10.3390/foods8020050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 12/27/2022] Open
Abstract
Food processing is used for transforming whole food ingredients into food commodities or edible products. The level of food processing occurs along a continuum from unprocessed to minimally processed, processed, and ultra-processed. Unprocessed foods use little to no processing and have zero additives. Minimally processed foods use finite processing techniques, including drying, freezing, etc., to make whole food ingredients more edible. Processed foods combine culinary ingredients with whole foods using processing and preservation techniques. Ultra-processed foods are manufactured using limited whole food ingredients and a large number of additives. Ultra-processed snack foods are increasing in food environments globally with detrimental implications for human health. This research characterizes the choices, consumption, and taste preferences of adolescents who were offered apple snack food items that varied along a processing level continuum (unprocessed, minimally processed, processed, and ultra-processed). A cross-sectional study was implemented in four elementary school classrooms utilizing a buffet of apple snack food items from the aforementioned four food processing categories. A survey was administered to measure students’ taste acceptance of the snacks. The study found that the students selected significantly (p < 0.0001) greater quantities of ultra-processed snack foods (M = 2.20 servings, SD = 1.23) compared to minimally processed (M = 0.56 servings, SD = 0.43) and unprocessed (M = 0.70 servings, SD = 0.37) snack foods. The students enjoyed the taste of ultra-processed snack foods (M = 2.72, SD = 0.66) significantly more (p < 0.0001) than minimally processed (M = 1.92, SD = 1.0) and unprocessed (M = 2.32, SD = 0.9) snack foods. A linear relationship was found between the selection and consumption quantities for each snack food item (R2 = 0.88). In conclusion, it was found that as processing levels increase in apple snack foods, they become more appealing and more heavily consumed by elementary school students. If applied broadly to snack foods, this conclusion presents one possible explanation regarding the high level of diet-related diseases and nutrient deficiencies across adolescents in America. Food and nutrition education, food product development, and marketing efforts are called upon to improve adolescent food choices and make less-processed snack food options more appealing and accessible to diverse consumers.
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361
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Gibney MJ. Ultra-Processed Foods: Definitions and Policy Issues. Curr Dev Nutr 2019; 3:nzy077. [PMID: 30820487 PMCID: PMC6389637 DOI: 10.1093/cdn/nzy077] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 09/13/2018] [Indexed: 11/12/2022] Open
Abstract
Four categories of foods are proposed in the NOVA food classification, which seeks to relate food processing as the primary driver of diet quality. Of these, the category "ultra-processed foods" has been widely studied in relation both to diet quality and to risk factors for noncommunicable disease. The present paper explores the definition of ultra-processed foods since its inception and clearly shows that the definition of such foods has varied considerably. Because of the difficulty of interpretation of the primary definition, the NOVA group and others have set out lists of examples of foods that fall under the category of ultra-processed foods. The present manuscript demonstrates that since the inception of the NOVA classification of foods, these examples of foods to which this category applies have varied considerably. Thus, there is little consistency either in the definition of ultra-processed foods or in examples of foods within this category. The public health nutrition advice of NOVA is that ultra-processed foods should be avoided to achieve improvements in nutrient intakes with an emphasis on fat, sugar, and salt. The present manuscript demonstrates that the published data for the United States, United Kingdom, France, Brazil, and Canada all show that across quintiles of intake of ultra-processed foods, nutritionally meaningful changes are seen for sugars and fiber but not for total fat, saturated fat, and sodium. Moreover, 2 national surveys in the United Kingdom and France fail to show any link between body mass index and consumption of ultra-processed foods. The paper concludes that constructive scholarly debate needs to be facilitated on many issues that would be affected by a policy to avoid ultra-processed foods.
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Affiliation(s)
- Michael J Gibney
- Institute of Food and Health, University College Dublin, Dublin, Ireland
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362
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Maternal dyslipidaemic diet induces sex-specific alterations in intestinal function and lipid metabolism in rat offspring. Br J Nutr 2019; 121:721-734. [DOI: 10.1017/s0007114519000011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThis study investigated the effects of a maternal dyslipidaemic (DLP) diet on lipid metabolism, microbial counts in faeces and hepatic and intestinal morphology in rat offspring with respect to sex during different phases of life. Wistar rats (dams) were fed a control (CTL) or DLP during gestation and lactation. After weaning, CTL and DLP offspring were fed a standard diet. The effects of a maternal DLP on body composition, biochemical parameters, faecal microbiota and intestinal and hepatic histomorphometric characteristics in rat offspring were evaluated at 30 and 90 d of age. The DLP diet during gestation and lactation caused lower birth weight and a greater weight gain percentage at the end of the 90-d period in both male and female offspring. Female pups from DLP dams had higher liver fat levels compared with CTL (P≤0·001) at 90 d of age. Males from DLP dams had greater visceral fat weight and lower Lactobacillus spp. faecal counts at 90 d of age (P≤0·001) as well as lower faecal fat excretion (P≤0·05) and Bacteroides spp. faecal counts (P≤0·001) at 30 d of age when compared with pups from CTL dams. However, both dams and DLP pups showed damage to intestinal villi. A maternal DLP alters intestinal function and lipid metabolism in a sex-specific manner and is a potential predisposing factor for health complications in offspring from the juvenile period to the adult period.
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363
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Ultra-processed Food Consumption by Pregnant Women: The Effect of an Educational Intervention with Health Professionals. Matern Child Health J 2019; 23:692-703. [DOI: 10.1007/s10995-018-2690-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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364
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Buszkiewicz J, House C, Aggarwal A, Long M, Drewnowski A, Otten JJ. The Impact of a City-Level Minimum Wage Policy on Supermarket Food Prices by Food Quality Metrics: A Two-Year Follow Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16010102. [PMID: 30609676 PMCID: PMC6339052 DOI: 10.3390/ijerph16010102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/12/2018] [Accepted: 12/24/2018] [Indexed: 12/24/2022]
Abstract
Objective: To examine the effects of increasing minimum wage on supermarket food prices in Seattle over 2 years of policy implementation, overall and differentially across food quality metrics. Methods: Prices for the UW Center for Public Health Nutrition (CPHN) market basket of 106 foods were obtained for 6 large supermarket chain stores in Seattle (“intervention”) and for the same chain stores in King County (“control”) at four time points: 1-month pre- (March 2015), 1-month post- (May 2015), 1-year post- (May 2016), and 2-years post-policy implementation (May 2017). Prices for all food items were standardized and converted to price per 100 kcal. Food quality metrics were used to explore potential differential price increases by (a) food groups, as defined by US Department of Agriculture; (b) NOVA food processing categories, and (c) nutrient density quartiles, based on the Nutrient Rich Foods Index 9.3. Separate difference-in-differences linear regression models with robust standard errors, examined price differences per 100 kcal overall, clustered by store chain, and stratified by each food quality metric. Results: There were no overall market basket price changes attributable to Seattle’s minimum wage policy. Moreover, no minimum wage effect was detected by USDA food group, food processing, or nutrient density categories. Conclusions: Local area supermarket food prices were not impacted by Seattle’s minimum wage policy 2 years into policy implementation and after the first increase to $15/h overall or by sub-classification. Low-income workers may be able to afford higher quality diets if wages increase yet supermarket prices stay the same.
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Affiliation(s)
- James Buszkiewicz
- Epidemiology, Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA.
| | - Cathy House
- Nutritional Sciences Program, University of Washington, Seattle, WA 98195, USA.
| | - Anju Aggarwal
- Epidemiology, Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA.
| | - Mark Long
- Daniel J. Evans School of Public Policy and Governance, University of Washington, Seattle, WA 98195, USA.
| | - Adam Drewnowski
- Epidemiology, Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA.
| | - Jennifer J Otten
- Environmental and Occupational Health Sciences, Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA.
