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Ravandi B, Mehler P, Ispirova G, Barabási AĹ, Menichetti G. GroceryDB: Prevalence of Processed Food in Grocery Stores. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2022.04.23.22274217. [PMID: 38883708 PMCID: PMC11177926 DOI: 10.1101/2022.04.23.22274217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
The offering of grocery stores is a strong driver of consumer decisions, shaping their diet and long-term health. While highly processed food like packaged products, processed meat, and sweetened soft drinks have been increasingly associated with unhealthy diet, information on the degree of processing characterizing an item in a store is not straightforward to obtain, limiting the ability of individuals to make informed choices. Here we introduce GroceryDB, a database with over 50,000 food items sold by Walmart, Target, and Wholefoods, unveiling how big data can be harnessed to empower consumers and policymakers with systematic access to the degree of processing of the foods they select, and the potential alternatives in the surrounding food environment. The wealth of data collected on ingredient lists and nutrition facts allows a large scale analysis of ingredient patterns and degree of processing stratified by store, food category, and price range. We find that the nutritional choices of the consumers, translated as the degree of food processing, strongly depend on the food categories and grocery stores. Moreover, the data allows us to quantify the individual contribution of over 1,000 ingredients to ultra-processing. GroceryDB and the associated http://TrueFood.Tech/ website make this information accessible, guiding consumers toward less processed food choices while assisting policymakers in reforming the food supply.
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Gunchick V, Wen W, Jia G, Roberts LR, Koshiol J, Shu XO, Zheng W. Dietary intake, obesity, and physical activity in association with biliary tract cancer risk: Results from meta-analyses of individual-level data from prospective cohort studies of 723,326 adults. Int J Cancer 2024. [PMID: 38847561 DOI: 10.1002/ijc.35048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/03/2024] [Accepted: 05/02/2024] [Indexed: 06/16/2024]
Abstract
Biliary tract cancer (BTC) is a rare and aggressive malignancy with increasing incidence. Most BTC cases are diagnosed with metastatic disease which carries a 5-year survival rate of <5%. Physical activity, diet, and obesity might be associated with BTC risk, but studies have been limited particularly in African descendants. We addressed this knowledge gap by evaluating associations of BTC risk with obesity, physical activity, and dietary intakes in 723,326 adult participants in four cohort studies conducted in China, the United Kingdom, and the United States. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) in each cohort; results were combined using meta-analysis. All cohorts had ≥11 median follow-up years with 839 incident BTC cases combined. BTC risk was positively associated with body mass index (BMI) and waist-to-hip ratio (WHR) whereas physical activity, fruit intake, and fish intake were inversely associated. HR and (95% CI) comparing BMI >35.0 to 18.5-24.9: 1.71 (1.26, 2.31), p-trend <.0001; comparing BMI-adjusted WHR top to bottom quartile: 1.20 (0.94, 1.53), p-trend = .05; comparing ≥15-0 metabolic equivalent task-hours/week 0.76 (0.61, 0.94), p-trend = .009; comparing highest to lowest intake tertile for fruit and fish 0.79 (0.66, 0.95), p-trend = .01; 0.82 (0.68, 0.98), p-trend = .04, respectively. Associations were, in general, similar across ancestry groups. Our study provides strong evidence for important roles of obesity, diet, and physical activity in BTC etiology and stresses the need for lifestyle modification to combat the rising incidence of this fatal malignancy.
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Affiliation(s)
- Valerie Gunchick
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wanqing Wen
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Guochong Jia
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Xiao-Ou Shu
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wei Zheng
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Martins AC, Kraemer MVDS, Rodrigues VM, Hinnig PDF, Fernandes AC, Bernardo GL, Proença RPDC, Uggioni PL. Market-driven fortification of vitamins and minerals in packaged foods targeted at children in Brazil. NUTR BULL 2024; 49:209-219. [PMID: 38698740 DOI: 10.1111/nbu.12676] [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: 11/07/2023] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
This study aimed to characterise the market-driven fortification of vitamins and minerals in packaged foods targeted at children in Brazil. We analysed 535 food labels using data collected in a census-type method (n = 5620) of food labels in a Brazilian supermarket in 2013. Micronutrients declared in nutrition claims and the ingredients list (synthetic compounds) were considered to be added for commercial purposes. Analysis of the ingredients list and nutrition claims showed that market-driven fortification of vitamins and minerals was present in 27.1% of foods. The main vitamins and minerals were vitamins A, B complex, C, D, calcium, iron and zinc. The food groups 'Milk and dairy products' and 'Sugars, sugary foods and snacks' had the highest frequencies of micronutrients declared in the ingredients list. Calcium, iron, phosphorus, zinc and all vitamins, except B7, were found to be added for commercial purposes. Micronutrients were found to be commonly added to packaged foods as a marketing strategy directed at parents and their children. Future studies should assess the amount of vitamins and minerals added to packaged foods targeted at children and whether intakes of vitamins and minerals in children are potentially excessive.
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Affiliation(s)
- Amanda Corrêa Martins
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Mariana Vieira Dos Santos Kraemer
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Vanessa Mello Rodrigues
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Patrícia de Fragas Hinnig
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Nutrition Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Ana Carolina Fernandes
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Nutrition Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Geyce Luci Bernardo
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Nutrition Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Rossana Pacheco da Costa Proença
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Paula Lazzarin Uggioni
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Nutrition Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Carvalho GC, Pereira MR, de Lima Macena M, Silva Junior AE, Silva DR, Ferro DC, Paula DTDC, Melo JMF, Farias da Silva MCT, Bueno NB. Type and timing of ultra-processed foods consumption and its association with dietary intake and physical activity in women with obesity living in poverty. J Hum Nutr Diet 2024; 37:737-748. [PMID: 38558169 DOI: 10.1111/jhn.13303] [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: 11/08/2023] [Revised: 02/14/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The present study aimed to investigate the type and timing of ultra-processed foods (UPF) consumption and its association with dietary intake (DI) and physical activity (PA) in women with obesity living in poverty. METHODS A cross-sectional study was employed. Obesity was defined by at least two criteria (body mass index, waist circumference or % fat mass). Poverty was defined as the three lowest classes of the Brazilian Economic Classification Criterion. PA was measured with triaxial accelerometers and DI was assessed with three 24-h dietary recalls. Foods were categorised according to the NOVA classification, with UPF classified into five subgroups, as well as the timing of consumption into six meals. RESULTS In total, 56 adult women were included. Overall energy intake was 1653.21 (503.22) kcal/day. UPF intake was 21.62% (11.94%) kcal/day, being higher at breakfast (4.91% kcal/day), afternoon snack (5.39% kcal/day) and dinner (5.01% kcal/day). Only UPF subgroup 4 (sandwich biscuits, sweets, or treats) showed a positive association with energy intake (β = 54.40 [27.6, 81.10] kcal/day) and a negative association with protein intake (β = -0.31% [-0.48%, -0.14%] kcal/day). UPF consumption in morning (β = -0.41% [-0.79%, -0.02%] kcal/day) and afternoon (β = -0.18% [-0.33%, -0.04%] kcal/day) snacks was associated with lower protein intake. Furthermore, lunchtime UPF consumption was positively associated with walking time (β = 0.16% [0.02%; 0.30%]) and steps/hour (β = 8.72 [1.50; 15.94] steps/h). CONCLUSIONS Women with obesity living in poverty consume more UPF during breakfast, afternoon snack and dinner. Physical activity is positively associated with UPF consumption at lunch. UPF, such as sandwich biscuits, sweets or treats, contribute to increasing energy intake and reducing protein intake.
