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da Silva NRJ, de Camargo MBJ, Dos Vaz JS, Correa MB, Matijasevich A, da Silva Dos Santos I, Cascaes AM. Ultra-processed food consumption and dental caries in adolescents from the 2004 Pelotas Birth Cohort study. Community Dent Oral Epidemiol 2023; 51:1180-1186. [PMID: 37032457 DOI: 10.1111/cdoe.12851] [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: 07/19/2021] [Revised: 01/21/2023] [Accepted: 02/15/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVE To investigate the relationship between ultra-processed food (UPF) consumption and dental caries in adolescents. METHODS Data from 996 adolescents aged 12-13 years who participated in an oral health sub-study of the 2004 Pelotas Birth Cohort in southern Brazil were analysed. The main exposure was daily UPF consumption at age 10-11 years, measured by a food frequency questionnaire containing 24 UPF items defined based on the NOVA system. UPF consumption was calculated in frequency, grams and calories, in general and for six types of food (biscuits, savoury snacks and sugar-sweetened cereals; ultra-processed meats and fats; sweets; fast food and instant noodles; soft drinks and artificially flavoured drinks; and sweetened milk and powdered chocolate). The outcome was dental caries, measured according to the decayed, missing and filled indexes (DMFS and dmfs) at age 12-13 years. Poisson regression models were used to analyse the association between UPF consumption and dental caries, adjusting for socioeconomic and demographic variables, dental visits and oral hygiene. RESULTS Overall, the daily UPF consumption in frequency, grams and calories was associated with caries. The findings were consistent for UPF consumption for all six food groups. The higher the UPF consumption, the higher the probability of having caries in adolescence. The associations between ultra-processed meats and fats, and fast food and instant noodles intake with dental caries alert to the cariogenic potential of such UPF foods. CONCLUSION Ultra-processed food consumption was associated with greater caries burdens in young adolescents. The findings reinforce the need for interventions and public policies to reduce UPF consumption in adolescence.
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Affiliation(s)
| | | | - Juliana Santos Dos Vaz
- Graduate Program in Nutrition and Foods, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Brazil
- Graduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Marcos Britto Correa
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Graduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil
| | - Iná da Silva Dos Santos
- Graduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Andreia Morales Cascaes
- Department of Public Health, Graduate Program in Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
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Vilela LA, de Lima Costa BV, Jardim MZ, Borges LD, do Carmo AS, Inácio MLC, Mendes LL. Private school canteens: an analysis of the economic and financial aspects of the traditional and the healthy models. BMC Public Health 2023; 23:2102. [PMID: 37880618 PMCID: PMC10601215 DOI: 10.1186/s12889-023-16965-1] [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: 12/12/2022] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND One of the reasons for the more prominent resistance of canteen managers to implementing healthy canteens is based on the belief in the economic infeasibility of these models. The research aimed to verify the economic and financial viability of traditional and healthy models of school canteens in a Brazilian metropolis. METHODS The case study was carried out with 36 companies in the school canteen sector in a Brazilian metropolis. The classification of items sold in canteens considered the extent and purpose of food processing according to the NOVA Classification. The characterization and definition of traditional canteens and healthy canteens were proposed considering the amount of in natura or minimally processed foods and culinary preparations without the presence of ultra-processed foods; the percentage of ultra-processed foods or processed foods or culinary preparations with the presence of ultra-processed foods; and the existence of prohibited foods. The economic and financial analysis was carried out mainly through the evaluation of profitability. Data were collected through an electronic self-administered questionnaire sent to canteen managers. The Mann-Whitney test was used to compare medians and the Chi-Square/Fisher's Exact Test to compare proportions. RESULTS The study included six companies, responsible for 36 canteen units in private schools, 30 classified in the traditional model (83.3%), and six in the healthy model (16.7%). The median percentage of natural, minimally processed foods and commercialized culinary preparations was higher among the healthy model canteens (87.9% vs. 60.0%, p < 0.001). While the median percentage of ultra-processed, processed, or preparations with the presence of ultra-processed (40.0% vs. 12.1%, p < 0.001) and prohibited foods (10.0% vs. 0%, p < 0.001) sold was higher in the traditional model canteens. The results indicated that the profitability in the healthy canteens was higher (p < 0.001) than in the traditional ones. CONCLUSIONS Healthy school canteens showed better financial and economic results compared to traditional canteens with emphasis on greater profitability and a shorter recovery time of the initial investment.