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365
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ALVES PC, SAMPAIO HADC, HENRIQUES EMV, ARRUDA SPM, CARIOCA AAF. Dietary assessment of women surviving breast cancer according to the Dietary Guidelines for the Brazilian Population. REV NUTR 2019. [DOI: 10.1590/1678-9865201932e190054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective Review the diet and nutritional status of women surviving breast cancer following the Dietary Guidelines for the Brazilian Population. Methods A cross-sectional study was conducted with 201 women, who underwent anthropometric measurements to determine body mass index, waist circumference and waist/hip ratio. Dietary assessment was performed usinga food frequency questionnaire. Consumption was stratifi ed into four groups: fresh/minimally processed food (Group 1), processed food ingredients (Group 2), processed food (Group 3) and ultra-processed food (Group 4).The ratio of daily contribution of each food group to total calories and macronutrients supply was calculated. Statistical analysis was performed using Chi-square tests and Spearman correlation, with p<0.05 as significance level. Results The mean age was 50 ± 11 years. An abdominal fat accumulation with a high excess weight condition in women under 60 years of age (p=0.003) was observed. A greater intake of group 1 food, but contributing with about 1/3 of the calories and macronutrients total intake as compared to food groups 3 and 4 was also observed. Conclusion The women assessed consumed a higher proportion of calories and macronutrients from fresh/minimally processed food. There is no theoretical reference that allows to affirm that the amount of processed andultra-processed food consumed represents a health hazard for those women. There was no association between dietary intake, nutritional status and age group.
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366
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Martin C, Issanchou S. Nutrient sensing: What can we learn from different tastes about the nutrient contents in today’s foods? Food Qual Prefer 2019. [DOI: 10.1016/j.foodqual.2018.07.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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367
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Effect of a health reminder on consumers’ selection of ultra-processed foods in a supermarket. Food Qual Prefer 2019. [DOI: 10.1016/j.foodqual.2018.08.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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368
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Consumption of ultra-processed food products and diet quality among children, adolescents and adults in Belgium. Eur J Nutr 2018; 58:3267-3278. [DOI: 10.1007/s00394-018-1870-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 11/23/2018] [Indexed: 01/17/2023]
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369
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Association of Dietary Advanced Glycation End Products with Metabolic Syndrome in Young Mexican Adults. MEDICINES 2018; 5:medicines5040128. [PMID: 30513741 PMCID: PMC6313307 DOI: 10.3390/medicines5040128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 11/22/2018] [Accepted: 11/27/2018] [Indexed: 01/13/2023]
Abstract
Background: Consumption of dietary advanced glycation end products is linked to metabolic syndrome. The objective was to describe the association between dietary advanced glycation end products intake and metabolic syndrome in young Mexican adults. Methods: The present was a cross-sectional study in 126 Mexican adults 18–35 years old evaluating metabolic syndrome through the harmonized criteria. Macronutrients and dietary advanced glycation end products intake were estimated through three 24-hour dietary recalls and food composition tables. Association between metabolic syndrome and high advanced glycation end products intake (≥10,000 kU/day) was evaluated through three logistic regression models adjusted by sex, age, family history of cardiometabolic diseases and energy intake. Results: Subjects with a higher advanced glycation end products intake were more likely to have impaired fasting glucose (OR: 4.91, 95% CI 1.29–18.60, p < 0.05) and metabolic syndrome (OR: 2.67, 95% CI 0.96–7.44, p = 0.059) than those participants with low consumption of these products after adjustment of sex, age, family history of cardiovascular disease and energy intake. Conclusions: High intake of dietary advanced glycation end products was significantly associated with impaired fasting glucose and marginally with metabolic syndrome in young Mexican adults regardless of sex, age, family history of cardiovascular disease and energy intake.
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370
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Noreen W, Johnson-Down L, Jean-Claude M, Lucas M, Robinson E, Batal M. Factors associated with the intake of traditional foods in the Eeyou Istchee (Cree) of northern Quebec include age, speaking the Cree language and food sovereignty indicators. Int J Circumpolar Health 2018; 77:1536251. [PMID: 30360700 PMCID: PMC6211274 DOI: 10.1080/22423982.2018.1536251] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/25/2018] [Accepted: 09/27/2018] [Indexed: 01/14/2023] Open
Abstract
The Eeyouch are a First Nations (Cree) population that live above 49.6°N latitude in Eeyou Istchee in northern Quebec. Eeyouch rely on traditional foods (TF) hunted, fished or gathered from the land. The overarching aim of this study was to achieve an understanding of the factors associated with TF intake among Eeyouch. Data were from 465 women and 330 men who participated in the Nituuchischaayihtitaau Aschii Multi-Community Environment-and-Health (E&H) study. The relationship between TF consumption and dietary, health, sociodemographic and food sovereignty (i.e. being a hunter or receiving Income Security to hunt, trap or fish) variables was examined using linear and logistic regression. Analyses were stratified by sex because of the male/female discrepancy in being a hunter. Among respondents, almost all (99.7%) consumed TF, 51% were hunters and 10% received Income Security. Higher intake of TF was associated with lower consumption of less nutritious ultra-processed products (UPP). In women, TF intake increased with age, hunting and receiving Income Security, but decreased with high school education. In men, TF intake increased with age and speaking only Cree at home. The findings suggest that increased food sovereignty would result in improved diet quality among Eeyouch through increased TF intake and decreased UPP intake.
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Affiliation(s)
- Willows Noreen
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Louise Johnson-Down
- Département de nutrition, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Moubarac Jean-Claude
- Département de nutrition, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Michel Lucas
- Axe Santé publique et pratiques optimales en santé, Centre de recherche du Centre Hospitalier Universitaire (CHU) de Québec, Québec, QC, Canada
- Department of Social and Preventive Medicine, Université Laval, Québec, QC, Canada
| | - Elizabeth Robinson
- Cree Board of health and Social Services of James Bay, Montreal, QC, Canada
| | - Malek Batal
- Département de nutrition, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
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371
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The impact of a multilevel childhood obesity prevention intervention on healthful food acquisition, preparation, and fruit and vegetable consumption on African-American adult caregivers. Public Health Nutr 2018; 22:1300-1315. [PMID: 30463637 DOI: 10.1017/s1368980018003038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the secondary impact of a multilevel, child-focused, obesity intervention on food-related behaviours (acquisition, preparation, fruit and vegetable (FV) consumption) on youths' primary caregivers. DESIGN B'More Healthy Communities for Kids (BHCK) group-randomized controlled trial promoted access to healthy foods and food-related behaviours through wholesaler and small store strategies, peer mentor-led nutrition education aimed at youths, and social media and text messaging targeting their adult caregivers. Measures included caregivers' (n 516) self-reported household food acquisition frequency for FV, snacks and grocery items over 30 d, and usual FV consumption in a sub-sample of 226 caregivers via the NCI FV Screener. Hierarchical models assessed average treatment effects (ATE). Treatment-on-the-treated-effect (TTE) analyses evaluated correlation between behavioural change and exposure to BHCK. Exposure scores at post-assessment were based on self-reported viewing of BHCK materials and participating in activities. SETTING Thirty Baltimore City low-income neighbourhoods, USA.ParticipantsAdult caregivers of youths aged 9-15 years. RESULTS Of caregivers, 90·89 % were female; mean age 39·31 (sd 9·31) years. Baseline mean (sd) intake (servings/d) was 1·30 (1·69) fruits and 1·35 (1·05) vegetables. In ATE, no significant intervention effect was found on caregivers' food-related behaviours. In TTE, each point increase in BHCK exposure score (range: 0-6·9) increased caregivers' daily fruit consumption by 0·2 servings (0·24 (se 0·11); 95 % CI 0·04, 0·47). Caregivers reporting greater social media exposure tripled their daily fruit intake (3·16 (se 0·92); 95 % CI 1·33, 4·99) and increased their frequency of unhealthy food purchasing v. baseline. CONCLUSIONS Child-focused community-based nutrition interventions may also benefit family members' fruit intake. Child-focused interventions should involve adult caregivers and intervention effects on family members should be assessed. Future multilevel studies should consider using social media to improve reach and engage caregiver participants.