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Affiliation(s)
| | | | - Mateus de Lima Macena
- Postgraduate Program in Nutrition, Paulista School of Medicine, Federal University of São Paulo, SP, São Paulo, Brazil
| | - André Eduardo Silva Junior
- Postgraduate Program in Nutrition, Paulista School of Medicine, Federal University of São Paulo, SP, São Paulo, Brazil
| | - Dafiny Rodrigues Silva
- Postgraduate Program in Nutrition, Paulista School of Medicine, Federal University of São Paulo, SP, São Paulo, Brazil
| | | | | | | | | | - Nassib Bezerra Bueno
- Faculty of Nutrition, Federal University of Alagoas, Maceió, Alagoas, Brazil
- Postgraduate Program in Nutrition, Paulista School of Medicine, Federal University of São Paulo, SP, São Paulo, Brazil
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Dai S, Wellens J, Yang N, Li D, Wang J, Wang L, Yuan S, He Y, Song P, Munger R, Kent MP, MacFarlane AJ, Mullie P, Duthie S, Little J, Theodoratou E, Li X. Ultra-processed foods and human health: An umbrella review and updated meta-analyses of observational evidence. Clin Nutr 2024; 43:1386-1394. [PMID: 38688162 DOI: 10.1016/j.clnu.2024.04.016] [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: 11/27/2023] [Revised: 03/04/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND & AIMS Ultra-processed food (UPF) intake has increased sharply over the last few decades and has been consistently asserted to be implicated in the development of non-communicable diseases. We aimed to evaluate and update the existing observational evidence for associations between ultra-processed food (UPF) consumption and human health. METHODS We searched Medline and Embase from inception to March 2023 to identify and update meta-analyses of observational studies examining the associations between UPF consumption, as defined by the NOVA classification, and a wide spectrum of health outcomes. For each health outcome, we estimated the summary effect size, 95% confidence interval (CI), between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. These metrics were used to evaluate evidence credibility of the identified associations. RESULTS This umbrella review identified 39 meta-analyses on the associations between UPF consumption and health outcomes. We updated all meta-analyses by including 122 individual articles on 49 unique health outcomes. The majority of the included studies divided UPF consumption into quartiles, with the lowest quartile being the reference group. We identified 25 health outcomes associated with UPF consumption. For observational studies, 2 health outcomes, including renal function decline (OR: 1.25; 95% CI: 1.18, 1.33) and wheezing in children and adolescents (OR: 1.42; 95% CI: 1.34, 1.49), showed convincing evidence (Class I); and five outcomes were reported with highly suggestive evidence (Class II), including diabetes mellitus, overweight, obesity, depression, and common mental disorders. CONCLUSIONS High UPF consumption is associated with an increased risk of a variety of chronic diseases and mental health disorders. At present, not a single study reported an association between UPF intake and a beneficial health outcome. These findings suggest that dietary patterns with low consumption of UPFs may render broad public health benefits.
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Affiliation(s)
- Shuhui Dai
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Judith Wellens
- Translational Gastro-Intestinal Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK; KU Leuven Department of Chronic Diseases and Metabolism, Translational Research Center for Gastrointestinal Disorders (TARGID), Leuven, Belgium
| | - Nan Yang
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Doudou Li
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jingjing Wang
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lijuan Wang
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Shuai Yuan
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Yazhou He
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ron Munger
- Department of Nutrition and Food Sciences and the Center for Epidemiologic Studies, Utah State University, Logan, UT, USA
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Patrick Mullie
- International Prevention Research Institute, Lyon, France; Belgian Centre for Evidence-Based Medicine, Leuven, Belgium
| | - Susan Duthie
- School of Pharmacy and Life Sciences, The Robert Gordon University, Aberdeen, UK
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK; Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China.
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Pries AM, Bassetti E, Badham J, Baker P, Blankenship J, Dunford EK, Kupka R. TEMPORARY REMOVAL: Ultraprocessing and presence of additives in commercially produced complementary foods in seven Southeast Asian countries: a cross-sectional study. Am J Clin Nutr 2024:S0002-9165(24)00393-9. [PMID: 38816268 DOI: 10.1016/j.ajcnut.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 06/01/2024] Open
Abstract
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
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Affiliation(s)
- Alissa M Pries
- UNICEF East Asia Pacific Regional Office, Bangkok, Thailand.
| | | | | | - Philip Baker
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | | | - Elizabeth K Dunford
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Nutrition, Gillings Global School of Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Roland Kupka
- UNICEF East Asia Pacific Regional Office, Bangkok, Thailand
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Mastrobattista L, Gomez Perez LJ, Gallimberti L, Genetti B, Andreotti A, Fassinato D, Monacis L, Anselmi P, Colledani D, Minutillo A, Mortali C. Psychosocial risk and protective factors for youth problem behavior are associated with food addiction in the Generation Z. Front Public Health 2024; 12:1414110. [PMID: 38859893 PMCID: PMC11163117 DOI: 10.3389/fpubh.2024.1414110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/16/2024] [Indexed: 06/12/2024] Open
Abstract
Objective Food Addiction (FA) and other well-known risk behavior as substance misuse tend to co-occur and may share similar risk and protective factors. The aim of this study was to assess the association between the diagnosis/severity of FA and psychosocial domains typically related to risk behavior syndrome in a large, nationally representative community sample of Generation Z underage Italian students. Method The sample consisted of 8,755 students (3,623 from middle schools, 5,132 from high schools). A short version of the Yale Food Addiction Scale 2.0 was administered to evaluate FA. Risk and protective factors related to demographic, personality, behavior, and family variables were examined. Stepwise multivariate logistic and linear regressions were conducted. Results The prevalence of FA was 30.8%. Female gender, social anxiety and depression symptoms, social withdrawal risk, Internet gaming disorder, social media addiction, current substance use, social challenge engagement and experienced doxing boosted the chance of FA diagnosis, whereas eating fruit and vegetables, playing competitive sports and an average sleep duration of 7-8 h per night reduced these odds. FA severity was significantly and positively associated with trait impulsiveness, social anxiety and depressive symptoms, risk of social withdrawal, recent substance use, social media, and gaming addiction, doxing suffered and risky social challenges participation. Negative associations between the severity of FA and fruit and vegetable diet habits were found. Conclusion Our findings confirm that FA is widespread among Italian adolescents. The associations between the diagnosis and severity of FA and psychosocial risk factors for health, including, addictive and deviant behaviors related to digital misuse, suggest its belonging to the risk behavior constellation. Health promotion schemes based on a multicomponent strategy of intervention should consider the inclusion of FA and its psychosocial correlates.
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Affiliation(s)
- Luisa Mastrobattista
- National Centre on Addiction and Doping, Italian National Institute of Health, Rome, Italy
| | | | | | - Bruno Genetti
- Explora Research and Statistical Analysis, Padua, Italy
| | | | | | - Lucia Monacis
- Department of Humanities, University of Foggia, Foggia, Italy
| | - Pasquale Anselmi
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padua, Italy
| | - Daiana Colledani
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padua, Italy
| | - Adele Minutillo
- National Centre on Addiction and Doping, Italian National Institute of Health, Rome, Italy
| | - Claudia Mortali
- National Centre on Addiction and Doping, Italian National Institute of Health, Rome, Italy
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Pereira de Araújo T, de Moraes MM, Afonso C, Rodrigues SSP. Trends in ultra-processed food availability and its association with diet-related non-communicable disease health indicators in the Portuguese population. Br J Nutr 2024; 131:1600-1607. [PMID: 38174417 DOI: 10.1017/s0007114523003045] [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] [Indexed: 01/05/2024]
Abstract
Broad variations in dietary and physical activity patterns are part of nutritional transition concept. An additional nutritional transition has as main characteristic the change of consumption of processed foods for ultra-processed foods (UPF). This study aims to evaluate trends of UPF availability in Portuguese population and its association with diet-related non-communicable diseases (NCD) health indicators. This ecological study used data from the Household Budget Surveys conducted by the National Statistics Institute each 5 years within a national representative sample of households. The percentage of UPF was calculated based on the total daily amount of food and beverages available per capita (in grams). Data from the years 1990, 1995, 2000 and 2005 were used, which were retrieved from DAFNE-Anemos Software. NCD age-standardised mortality, prevalence and incidence were obtained from the Global Burden of Disease database, for the years 2000, 2005, 2010 and 2015. Between 1990 and 2005, the UPF availability increased from 3·9 % to 13·8 %. Over the years, almost all food and beverages categories increased the UPF availability contribution, mainly noticeable for milk, sugar, cereal and meat products. Positive correlations were observed between UPF availability and digestive diseases both in prevalence (r = 0·062; P = 0·037) and incidence (r = 0·005; P = 0·010) measures. Neoplasms incidence also showed positive correlation with UPF availability (r = 0·002; P = 0·012). Trends in UPF availability in Portugal increased exponentially. At the same time, there is a trend towards a decrease in unprocessed and processed food availability. The Portuguese population should be made aware of the health risks resulting from excessive consumption of UPF.
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Affiliation(s)
- Taissa Pereira de Araújo
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Milena Miranda de Moraes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Sara Simões Pereira Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
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Popkin BM, Miles DR, Taillie LS, Dunford EK. A policy approach to identifying food and beverage products that are ultra-processed and high in added salt, sugar and saturated fat in the United States: a cross-sectional analysis of packaged foods. LANCET REGIONAL HEALTH. AMERICAS 2024; 32:100713. [PMID: 38495314 PMCID: PMC10943474 DOI: 10.1016/j.lana.2024.100713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Abstract
Background Governments globally aim to reduce the intake of unhealthy foods. Many policies exist that aim to address foods high in saturated fat, salt and sugar (HFSS) but the identification of ultra-processed foods (UPF) have presented a greater challenge due to the lack of an appropriate policy definition. To support policymakers, we provide approaches that can support governments to identify both HFSS foods and UPFs. Methods Four approaches combining elements of UPF definitions (i.e., presence of additives) and HFSS definitions were compared attempting to simplify and standardize the identification of less healthy products. Nationally representative food purchase data from NielsenIQ linked with nutrition facts label data were used to examine the mean proportion of product volume purchased by US households to be targeted. Differences between approaches were examined using Student t test; Bonferroni adjusted P value < 0.0001 was considered significant. Findings In 2020, 50% of 33,054,687 products purchased by US households were considered UPFs (65% of foods and 38% of beverages) and 43% HFSS (65% of foods and 26% of beverages), however there was not 100% agreement between the two definitions (P < 0.0001). By starting with HFSS criteria and adding elements of UPF (colors and flavors), we were able to provide a method with 100% agreement between the identification of UPFs and HFSS products. Interpretation Results demonstrated how combining HFSS criteria with UPF criteria can be used to identify less healthy foods and ensure policymakers have both a simple and accurate method to target products for policy intervention. Funding Bloomberg Philanthropies and the Global Food Research Program of UNC-Chapel Hill provided funds.