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Affiliation(s)
- Luisa Arantes Vilela
- Department of Nutrition, Federal University of Minas Gerais, 190 Professor Alfredo Balena avenue, Santa Efigenia, Belo Horizonte, MG, 30130-090, Brazil
| | - Bruna Vieira de Lima Costa
- Department of Nutrition, Federal University of Minas Gerais, 190 Professor Alfredo Balena avenue, Santa Efigenia, Belo Horizonte, MG, 30130-090, Brazil
| | - Mariana Zogbi Jardim
- Department of Pediatrics, Federal University of Minas Gerais, 190 Professor Alfredo Balena avenue, Santa Efigenia, Belo Horizonte, MG, 30130-090, Brazil
| | - Luiza Delazari Borges
- Department of Pediatrics, Federal University of Minas Gerais, 190 Professor Alfredo Balena avenue, Santa Efigenia, Belo Horizonte, MG, 30130-090, Brazil
| | - Ariene Silva do Carmo
- Researcher, Group of Studies, Research and Practices in Food Environment and Health (GEPPAAS), Federal University of Minas Gerais, 190 Professor Alfredo Balena avenue, Santa Efigenia, Belo Horizonte, MG, 30130-090, Brazil
| | | | - Larissa Loures Mendes
- Department of Nutrition, Federal University of Minas Gerais, 190 Professor Alfredo Balena avenue, Santa Efigenia, Belo Horizonte, MG, 30130-090, Brazil
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del Pilar Angarita-Díaz M, Lopez-Ramos R, Tipan-Asimbaya L, Ruiz-Gómez A, Gonzalez-Bernal MA, Vicuña-Huaqui L. Sugar in ultraprocessed foods in Latin American capitals: From dentistry perspective. NFS JOURNAL 2023. [DOI: 10.1016/j.nfs.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Cascaes AM, Silva NRJD, Fernandez MDS, Bomfim RA, Vaz JDS. Ultra-processed food consumption and dental caries in children and adolescents: a systematic review and meta-analysis. Br J Nutr 2022; 129:1-10. [PMID: 35894293 DOI: 10.1017/s0007114522002409] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study summarised the association between ultra-processed food (UPF) consumption and dental caries in children and adolescents through a systematic review and meta-analysis. The search of PubMed, Cochrane, Web of Science and Scopus databases using the 'PECOS' strategy retrieved 1462 eligible articles. Only studies with humans aged ≤ 19 years; that assessed groups of any UPF or specific UPF items; that measured dental caries as the decayed, filled and missing surfaces or teeth indexes, based on the WHO criteria; cross-sectional, case-control, cohort and all types of interventions that examined the adjusted association between UPF consumption and dental caries were included. All studies received qualitative evaluation. Meta-analysis using random-effects models combined multivariable-adjusted OR for case-control and cross-sectional studies and risk ratio (RR) for longitudinal studies of the highest v. lowest category of UPF consumption. Forty-two studies were included in the qualitative synthesis and twenty-seven in the meta-analysis. The pooled RR was 1·71 (95 % CI 1·31, 2·24), and the pooled OR was 1·55 (95 % CI 1·37, 1·75). The highest OR was found among participants who had dental caries prevalence >70 % (OR = 3·67, 95 % CI 2·16, 6·23). Better evidence quality was found among cohort studies that evaluated children <6 years old. The findings suggest that higher UPF consumption is associated with greater dental caries in children and adolescents. Public health efforts to reduce UPF consumption are needed to improve the oral health of children and adolescents.
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Affiliation(s)
- Andreia Morales Cascaes
- Federal University of Santa Catarina, Department of Public Health, Graduate Program in Public Health, Graduate Program in Dentistry, Florianópolis, SC, Brazil
| | | | | | - Rafael Aiello Bomfim
- Federal University of Mato Grosso do Sul, School of Dentistry, Graduate Program in Dentistry, Campo Grande, MS, Brazil
| | - Juliana Dos Santos Vaz
- Federal University of Pelotas, Faculty of Nutrition, Graduate Program in Nutrition and Foods, Pelotas, RS, Brazil
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de Oliveira PG, de Sousa JM, Assunção DGF, de Araujo EKS, Bezerra DS, Dametto JFDS, Ribeiro KDDS. Impacts of Consumption of Ultra-Processed Foods on the Maternal-Child Health: A Systematic Review. Front Nutr 2022; 9:821657. [PMID: 35634416 PMCID: PMC9136982 DOI: 10.3389/fnut.2022.821657] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/20/2022] [Indexed: 12/17/2022] Open
Abstract
Background and Aims Changes in eating patterns have been leading to an increase in the consumption of ultra-processed foods (UPF), negatively impacting the quality of the diet and generating risk of harm to the health of the adult population, however, there is no systematized evidence of the impact of UPF in maternal-child health. Thus, in this study we aimed to evaluated the association between UPF consumption and health outcomes in the maternal-child population. Methods Systematic review registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021236633), conducted according to the PRISMA diagram in the following databases: PubMed, Medline, Scopus, Web of Science, Scielo, and CAPES thesis and dissertation directory. We included original cross-sectional, case-control and cohort studies in any language. Eligibility criteria were (a) food consumption assessment by the NOVA classification, (b) health outcome (nutritional or diseases), and (c) maternal-child population (pregnant, lactating women and infants/children). All data were analyzed and extracted to a spreadsheet structured by two independent reviewers. We evaluated the methodological quality of the studies included using the Newcastle-Otawa Scale and RoB 2. Results Searches retrieved 7,801 studies and 15 contemplated the eligibility criteria. Most studies included were cohort studies (n = 8, 53%), had children as their population (n = 9, 60%) and only one study evaluated UPF consumption in infants and lactating women. Panoramically, we observed that a higher participation of UPF in children’s diet has been associated with different maternal-child outcomes, such as increase of weight gain, adiposity measures, overweight, early weaning, lower diet quality, metabolic alterations, diseases, and consumption of plastic originated from packaging. Only one of the studies included did not present high methodological quality. Conclusion Despite the limited literature on UPF consumption and health outcomes in the maternal-child population, the highest UPF consumption negatively impacted nutrition and disease development indicators in pregnant, lactating women and children. Considering the expressive participation of these foods in the diet, other studies should be conducted to further investigate the impact of UPF consumption on different health indicators, especially in the lactation phase for this was the one to present the most important knowledge gap. Systematic Review Registration [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021236633], identifier [CRD42021236633].
