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Logan AC, D'Adamo CR, Pizzorno JE, Prescott SL. "Food faddists and pseudoscientists!": Reflections on the history of resistance to ultra-processed foods. Explore (NY) 2024; 20:470-476. [PMID: 38176973 DOI: 10.1016/j.explore.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/10/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
The term 'ultra-processed food' emerged in the 1980s, mostly used in reference to highly-processed convenience foods and snacks, often energy-dense, poor in nutrients, and inclusive of various synthetic additives such as emulsifiers, colors, artificial sweeteners, and/or flavor enhancers. Concern over such foods was part of the growing holistic and environmental health movements of the 1970-80s; yet, those who raised alarm about the encroachment of ultra-processed foods were often labeled, especially by industry and their powerful allies, as 'food faddists' and 'pseudoscientists'. Today, the topic of ultra-processed foods is generating massive personal, public, and planetary health interest. However, other than discussing the history of the NOVA food classification system, a useful tool that has allowed researchers to more accurately separate foods based on processing, most lay media and academic articles are ahistorical. That is, there is a tendency to present the term ultra-processed food(s) as a relatively new entrance into the lexicon, and by default, the idea that health-related pushback on ultra-processed foods is a relatively new phenomenon. This omission overlooks decades of determined advocacy and clinical work, much of it by pioneers within the holistic medicine (now integrative, functional, and lifestyle medicine) movement. Here in this reflection paper, the authors will use historical research and reporting to fill in the historical gap and articulate the saliency of why it matters.
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Affiliation(s)
- Alan C Logan
- Nova Institute for Health, Baltimore, MD 21231, USA.
| | - Christopher R D'Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA; Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | | | - Susan L Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA; Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Medical School, University of Western Australia, Nedlands, WA 6009, Australia; The ORIGINS Project, Telethon Kids Institute, Nedlands, WA 6009, Australia
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Disdier AC, Etilé F, Rotunno L. The international diffusion of food innovations and the nutrition transition: retrospective longitudinal evidence from country-level data, 1970-2010. BMJ Glob Health 2023; 8:e012062. [PMID: 37967902 PMCID: PMC10660632 DOI: 10.1136/bmjgh-2023-012062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/10/2023] [Indexed: 11/17/2023] Open
Abstract
INTRODUCTION There is a lack of quantitative evidence on the role of food innovations-new food ingredients and processing techniques-in the nutrition transition. OBJECTIVE Document the distribution of food innovations across 67 high-income (HIC) and middle-income (MIC) countries between 1970 and 2010, and its association with the nutritional composition of food supply. METHODS We used all available data on food patents, as compiled by the European Patent Office, to measure food innovations. We considered innovations directly received by countries from inventors seeking protection in their territories, and those embedded in processed food imports. Food and Agricultural Organization data were used to estimate the associations between international diffusion of food innovations and trends in total food supply and its macronutrient composition, after adjusting for confounding trends in demand-side factors. We identified the role of trade by simulating the changes in average diet due to innovations embedded in food imports. RESULTS Trends in food innovations were positively and significantly associated with changes in daily per capita calorie supply available for human consumption in MIC between 1990 and 2010 (elasticity of 0.027, 95% CI 0.019 to 0.036). Food innovations were positively correlated with the share of animal and free fats in total food supply (elasticities of 0.044, 95% CI 0.030 to 0.058 for MIC between 1970 and 1989 and 0.023, 95% CI 0.003 to 0.043 for HIC between 1990 and 2010). Food innovations were associated with substitutions from complex carbohydrates towards sugars in total food supply for MIC after 1990 (elasticities of -0.037, 95% CI -0.045 to -0.029 for complex carbs, 0.082, 95% CI 0.066 to 0.098 for sugars). For these countries, the trade channel capturing access to innovations through imports of processed food played a key role. CONCLUSION Policy-makers should consider the impacts of the international diffusion of food innovations in assessing the costs and benefits of international trade regulations.
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Affiliation(s)
- Anne-Célia Disdier
- Paris School of Economics, Paris, France
- UMR 1393, Paris-Jourdan Sciences Economiques, INRAE, Paris, France
| | - Fabrice Etilé
- Paris School of Economics, Paris, France
- UMR 1393, Paris-Jourdan Sciences Economiques, INRAE, Paris, France
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Prescott SL, D’Adamo CR, Holton KF, Ortiz S, Overby N, Logan AC. Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6461. [PMID: 37569002 PMCID: PMC10419141 DOI: 10.3390/ijerph20156461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this "great plant transition" with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed "plant-based" commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into "plant-based" foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales-of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the "Future of Food", which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources-meat vs. novel soy/pea protein burgers, etc.-the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.