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372
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Tippens KM, Erlandsen A, Hanes DA, Graybill R, Jackson C, Briley J, Zwickey H. Impact of a Short-Term Naturopathic Whole-Foods-Based Nutrition Education Intervention on Dietary Behavior and Diabetes Risk Markers: A Pilot Study. J Altern Complement Med 2018; 25:234-240. [PMID: 30312107 DOI: 10.1089/acm.2018.0025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To assess the feasibility of measuring the health impacts of a 12-week naturopathic whole foods nutrition education course among adults with or at risk for prediabetes. DESIGN A pilot nonrandomized pre-post intervention design investigated physiological changes associated with participation in a 12-week structured naturopathic nutrition education course. Follow-up measures were assessed at 6 and 12 months from baseline. SETTINGS/LOCATION Three community-based kitchens in Oregon. SUBJECTS Forty-five adults with or at risk for prediabetes. INTERVENTION Twelve weekly 90-min workshops emphasizing the health benefits of a naturopathic whole foods diet and including collective meal preparation and communal dining. OUTCOME MEASURES Changes in biomarkers of diabetes and cardiovascular disease risk, including high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c, insulin, and lipids, and changes in dietary behaviors at baseline, postintervention (12 weeks), and 6- and 12-month follow-up. Changes in biomarkers and food consumption patterns were assessed using linear mixed models with random intercept, including data from all participants who completed the end-of-intervention assessment. RESULTS Pre-post intervention results for 45 participants showed decreases in blood glucose and hs-CRP. Food frequency questionnaire data showed decreases in daily servings of grain, dairy, and fat postintervention. Decreases in blood glucose, hs-CRP, triglycerides, cholesterol, low-density lipoprotein, very-low-density lipoprotein, and HbA1c from baseline were observed at 12-month follow-up. Both insulin and high-density lipoprotein were decreased from baseline and 12-week levels at the 6-month follow-up but increased from all earlier levels at 12 months (all p < 0.0001). Daily servings of meat, dairy, and fat remained decreased at 6-month follow-up. Reduced grain consumption observed at 12-week and at 6-month follow-up was not sustained, and increased at 12 months, although still decreased from baseline. CONCLUSIONS Results suggest that this naturopathic nutrition education series may promote dietary behavior change with associated changes in clinical biomarkers. Larger controlled studies are needed to confirm these results.
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Affiliation(s)
- Kimberly M Tippens
- 1 National University of Natural Medicine, Portland, OR.,2 Helfgott Research Institute, Portland, OR
| | - Andrew Erlandsen
- 1 National University of Natural Medicine, Portland, OR.,2 Helfgott Research Institute, Portland, OR.,3 Food As Medicine Institute, Portland, OR
| | - Douglas A Hanes
- 1 National University of Natural Medicine, Portland, OR.,2 Helfgott Research Institute, Portland, OR
| | - Robert Graybill
- 1 National University of Natural Medicine, Portland, OR.,2 Helfgott Research Institute, Portland, OR
| | - Courtney Jackson
- 1 National University of Natural Medicine, Portland, OR.,3 Food As Medicine Institute, Portland, OR
| | - Julie Briley
- 1 National University of Natural Medicine, Portland, OR.,3 Food As Medicine Institute, Portland, OR
| | - Heather Zwickey
- 1 National University of Natural Medicine, Portland, OR.,2 Helfgott Research Institute, Portland, OR
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373
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Abstract
The NOVA food categorisation recommends ‘avoiding processed foods (PF), especially ultra-processed foods (UPF)’ and selecting minimally PF to address obesity and chronic disease. However, NOVA categories are drawn using non-traditional views of food processing with additional criteria including a number of ingredients, added sugars, and additives. Comparison of NOVA's definition and categorisation of PF with codified and published ones shows limited congruence with respect to either definition or food placement into categories. While NOVA studies associate PF with decreased nutrient density, other classifications find nutrient-dense foods at all levels of processing. Analyses of food intake data using NOVA show UPF provide much added sugars. Since added sugars are one criterion for designation as UPF, such a proof demonstrates a tautology. Avoidance of foods deemed as UPF, such as wholegrain/enriched bread and cereals or flavoured milk, may not address obesity but could decrease intakes of folate, calcium and dietary fibre. Consumer understanding and implementation of NOVA have not been tested. Neither have outcomes been compared with vetted patterns, such as Dietary Approaches to Stop Hypertension, which base food selection on food groups and nutrient contribution. NOVA fails to demonstrate the criteria required for dietary guidance: understandability, affordability, workability and practicality. Consumers’ confusion about definitions and food categorisations, inadequate cooking and meal planning skills and scarcity of resources (time, money), may impede adoption and success of NOVA. Research documenting that NOVA can be implemented by consumers and has nutrition and health outcomes equal to vetted patterns is needed.
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374
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Workinger JL, Doyle RP, Bortz J. Challenges in the Diagnosis of Magnesium Status. Nutrients 2018; 10:E1202. [PMID: 30200431 PMCID: PMC6163803 DOI: 10.3390/nu10091202] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 12/31/2022] Open
Abstract
Magnesium is a critical mineral in the human body and is involved in ~80% of known metabolic functions. It is currently estimated that 60% of adults do not achieve the average dietary intake (ADI) and 45% of Americans are magnesium deficient, a condition associated with disease states like hypertension, diabetes, and neurological disorders, to name a few. Magnesium deficiency can be attributed to common dietary practices, medications, and farming techniques, along with estimates that the mineral content of vegetables has declined by as much as 80⁻90% in the last 100 years. However, despite this mineral's importance, it is poorly understood from several standpoints, not the least of which is its unique mechanism of absorption and sensitive compartmental handling in the body, making the determination of magnesium status difficult. The reliance on several popular sample assays has contributed to a great deal of confusion in the literature. This review will discuss causes of magnesium deficiency, absorption, handling, and compartmentalization in the body, highlighting the challenges this creates in determining magnesium status in both clinical and research settings.
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Affiliation(s)
- Jayme L Workinger
- Human Nutrition and Pharma, Balchem Corporation, 52 Sunrise Park Road, New Hampton, NY 10958, USA.
| | - Robert P Doyle
- Department of Chemistry, Center for Science and Technology, Syracuse University, 111 College Place, Syracuse, NY 13244, USA.
| | - Jonathan Bortz
- Human Nutrition and Pharma, Balchem Corporation, 52 Sunrise Park Road, New Hampton, NY 10958, USA.
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375
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Abstract
AbstractObjectiveStudies have shown that the consumption of added sugars may be associated with harmful health effects. The present study investigated the presence and types of added sugars in packaged foods.DesignCross-sectional analysis of the presence and types of added sugars in the ingredients lists of packaged foods sold in a major Brazilian supermarket. The nomenclature of ingredients classified as added sugars and their frequency were identified. Data were organised and analysed through descriptive statistics: absolute and relative frequencies of the presence of added sugars categorised by food groups were calculated, and ingredients were analysed by text mining using R statistical environment.SettingA supermarket in Florianópolis, a metropolis in southern Brazil.SubjectsPackaged food products (n 4539) classified into eight groups.ResultsOf the 4539 products, 71 % had some type of added sugar. The group with the highest frequency of added sugars was ‘products in which carbohydrates and fats are the main energy source’ (93 %). Food groups containing predominantly salty foods had a high frequency of added sugars, such as ‘meats and eggs’ (61 %). In total, 179 different terms for added sugars were identified, of which sugar, maltodextrin and glucose syrup were the most frequent.ConclusionsMost of the packaged foods sold in Brazil contain added sugars, which may hamper adherence to the recommendation of limiting added sugars intake. The data may be useful for monitoring tendencies in the use of added sugars in packaged foods and as supplementary information to support the improvement of food label regulations.