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Affiliation(s)
- Barry M. Popkin
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, USA
| | - Donna R. Miles
- Carolina Population Center, The University of North Carolina at Chapel Hill, USA
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, USA
| | - Elizabeth K. Dunford
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, USA
- Food Policy Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia
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10
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Wolfson JA, Martinez-Steele E, Tucker AC, Leung CW. Greater Frequency of Cooking Dinner at Home and More Time Spent Cooking Are Inversely Associated With Ultra-Processed Food Consumption Among US Adults. J Acad Nutr Diet 2024:S2212-2672(24)00113-8. [PMID: 38462128 DOI: 10.1016/j.jand.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/28/2023] [Accepted: 03/06/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Cooking at home has been promoted as a strategy to improve diet quality; however, the association between cooking behavior and ultra-processed food intake is unknown. OBJECTIVE The objective of this study was to examine associations between frequency of cooking dinner at home and time spent cooking dinner with ultra-processed food intake. DESIGN Cross-sectional, nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey were analyzed. PARTICIPANTS/SETTING Participants were 9,491 adults (20 years and older) in the United States. MAIN OUTCOME MEASURES The main outcome measure was the proportion of energy intake (averaged from two 24-hour dietary recalls) from the following 4 Nova food-processing groups: (1) unprocessed or minimally processed foods, (2) processed culinary ingredients, (3) processed foods, and (4) ultra-processed foods. STATISTICAL ANALYSES PERFORMED Separate linear regression models examined associations between cooking frequency and time spent cooking dinner and proportion of energy intake from the 4 Nova food-processing groups, adjusting for sociodemographic characteristics and total energy intake. RESULTS Ultra-processed foods comprised >50% of energy consumed independent of cooking frequency or time spent cooking. Higher household frequency of cooking dinner and greater time spent cooking dinner were both associated with lower intake of ultra-processed foods (P trends < .001) and higher intake of unprocessed or minimally processed foods (P trends < .001) in a dose-response manner. Compared with cooking 0 to 2 times/wk, adults who cooked dinner 7 times/wk consumed a mean of 6.30% (95% CI -7.96% to -4.64%; P < .001) less energy from ultra-processed foods. Adults who spent more than 90 minutes cooking dinner consumed 4.28% less energy from ultra-processed foods (95% CI -6.08% to -2.49%; P < .001) compared with those who spent 0 to 45 minutes cooking dinner. CONCLUSIONS Cooking at home is associated with lower consumption of ultra-processed foods and higher consumption of unprocessed or minimally processed foods. However, ultra-processed food intake is high among US adults regardless of cooking frequency.
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Affiliation(s)
- Julia A Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Health Policy and Management, Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - 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
| | - Anna Claire Tucker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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11
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Vale C, Almeida C, Azevedo J, Padrão P. Nutrient profile of packaged foods according to the degree of processing. Int J Food Sci Nutr 2024; 75:148-158. [PMID: 38186325 DOI: 10.1080/09637486.2023.2299771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
An increased consumption of ultra-processed foods (UPF) leads to a rising prevalence of chronic noncommunicable diseases. This study aims to characterise the nutrient profile of white-label pre-packaged foods and bakery products available in a market leader Portuguese food retail chain, according to the extent of processing proposed by NOVA classification system. The nutrient profile (energy, sugar, total fat, saturated fat and sodium) according to processing degree was analysed using non-parametric tests. UPF were the most energy dense (278 kcal/100 g, p < .001) and the highest in sugar (15.9 g/100 g, p < .001). Processed foods were the highest in sodium (538 mg/100 g, p < .001). Processed and UPF showed significantly higher total (12.4 and 10.8 g/100 g, respectively) and saturated fat content (6.10 and 4.61 g/100 g, respectively) than unprocessed/minimally processed foods (p < .001). Regarding the variation of the nutritional value across the extent of processing, different results were observed for some categories suggesting the importance of a stratified analysis. The consumption of less processed foods and the manufacture of processed/UPF with better nutrient profile should be promoted.
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Affiliation(s)
- Catarina Vale
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Carla Almeida
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - José Azevedo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Faculdade de Letras de Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
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12
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Kong W, Xie Y, Hu J, Ding W, Cao C. Higher ultra processed foods intake is associated with low muscle mass in young to middle-aged adults: a cross-sectional NHANES study. Front Nutr 2024; 11:1280665. [PMID: 38439924 PMCID: PMC10909937 DOI: 10.3389/fnut.2024.1280665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/09/2024] [Indexed: 03/06/2024] Open
Abstract
Design Ultra-processed foods (UPFs) have become a pressing global health concern, prompting investigations into their potential association with low muscle mass in adults. Methods This cross-sectional study analyzed data from 10,255 adults aged 20-59 years who participated in the National Health and Nutritional Examination Survey (NHANES) during cycles spanning from 2011 to 2018. The primary outcome, low muscle mass, was assessed using the Foundation for the National Institutes of Health (FNIH) definition, employing restricted cubic splines and weighted multivariate regression for analysis. Sensitivity analysis incorporated three other prevalent definitions to explore optimal cut points for muscle quality in the context of sarcopenia. Results The weighted prevalence of low muscle mass was 7.65%. Comparing the percentage of UPFs calories intake between individuals with normal and low muscle mass, the values were found to be similar (55.70 vs. 54.62%). Significantly linear associations were observed between UPFs consumption and low muscle mass (P for non-linear = 0.7915, P for total = 0.0117). Upon full adjustment for potential confounding factors, participants with the highest UPFs intake exhibited a 60% increased risk of low muscle mass (OR = 1.60, 95% CI: 1.13 to 2.26, P for trend = 0.003) and a decrease in ALM/BMI (β = -0.0176, 95% CI: -0.0274 to -0.0077, P for trend = 0.003). Sensitivity analysis confirmed the consistency of these associations, except for the International Working Group on Sarcopenia (IWGS) definition, where the observed association between the highest quartiles of UPFs (%Kcal) and low muscle mass did not attain statistical significance (OR = 1.35, 95% CI: 0.97 to 1.87, P for trend = 0.082). Conclusion Our study underscores a significant linear association between higher UPFs consumption and an elevated risk of low muscle mass in adults. These findings emphasize the potential adverse impact of UPFs on muscle health and emphasize the need to address UPFs consumption as a modifiable risk factor in the context of sarcopenia.
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Affiliation(s)
- Weiliang Kong
- Key Laboratory of Respiratory Disease of Ningbo, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Yilian Xie
- Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Jingjing Hu
- Key Laboratory of Respiratory Disease of Ningbo, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Weiping Ding
- Key Laboratory of Respiratory Disease of Ningbo, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Chao Cao
- Key Laboratory of Respiratory Disease of Ningbo, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, China
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13
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Kikuta C, Borges CA, Duran AC. Monitoring health and nutrition claims on food labels in Brazil. Front Nutr 2024; 11:1308110. [PMID: 38385015 PMCID: PMC10879323 DOI: 10.3389/fnut.2024.1308110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction The monitoring of nutrition and health claims on food and beverage labels has been proposed by international and national organizations because it can collaborate with the development of public policies to regulate food labeling and marketing strategies. One way of carrying out this monitoring is by using data collected by private companies. Objective To compare information on nutrition and health claims available in a commercial database of a private company that monitors the launch of new foods and beverages in Brazilian food retailers with information on those same claims manually coded by trained research assistants. Methods This is a cross-sectional observational study using a data sample of newly launched food and beverages available at a commercial database from 2018 to 2021. We compared the information on health and nutrition claims available on the commercial dataset with reliable information on the same nutrition and health claims manually coded by trained research assistants using a tested taxonomy to classify such claims. We used Gwet's Kappa AC1 with 95% CI and percentage agreement to compare both data sources and calculated sensitivity and specificity of the compared data. Results A total of 6,722 foods and beverages were analyzed. Mintel-GNPD presented 36.28% (n = 2,439) of nutrition claims, while in the trained researchers' coding, it was 33.73% (n = 2,267). We found a prevalence of 5.4% (n = 362) for health claims in Mintel-GNPD and 10.8% (n = 723) in the researchers' coding. All subcategories of nutrition and health claims showed high agreement (Kappa >0.81). Health claims presented kappa = 0.89 with 33.7% sensitivity and 98.0% specificity while nutrition claims showed kappa = 0.86 with 92.9% sensitivity and 92.5% specificity. Conclusion Nutrition and health claims showed high agreement, with great results in nutrition claims, indicating that Mintel-GPND is suitable for monitoring such claims on food and beverage packaging in Brazil. Additionally, our findings show a high prevalence of nutrition and health claims on food packages launched in the Brazilian food retail, highlighting the need to monitor these to develop public policies to regulate food marketing on packaging in Brazil.