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Affiliation(s)
- Susan L. Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Medical School, University of Western Australia, Nedlands, WA 6009, Australia
- The ORIGINS Project, Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Christopher R. D’Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Kathleen F. Holton
- Departments of Health Studies and Neuroscience, Center for Neuroscience and Behavior, American University, Washington, DC 20016, USA;
| | - Selena Ortiz
- Department of Health Policy and Administration, The Pennsylvania State University, State College, PA 16802, USA;
| | - Nina Overby
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, 4630 Kristiansand, Norway;
| | - Alan C. Logan
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
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Fitzgerald M. It is time to appreciate the value of processed foods. Trends Food Sci Technol 2023. [DOI: 10.1016/j.tifs.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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Sadler CR, Grassby T, Hart K, Raats MM, Sokolović M, Timotijevic L. “Even We Are Confused”: A Thematic Analysis of Professionals' Perceptions of Processed Foods and Challenges for Communication. Front Nutr 2022; 9:826162. [PMID: 35284464 PMCID: PMC8904920 DOI: 10.3389/fnut.2022.826162] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/11/2022] [Indexed: 12/29/2022] Open
Abstract
Processed foods are increasingly under the spotlight since the development of classification systems based on proxies for food processing. Published critical reviews and commentaries suggest different views among professional disciplines about the definition and classification of processed food. There is a need to further understand perspectives of professionals on the conceptualisation of processed food and the agreements and disagreements among experts, to encourage interdisciplinary dialogue and aid communication to the public. The aim of this research was to elicit views and understandings of professionals on processed food, their perceptions of lay people's perceptions of the same, and their perspectives on the challenges of communicating about processed foods to the public. The online discussion groups brought together a range of professionals (n = 27), covering the fields of nutrition, food technology, policy making, industry, and civil society, mixed in 5 heterogenous groups. Through thematic analysis the following themes relating to the conceptualisation of processed food and challenges for communication were identified: (1) Broad concepts that need differentiation; (2) Disagreements on scope and degree of processing; (3) The role of food processing within the food system: the challenges in framing risks and benefits; and (4) The challenge of different perspectives and interests for risk communication. Throughout the discussions blurred lines in the characterisation of processing, processed foods, and unhealthy foods were observed. Participants agreed that consensus is important, but difficult. Participants identified a need for further interdisciplinary dialogue, including public engagement, to break down the observed issues, and work towards a mutual understanding and develop clear communication messages.
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Affiliation(s)
- Christina R. Sadler
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Food, Consumer Behaviour and Health Research Centre, School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- European Food Information Council, Brussels, Belgium
- *Correspondence: Christina R. Sadler
| | - Terri Grassby
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Kathryn Hart
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Monique M. Raats
- Food, Consumer Behaviour and Health Research Centre, School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | | | - Lada Timotijevic
- Food, Consumer Behaviour and Health Research Centre, School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Gislaine GM, Montserrat VR, Carrasco JA, Sáez KC, Bibiloni MDM, Tur JA. Adaption and reliability of the Nutrition Environment Measures for stores (NEMS-S) instrument for use in urban areas of Chile. BMC Public Health 2022; 22:224. [PMID: 35114954 PMCID: PMC8815185 DOI: 10.1186/s12889-022-12651-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To adapt and assess reliability of the Chilean version of Nutritional Environment Measurement for Stores (NEMS-S-CHILE) to measure the food environment of stores in urban areas. Design NEMS-S-CHILE was the NEMS-S tool adapted to the Chilean food patterns; foods were grouped according to level of processing in (a) unprocessed or minimally processed foods, (b) processed culinary ingredients, (c) processed foods, and (d) ultra-processed foods, and scored according to NEMS-S-CHILE tool. Reliability inter evaluators was measured. Setting City of Concepción, Bio-Bio region, Chile. Participants Seventeen of a total of 25 supermarkets, and 9 out of 10 street markets according to the municipal registry and the street market trade unions, representing 74.3% of both types of food premises in Concepción. Results Reliability inter evaluators was measured by the following aspects: product availability, price, quality, and variety, through the intraclass correlation coefficient (ICC), percent agreement, and Cohen’s kappa analysis. Reliability was high for availability, where the kappa index and ICC were acceptable, ranging from moderate to high (0.42 to 1.00 for the kappa coefficient and 0.65 to 1.00 for ICC), as well as for prices (ICC: 0.65-1.00 ), variety (kappa: 0.76-1.00) and quality (percent agreement: 68.2- 100%). Conclusions The adapted instrument, NEMS-S-CHILE, has a high reliability inter evaluators and can be useful to measure the availability of foods by the level of processing according to the prevalent food system in developing countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12651-w.
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Affiliation(s)
- Granfeldt M Gislaine
- Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepción, Concepción, Chile
| | - Victoriano R Montserrat
- Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepción, Concepción, Chile
| | - Juan Antonio Carrasco
- Department of Civil Engineering, Faculty of Engineering, University of Concepción, Concepción, Chile
| | - Katia C Sáez
- Faculty of Physical Sciences and Mathematics, Department of Statistics, University of Concepción, Concepción, Chile
| | - Maria Del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, E-07122, Palma de Mallorca, Spain.,Institute of Health Carlos III, CIBEROBN (Physiopathology of Obesity and Nutrition, CB12/03/30038), E-28029, Madrid, Spain.,Health Research Institute of the Balearic Islands (IDISBA), E-07120, Palma de Mallorca, Spain
| | - Josep A Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, E-07122, Palma de Mallorca, Spain. .,Institute of Health Carlos III, CIBEROBN (Physiopathology of Obesity and Nutrition, CB12/03/30038), E-28029, Madrid, Spain. .,Health Research Institute of the Balearic Islands (IDISBA), E-07120, Palma de Mallorca, Spain. .,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, IDISBA & CIBEROBN, Guillem Colom Bldg, Campus, E-07122, Palma de Mallorca, Spain.