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Affiliation(s)
| | - Juliana Morais de Sousa
- Post Graduate Program in Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | - Danielle Soares Bezerra
- Health Sciences College of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | | | - Karla Danielly da Silva Ribeiro
- Post Graduate Program in Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
- *Correspondence: Karla Danielly da Silva Ribeiro,
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The Associations between Caregivers' Emotional and Instrumental Feeding, Children's Emotional Eating, and Children's Consumption of Ultra-Processed Foods in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084439. [PMID: 35457306 PMCID: PMC9028148 DOI: 10.3390/ijerph19084439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 12/21/2022]
Abstract
High consumption of ultra-processed foods (UPF) increases the risks of non-communicable diseases and all-cause mortality in adulthood, and the risk of early childhood caries. Limited evidence about factors influencing children's consumption of UPF exists. This study was conducted to assess the prevalence of UPF consumption among children less than three years of age, and identify its associations with caregivers' emotional and instrumental feeding, and children's emotional eating. A cross-sectional study was conducted in Shijiazhuang, Hebei Province, China. Caregivers caring for children aged 6-36 months (n = 408) were recruited. Caregivers' emotional and instrumental feeding practices and children's emotional eating were assessed by the Parents' Feeding Practices Scale for Infant and Young Child and Children's Eating Behaviour Questionnaire, respectively. Children's UPF consumption was assessed by a validated Food Frequency Questionnaire. Of the children, 86.8% consumed UPF. The highest percentage of UPF consumed was pastries (63.5%), followed by solid or semi-solid dairy products (58.8%), and reconstituted meat products (56.4%). Caregivers' emotional and instrumental feeding was positively associated with children's consumption of UPF (OR = 1.59, 95%CI: 1.01, 2.49), a higher frequency of UPF consumption weekly (OR = 1.80, 95%CI: 1.35, 2.39), and a larger amount of UPF consumption weekly (OR = 1.85, 95% CI: 1.38, 2.49). Children's higher frequency of emotional undereating was associated with their UPF consumption (OR = 1.61, 95%CI: 1.07, 2.42) and a higher frequency of UPF consumption weekly (OR = 1.33, 95%CI: 1.03, 1.73). Children's emotional undereating significantly mediated the associations between caregivers' emotional and instrumental feeding and children's consumption of reconstituted meat products. Caregivers should be educated to avoid emotional and instrumental feeding practices, and cultivate children's good eating habits to improve children's diet quality.
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Gibney MJ, Forde CG. Nutrition research challenges for processed food and health. NATURE FOOD 2022; 3:104-109. [PMID: 37117956 DOI: 10.1038/s43016-021-00457-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/22/2021] [Indexed: 04/30/2023]
Abstract
Existing highly processed food (HPF) classification systems show large differences in the impact of these foods on biochemical risk factors for disease. If public health nutrition is to consider the degree of food processing as an important element of the link between food and health, certain gaps in research must be acknowledged. Quantifying the food additive exposure derived from HPFs is a task made challenging by the lack of data available on the occurrence and concentration of additives in food and the degree to which the natural occurrence of additives in unprocessed foods confounds exposure estimates. The proposed role of HPFs in health outcomes could also be associated with altered nutrient profiles. Differences exist within and between HPF classification systems in this regard and there are conflicting data on the impact of controlling for nutrient intake. Furthermore, research is needed on how the sensory aspects of HPFs contribute to energy intake. Current data suggest that high energy intake rate may be the mechanism linking HPFs and increased energy intake. A high priority now is to clarify the basis of definitions used to categorize foods as highly processed and, in a constructive sense, to distinguish between the contributions of nutrients, additives and sensory properties to health.
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Affiliation(s)
- Michael J Gibney
- Institute of Food and Health, University College Dublin, Dublin, Ireland.
| | - Ciarán G Forde
- Sensory Science and Eating Behaviour, Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
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Ultra-processed foods and early childhood caries in 0-3-year-olds enrolled at Primary Healthcare Centers in Southern Brazil – ERRATUM. Public Health Nutr 2020; 24:377. [DOI: 10.1017/s1368980020004498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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