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Affiliation(s)
- Carolina Kikuta
- Graduate Program in Public Health, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Camila Aparecida Borges
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Ana Clara Duran
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Center for Food Studies and Research, University of Campinas, Campinas, Brazil
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14
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Amson A, Pauzé E, Ramsay T, Welch V, Hamid JS, Lee J, Olstad DL, Mah C, Raine K, Potvin Kent M. Examining gender differences in adolescent exposure to food and beverage marketing through go-along interviews. Appetite 2024; 193:107153. [PMID: 38072086 DOI: 10.1016/j.appet.2023.107153] [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: 10/12/2023] [Revised: 11/17/2023] [Accepted: 12/04/2023] [Indexed: 01/01/2024]
Abstract
This study explores how adolescents engage with unhealthy food and beverage marketing in online settings, from a gender perspective. Employing an online ethnography approach and using go-along interviews, we explored the experiences of adolescent boys and girls aged 13-17 as they navigated their online experiences with digital food and beverage marketing. Notable themes emerged, including the identification of predatory actions by food companies, the role of protective factors such as family, and the influence of social media influencers in shaping adolescent dietary preferences. Importantly, this research unearthed gender disparities in the participants' responses. Girls, in particular, exhibited a heightened awareness of the protective role played by their families, emphasized the influence of color in marketing strategies, recognized the significance of gender in marketing, and reported exposure to alcohol advertisements-findings that boys less frequently echoed. The study underscores the importance of adolescence as a critical phase in development, during which food companies target these impressionable individuals, driven by their independence and potential for brand loyalty. Moreover, it highlights the potential avenue of gender-specific marketing, offering valuable insights into the gendered dimensions of adolescents' food marketing experiences. By examining the interplay between digital food marketing and gender, this research addresses a critical gap in the literature, shedding light on how gender influences adolescents' perceptions, responses, and behaviors in the context of food marketing strategies. These findings have the potential to inform adolescents of the marketing techniques that target them and guide policymakers in developing and implementing evidence-based regulations aimed at safeguarding adolescents from exposure to unhealthy food marketing.
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Affiliation(s)
- A Amson
- Interdisciplinary School of Health Sciences, University of Ottawa, 75 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada
| | - E Pauzé
- Interdisciplinary School of Health Sciences, University of Ottawa, 75 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada
| | - T Ramsay
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - V Welch
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - J S Hamid
- Department of Mathematics and Statistics, University of Ottawa, 75 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada
| | - J Lee
- Cumming School of Medicine - Department of Community Health Sciences & Cardiac Sciences, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - D L Olstad
- Cumming School of Medicine - Department of Community Health Sciences, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - C Mah
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building 2nd Floor 2A01, Office 2A03, 5850 College Street, PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
| | - K Raine
- Center for Health Promotion Studies, School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - M Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.
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15
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Abstract
The analysis of food using a perspective centred on nutrients seems inadequate for understanding the dietary transition and its impact on the growth of obesity and chronic diseases. Industrial food processing is now proposed as the key to explain the relationship between food and health. The NOVA food classification considers the degree and the purpose of food processing, which includes physical, biological and chemical processes used after foods are separated from nature, and before being consumed or prepared as dishes and meals. NOVA has four food groups: (1) unprocessed and minimally processed foods; (2) processed culinary ingredients; (3) processed foods and (4) ultra-processed foods, which are formulations made mostly or entirely from substances derived from group 1 foods and additives, with little if any intact group 1 food. Many investigations linking high ultra-processed food consumption with deterioration of diets and adverse health outcomes are reinforced by prospective studies, systematic reviews and meta-analyses. There are various plausible explanations of why diets high in ultra-processed foods are harmful. Their production and consumption continue to rise worldwide. Efficient and effective public policies and actions that reduce production and consumption of ultra-processed products are needed, to protect human health now and in future.
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Affiliation(s)
- Renata Bertazzi Levy
- Preventive Medicine Department, Medical School, University of Sao Paulo, Ave. Dr Arnaldo, 455, Zip Code: 01246-903, São Paulo, SP, Brazil
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
| | - Mayra Figueiredo Barata
- Preventive Medicine Department, Medical School, University of Sao Paulo, Ave. Dr Arnaldo, 455, Zip Code: 01246-903, São Paulo, SP, Brazil
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
| | - Maria Alvim Leite
- Preventive Medicine Department, Medical School, University of Sao Paulo, Ave. Dr Arnaldo, 455, Zip Code: 01246-903, São Paulo, SP, Brazil
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
| | - Giovanna Calixto Andrade
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
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16
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Kébé SD, Diouf A, Sylla PMDD, Kane K, Dos Santos Costa C, Leite FHM, Andrade GC, Badiane A, Moubarac JC, Idohou-Dossou N, Monteiro CA. Assessment of ultra processed foods consumption in Senegal: validation of the Nova-UPF screener. Arch Public Health 2024; 82:4. [PMID: 38200567 PMCID: PMC10777632 DOI: 10.1186/s13690-024-01239-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Ultra-processed foods (UPF), as proposed by the Nova food classification system, are linked to the development of obesity and several non-communicable chronic diseases and deaths from all causes. The Nova-UPF screener developed in Brazil is a simple and quick tool to assess and monitor the consumption of these food products. The aim of this study was to adapt and validate, against the 24-hour dietary recall, this short food-based screener to assess UPF consumption in the Senegalese context. METHODS The tool adaptation was undertaken using DELPHI methodology with national experts and data from a food market survey. Following the adaptation, sub-categories were renamed, restructured and new ones introduced. The validation study was conducted in the urban area of Dakar in a convenience sample of 301 adults, using as a reference the dietary share of UPF on the day prior to the survey, expressed as a percentage of total energy intake obtained via 24-hour recall. Association between the Nova-UPF score and the dietary share of UPF was evaluated using linear regression models. The Pabak index was used to assess the agreement in participants' classification according to quintiles of Nova-UPF score and quintiles of the dietary share of UPF. RESULTS The results show a linear and positive association (p-value < 0.001) between intervals of the Nova-UPF score and the average dietary share of UPF. There was a near perfect agreement in the distribution of individuals according to score's quintiles and UPF dietary share quintiles (Pabak index = 0.84). CONCLUSION The study concluded that the score provided by the Nova-UPF screener adapted to the Senegalese context is a valid estimate of UPF consumption.
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Affiliation(s)
- Saliou Diombo Kébé
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal.
| | - Adama Diouf
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Papa Mamadou Dit Doudou Sylla
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
- Laboratoire des sciences Biologiques, Agronomiques, Alimentaires et de Modélisation des Systèmes complexes, Université Gaston Berger, Saint-Louis, Sénégal
| | - Kalidou Kane
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Caroline Dos Santos Costa
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of Sao Paulo, São Paulo, Brazil
| | - Fernanda Helena Marrocos Leite
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of Sao Paulo, São Paulo, Brazil
| | - Giovanna Calixto Andrade
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of Sao Paulo, São Paulo, Brazil
| | - Abdou Badiane
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
| | | | - Nicole Idohou-Dossou
- Laboratoire de Recherche en Nutrition et Alimentation Humaine, Département de Biologie Animale, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Carlos Augusto Monteiro
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of Sao Paulo, São Paulo, Brazil
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17
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Santos MI, Grácio M, Silva MC, Pedroso L, Lima A. One Health Perspectives on Food Safety in Minimally Processed Vegetables and Fruits: From Farm to Fork. Microorganisms 2023; 11:2990. [PMID: 38138132 PMCID: PMC10745503 DOI: 10.3390/microorganisms11122990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
While food markets and food production chains are experiencing exponential growth, global attention to food safety is steadily increasing. This is particularly crucial for ready-to-eat products such as fresh-cut salads and fruits, as these items are consumed raw without prior heat treatment, making the presence of pathogenic microorganisms quite frequent. Moreover, many studies on foodborne illnesses associated with these foods often overlook the transmission links from the initial contamination source. The prevention and control of the dissemination of foodborne pathogens should be approached holistically, involving agricultural production, processing, transport, food production, and extending to final consumption, all while adopting a One Health perspective. In this context, our objective is to compile available information on the challenges related to microbiological contamination in minimally handled fruits and vegetables. This includes major reported outbreaks, specific bacterial strains, and associated statistics throughout the production chain. We address the sources of contamination at each stage, along with issues related to food manipulation and disinfection. Additionally, we provide potential solutions to promote a healthier approach to fresh-cut fruits and vegetables. This information will be valuable for both researchers and food producers, particularly those focused on ensuring food safety and quality.