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Romieu I, Khandpur N, Katsikari A, Biessy C, Torres-Mejía G, Ángeles-Llerenas A, Alvarado-Cabrero I, Sánchez GI, Maldonado ME, Porras C, Rodriguez AC, Garmendia ML, Chajés V, Aglago EK, Porter PL, Lin M, His M, Gunter MJ, Huybrechts I, Rinaldi S. Consumption of industrial processed foods and risk of premenopausal breast cancer among Latin American women: the PRECAMA study. BMJ Nutr Prev Health 2022; 5:1-9. [PMID: 35814719 PMCID: PMC9237890 DOI: 10.1136/bmjnph-2021-000335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/08/2021] [Indexed: 12/24/2022] Open
Abstract
Ultra-processed food intake has been linked to an increased risk of breast cancer in Western populations. No data are available in the Latin American population although the consumption of ultra-processed foods is increasing rapidly in this region. We evaluated the association of ultra-processed food intake to breast cancer risk in a case-control study including 525 cases (women aged 20-45 years) and 525 matched population-based controls from Chile, Colombia, Costa Rica and Mexico. The degree of processing of foods was classified according to the NOVA classification. Overall, the major contributors to ultra-processed food intake were ready-to-eat/heat foods (18.2%), cakes and desserts (16.7%), carbonated and industrial fruit juice beverages (16.7%), breakfast cereals (12.9%), sausages and reconstituted meat products (12.1%), industrial bread (6.1%), dairy products and derivatives (7.6%) and package savoury snacks (6.1%). Ultra-processed food intake was positively associated with the risk of breast cancer in adjusted models (OR T3-T1=1.93; 95% CI=1.11 to 3.35). Specifically, a higher risk was observed with oestrogen receptor positive breast cancer (ORT3-T1=2.44, (95% CI=1.01 to 5.90, P-trend=0.049), while no significant association was observed with oestrogen receptor negative breast cancer (ORT3-T1=1.87, 95% CI=0.43 to 8.13, P-trend=0.36). Our findings suggest that the consumption of ultra-processed foods might increase the risk of breast cancer in young women in Latin America. Further studies should confirm these findings and disentangle specific mechanisms relating ultra-processed food intake and carcinogenic processes in the breast.
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Affiliation(s)
- Isabelle Romieu
- Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA
| | - Neha Khandpur
- Department of Nutrition, Faculty of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Aikaterini Katsikari
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Gabriela Torres-Mejía
- Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Angélica Ángeles-Llerenas
- Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Isabel Alvarado-Cabrero
- Servicio de Patología del Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
| | - Gloria Inés Sánchez
- Group Infection and Cancer, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Maria Elena Maldonado
- Grupo Impacto de los Componentes Alimentarios en la Salud, School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - Carolina Porras
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA, San Jose, Costa Rica
| | - Ana Cecilia Rodriguez
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA, San Jose, Costa Rica
| | - Maria Luisa Garmendia
- Instituto de Nutrición y de Tecnología de los Alimentos, Universidad de Chile, Santiago de Chile, Chile
| | - Vèronique Chajés
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Elom K Aglago
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Peggy L Porter
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - MingGang Lin
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Mathilde His
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
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Konieczna J, Morey M, Abete I, Bes-Rastrollo M, Ruiz-Canela M, Vioque J, Gonzalez-Palacios S, Daimiel L, Salas-Salvadó J, Fiol M, Martín V, Estruch R, Vidal J, Martínez-González MA, Canudas S, Jover AJ, Fernández-Villa T, Casas R, Olbeyra R, Buil-Cosiales P, Babio N, Schröder H, Martínez JA, Romaguera D. Contribution of ultra-processed foods in visceral fat deposition and other adiposity indicators: Prospective analysis nested in the PREDIMED-Plus trial. Clin Nutr 2021; 40:4290-4300. [PMID: 33610419 DOI: 10.1016/j.clnu.2021.01.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/28/2020] [Accepted: 01/11/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Ultra-processed food and drink products (UPF) consumption has been associated with obesity and its-related comorbidities. Excess of visceral fat, which appears with increasing age, has been considered as the culprit contributing to adiposity-associated adverse health outcomes. However, none of previous studies elucidated the link between UPF and directly quantified adiposity and its distribution. We aimed to prospectively investigate the association between concurrent changes in UPF consumption and objectively assessed adiposity distribution. METHODS A subsample of 1485 PREDIMED-Plus participants (Spanish men and women aged 55-75 years with overweight/obesity and metabolic syndrome) underwent body composition measurements. Consumption of UPF at baseline, 6 and 12 months was evaluated using a validated 143-item semi-quantitative Food Frequency