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376
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Association Between Ultra-Processed Food Consumption and Functional Gastrointestinal Disorders: Results From the French NutriNet-Santé Cohort. Am J Gastroenterol 2018; 113:1217-1228. [PMID: 29904158 DOI: 10.1038/s41395-018-0137-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/30/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Ultra-processed foods (UPF) consumption has increased over the last decades and is raising concerns about potential adverse health effects. Our objective was to assess the association between UPF consumption and four functional gastrointestinal disorders (FGIDs): irritable bowel syndrome (IBS), functional constipation (FC), functional diarrhea (FDh), and functional dyspepsia (FDy), in a large sample of French adults. METHODS We analyzed dietary data of 33,343 participants from the web-based NutriNet-Santé cohort, who completed at least three 24 h food records, prior to a Rome III self-administered questionnaire. Proportion (in weight) of UPF in the diet (UPFp) was computed for each subject. The association between UPFp quartiles and FGIDs was estimated by multivariable logistic regression. RESULTS Participants included in the analysis were mainly women (76.4%), and the mean age was 50.4 (SD = 14.0) years. UPF accounted for 16.0% of food consumed in weight, corresponding to 33.0% of total energy intake. UPF consumption was associated with younger age, living alone, lower incomes, higher BMI, and lower physical activity level (all p < 0.0001). A total of 3516 participants reported IBS (10.5%), 1785 FC (5.4%), 1303 FDy (3.9%), and 396 FDh (1.1%). After adjusting for confounding factors, an increase in UPFp was associated with a higher risk of IBS (aOR Q4 vs. Q1 [95% CI]: 1.25 [1.12-1.39], p-trend < 0.0001). CONCLUSIONS This study suggests an association between UPF and IBS. Further longitudinal studies are needed to confirm those results and understand the relative impact of the nutritional composition and specific characteristics of UPF in this relationship.
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377
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Serving Size and Nutrition Labelling: Implications for Nutrition Information and Nutrition Claims on Packaged Foods. Nutrients 2018; 10:nu10070891. [PMID: 30002339 PMCID: PMC6073381 DOI: 10.3390/nu10070891] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/08/2018] [Accepted: 06/23/2018] [Indexed: 12/13/2022] Open
Abstract
The presentation of nutrition information on a serving size basis is a strategy that has been adopted by several countries to promote healthy eating. Variation in serving size, however, can alter the nutritional values reported on food labels and compromise the food choices made by the population. This narrative review aimed to discuss (1) current nutrition labelling legislation regarding serving size and (2) the implications of declared serving size for nutrition information available on packaged foods. Most countries with mandatory food labelling require that serving size be presented on food labels, but variation in this information is generally allowed. Studies have reported a lack of standardisation among serving sizes of similar products which may compromise the usability of nutrition information. Moreover, studies indicate that food companies may be varying serving sizes as a marketing strategy to stimulate sales by reporting lower values of certain nutrients or lower energy values on nutrition information labels. There is a need to define the best format for presenting serving size on food labels in order to provide clear and easily comprehensible nutrition information to the consumer.
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378
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Sammugam L, Pasupuleti VR. Balanced diets in food systems: Emerging trends and challenges for human health. Crit Rev Food Sci Nutr 2018; 59:2746-2759. [PMID: 29693412 DOI: 10.1080/10408398.2018.1468729] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Processed foods, generally known as modified raw foods produced by innovative processing technologies alters the food constituents such natural enzymes, fatty acids, micronutrients, macronutrients and vitamins. In contrast to fresh and unprocessed foods, processed foods are guaranteed to be safer, imperishable, long lasting and consist high level of nutrients bioactivity. Currently, the evolution in food processing technologies is necessary to face food security and safety, nutrition demand, its availability and also other global challenges in the food system. In this scenario, this review consists of information on two food processing technologies, which effects on processed foods before and after processing and the impact of food products on human health. It is also very well established that understanding the type and structure of foods to be processed can assist food processing industries towards advancement of novel food products. In connection with this fact, the present article also discusses the emerging trends and possible modifications in food processing technologies with the combination of conventional and modern techniques to get the suitable nutritional and safety qualities in food.
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Affiliation(s)
- Lakhsmi Sammugam
- Faculty of Agro-Based Industry, Universiti Malaysia Kelantan , Campus Jeli, Jeli , Malaysia
| | - Visweswara Rao Pasupuleti
- Faculty of Agro-Based Industry, Universiti Malaysia Kelantan , Campus Jeli, Jeli , Malaysia.,Institute of Food Security and Sustainable Agriculture, Universiti Malaysia Kelantan , Campus Jeli, Jeli , Malaysia
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379
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Abstract
AbstractUltra-processed foods provide 58 % of energy intake and 89 % of added sugars in the American diet. Nevertheless, the association between ultra-processed foods and excess weight has not been investigated in a US sample. The present investigation therefore aims to examine the association between ultra-processed foods and excess weight in a nationally representative sample of US adults. We performed a cross-sectional analysis of anthropometric and dietary data from 15 977 adults (20–64 years) participating in the National Health and Nutrition Examination Survey 2005–2014. Dietary data were collected by 24-h recall. Height, weight and waist circumference (WC) were measured. Foods were classified as ultra-processed/non-ultra-processed according to the NOVA classification. Multivariable linear and logistic regression was used to evaluate the association between ultra-processed food consumption (% energy) and BMI, WC and odds of BMI≥25 kg/m2, BMI≥30 kg/m2 and abdominal obesity (men: WC≥102 cm, women: WC≥88 cm). Prevalence of BMI≥25 kg/m2, BMI≥30 kg/m2 and abdominal obesity was 69·2, 36·1 and 53·0 %, respectively. Consuming ≥74·2 v. ≤36·5 % of total energy from ultra-processed foods was associated with 1·61 units higher BMI (95 % CI 1·11, 2·10), 4·07 cm greater WC (95 % CI 2·94, 5·19) and 48, 53 and 62 % higher odds of BMI≥25 kg/m2, BMI≥30 kg/m2 and abdominal obesity, respectively (OR 1·48; 95 % CI 1·25, 1·76; OR 1·53; 95 % CI 1·29, 1·81; OR 1·62; 95 % CI 1·39, 1·89, respectively; Pfor trend<0·001 for all). A significant interaction between being female and ultra-processed food consumption was found for BMI (F4,79=4·89, P=0·002), WC (F4,79=3·71, P=0·008) and BMI≥25 kg/m2 (F4,79=5·35, P<0·001). As the first study in a US population, our findings support that higher consumption of ultra-processed food is associated with excess weight, and that the association is more pronounced among women.
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380
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Fardet A. Characterization of the Degree of Food Processing in Relation With Its Health Potential and Effects. ADVANCES IN FOOD AND NUTRITION RESEARCH 2018; 85:79-129. [PMID: 29860978 DOI: 10.1016/bs.afnr.2018.02.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Up today technological processes are intended to produce safe and palatable food products. Yet, it is also expected that processing produces healthy and sustainable foods. However, due to the dramatic increase of chronic diseases prevalence worldwide, i.e., obesity, type 2 diabetes, cardiovascular diseases, and some cancers, ultraprocessing has been pointed out as producing unhealthy foods, rich in energy and poor in protective micronutrients and fiber, i.e., "empty" calories. Indeed the 1980s saw massive arrivals of ultraprocessed foods in supermarkets, i.e., fractionated-recombined foods with added ingredients and/or additives. Epidemiological studies clearly emphasized that populations adhering the most to ultraprocessed foods, e.g., processed meat, refined grains, ultraprocessed plant-based foods, and/or sweetened beverages, exhibited the higher prevalence of chronic diseases. This prompted researchers to classify foods according to their degree of processing as with the international NOVA classification (i.e., un/minimally processed, processed, and ultraprocessed foods). More and more studies showed that such a classification makes sense for health. Overall one distinguishes three categories of processes: mechanical, thermal, and fermentative treatments, this latter being the more favorable to food health potential. This chapter has therefore several ambitions: (1) to review association between degree of food processing and chronic disease risk prevalence; (2) to explore the impact of technological processes on food health potential considering both matrix and compositional effects; (3) to discuss the need for classifying food according to their degree of processing in future epidemiological studies; and (4) to analyze consequences of adhering to a more holistic paradigm in both food processing and nutrition.
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Affiliation(s)
- Anthony Fardet
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France.