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Affiliation(s)
- Maria Isabel Santos
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal; (M.C.S.); (L.P.)
- CECAV—Centre of Animal and Veterinary Science, Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
| | - Madalena Grácio
- Instituto Superior de Agronomia, University of Lisbon, 1349-017 Lisbon, Portugal;
| | - Mariana Camoesas Silva
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal; (M.C.S.); (L.P.)
| | - Laurentina Pedroso
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal; (M.C.S.); (L.P.)
- CECAV—Centre of Animal and Veterinary Science, Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
| | - Ana Lima
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal; (M.C.S.); (L.P.)
- CECAV—Centre of Animal and Veterinary Science, Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
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Bestari FF, Andarwulan N, Palupi E. Synthesis of Effect Sizes on Dose Response from Ultra-Processed Food Consumption against Various Noncommunicable Diseases. Foods 2023; 12:4457. [PMID: 38137261 PMCID: PMC10742878 DOI: 10.3390/foods12244457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Ultra-processed foods (UPFs), according to the NOVA classification food system, are food products that are processed using advanced processing technology, which improves palatability and sensory quality. However, UPFs increase the daily intake of energy, sodium, sugar, and total fat (including saturated fat), and decrease the intake of fiber. This might trigger overweight and obesity, the initial stages of noncommunicable diseases (NCDs). However, the effect of UPF consumption on NCDs remains under debate. This study aimed to synthesize the effect size of UPF dose response on various NCDs by using a meta-analysis method. The main output was a hazard ratio (HR) and a 95% confidence interval (CI). Using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) selection guidelines, 18 research articles were chosen for further effect size synthesis. The results showed that UPF consumption significantly increased the daily intake of carbohydrates, added sugar, saturated fat, sodium, energy, cholesterol, and total fat; increases of 49.64, 40.78, 30.00, 27.76, 26.67, 25.69, and 15.77%, respectively, were observed. Moreover, with UPF consumption, the fiber intake was way below the daily dietary recommendation (DR), at -38.55%. Further, a 10% increment in UPF consumption significantly affects diabetes, cardiovascular diseases, obesity, and cancer (HR ± 95% CI: 1.115 ± 0.044, 1.096 ± 0.053, 1.068 ± 0.050, and 1.020 ± 0.020, respectively). Thus, limiting daily UPF consumption could help prevent obesity and various NCDs.
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Affiliation(s)
- Fairuz Firda Bestari
- Department of Food Science, Faculty of Agricultural Technology, IPB University, Bogor 16680, Indonesia
| | - Nuri Andarwulan
- Department of Food Science, Faculty of Agricultural Technology, IPB University, Bogor 16680, Indonesia
| | - Eny Palupi
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor 16680, Indonesia
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de Azevedo ABC, Bandoni DH, de Amorim ALB, Canella DS. Evaluation of food purchasing in the Brazilian School Feeding Programme: feasibility of the requirements and recommendations. Public Health Nutr 2023; 26:3331-3342. [PMID: 37905595 PMCID: PMC10755429 DOI: 10.1017/s136898002300229x] [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: 11/28/2022] [Revised: 08/01/2023] [Accepted: 10/23/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To analyse the purchase of food for school feeding, according to the extent and purpose of industrial processing and variety, exploring the feasibility of achieving the requirements and recommendations of the Brazilian School Feeding Programme, and the variety of unprocessed or minimally processed foods according to the purchase of ultra-processed foods. DESIGN Secondary data from 2016 from the Accountability Management System of the National Fund for Educational Development, concerning the food items purchased, were used to explore the feasibility of the requirements and recommendations. The foods were grouped according to the NOVA classification system. Variety was assessed by counting different types of unprocessed or minimally processed foods. SETTING Brazil. PARTICIPANTS 3698 Brazilian municipalities. RESULTS Energy share from unprocessed or minimally processed foods was 44·1 % while that of ultra-processed foods was 29·9 %. The average of unprocessed or minimally processed food types purchased annually was 33·8 items. Of the municipalities, 35·8 % were within the limit established for the expenditure of funds for the purchase of processed and ultra-processed foods, while 8·7 % followed the recommendation for variety. The proportion of ultra-processed foods did not influence the variety of food items purchased. CONCLUSIONS The results showed the feasibility of achieving the requirements and recommendations and underscored the importance of continued efforts to promote the inclusion of unprocessed or minimally processed foods in the school feeding programme while addressing the challenges associated with expenditure limits of processed and ultra-processed foods and enhancing variety, which is strategic to promote adequate and healthy meals.
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Affiliation(s)
- Ana Beatriz Coelho de Azevedo
- Rio de Janeiro State University, Institute of Nutrition, Rua São Francisco Xavier, nº 524, Maracanã, Pavilhão João Lyra Filho, 12º andar, Bloco E, sala 12002, Rio de Janeiro, RJ, Brazil
| | - Daniel Henrique Bandoni
- Federal University of São Paulo, Center of Practices and Research in Nutrition and Collective Food Services, Edifício Central – Rua Silva Jardim, nº 136, Vila Matias, Santos, SP, Brazil
| | | | - Daniela Silva Canella
- Rio de Janeiro State University, Institute of Nutrition, Rua São Francisco Xavier, nº 524, Maracanã, Pavilhão João Lyra Filho, 12º andar, Bloco E, sala 12002, Rio de Janeiro, RJ, Brazil
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Vandevijvere S, De Pauw R, Djojosoeparto S, Gorasso V, Guariguata L, Løvhaug AL, Mialon M, Van Dam I, von Philipsborn P. Upstream Determinants of Overweight and Obesity in Europe. Curr Obes Rep 2023; 12:417-428. [PMID: 37594616 DOI: 10.1007/s13679-023-00524-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE OF REVIEW To review the upstream determinants of overweight and obesity in Europe, including food and built environments, and political, commercial, and socioeconomic determinants. RECENT FINDINGS Overweight and obesity affect 60% of European adults, and one in three children, and are more common in individuals with low compared to high socioeconomic position (SEP). Individuals in low SEP groups are more exposed to unhealthy built and food environments, including higher exposure to unhealthy food marketing. Industries influencing the food system have much economic power, resulting in ignoring or silencing the role of ultra-processed foods and commercial practices in weight gain. Overall, effective policies to address overweight and obesity have been insufficiently implemented by governments. To accelerate implementation, strengthened political commitment is essential. Policies must also focus on the upstream, structural, and systemic drivers of overweight and obesity; be comprehensive; and target socioeconomic inequalities in diets and physical activity.
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Affiliation(s)
- Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium.
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Sanne Djojosoeparto
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Wageningen, The Netherlands
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Leonor Guariguata
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Anne Lene Løvhaug
- Department of Nursing and Health Promotion, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | | | - Iris Van Dam
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Peter von Philipsborn
- Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Munich, Germany
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21
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Flanagan EW, Spann R, Berry SE, Berthoud HR, Broyles S, Foster GD, Krakoff J, Loos RJF, Lowe MR, Ostendorf DM, Powell-Wiley TM, Redman LM, Rosenbaum M, Schauer PR, Seeley RJ, Swinburn BA, Hall K, Ravussin E. New insights in the mechanisms of weight-loss maintenance: Summary from a Pennington symposium. Obesity (Silver Spring) 2023; 31:2895-2908. [PMID: 37845825 PMCID: PMC10915908 DOI: 10.1002/oby.23905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/18/2023] [Accepted: 08/04/2023] [Indexed: 10/18/2023]
Abstract
Obesity is a chronic disease that affects more than 650 million adults worldwide. Obesity not only is a significant health concern on its own, but predisposes to cardiometabolic comorbidities, including coronary heart disease, dyslipidemia, hypertension, type 2 diabetes, and some cancers. Lifestyle interventions effectively promote weight loss of 5% to 10%, and pharmacological and surgical interventions even more, with some novel approved drugs inducing up to an average of 25% weight loss. Yet, maintaining weight loss over the long-term remains extremely challenging, and subsequent weight gain is typical. The mechanisms underlying weight regain remain to be fully elucidated. The purpose of this Pennington Biomedical Scientific Symposium was to review and highlight the complex interplay between the physiological, behavioral, and environmental systems controlling energy intake and expenditure. Each of these contributions were further discussed in the context of weight-loss maintenance, and systems-level viewpoints were highlighted to interpret gaps in current approaches. The invited speakers built upon the science of obesity and weight loss to collectively propose future research directions that will aid in revealing the complicated mechanisms involved in the weight-reduced state.