Questionnaire. Food items (g/day) were categorized according to their degree of processing using NOVA system. Regional adiposity (visceral fat (in g) and android-to-gynoid fat ratio) and total fat mass (in g) at three time points were measured with dual-energy X-ray absorptiometry (DXA) and were normalized using sex-specific z-scores. The association of changes in UPF consumption, expressed as the percentage of total daily intake (daily g of UPF/total daily g of food and beverage intake∗100), with adiposity changes was evaluated using linear mixed-effects models. RESULTS On average, the consumption of UPF accounted for 8.11% (SD 7.41%) of total daily intake (in grams) at baseline. In multivariable-adjusted model, 10% daily increment in consumption of UPF was associated with significantly (all p-values <0.05) greater accumulation of visceral fat (β 0.09 z-scores, 95% CI 0.05; 0.13), android-to-gynoid fat ratio (0.05, 0.00; 0.09) and total fat (0.09, 0.06; 0.13). CONCLUSION A higher consumption of UPF was associated with greater age-related visceral and overall adiposity accumulation. Further studies are warranted to confirm these results in other populations and settings. TRIAL REGISTRATION The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
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Affiliation(s)
- Jadwiga Konieczna
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Marga Morey
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Itziar Abete
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, Pamplona, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Maira Bes-Rastrollo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Miguel Ruiz-Canela
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Jesus Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, Alicante, Spain
| | - Sandra Gonzalez-Palacios
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, Alicante, Spain
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Hospital Universitari San Joan de Reus, Reus, Spain; Institut d'Investigació Pere Virgili (IISPV), Reus, Spain
| | - Miguel Fiol
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Grupo de Investigación en Interacciones Gen - Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Ramón Estruch
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Miguel A Martínez-González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Silvia Canudas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Hospital Universitari San Joan de Reus, Reus, Spain; Institut d'Investigació Pere Virgili (IISPV), Reus, Spain
| | - Antoni J Jover
- Atención Primaria Mallorca, Centro de Salud Arquitecte Bennàssar, Palma de Mallorca, Spain
| | - Tania Fernández-Villa
- Grupo de Investigación en Interacciones Gen - Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Rosa Casas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Romina Olbeyra
- Department of Endocrinology, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Pilar Buil-Cosiales
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Nancy Babio
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Hospital Universitari San Joan de Reus, Reus, Spain; Institut d'Investigació Pere Virgili (IISPV), Reus, Spain
| | - Helmut Schröder
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - J Alfredo Martínez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, Pamplona, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Dora Romaguera
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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10
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Baker P, Machado P, Santos T, Sievert K, Backholer K, Hadjikakou M, Russell C, Huse O, Bell C, Scrinis G, Worsley A, Friel S, Lawrence M. Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers. Obes Rev 2020; 21:e13126. [PMID: 32761763 DOI: 10.1111/obr.13126] [Citation(s) in RCA: 402] [Impact Index Per Article: 100.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022]
Abstract
Understanding the drivers and dynamics of global ultra-processed food (UPF) consumption is essential, given the evidence linking these foods with adverse health outcomes. In this synthesis review, we take two steps. First, we quantify per capita volumes and trends in UPF sales, and ingredients (sweeteners, fats, sodium and cosmetic additives) supplied by these foods, in countries classified by income and region. Second, we review the literature on food systems and political economy factors that likely explain the observed changes. We find evidence for a substantial expansion in the types and quantities of UPFs sold worldwide, representing a transition towards a more processed global diet but with wide variations between regions and countries. As countries grow richer, higher volumes and a wider variety of UPFs are sold. Sales are highest in Australasia, North America, Europe and Latin America but growing rapidly in Asia, the Middle East and Africa. These developments are closely linked with the industrialization of food systems, technological change and globalization, including growth in the market and political activities of transnational food corporations and inadequate policies to protect nutrition in these new contexts. The scale of dietary change underway, especially in highly populated middle-income countries, raises serious concern for global health.