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381
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Baraldi LG, Martinez Steele E, Canella DS, Monteiro CA. Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study. BMJ Open 2018; 8:e020574. [PMID: 29525772 PMCID: PMC5855172 DOI: 10.1136/bmjopen-2017-020574] [Citation(s) in RCA: 225] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/05/2018] [Accepted: 01/31/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To compare ultra-processed food consumption across sociodemographic groups and over time (2007-2008, 2009-2010, 2011-2012) in the USA. DESIGN Cross-sectional study. SETTING National Health and Nutrition Examination Survey (NHANES) 2007-2012. PARTICIPANTS All individuals aged ≥2 years with at least one 24-hour dietary recall were included (n=23 847). MAIN OUTCOME MEASURES Average dietary contribution of ultra-processed foods (expressed as a percentage of the total caloric value of the diet), obtained after classifying all food items according to extent and purpose of industrial food processing using NOVA classification. DATA ANALYSIS Linear regression was used to evaluate the association between sociodemographic characteristics or NHANES cycles and dietary contribution of ultra-processed foods. RESULTS Almost 60% of calories consumed in the period 2007-2012 came from ultra-processed foods. Consumption of ultra-processed foods decreased with age and income level, was higher for non-Hispanic whites or non-Hispanic blacks than for other race/ethnicity groups and lower for people with college than for lower levels of education, all differences being statistically significant. Overall contribution of ultra-processed foods increased significantly between NHANES cycles (nearly 1% point per cycle), the same being observed among males, adolescents and high school education-level individuals. CONCLUSIONS Ultra-processed food consumption in the USA in the period 2007-2012 was overall high, greater among non-Hispanic whites or non-Hispanic blacks, less educated, younger, lower-income strata and increased across time.
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Affiliation(s)
- Larissa Galastri Baraldi
- 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
| | - Euridice Martinez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Daniela Silva Canella
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
- Department of Applied Nutrition, Institute of Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Carlos Augusto 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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382
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Simões BDS, Barreto SM, Molina MDCB, Luft VC, Duncan BB, Schmidt MI, Benseñor IJM, Cardoso LDO, Levy RB, Giatti L. Consumption of ultra-processed foods and socioeconomic position: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health. CAD SAUDE PUBLICA 2018. [DOI: 10.1590/0102-311x00019717] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The objective of the study was to estimate the contribution of ultra-processed foods to total caloric intake and investigate whether it differs according to socioeconomic position. We analyzed baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil 2008-2010; N = 14.378) and data on dietary intake using a food frequency questionnaire, assigning it into three categories: unprocessed or minimally processed foods and processed culinary ingredients, processed foods, and ultra-processed foods. We measured the associations between socioeconomic position (education, per capita household income, and occupational social class) and the percentage of caloric contribution of ultra-processed foods, using generalized linear regression models adjusted for age and sex. Unprocessed or minimally processed foods and processed culinary ingredients contributed to 65.7% of the total caloric intake, followed by ultra-processed foods (22.7%). After adjustments, the percentage of caloric contribution of ultra-processed foods was 20% lower among participants with incomplete elementary school when compared to postgraduates. Compared to individuals from upper income classes, the caloric contribution of ultra-processed foods was 10%, 15% and 20% lower among the ones from the three lowest income, respectively. The caloric contribution of ultra-processed foods was also 7%, 12%, 12%, and 17% lower among participants in the lowest occupational social class compared to those from high social classes. Results suggest that the caloric contribution of ultra-processed foods is higher among individuals from high socioeconomic positions with a dose-response relationship for the associations.
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383
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Tseng M, Neill DB, Teaford SF, Nazmi A. Alternative MyPlate Menus: Effects of Ultra-Processed Foods on Saturated Fat, Sugar, and Sodium Content. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:258-266.e1. [PMID: 29229564 DOI: 10.1016/j.jneb.2017.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/12/2017] [Accepted: 10/19/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Compare saturated fat, sugar, and sodium in the US Department of Agriculture sample menu with a version in which menu items were replaced with comparable ultra-processed foods. DESIGN AND SETTING The authors modified 7 days of a US Department of Agriculture sample menu providing approximately 2,000 kcal/d by replacing foods with comparable ultra-processed alternatives and then visited 2 chain supermarkets in San Luis Obispo, CA (August, 2016) to locate shopping list items for the 2 menu versions. Product-specific bar codes were entered into an application for recording dietary intake and analyzing nutrient content. VARIABLES MEASURED/ANALYSIS Paired t tests (with Bonferroni correction, α = .003) were performed to compare the menus' percent energy from saturated fat and sugar, and energy and sodium content. RESULTS Mean energy was lower (1,618 vs 1,892 kcal/d; P = .002) whereas percent energy from sugar (24.9% vs 21.4%; P ≤ .001) and sodium content (2,784 vs 2,101 mg/d; P = .001) were higher in the ultra-processed vs original menu. In secondary analyses, mean cost of the ultra-processed version exceeded that of the original menu by $36.87. CONCLUSIONS AND IMPLICATIONS In a sample menu developed to meet US Dietary Guidelines, substituting items with ultra-processed foods provided fewer calories but more sugar and sodium. Distinguishing ultra-processed from less processed foods may help consumers make healthier choices when using MyPlate tools, particularly in a food environment that presents a wide range of alternatives.
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Affiliation(s)
- Marilyn Tseng
- STRIDE and the Kinesiology Department, California Polytechnic State University, San Luis Obispo, CA.
| | - Dawn B Neill
- Social Sciences Department, California Polytechnic State University, San Luis Obispo, CA
| | - Stephanie F Teaford
- STRIDE and the Kinesiology Department, California Polytechnic State University, San Luis Obispo, CA
| | - Aydin Nazmi
- Food Science and Nutrition Department, California Polytechnic State University, San Luis Obispo, CA
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384
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Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, Deschasaux M, Fassier P, Latino-Martel P, Beslay M, Hercberg S, Lavalette C, Monteiro CA, Julia C, Touvier M. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ 2018; 360:k322. [PMID: 29444771 PMCID: PMC5811844 DOI: 10.1136/bmj.k322] [Citation(s) in RCA: 505] [Impact Index Per Article: 84.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To assess the prospective associations between consumption of ultra-processed food and risk of cancer. DESIGN Population based cohort study. SETTING AND PARTICIPANTS 104 980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Santé cohort (2009-17). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants' usual consumption for 3300 different food items. These were categorised according to their degree of processing by the NOVA classification. MAIN OUTCOME MEASURES Associations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer assessed by multivariable Cox proportional hazard models adjusted for known risk factors. RESULTS Ultra-processed food intake was associated with higher overall cancer risk (n=2228 cases; hazard ratio for a 10% increment in the proportion of ultra-processed food in the diet 1.12 (95% confidence interval 1.06 to 1.18); P for trend<0.001) and breast cancer risk (n=739 cases; hazard ratio 1.11 (1.02 to 1.22); P for trend=0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (lipid, sodium, and carbohydrate intakes and/or a Western pattern derived by principal component analysis). CONCLUSIONS In this large prospective study, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer. Further studies are needed to better understand the relative effect of the various dimensions of processing (nutritional composition, food additives, contact materials, and neoformed contaminants) in these associations. STUDY REGISTRATION Clinicaltrials.gov NCT03335644.
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Affiliation(s)
- Thibault Fiolet
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Laury Sellem
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Benjamin Allès
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | | | - Mélanie Deschasaux
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Philippine Fassier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Paule Latino-Martel
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Marie Beslay
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Céline Lavalette
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Carlos A Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Chantal Julia
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
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385
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Spiteri SA, Olstad DL, Woods JL. Nutritional quality of new food products released into the Australian retail food market in 2015 - is the food industry part of the solution? BMC Public Health 2018; 18:222. [PMID: 29415698 PMCID: PMC5804078 DOI: 10.1186/s12889-018-5127-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 01/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food manufacturers have made public statements and voluntary commitments, such as the Healthier Australia Commitment (HAC), to improve the nutritional quality of foods. However, limited information about the nutritional quality or healthfulness of new products makes it difficult to determine if manufacturers are doing this. The purpose of this study was to assess the healthfulness of new food products released into the Australian retail market in 2015, and whether those companies who were HAC members released healthier food options compared to non-HAC members. METHODS This cross-sectional study assessed the healthfulness of all new retail food products launched in Australia in 2015 as indexed in Mintel's Global New Products Database. Healthfulness was assessed using three classification schemes: Healthy Choices Framework Victoria, Australian Dietary Guidelines and NOVA Food Classification System. Descriptive statistics and chi-squared tests described and compared the number and proportions of new foods falling within each of the food classification schemes' categories for companies that were and were not HAC members. RESULTS In 2015, 4143 new food products were launched into the Australian market. The majority of new products were classified in each schemes' least healthy category (i.e. red, discretionary and ultra-processed). Fruits and vegetables represented just 3% of new products. HAC members launched a significantly greater proportion of foods classified as red (59% vs 51% for members and non-members, respectively) discretionary (79% vs 61%), and ultra-processed (94% vs 81%), and significantly fewer were classified as green (8% vs 15%), core foods (18% vs 36%) and minimally processed (0% vs 6%) (all p < 0.001). CONCLUSIONS This study found that the majority of new products released into the Australian retail food market in 2015 were classified in each of three schemes' least healthy categories. A greater proportion of new products launched by companies that publicly committed to improve the nutritional quality of their products were unhealthy, and a lower proportion were healthy, compared with new products launched by companies that did not so commit. Greater monitoring of industry progress in improving the healthfulness of the food supply may be warranted, with public accountability if the necessary changes are not seen.