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Affiliation(s)
| | - Redin Spann
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Sarah E. Berry
- Department of Nutritional Sciences, King’s College London, London, UK
| | | | | | - Gary D. Foster
- WW International, New York, New York, USA
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology & Clinical Research Branch, NIDDK-Phoenix, Phoenix, Arizona, USA
| | - Ruth J. F. Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Danielle M. Ostendorf
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Leanne M. Redman
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics and Irving Center for Clinical and Translational Research, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Randy J. Seeley
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Boyd A. Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Kevin Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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22
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Gangopadhyay A. Ultraprocessed Foods and Cancer in Low-Middle-Income Countries. Nutr Cancer 2023; 75:1863-1873. [PMID: 37873656 DOI: 10.1080/01635581.2023.2272814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023]
Abstract
Low middle income countries (LMICs) are the predominant contributors to global cancer-related mortality and are projected to bear the greater share of the global cancer burden in the next few decades. Among other factors, lifestyle changes have been linked to the rising incidence of cancer in these countries. As one of the keys to a healthy lifestyle, a balanced diet plays a major role in the preservation of health. Globalization and rapid urbanization have prompted a paradigm shift in various aspects of daily life in LMICs; the influence on dietary choices has been particularly noticeable. Studies show a concerning rise in the sale and consumption of ultraprocessed foods in these countries. In addition to hyperpalatability, this trend has been attributed to various other factors including convenience, availability, economic considerations, and marketing strategies. Although several studies from LMICs recognize and recommend the need for effective public health measures to reduce the consumption of these foods, findings from certain studies suggest that established public health strategies occasionally fail in the real-world scenario. Barriers to effective policymaking also contribute to the prevailing dietary trends. This review of studies from the LMIC setting demonstrates the current problem, limitations of established public health measures, and the complexities associated with effective policymaking. In view of the threat posed to cancer risk, there is an urgent need to curb the consumption of ultraprocessed foods in LMICs. National policymakers therefore need to circumnavigate the challenges effectively to ensure timely achievement of the United Nations sustainable development goals.
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23
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Ares G, Natero V, Gugliucci V, Machín L, Alcaire F, de León C, Otterbring T. Health-Washing of Ultraprocessed Products on Instagram: Prevalence and Strategies in an Emerging Market. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:815-822. [PMID: 37777932 DOI: 10.1016/j.jneb.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE To evaluate the prevalence of health-related cues as part of the digital marketing of ultraprocessed foods on Instagram among food companies in Uruguay. METHODS Cross-sectional exploratory study. All content posted by 118 Instagram accounts of companies promoting ultraprocessed foods in Uruguay over 6 months (from August 2020 to February 2021) was retrieved. The content of 1,893 Instagram posts was coded considering visual and textual cues conveying health-related associations. The number and percentage of posts, including cues within each category and theme, were calculated. RESULTS More than half of all posts contained at least 1 visual or textual cue conveying health-related associations. Three main themes emerged: i) product composition, ii) healthy lifestyle, and iii) health and health benefits. The prevalence of health-related cues differed dramatically across product categories, ranging from 100% to 1.5%. CONCLUSIONS AND IMPLICATIONS Health-washing constitutes an integral part of the digital marketing of ultraprocessed foods on Instagram in Uruguay. The inclusion of health-related cues can potentially undermine public health efforts targeted at reducing consumption of these foods. These findings suggest that strict and comprehensive regulations on the digital marketing of such products are needed in policies promoting healthy eating habits globally.
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Affiliation(s)
- Gastón Ares
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Uruguay; Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay.
| | - Virginia Natero
- Departamento de Alimentos, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Vanessa Gugliucci
- Espacio Interdisciplinario, Universidad de la República, Montevideo, Uruguay
| | - Leandro Machín
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Florencia Alcaire
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Uruguay
| | | | - Tobias Otterbring
- School of Business and Law, Department of Management, University of Agder, Kristiansand, Norway; Institute of Retail Economics, Stockholm, Sweden
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Avesani CM, Cuppari L, Nerbass FB, Lindholm B, Stenvinkel P. Ultraprocessed foods and chronic kidney disease-double trouble. Clin Kidney J 2023; 16:1723-1736. [PMID: 37915903 PMCID: PMC10616474 DOI: 10.1093/ckj/sfad103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Indexed: 11/03/2023] Open
Abstract
High energy intake combined with low physical activity generates positive energy balance, which, when maintained, favours obesity, a highly prevalent morbidity linked to development of non-communicable chronic diseases, including chronic kidney disease (CKD). Among many factors contributing to disproportionately high energy intakes, and thereby to the obesity epidemic, the type and degree of food processing play an important role. Ultraprocessed foods (UPFs) are industrialized and quite often high-energy-dense products with added sugar, salt, unhealthy fats and food additives formulated to be palatable or hyperpalatable. UPFs can trigger an addictive eating behaviour and is typically characterized by an increase in energy intake. Furthermore, high consumption of UPFs, a hallmark of a Western diet, results in diets with poor quality. A high UPF intake is associated with higher risk for CKD. In addition, UPF consumption by patients with CKD is likely to predispose and/or to exacerbate uraemic metabolic derangements, such as insulin resistance, metabolic acidosis, hypertension, dysbiosis, hyperkalaemia and hyperphosphatemia. Global sales of UPFs per capita increased in all continents in recent decades. This is an important factor responsible for the nutrition transition, with home-made meals being replaced by ready-to-eat products. In this review we discuss the potential risk of UPFs in activating hedonic eating and their main implications for health, especially for kidney health and metabolic complications of CKD. We also present various aspects of consequences of UPFs on planetary health and discuss future directions for research to bring awareness of the harms of UPFs within the CKD scenario.
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Affiliation(s)
- Carla Maria Avesani
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Instituted, Stockholm, Sweden
| | - Lilian Cuppari
- Division of Nephrology and Nutrition Program, Federal University of São Paulo and Sāo Paulo, Brazil
| | | | - Bengt Lindholm
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Instituted, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Instituted, Stockholm, Sweden
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25
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Dicken SJ, Qamar S, Batterham RL. Who consumes ultra-processed food? A systematic review of sociodemographic determinants of ultra-processed food consumption from nationally representative samples. Nutr Res Rev 2023:1-41. [PMID: 37905428 DOI: 10.1017/s0954422423000240] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Ultra-processed food (UPF) intake is associated with increased non-communicable disease risks. However, systematic reports on sociodemographic predictors of UPF intake are lacking. This review aimed to understand UPF consumption based on sociodemographic factors, using nationally representative cohorts. The systematic review was pre-registered (PROSPERO:CRD42022360199), following PRISMA guidelines. PubMed/MEDLINE searches (‘ultra-processed/ultraprocessed’ and ‘ultra-processing/ultraprocessing’) until 7 September 2022 retrieved 1131 results. Inclusion criteria included: observational, nationally representative adult samples, in English, in peer-reviewed journals, assessing the association between sociodemographics and individual-level UPF intake defined by the NOVA classification. Exclusion criteria included: not nationally representative, no assessment of sociodemographics and individual-level UPF intake defined by NOVA. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Fifty-five papers were included, spanning thirty-two countries. All thirteen sociodemographic variables identified were significantly associated with UPF intake in one or more studies. Significant differences in UPF intake were seen across age, race/ethnicity, rural/urbanisation, food insecurity, income and region, with up to 10–20% differences in UPF intake (% total energy). Higher UPF intakes were associated with younger age, urbanisation and being unmarried, single, separated or divorced. Education, income and socioeconomic status showed varying associations, depending on country. Multivariate analyses indicated that associations were independent of other sociodemographics. Household status and gender were generally not associated with UPF intake. NOS averaged 5·7/10. Several characteristics are independently associated with high UPF intake, indicating large sociodemographic variation in non-communicable disease risk. These findings highlight significant public health inequalities associated with UPF intake, and the urgent need for policy action to minimise social injustice-related health inequalities.