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Affiliation(s)
- Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Priscila Machado
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Thiago Santos
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Katherine Sievert
- School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Michalis Hadjikakou
- School of Life and Environmental Sciences, Deakin University, Geelong, Victoria, Australia
| | - Cherie Russell
- School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Oliver Huse
- Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Colin Bell
- Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Gyorgy Scrinis
- School of Agriculture and Food, University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Sharon Friel
- School of Regulation and Global Governance, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mark Lawrence
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
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11
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Martins CA, Andrade GC, Oliveira MFBD, Rauber F, Castro IRRD, Couto MT, Levy RB. "Healthy", "usual" and "convenience" cooking practices patterns: How do they influence children's food consumption? Appetite 2020; 158:105018. [PMID: 33166600 DOI: 10.1016/j.appet.2020.105018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/24/2020] [Accepted: 10/31/2020] [Indexed: 10/23/2022]
Abstract
This study identified adults' cooking practices patterns and tested their associations with children's consumption of ultra-processed foods. Cross-sectional study conducted with 551 adult-child pairs from São Paulo, Brazil. Children's food consumption was collected through dietary recalls. Adults' cooking practices were identified using a questionnaire developed for the Brazilian's context. Principal Component Analysis has been employed to identify cooking patterns and linear regression models (crude and adjusted for sociodemographic variables) have been used to test associations between pattern's scores and contribution of ultra-processed foods to total energy at dinners. Three cooking patterns were identified: "Healthy", "Usual" and "Convenience". The first two patterns reflected behaviors of people who mostly cook "from scratch". Only the Healthy pattern (confidence to cook several meals using fresh foods and natural seasonings; healthier cooking techniques) was inversely associated with ultra-processed food consumption (β = -4.1; p = 0.002), whereas the Convenience pattern (less frequency and time to cook, using microwave and ready-to-heat meals) was positively associated with (β = 3.6; p = 0.008). Our results suggest that cooking at home, as an isolated action, is not enough to protect the consumption of ultra-processed foods. To promote healthy eating among children, the adults' cooking practices should be aligned with the preparation of meals made "from scratch", taking into account the healthiness of what is being cooked.
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Affiliation(s)
- Carla Adriano Martins
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Av. Dr Arnaldo 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil.
| | - Giovanna Calixto Andrade
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Av. Dr Arnaldo 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil
| | | | - Fernanda Rauber
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil; Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil
| | - Inês Rugani Ribeiro de Castro
- Nutrition Institute, Rio de Janeiro State University. R. São Francisco Xavier, 524, Maracanã, Rio de Janeiro, RJ, Brazil
| | - Marcia Thereza Couto
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Av. Dr Arnaldo 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Av. Dr Arnaldo 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil
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12
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Montero-Salazar H, Donat-Vargas C, Moreno-Franco B, Sandoval-Insausti H, Civeira F, Laclaustra M, Guallar-Castillón P. High consumption of ultra-processed food may double the risk of subclinical coronary atherosclerosis: the Aragon Workers' Health Study (AWHS). BMC Med 2020; 18:235. [PMID: 32787915 PMCID: PMC7425006 DOI: 10.1186/s12916-020-01678-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/23/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption, which is increasing worldwide, has recently been associated with an increased risk of death and cardiovascular disease. We aimed to assess whether consumption of UPF is directly associated with subclinical coronary atherosclerosis in middle-aged men. METHODS A computed tomography scan was performed on 1876 men from the Aragon Workers' Health Study, recruited from January 2011 to December 2014, to assess coronary calcium. All participants were free of coronary heart disease. Dietary intake was collected by a validated 136-item semi-quantitative food frequency questionnaire. UPF was defined according to the NOVA classification. Associations between consumption of total energy-adjusted UPF and Coronary Calcium Agatston Score (CACS)-categorized into CACS of 0, > 0 and < 100, and ≥ 100-were cross-sectionally assessed by generalized ordered logistic regression adjusted for main confounders. RESULTS No coronary calcium was detected in 60.2% of the participants, whereas 10.2% had a CACS ≥ 100. A significant dose-response association was observed between energy-adjusted UPF consumption and the risk of having a CACS ≥ 100, when compared with those in the lowest CACS categories (CACS of 0 together with CACS > 0 and < 100). The fully adjusted ORs (95% CI) of having a CACS ≥ 100 across quartiles of energy-adjusted UPF consumption (approximately 100 g/day in the lowest quartile (ref.) and 500 g/day in the highest) were 1.00 (ref.), 1.50 (0.93, 2.42), 1.56 (0.96, 2.52), and 2.00 (1.26, 3.16), p trend .005. CONCLUSION In this middle-aged worker's sample, approximately 500 g/day of UPF consumption was associated with a 2-fold greater prevalence of subclinical coronary atherosclerosis than consuming only 100 g/day, independently of total energy intake and other well-established cardiovascular risk factors.
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Affiliation(s)
- Henry Montero-Salazar
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain
| | - Carolina Donat-Vargas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain. .,Unit of Nutritional and Cardiovascular Epidemiology, Environmental Medicine Institute (IMM), Karolinska Institutet, Stockholm, Sweden. .,CIBERESP (CIBER of Epidemiology and Public Health) Instituto de Salud Carlos III, Madrid, Spain. .,Instituto de Investigación IdiPaz, Madrid, Spain. .,IMDEA-Food Institute CEI UAM+CSIC, Madrid, Spain.