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Affiliation(s)
- Sheree A. Spiteri
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Dana Lee Olstad
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Julie L. Woods
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
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386
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Seattle's minimum wage ordinance did not affect supermarket food prices by food processing category. Public Health Nutr 2018; 21:1762-1770. [PMID: 29409555 DOI: 10.1017/s1368980017004037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the impacts of Seattle's minimum wage ordinance on food prices by food processing category. DESIGN Supermarket food prices were collected for 106 items using a University of Washington Center for Public Health Nutrition market basket at affected and unaffected supermarket chain stores at three times: March 2015 (1-month pre-policy enactment), May 2015 (1-month post-policy enactment) and May 2016 (1-year post-policy enactment). Food items were categorized into four food processing groups, from minimally to ultra-processed. Data were analysed across time using a multilevel, linear difference-in-differences model at the store and price level stratified by level of food processing. SETTING Six large supermarket chain stores located in Seattle ('intervention') affected by the policy and six same-chain but unaffected stores in King County ('control'), Washington, USA. SUBJECTS One hundred and six food and beverage items. RESULTS The largest change in average price by food item was +$US 0·53 for 'processed foods' in King County between 1-month post-policy and 1-year post-policy enactment (P < 0·01). The smallest change was $US 0·00 for 'unprocessed or minimally processed foods' in Seattle between 1-month post-policy and 1-year post-policy enactment (P = 0·94). No significant changes in averaged chain prices were observed across food processing level strata in Seattle v. King County stores at 1-month or 1-year post-policy enactment. CONCLUSIONS Supermarket food prices do not appear to be differentially impacted by Seattle's minimum wage ordinance by level of the food's processing. These results suggest that the early implementation of a city-level minimum wage policy does not alter supermarket food prices by level of food processing.
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387
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Yonemori KM, Ennis T, Novotny R, Fialkowski MK, Ettienne R, Wilkens LR, Leon Guerrero RT, Bersamin A, Coleman P, Li F, Boushey CJ. Collecting wrappers, labels, and packages to enhance accuracy of food records among children 2-8 years in the Pacific region: Children's Healthy Living Program (CHL). J Food Compost Anal 2018; 64:112-118. [PMID: 29398780 DOI: 10.1016/j.jfca.2017.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim was to describe differences in dietary outcomes based on the provision of food wrappers, labels or packages (WLP) to complement data from dietary records (DR) among children from the US Affiliated Pacific. The WLP were intended to aid food coding. Since WLP can be associated with ultra-processed foods, one might expect differences in sodium, sugar, and other added ingredients to emerge. Dietary intakes of children (2-8 y) in Alaska, Hawai'i, Commonwealth of the Northern Mariana Islands, and Guam were collected using parent/caregiver completed 2-day DR. Parents were encouraged to collect WLP associated with the child's intake. Trained staff entered data from the DRs including the WLP when available using PacTrac3, a web application. Of the 1,868 DRs collected and entered at the time of this report, 498 (27%) included WLP. After adjusting for confounders (sex, age, location, education, food assistance), the DRs with WLP had significantly higher amounts of energy (kcal), total fat, saturated fat, added sugar, and sodium. These results suggest the inclusion of WLP enhanced the dietary intake data. The intake of energy, fat, added sugar and sodium derived from processed foods and foods consumed outside the home was better captured in children who had WLP.
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Affiliation(s)
- Kim M Yonemori
- University of Hawai'i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA
| | | | | | | | | | - Lynne R Wilkens
- University of Hawai'i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA
| | | | | | | | | | - Carol J Boushey
- University of Hawai'i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA
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388
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David IA, Krutman L, Fernández-Santaella MC, Andrade JR, Andrade EB, Oliveira L, Pereira MG, Gomes FS, Gleiser S, Oliveira JM, Araújo RL, Volchan E, Braga F. Appetitive drives for ultra-processed food products and the ability of text warnings to counteract consumption predispositions. Public Health Nutr 2018; 21:543-557. [PMID: 29173214 PMCID: PMC10284718 DOI: 10.1017/s1368980017003263] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 09/12/2017] [Accepted: 10/06/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study aimed to (i) assess the appetitive drives evoked by the visual cues of ultra-processed food and drink products and (ii) investigate whether text warnings reduce appetitive drives and consumers' reported intentions to eat or drink ultra-processed products. DESIGN In Study I, a well-established psychometric tool was applied to estimate the appetitive drives associated with ultra-processed products using sixty-four image representations. Sixteen product types with four exemplars of a given product were included. Pictures from the International Affective Picture System (IAPS) served as controls. The two exemplars of each product type rated as more appetitive were selected for investigation in the second study. Study II assessed the impact of textual warnings on the appetitive drive towards these thirty-two exemplars. Each participant was exposed to two picture exemplars of the same product type preceded by a text warning or a control text. After viewing each displayed picture, the participants reported their emotional reactions and their intention to consume the product. SETTING Controlled classroom experiments SUBJECTS: Undergraduate students (Study I: n 215, 135 women; Study II: n 98, 52 women). RESULTS In Study I, the pictures of ultra-processed products prompted an appetitive motivation associated with the products' nutritional content. In Study II, text warnings were effective in reducing the intention to consume and the appetitive drive evoked by ultra-processed products. CONCLUSIONS This research provides initial evidence favouring the use of text warnings as a public policy tool to curb the powerful influence of highly appetitive ultra-processed food cues.
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Affiliation(s)
- Isabel A David
- Departamento de Fisiologia e Farmacologia, Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Pires de Mello 101, Niterói, RJ 24210-130, Brazil
| | - Laura Krutman
- Departamento de Fisiologia e Farmacologia, Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Pires de Mello 101, Niterói, RJ 24210-130, Brazil
- Facultad de Psicología, Universidad de Granada, Granada, Spain
| | | | - Jéssica R Andrade
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Eduardo B Andrade
- Fundação Getulio Vargas, Escola Brasileira de Administração Pública e de Empresas, Rio de Janeiro, RJ, Brazil
| | - Leticia Oliveira
- Departamento de Fisiologia e Farmacologia, Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Pires de Mello 101, Niterói, RJ 24210-130, Brazil
| | - Mirtes G Pereira
- Departamento de Fisiologia e Farmacologia, Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Pires de Mello 101, Niterói, RJ 24210-130, Brazil
| | - Fabio S Gomes
- Pan American Health Organization/World Health Organization, Washington, DC, USA
| | - Sonia Gleiser
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - José M Oliveira
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Renata L Araújo
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Eliane Volchan
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Filipe Braga
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Campus-UFRJ-Macaé Professor Aloísio Teixeira, Universidade Federal do Rio de Janeiro, Macaé, RJ, Brazil
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389
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Abstract
Weight loss can be achieved through a variety of modalities, but long-term maintenance of lost weight is much more challenging. Obesity interventions typically result in early weight loss followed by a weight plateau and progressive regain. This review describes current understanding of the biological, behavioral, and environmental factors driving this near-ubiquitous body weight trajectory and the implications for long-term weight management. Treatment of obesity requires ongoing clinical attention and weight maintenance-specific counseling to support sustainable healthful behaviors and positive weight regulation.