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Affiliation(s)
- Samuel J Dicken
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London WC1E 6JF, UK
| | - Sulmaaz Qamar
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London WC1E 6JF, UK
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital (UCLH), London NW1 2BU, UK
- National Institute for Health Research, Biomedical Research Centre, University College London Hospital (UCLH), London W1T 7DN, UK
| | - Rachel L Batterham
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London WC1E 6JF, UK
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital (UCLH), London NW1 2BU, UK
- National Institute for Health Research, Biomedical Research Centre, University College London Hospital (UCLH), London W1T 7DN, UK
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Barros AKC, de Jesus GM, Vieira GO, Dias LA. Use of screens and intake of unhealthy food among children and adolescents: association with physical activity in a cross-sectional study. BMC Nutr 2023; 9:104. [PMID: 37723539 PMCID: PMC10507888 DOI: 10.1186/s40795-023-00763-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 09/05/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The intake of unhealthy food taken on very regular basis may bring even further negative impact on health if associated with excessive time using of screen-based electronic devices. OBJECTIVE To estimate the association between the use of different types of screen-based devices and the intake of unhealthy foods amongst children and adolescents and to determine whether daily physical activity (DPA) has a moderating effect on the association. METHODS Cross-sectional study carried out with a probabilistic sample of students from second to fifth grade of public elementary schools in Feira de Santana, Bahia (n = 2,477; girls: 53.2%; age: 9.1 ± 1.38 years; BMI z-score 0.37 ± 4.19 Kg/m²). Food intake, screen use, and physical activity were assessed using an online questionnaire based on previous day recall (Web-CAAFE). Prevalence Ratios (PR) and 95% Confidence Intervals (95%CI) were estimated via multiple zero-inflated negative binomial regression, with adjustments for sex, age, and weekly frequency of school meal intake. The moderating effect of DPA was verified by inserting interaction terms with each screen-based device individually and with the daily sum of screen-based device exposure (∑ Screens). RESULTS The majority of students (72.2%) reported using screens. The intake of unhealthy foods was positively associated with the use of cell phones (PR = 1.21; 95%CI = 1.13-1.30), computers (PR = 1.33; 95%CI = 1.22-1.46), and video games (PR = 1.36; 95%CI = 1.22-1.52). TV use was inversely associated with intake of unhealthy foods (PR = 0.92; 95%CI = 0.87-0.99). DPA moderated the effect of video game use on intake of unhealthy foods, that is, among students with DPA ≥ 4 who used video games, the intake of unhealthy foods was 21% lower (PR = 0.79; 95%CI = 0. 65-0.97). Overall, ∑ Screen-based devices were associated with a 20% increase in intake of unhealthy foods. CONCLUSION The intake of unhealthy foods was positively associated with the use of cell phones, computers, and video games. In addition, a frequency of four or more DPA attenuated the effect of video game exposure on intake of unhealthy foods. Upcoming investigations on the use of screen-based devices and the intake of unhealthy foods among schoolchildren should consider the exposure to different types of screen-based devices, as well as the influence of DPA.
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Blake CE, Monterrosa EC, Rampalli KK, Khan ANS, Reyes LI, Drew SD, Dominguez-Salas P, Bukachi SA, Ngutu M, Frongillo EA, Iruhiriye E, Girard AW. Basic human values drive food choice decision-making in different food environments of Kenya and Tanzania. Appetite 2023; 188:106620. [PMID: 37271253 PMCID: PMC10423943 DOI: 10.1016/j.appet.2023.106620] [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: 01/06/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
Increased access to a variety of foods in low-and-middle-income countries (LMICs) has led to greater autonomy in food choice decision-making. Autonomy allows individuals to make decisions through negotiation of considerations in ways that are consistent with basic values. The aim of this study was to identify and describe how basic human values drive food choice in two diverse populations with transitioning food environments living in the neighboring East African countries of Kenya and Tanzania. Secondary data analysis was carried out on focus group discussions conducted with men and women in Kenya (n = 28) and Tanzania (n = 28) as part of prior studies on food choice. A priori coding based on Schwartz's theory of basic human values was conducted, followed by a narrative comparative analysis, which included review by original principal investigators. Values of conservation (security, conformity, tradition), openness to change (self-directed thought and action, stimulation, indulgence), self-enhancement (achievement, power, face), and self-transcendence (benevolence-dependability and -caring) were prominent drivers of food choice in both settings. Participants described how values were negotiated and highlighted existing tensions. For example, the value of tradition was cited as important in both settings but changing food contexts (e.g., new foods, diverse neighborhoods) increased prioritization of values like stimulation, indulgence, and self-directed thought and action. The application of a basic values framework was useful for understanding food choice in both settings. A focused understanding of how values drive food choice decision-making in the context of changing food availability in LMICs is essential for the promotion of sustainable healthy diets.
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Affiliation(s)
- Christine E Blake
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Eva C Monterrosa
- Global Alliance for Improved Nutrition, Rue de Varembé 7, 1202, Geneva, Switzerland.
| | - Krystal K Rampalli
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | | | - Ligia I Reyes
- Cornell University, Division of Nutritional Sciences, Ithaca, NY, 14853, USA.
| | - Shiny Deepika Drew
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Paula Dominguez-Salas
- Natural Resources Institute, University of Greenwich, London, UK; International Livestock Research Institute, Nairobi, Kenya.
| | - Salome A Bukachi
- Institute of Anthropology, Gender and African Studies (IAGAS), University of Nairobi, Kenya.
| | - Mariah Ngutu
- Institute of Anthropology, Gender and African Studies (IAGAS), University of Nairobi, Kenya.
| | - Edward A Frongillo
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Elyse Iruhiriye
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Amy Webb Girard
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Zhao L, Zhang X, Martinez Steele E, Lo CH, Zhang FF, Zhang X. Higher ultra-processed food intake was positively associated with odds of NAFLD in both US adolescents and adults: A national survey. Hepatol Commun 2023; 7:e0240. [PMID: 37655983 PMCID: PMC10476803 DOI: 10.1097/hc9.0000000000000240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/01/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The effect of ultra-processed foods (UPF) on NAFLD remains unclear. Related evidence for adult NAFLD is limited and no study has yet evaluated UPF's impact on NAFLD in adolescence. METHODS We used data from the National Health and Nutrition Examination Survey (2017-2018) with 806 adolescents and 2734 adults. UPF intake was estimated using dietary data from two 24-hour dietary recalls. NAFLD was defined by transient elastography. Logistic regression was used to estimate the multivariable OR and 95% CI for associations between UPF and NAFLD with survey weight adjustments. RESULTS The mean UPF intake was 812 g/d in adolescents and 823 g/d in adults. A total of 12.4% of the adolescents and 35.6% of the adults had NAFLD. Higher UPF intake was associated with higher odds of NAFLD in both adolescents (OR Quintile 5 vs. Quartile 1 = 2.34, 95% CI, 1.01, 5.41; ptrend = 0.15) and adults (OR Quintile 5 vs. Quintile 1 = 1.72, 95% CI, 1.01, 2.93; ptrend = 0.002). In adults, ~68% and 71% of the association between UPF intake and NAFLD was mediated by body mass index and waist circumference (all p-values < 0.001), respectively. The results were similar for adolescents but not statistically significant. A higher UPF intake was associated with lower levels of serum albumin and higher levels of C-reactive protein in adults. CONCLUSIONS Higher UPF intake was linked to higher NAFLD odds in both adolescents and adults, mainly because of elevated body fatness. If confirmed, reducing UPF intake may help prevent NAFLD in both adolescents and adults.
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Affiliation(s)
- Longgang Zhao
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Xinyuan Zhang
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Euridice Martinez Steele
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Chun-Han Lo
- Internal Medicine and Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Nevada, USA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Xuehong Zhang
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Bjøntegaard MM, Molin M, Kolby M, Torheim LE. Purchase of ultra-processed foods in Norway: a repeated cross-sectional analysis of food sales in 2013 and 2019. Public Health Nutr 2023; 26:1743-1753. [PMID: 37339927 PMCID: PMC10478042 DOI: 10.1017/s1368980023001192] [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: 08/23/2022] [Revised: 05/04/2023] [Accepted: 06/14/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVE A dietary pattern dominated by ultra-processed foods has been associated with non-communicable diseases in several studies. A previous study from 2013 found a high share of ultra-processed foods in Norwegian food sales. This study aimed to investigate the current share of ultra-processed foods in Norway and the development in expenditure on ultra-processed foods from 2013. DESIGN A repeated cross-sectional analysis of scanner data from the Consumer Price Index from September 2013 and 2019 and an investigation of the processing degree according to the NOVA classification system. SETTING Food sales in Norway. PARTICIPANTS Norwegian grocery stores (n 180, for both time periods). RESULTS The share of expenditure in 2019 was highest for ultra-processed foods (46·5 %) and minimally or unprocessed foods (36·3 %), followed by processed foods (8·5 %) and processed culinary ingredients (1·3 %). An increasing degree of processing was found for several of the food groups between 2013 and 2019; however, most effect sizes were weak. In 2019, soft drinks became the most frequently purchased food item, surpassing milk and cheese, with the highest expenditure in Norwegian grocery stores. Increases in expenditure on ultra-processed foods were mainly due to increased expenditures on soft drinks, sweets and potato products. CONCLUSIONS A high share of expenditure on ultra-processed food was found in Norway, which may imply a high consumption of these foods. The change in expenditure of NOVA groups between 2013 and 2019 was small. Carbonated and non-carbonated soft drinks were the most frequently purchased products in Norwegian grocery stores and contributed to most of the expenditures.