| | - Belén Moreno-Franco
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,CIBERCV Instituto de Salud Carlos III, Madrid, Spain.,Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Civeira
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,CIBERCV Instituto de Salud Carlos III, Madrid, Spain.,Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), Zaragoza, Spain
| | - Martín Laclaustra
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,CIBERCV Instituto de Salud Carlos III, Madrid, Spain.,Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), Zaragoza, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health) Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación IdiPaz, Madrid, Spain.,IMDEA-Food Institute CEI UAM+CSIC, Madrid, Spain
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13
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Abstract
Growing evidence confirms a link between consumption of ultra-processed food and drinks and non-communicable diseases. Jean Adams and colleagues explore the implications for public health action
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Affiliation(s)
- Jean Adams
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Karen Hofman
- South Africa MRC/Wits Centre for Health Economics and Decision Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Jean-Claude Moubarac
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Anne Marie Thow
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney Australia
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14
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Cooking without thinking: How understanding cooking as a practice can shed new light on inequalities in healthy eating. Appetite 2020; 147:104503. [DOI: 10.1016/j.appet.2019.104503] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 11/20/2022]
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15
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Brazilian Children's Dietary Intake in Relation to Brazil's New Nutrition Guidelines: a Systematic Review. Curr Nutr Rep 2020; 8:145-166. [PMID: 30927218 DOI: 10.1007/s13668-019-0261-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW This systematic review reports the latest scientific evidence, from cross-sectional and cohort studies, describing the dietary intake of children and adolescents from Brazil. The goal of the review was to describe intakes according to Brazil's new food classification system (NOVA) which classifies foods according to the degree of processing, i.e., unprocessed/minimally processed, processed culinary ingredients, processed food, and ultra-processed food. Due to a paucity of data using the NOVA classification system, studies with other intake descriptors were included. RECENT FINDINGS Results using the NOVA system showed a somewhat high intake of (ultra-)processed items, than of minimally processed items. Studies using other methods of dietary assessment showed not only high intake of sources rich in fat, sugar, and sodium, most of them processed items (e.g., savory snacks and sweets) but also intake of fruit, vegetables, and whole grains. Overall, the literature was marred by inconsistencies and variation in study definitions and methods making it hard to make firm conclusions regarding the dietary intake of Brazilian children. The development of tools to evaluate the complexities of dietary intake is much needed. Such a tool needs to be accepted and adopted by numerous study groups, to describe dietary status among Brazilian children and devise the most effective, and to evaluate the success of nutrition education programs.
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16
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Kim H, Rebholz CM, Wong E, Buckley JP. Urinary organophosphate ester concentrations in relation to ultra-processed food consumption in the general US population. ENVIRONMENTAL RESEARCH 2020; 182:109070. [PMID: 31915114 PMCID: PMC7024645 DOI: 10.1016/j.envres.2019.109070] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND Ultra-processed foods are highly processed foods which are manufactured with industrial substances to increase convenience and palatability. Some organophosphate esters (OPEs) are used as flame retardants and plasticizers and have been detected in food samples, particularly processed foods. However, little is known about dietary sources of OPEs or whether higher consumption of ultra-processed foods increases exposures. OBJECTIVES We evaluated whether higher consumption of ultra-processed food is associated with urinary OPE metabolite concentrations in a nationally representative sample of US children and adults. METHODS Among 2242 participants (≥6 years) in the National Health and Nutrition Examination Survey (NHANES) 2013-2014, we used the NOVA classification system to calculate percent of total energy from ultra-processed food using a 24 h dietary recall. Concentrations of 7 OPE metabolites, including diphenyl phosphate (DPHP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP), bis(2-chloroethyl) phosphate (BCEP), dibutyl phosphate (DBUP), di-p-cresyl phosphate (DPCP), 2,3,4,5-tetrabromobenzoic acid (TBBA), and bis(1-chloro-2-propyl) phosphate (BCPP) were measured in urine. We used multivariable linear or logistic regressions to examine associations per 10% higher total energy from ultra-processed foods with percent changes or prevalence of detectable levels of creatinine-standardized OPEs. RESULTS In a model adjusting for only urinary creatinine, each 10% higher total energy from ultra-processed food was associated with 3.5% (95% CI: 0.7%, 6.3%) higher DPHP and 8.2% (95% CI: 4.6, 11.9%) higher BDCPP concentrations. However, none of the OPE metabolites was associated with ultra-processed food consumption in models adjusted for sociodemographic characteristics, health behaviors, and BMI (all p-values >0.05). Ultra-processed breads and tortillas; sauces, dressing, and gravies; and milk-based drinks were associated with higher concentrations of BDCPP while frozen and shelf-stable plate meals were associated with lower concentrations. Reconstituted meat or fish products and ultra-processed milk-based desserts were associated with greater odds of detectable levels of BCPP. CONCLUSION While some food groups were associated with urinary OPE metabolite concentrations, ultra-processed foods do not appear to be a major source of current OPE exposure in the US.