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Affiliation(s)
- Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, 12A South Drive, Room 4007, Bethesda, MD 20892, USA.
| | - Scott Kahan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; George Washington University School of Medicine, 1020 19th Street NW, Suite 450, Washington, DC 20036, USA
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390
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Latasa P, Louzada MLDC, Martinez Steele E, Monteiro CA. Added sugars and ultra-processed foods in Spanish households (1990-2010). Eur J Clin Nutr 2017; 72:1404-1412. [PMID: 29277837 DOI: 10.1038/s41430-017-0039-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/20/2017] [Accepted: 10/16/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND/OBJECTIVES To study the association between ultra-processed foods acquisitions and added sugar content of total food purchases in Spanish households in 2010. Changes over time (1990-2000-2010) in ultra-processed food purchases and added sugars content of total food purchases are also compared. SUBJECTS/METHODS We used data from three nationally representative Household Budget Surveys (HBS) conducted in 1990, 2000 and 2010. Number of studied households was 21,012, 33,730 and 22,116, respectively. Purchased foods and drinks were classified according to NOVA food groups as ultra-processed foods, processed foods, unprocessed or minimally processed foods, or processed culinary ingredients. Linear and Poisson regressions were used to estimate the association between quintiles of energy contribution of ultra-processed foods and added sugars contents of total food purchases in 2010. Changes over time were assessed using tests of linear trend and Student's t test. RESULTS In 2010, ultra-processed foods represented 31.7% of daily energy acquisitions and 80.4% of all added sugars. Added sugars content of food purchases raised from 7.3% in the lowest to 18.2% in the highest quintiles of energy contribution of ultra-processed foods. The risk of exceeding 10% energy from added sugars quadrupled between the lowest and highest quintiles. The percentage of ultra-processed foods on all food purchases almost tripled between 1990 and 2010 (from 11.0 to 31.7%), paralleling the increase of added sugars content (from 8.4 to 13.0%). CONCLUSIONS Cutting down exceeding added sugars availability in Spain may require a reduction in ultra-processed food purchasing.
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Affiliation(s)
- P Latasa
- Servicio de Epidemiología, Dirección General de Salud Pública de la Comunidad de Madrid, Madrid, Spain
| | - M L D 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
| | - 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
| | - 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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391
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Batal M, Johnson-Down L, Moubarac JC, Ing A, Fediuk K, Sadik T, Chan HM, Willows N. Sociodemographic associations of the dietary proportion of ultra-processed foods in First Nations peoples in the Canadian provinces of British Columbia, Manitoba, Alberta and Ontario. Int J Food Sci Nutr 2017; 69:753-761. [PMID: 29252033 DOI: 10.1080/09637486.2017.1412405] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We investigated the food types consumed by 3276 First Nations citizens from the First Nations Food Nutrition and Environment Study (FNFNES) living on-reserve in Canada. Data from 24-h dietary recalls were classified into NOVA categories: fresh or minimally processed foods (MPF), processed culinary ingredients, processed foods, and ultra-processed foods (UPF). Individuals were classified as traditional food (TF) eaters if they ate MPF of their First Nations culture. UPF accounted for 54.0% of energy intake; 23% of participants ate TF. Increasing age and household size, living in British Columbia and TF eating were associated with a lower intake of energy from UPF. Eating TF appeared to be protective against intake of UPF.
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Affiliation(s)
- Malek Batal
- a Département de nutrition, Faculté de Médecine , Université de Montréal, Pavillon Liliane de Stewart , Montréal , QC , Canada
| | - Louise Johnson-Down
- b School of Dietetics and Human Nutrition , McGill University , Ste Anne de Bellevue , QC , Canada
| | - Jean-Claude Moubarac
- a Département de nutrition, Faculté de Médecine , Université de Montréal, Pavillon Liliane de Stewart , Montréal , QC , Canada
| | - Amy Ing
- a Département de nutrition, Faculté de Médecine , Université de Montréal, Pavillon Liliane de Stewart , Montréal , QC , Canada
| | - Karen Fediuk
- c First Nations Food, Nutrition and Environment Study , University of Ottawa , Ottawa , ON , Canada
| | - Tonio Sadik
- d Assembly of First Nations , Ottawa , ON , Canada
| | - Hing Man Chan
- e Department of Biology , University of Ottawa , Ottawa , ON , Canada
| | - Noreen Willows
- f Department of Agricultural, Food and Nutritional Science , University of Alberta , Edmonton , AB , Canada
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Rohatgi KW, Tinius RA, Cade WT, Steele EM, Cahill AG, Parra DC. Relationships between consumption of ultra-processed foods, gestational weight gain and neonatal outcomes in a sample of US pregnant women. PeerJ 2017; 5:e4091. [PMID: 29230355 PMCID: PMC5723430 DOI: 10.7717/peerj.4091] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 11/03/2017] [Indexed: 01/22/2023] Open
Abstract
Background An increasingly large share of diet comes from ultra-processed foods (UPFs), which are assemblages of food substances designed to create durable, convenient and palatable ready-to-eat products. There is increasing evidence that high UPF consumption is indicative of poor diet and is associated with obesity and metabolic disorders. This study sought to examine the relationship between percent of energy intake from ultra-processed foods (PEI-UPF) during pregnancy and maternal gestational weight gain, maternal lipids and glycemia, and neonatal body composition. We also compared the PEI-UPF indicator against the US government’s Healthy Eating Index-2010 (HEI-2010). Methods Data were used from a longitudinal study performed in 2013–2014 at the Women’s Health Center and Obstetrics & Gynecology Clinic in St. Louis, MO, USA. Subjects were pregnant women in the normal and obese weight ranges, as well as their newborns (n = 45). PEI-UPF and the Healthy Eating Index-2010 (HEI-2010) were calculated for each subject from a one-month food frequency questionnaire (FFQ). Multiple regression (ANCOVA-like) analysis was used to analyze the relationship between PEI-UPF or HEI-2010 and various clinical outcomes. The ability of these dietary indices to predict clinical outcomes was also compared with the predictive abilities of total energy intake and total fat intake. Results An average of 54.4 ± 13.2% of energy intake was derived from UPFs. A 1%-point increase in PEI-UPF was associated with a 1.33 kg increase in gestational weight gain (p = 0.016). Similarly, a 1%-point increase in PEI-UPF was associated with a 0.22 mm increase in thigh skinfold (p = 0.045), 0.14 mm in subscapular skinfold (p = 0.026), and 0.62 percentage points of total body adiposity (p = 0.037) in the neonate. Discussion PEI-UPF (percent of energy intake from ultra-processed foods) was associated with and may be a useful predictor of increased gestational weight gain and neonatal body fat. PEI-UPF was a better predictor of all tested outcomes than either total energy or fat intake, and a better predictor of the three infant body fat measures than HEI-2010. UPF consumption should be limited during pregnancy and diet quality should be maximized in order to improve maternal and neonatal health.
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Affiliation(s)
- Karthik W Rohatgi
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Rachel A Tinius
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, United States of America
| | - W Todd Cade
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, United States of America
| | | | - Alison G Cahill
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Diana C Parra
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, United States of America
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393
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Barco Leme AC, Tucunduva Philippi S. Home food availability, parents’/caregivers’ support, and family meals influence on dietary servings of low-income urban adolescent girls from Brazil. ACTA ACUST UNITED AC 2017. [DOI: 10.1186/s41110-017-0053-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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394
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Poti JM, Braga B, Qin B. Ultra-processed Food Intake and Obesity: What Really Matters for Health-Processing or Nutrient Content? Curr Obes Rep 2017; 6:420-431. [PMID: 29071481 PMCID: PMC5787353 DOI: 10.1007/s13679-017-0285-4] [Citation(s) in RCA: 232] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW The aim of this narrative review was to summarize and critique recent evidence evaluating the association between ultra-processed food intake and obesity. RECENT FINDINGS Four of five studies found that higher purchases or consumption of ultra-processed food was associated with overweight/obesity. Additional studies reported relationships between ultra-processed food intake and higher fasting glucose, metabolic syndrome, increases in total and LDL cholesterol, and risk of hypertension. It remains unclear whether associations can be attributed to processing itself or the nutrient content of ultra-processed foods. Only three of nine studies used a prospective design, and the potential for residual confounding was high. Recent research provides fairly consistent support for the association of ultra-processed food intake with obesity and related cardiometabolic outcomes. There is a clear need for further studies, particularly those using longitudinal designs and with sufficient control for confounding, to potentially confirm these findings in different populations and to determine whether ultra-processed food consumption is associated with obesity independent of nutrient content.