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Affiliation(s)
- Hyunju Kim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eugenia Wong
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessie P Buckley
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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17
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Ultra-processed foods, incident overweight and obesity, and longitudinal changes in weight and waist circumference: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Public Health Nutr 2019; 23:1076-1086. [PMID: 31619309 PMCID: PMC7282862 DOI: 10.1017/s1368980019002854] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Design: We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity. Setting: Brazil. Participants: Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35–74 years at baseline (2008–2010). Results: UPF provided a mean 24·6 (sd 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first (<17·8 %) quartile of UPF consumption was associated (relative risk (95 % CI)) with 27 and 33 % greater risk of large weight and waist gains (1·27 (1·07, 1·50) and 1·33 (1·12, 1·58)), respectively. Similarly, those in the fourth consumption quartile presented 20 % greater risk (1·20 (1·03, 1·40)) of incident overweight/obesity and 2 % greater risk (1·02; (0·85, 1·21)) of incident obesity. Approximately 15 % of cases of large weight and waist gains and of incident overweight/obesity could be attributed to consumption of >17·8 % of energy as UPF. Conclusions: Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide.
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18
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Unsain RF, Ulian MD, de Morais Sato P, Sabatini F, da Silva Oliveira MS, Scagliusi FB. "Macho food": Masculinities, food preferences, eating practices history and commensality among gay bears in São Paulo, Brazil. Appetite 2019; 144:104453. [PMID: 31521772 DOI: 10.1016/j.appet.2019.104453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/05/2019] [Accepted: 09/11/2019] [Indexed: 10/26/2022]
Abstract
This article describes and explore eating practices and food preferences among gay men who call themselves bears in São Paulo, Brazil, and their relation with their life history, masculinities representations, and sexuality. It is a qualitative and quantitative research within an ethnographic perspective. A purposive sample of thirty-five self-declared gay bears. The data were analyzed identifying the regular, expressive and meaningful significance units collected through the interviews. We identified that the self-declared bears in São Paulo, Brazil, build a solid relation between food preferences, eating practices, masculinity, and group belonging. From the bear's perspective, meat, especially bovine, is related to masculinity and extensively understood as a strong common bond within the community, leveraging their sexuality. For these persons, eating meat as well as drinking beer can build the ideal mannish and unfeminine body that is overvalue. Being gay and "eating like a man," as well as exposing a "macho" body while disdaining other body types constructions could represent a strategy to avoid discrimination, shame and humiliation. On the other way, this community does not just linearly imitate heterosexual men although their conducts can reproduce patriarchal representations and meanings through eating practices. These findings could be used to understand the complexity of alimentary practices, particularly food preferences as well as commensalities, among specific communities or membership groups.
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Affiliation(s)
- Ramiro Fernandez Unsain
- Universidade Federal de São Paulo, Campus Baixada Santista, Programa de Pós-Graduação Interdisciplinar de Ciências da Saúde, Santos, São Paulo, Brazil.
| | | | | | - Fernanda Sabatini
- Universidade de São Paulo, Faculdade de Saúde Pública, São Paulo, Brazil
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19
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Sievert K, Lawrence M, Naika A, Baker P. Processed Foods and Nutrition Transition in the Pacific: Regional Trends, Patterns and Food System Drivers. Nutrients 2019; 11:E1328. [PMID: 31200513 PMCID: PMC6628317 DOI: 10.3390/nu11061328] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/03/2019] [Accepted: 06/10/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The role of processed foods in nutrition transition in the Pacific is receiving some attention in the context of a significant obesity and diet-related noncommunicable disease health burden. However, trends, patterns and underlying drivers of processed food markets in the Pacific are not well understood. The aim of this study was to investigate recent trends and patterns of processed food markets in the region and interpret the findings by engaging key literature on relevant food systems drivers. METHODS We conducted a mixed-methods approach involving two steps; (1) We analysed Euromonitor market sales data for processed food and beverage products sold from 2004-2018 for 16 countries differentiated by income level, and (2) guided by a food systems conceptual framework, we drew upon key literature to understand the likely drivers of our observations. RESULTS We observed plateaus and declines in processed food sales in some high-income countries but increases in upper-middle and lower-middle income countries, and most rapidly in the latter. Beverage markets appear to be stagnating across all income groups. Carbonated soft drinks, baked goods, vegetable oils, processed meats, noodles and sweet biscuits made up the majority of sales in transitioning countries. These observations are likely a result of income growth, urbanising populations, trade and globalisation, and various policies implemented by Pacific governments. CONCLUSIONS A processed foods nutrition transition is well underway in the Pacific region and accelerating most prominently in lower-middle income countries.
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Affiliation(s)
- Katherine Sievert
- School of Exercise and Nutrition Science, Deakin University, Geelong VIC 3220, Australia.
| | - Mark Lawrence
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong VIC 3220, Australia.
| | | | - Phillip Baker
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong VIC 3220, Australia.
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20
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Dickie S, Woods JL, Lawrence M. Analysing the use of the Australian Health Star Rating system by level of food processing. Int J Behav Nutr Phys Act 2018; 15:128. [PMID: 30545373 PMCID: PMC6293654 DOI: 10.1186/s12966-018-0760-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 12/05/2018] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The consumption of ultra-processed foods is associated with diminished dietary quality and adverse health outcomes. The Australian Health Star Rating (HSR) is a nutrient-based front-of-pack (FOP) labelling system that assesses the 'healthiness' of foods on a scale of 0.5 to 5 stars based on their content of 'risk' and 'positive' nutrients. This study aimed to analyse the use of health stars on new packaged food products entering the Australian marketplace by level of food processing. METHODS The Mintel Global New Product Database (GNPD) was searched to identify the number of stars displayed on the labels of all new packaged food products participating in the HSR system released into the Australian retail food supply between 27 June 2014 (the endorsement date) and 30 June 2017. Products were categorised by the four NOVA food processing categories: unprocessed and minimally processed (MP), processed culinary ingredients (PCI), processed (P), and ultra-processed (UP), and the distribution of the star ratings within each category was compared and analysed. RESULTS The majority of new food products displaying an HSR were UP (74.4%), followed by MP (12.5%), P (11.6%), and PCI (1.5%). The median HSR of MP products (4.5) was significantly higher than the median of P (4) and UP products (3.5) (all p < 0.05). In all NOVA categories HSR profiles were distributed towards higher star ratings, and the majority (77%) of UP products displayed an HSR ≥ 2.5. CONCLUSIONS The HSR is being displayed on a substantial proportion of newly released UP foods. Technical weaknesses, design flaws and governance limitations with the HSR system are resulting in 3 out of 4 instances of these UP foods displaying at least 2.5 so-called 'health' stars. These findings add further evidence to concerns that the HSR system, in its current form, is misrepresenting the healthiness of new packaged food products and creating a risk for behavioural nutrition.
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Affiliation(s)
- Sarah Dickie
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Julie L. Woods
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Mark Lawrence
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
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Silva FM, Giatti L, de Figueiredo RC, Molina MDCB, de Oliveira Cardoso L, Duncan BB, Barreto SM. Consumption of ultra-processed food and obesity: cross sectional results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort (2008-2010). Public Health Nutr 2018; 21:2271-2279. [PMID: 29642958 PMCID: PMC11106008 DOI: 10.1017/s1368980018000861] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/12/2018] [Accepted: 03/05/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To verify if the intake of ultra-processed foods is associated with higher BMI and waist circumference (WC) among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. DESIGN Cross-sectional analysis of the ELSA-Brasil baseline (2008-2010). Dietary information obtained through an FFQ was classified according to characteristics of food processing (NOVA) and used to estimate the percentage energy contribution from ultra-processed foods (i.e. industrial formulations, elaborated from food processing, synthetic constituents and food additives) to individuals' total energy intake. BMI and WC and their respective cut-off points served as response variables. Associations were estimated through linear and multinomial logistic regression models, after adjusting for confounders and total energy intake. SETTING Six Brazilian capital cities, 2008-2010. SUBJECTS Active and retired civil servants, aged 35-64 years, from universities and research organizations (n 8977). RESULTS Ultra-processed foods accounted for 22·7 % of total energy intake. After adjustments, individuals in the fourth quartile of percentage energy contribution from ultra-processed foods presented (β; 95 % CI) a higher BMI (0·80; CI 0·53, 1·07 kg/m2) and WC (1·71; 1·02, 2·40 cm), and higher chances (OR; 95 % CI) of being overweight (1·31; 1·13, 1·51), obese (1·41; 1·18, 1·69) and having significantly increased WC (1·41; 1·20, 1·66), compared with those in the first quartile. All associations suggest a dose-response gradient. CONCLUSIONS Results indicate the existence of associations between greater energy contribution from ultra-processed foods and higher BMI and WC, which are independent of total energy intake. These findings corroborate public policies designed to reduce the intake of this type of food.
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Affiliation(s)
- Fernanda Marcelina Silva
- Postgraduate Program in Sciences Applied to Adult Health Care, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luana Giatti
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, Sala 814, CEP 30130100, Belo Horizonte, MG, Brazil
| | | | | | | | | | - Sandhi Maria Barreto
- Postgraduate Program in Sciences Applied to Adult Health Care, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, Sala 814, CEP 30130100, Belo Horizonte, MG, Brazil
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Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions. Microorganisms 2018; 6:microorganisms6020035. [PMID: 29693607 PMCID: PMC6027349 DOI: 10.3390/microorganisms6020035] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/02/2018] [Accepted: 04/20/2018] [Indexed: 12/11/2022] Open
Abstract
An extensive body of evidence documents the importance of the gut microbiome both in health and in a variety of human diseases. Cell and animal studies describing this relationship abound, whilst clinical studies exploring the associations between changes in gut microbiota and the corresponding metabolites with neurodegeneration in the human brain have only begun to emerge more recently. Further, the findings of such studies are often difficult to translate into simple clinical applications that result in measurable health outcomes. The purpose of this paper is to appraise the literature on a select set of faecal biomarkers from a clinician’s perspective. This practical review aims to examine key physiological processes that influence both gastrointestinal, as well as brain health, and to discuss how tools such as the characterisation of commensal bacteria, the identification of potential opportunistic, pathogenic and parasitic organisms and the quantification of gut microbiome biomarkers and metabolites can help inform clinical decisions of nutrition and lifestyle medicine practitioners.
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