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Affiliation(s)
- Jennifer M Poti
- Department of Nutrition, Carolina Population Center, University of North Carolina at Chapel Hill, Campus Box #7461, Chapel Hill, NC, 27599, USA.
| | - Bianca Braga
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of International Studies, Universidad Torcuato Di Tella, Buenos Aires, Argentina
| | - Bo Qin
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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395
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Aguayo-Patrón SV, Calderón de la Barca AM. Old Fashioned vs. Ultra-Processed-Based Current Diets: Possible Implication in the Increased Susceptibility to Type 1 Diabetes and Celiac Disease in Childhood. Foods 2017; 6:foods6110100. [PMID: 29140275 PMCID: PMC5704144 DOI: 10.3390/foods6110100] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 10/27/2017] [Accepted: 11/08/2017] [Indexed: 01/14/2023] Open
Abstract
Ultra-processed foods are ready-to-heat and ready-to-eat products created to replace traditional homemade meals and dishes due to convenience and accessibility. Because of their low-fiber and high-fat and sugar composition, these foodstuffs could induce a negative impact on health. They are partially responsible for obesity and chronic non-transmissible diseases; additionally, they could impact in the prevalence of autoimmune diseases such as type 1 diabetes and celiac disease. The rationale is that the nutritional composition of ultra-processed foodstuffs can induce gut dysbiosis, promoting a pro-inflammatory response and consequently, a “leaky gut”. These factors have been associated with increased risk of autoimmunity in genetically predisposed children. In addition, food emulsifiers, commonly used in ultra-processed products could modify the gut microbiota and intestinal permeability, which could increase the risk of autoimmunity. In contrast, unprocessed and minimally processed food-based diets have shown the capacity to promote gut microbiota eubiosis, anti-inflammatory response, and epithelial integrity, through bacterial butyrate production. Thus, to decrease the susceptibility to autoimmunity, genetically predisposed children should avoid ultra-processed food products and encourage the consumption of fresh and minimally processed foods.
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Affiliation(s)
- Sandra V Aguayo-Patrón
- Departamento de Nutrición y Metabolismo, Centro de Investigación en Alimentación y Desarrollo, A.C., Carretera a La Victoria, Km. 0.6, Hermosillo, Sonora 83304, Mexico.
| | - Ana M Calderón de la Barca
- Departamento de Nutrición y Metabolismo, Centro de Investigación en Alimentación y Desarrollo, A.C., Carretera a La Victoria, Km. 0.6, Hermosillo, Sonora 83304, Mexico.
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396
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Abstract
It is now generally agreed that the impact of the current nature, purpose and extent of food processing on human well-being, health and disease needs to be better understood and explained, in order to improve public health. The special issue of Public Health Nutrition devoted to the concept of ultra-processing of food, and the NOVA classification of which ultra-processed foods are one category, is a great step forward in this work. Coincidentally, a polemical 'critical appraisal' of ultra-processing was recently published in another journal. Debate and discussion are an essential part of the scientific endeavour. In this commentary, we correct inaccurate statements made about NOVA in the 'appraisal,' rebut points raised, and discuss the larger issue of scientific responsibility for publishing opposing views on controversial topics.
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397
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Harrison CA, Taren D. How poverty affects diet to shape the microbiota and chronic disease. Nat Rev Immunol 2017; 18:279-287. [PMID: 29109542 DOI: 10.1038/nri.2017.121] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Here, we discuss the link between nutrition, non-communicable chronic diseases and socio-economic standing, with a special focus on the microbiota. We provide a theoretical framework and several lines of evidence from both animal and human studies that support the idea that income inequality is an underlying factor for the maladaptive changes seen in the microbiota in certain populations. We propose that this contributes to the health disparities that are seen between lower-income and higher-income populations in high-income countries.
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Affiliation(s)
- Christy A Harrison
- Departments of Immunobiology and Pediatrics, University of Arizona, Tucson, USA
| | - Douglas Taren
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
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398
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Nieto-Orozco C, Chanin Sangochian A, Tamborrel Signoret N, Vidal González E, Tolentino-Mayo L, Vergara-Castañeda A. Percepción sobre el consumo de alimentos procesados y productos ultraprocesados en estudiantes de posgrado de la Ciudad de México. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jbhsi.2018.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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399
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Prescott SL, Logan AC. Each meal matters in the exposome: Biological and community considerations in fast-food-socioeconomic associations. ECONOMICS AND HUMAN BIOLOGY 2017; 27:328-335. [PMID: 29107462 DOI: 10.1016/j.ehb.2017.09.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/23/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
Advances in omics and microbiome technology have transformed the ways in which the biological consequences of life in the 'ecological theatre' can be visualized. Exposome science examines the total accumulated environmental exposures (both detrimental and beneficial) as a means to understand the response of the 'total organism to the total environment' over time. The repetitive stimulation of compensatory physiological responses (immune, cardiovascular, neuroendocrine) in response to stress - including sources of stress highly relevant to socioeconomic disadvantage - may lead to metabolic dysregulation and cellular damage, ultimately influencing behavior and disease. The collective toll of physiological wear and tear, known as allostatic load, is not paid equally throughout developed societies. It is paid in excess by the disadvantaged. In the context of fast-food, human and experimental research demonstrates that the biological response to a single fast-food-style meal - especially as mediated by the microbiome- is a product of the person's total lived experience, including the ability to buffer the fast-food meal-induced promotion of inflammation and oxidative stress. Emerging research indicates that each meal and its nutritional context matters. As we discuss, equal weekly visits to major fast-food outlets by the affluent and deprived do not translate into biological equivalency. Hence, debate concerning reducing fast-food outlets through policy - especially in disadvantaged neighborhoods where they are prevalent - requires a biological context. The fast-food establishment and fast-food meal - as they represent matters of food justice and press upon non-communicable disease risk - are far more than physical structures and collections of carbohydrate, fat, sugar and sodium.
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Affiliation(s)
- Susan L Prescott
- School of Medicine, University of Western Australia, PO Box D184, Princess Margaret Hospital, Perth, WA, 6001, Australia; International Inflammation (in-FLAME) Network, Research Group of the Worldwide Universities Network (WUN), 6010 Park Ave, Suite #4081, West New York, NJ, 07093, United States.
| | - Alan C Logan
- International Inflammation (in-FLAME) Network, Research Group of the Worldwide Universities Network (WUN), 6010 Park Ave, Suite #4081, West New York, NJ, 07093, United States
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400
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Abstract
Obesity rates are increasing worldwide. Potential reasons include excessive consumption of sugary beverages and energy-dense foods instead of more nutrient-rich options. On a per kJ basis, energy-dense grains, added sugars and fats cost less, whereas lean meats, seafood, leafy greens and whole fruit generally cost more. Given that consumer food choices are often driven by price, the observed social inequities in diet quality and health can be explained, in part, by nutrition economics. Achieving a nutrient-rich diet at an affordable cost has become progressively more difficult within the constraints of global food supply. However, given the necessary metrics and educational tools, it may be possible to eat better for less. New metrics of nutrient density help consumers identify foods, processed and unprocessed, that are nutrient-rich, affordable and appealing. Affordability metrics, created by adding food prices to food composition data, permit calculations of both kJ and nutrients per penny, allowing for new studies on the economic drivers of food choice. Merging dietary intake data with local or national food prices permits the estimation of individual-level diet costs. New metrics of nutrient balance can help identify those food patterns that provide optimal nutritional value. Behavioural factors, including cooking at home, have been associated with nutrition resilience, defined as healthier diets at lower cost. Studies of the energy and nutrient costs of the global food supply and diverse food patterns will permit a better understanding of the socioeconomic determinants of health. Dietary advice ought to be accompanied by economic feasibility studies.
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