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Affiliation(s)
- Marie Michaelsen Bjøntegaard
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4 St. Olavs Plass, N-0130 Oslo, Norway
- Department of Nutrition, Faculty of Medicine, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
| | - Marianne Molin
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4 St. Olavs Plass, N-0130 Oslo, Norway
- Department of Health Sciences, Oslo New University College, NO-0456 Oslo, Norway
| | - Marit Kolby
- Department of Health Sciences, Oslo New University College, NO-0456 Oslo, Norway
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4 St. Olavs Plass, N-0130 Oslo, Norway
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Shim JS, Ha KH, Kim DJ, Kim HC. Diet quality partially mediates the association between ultraprocessed food consumption and adiposity indicators. Obesity (Silver Spring) 2023; 31:2430-2439. [PMID: 37548276 DOI: 10.1002/oby.23853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 04/27/2023] [Accepted: 05/25/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE This study evaluated the potential role of overall diet quality in the associations between ultraprocessed food (UPF) consumption and adiposity indicators among Korean adults. METHODS Baseline data of participants (n = 4331) of the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study were obtained. Dietary information was collected by a validated food frequency questionnaire. UPF was defined using the NOVA classification. Overall diet quality was assessed using the Korean Healthy Eating Index. Adiposity indicators included BMI, waist circumference, percentage body fat by bioimpedance, and visceral fat mass by whole-body dual-energy x-ray absorptiometry. Mediation analysis after adjustment for potential confounders was performed. RESULTS UPF intake was associated with higher adiposity indicators after adjustment for confounders. The mediating effect of the Korean Healthy Eating Index on the relationship between UPF consumption and each adiposity indicator was 35.6% (95% CI: 4.9% to 255.9%) for BMI, 38.3% (17.9% to 132.1%) for waist circumference, 40.2% (8.3% to 259.4%) for percentage body fat, and 60.7% (-396.4% to 662.7%) for visceral fat mass. CONCLUSIONS UPF consumption was positively associated with adiposity indicators, which were partially attributed to the overall diet quality. Further studies are needed to better understand the causal mechanisms of these associations.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
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Gallagher-Squires C, Isaacs A, Reynolds C, Coleman PC. Snacking practices from infancy to adolescence: parental perspectives from longitudinal lived experience research in England. Proc Nutr Soc 2023:1-9. [PMID: 37759428 DOI: 10.1017/s0029665123003592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Consumption of snacks and ultra-processed foods (UPF) high in fat, salt and sugar (HFSS) is associated with rising rates of obesity and growing socioeconomic disparities in nutrition. While infancy, childhood and adolescence are critical periods for development of dietary preferences, there remains a dearth of research exploring factors that underpin snacking behaviour over this time. This review aims to address this gap by drawing from qualitative lived experience research, with 122 families of different socioeconomic position (SEP), to explore how the (i) home food environment, (ii) food environment and (iii) social value and meanings of food shape parental provision of snacks. This review shows that snacking holds important meanings in everyday family life, with infants integrated into existing snacking practices from an early age. Price promotions, low-cost and long shelf-lives all make UPF and HFSS snacks an appealing option for many low-SEP parents; while children's requests and preferences for HFSS snacks present a challenge across SEP. However, higher-SEP parents can ensure fresh fruits are always available as an alternative snack, while fruit is described as a financially risky expenditure for low-SEP families. The present findings also indicate that retailers and producers are increasingly promoting 'healthier' snacks through product packaging and marketing, such as 'meets one of your five a day', despite these products displaying similar nutritional profiles to traditional UPF and HFSS snacks. We outline a series of policy recommendations, including extending Healthy Start Vouchers and the Fruit and Vegetable Scheme in schools and action to address misleading product marketing and packaging.
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Affiliation(s)
- C Gallagher-Squires
- Centre for Food Policy, School of Health and Psychological Sciences, City, University of London, 1 Myddelton Street, London EC1R 1UW, UK
| | - A Isaacs
- Centre for Food Policy, School of Health and Psychological Sciences, City, University of London, 1 Myddelton Street, London EC1R 1UW, UK
| | - C Reynolds
- Centre for Food Policy, School of Health and Psychological Sciences, City, University of London, 1 Myddelton Street, London EC1R 1UW, UK
| | - P C Coleman
- Centre for Food Policy, School of Health and Psychological Sciences, City, University of London, 1 Myddelton Street, London EC1R 1UW, UK
- Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
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Shim JS, Ha KH, Kim DJ, Kim HC. Ultra-Processed Food Consumption and Obesity in Korean Adults. Diabetes Metab J 2023; 47:547-558. [PMID: 37095686 PMCID: PMC10404531 DOI: 10.4093/dmj.2022.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/27/2022] [Indexed: 04/26/2023] Open
Abstract
BACKGRUOUND This study aimed to investigate the association between consumption of ultra-processed foods (UPF) and obesity in Korean adults. METHODS We included the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study baseline data of adults aged 30 to 64 years who completed a validated food frequency questionnaire. UPF was defined using the NOVA food classification. Multivariable linear and logistic regression analyses were performed to assess the association of dietary energy contribution of UPF with obesity indicators (body mass index [BMI], obesity, waist circumference [WC], and abdominal obesity). RESULTS Consumption of UPF accounted for 17.9% of total energy intake and obesity and abdominal obesity prevalence was 35.4% and 30.2%, respectively. Compared with those in the lowest quartile of UPF consumption, adults in the highest quartile had greater BMI (β=0.36; 95% confidence interval [CI], 0.15 to 0.56), WC (β=1.03; 95% CI, 0.46 to 1.60), higher odds of having obesity (odds ratio [OR], 1.24; 95% CI, 1.07 to 1.45), and abdominal obesity (OR, 1.34; 95% CI, 1.14 to 1.57), after adjusting for sociodemographic characteristics, health-related behaviors, and family history of diseases. Dose-response associations between UPF consumption and obesity indicators were consistently found (all P trend <0.01). However, the strength of association was halved for all obesity indicators after further adjustments for total energy intake and overall diet quality score, and the trend toward association for obesity and WC disappeared. CONCLUSION Our finding supports the evidence that consumption of UPF is positively associated with obesity among Korean adults.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Meyer A, Dong C, Casagrande C, Chan SSM, Huybrechts I, Nicolas G, Rauber F, Levy RB, Millett C, Oldenburg B, Weiderpass E, Heath AK, Tong TYN, Tjønneland A, Kyrø C, Kaaks R, Katzke VA, Bergman MM, Palli D, Masala G, Tumino R, Sacerdote C, Colorado-Yohar SM, Sánchez MJ, Grip O, Lindgren S, Luben R, Gunter MJ, Mahamat-Saleh Y, Boutron-Ruault MC, Carbonnel F. Food Processing and Risk of Crohn's Disease and Ulcerative Colitis: A European Prospective Cohort Study. Clin Gastroenterol Hepatol 2023; 21:1607-1616.e6. [PMID: 36243353 DOI: 10.1016/j.cgh.2022.09.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/10/2022] [Accepted: 09/29/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Industrial foods have been associated with increased risks of several chronic conditions. We investigated the relationship between the degree of food processing and risks of Crohn's disease (CD) and ulcerative colitis (UC) in the European Prospective Investigation into Cancer and Nutrition cohort. METHODS Analyses included 413,590 participants (68.6% women; mean baseline age, 51.7 y) from 8 European countries. Dietary data were collected at baseline from validated country-specific dietary questionnaires. Associations between proportions of unprocessed/minimally processed and ultraprocessed food intake and CD and UC risks were estimated using Cox models to obtain hazard ratios (HRs) and 95% CIs. Models were stratified by center, age, and sex, and adjusted for smoking status, body mass index, physical activity, energy intake, educational level, and alcohol consumption. RESULTS During a mean follow-up period of 13.2 years, 179 incident cases of CD and 431 incident cases of UC were identified. The risk of CD was lower in people consuming high proportions of unprocessed/minimally processed foods (adjusted HR for the highest vs lowest quartile: 0.57; 95% CI, 0.35-0.93; P trend < .01), particularly fruits and vegetables (adjusted HRs, 0.54; 95% CI, 0.34-0.87 and 0.55; 95% CI, 0.34-0.91, respectively). There was no association between unprocessed/minimally processed food intake and the risk of UC. No association was detected between ultraprocessed food consumption and CD or UC risks. CONCLUSIONS In the European Prospective Investigation into Cancer and Nutrition cohort, consumption of unprocessed/minimally processed foods was associated with a lower risk of CD. No association between UC risk and food processing was found.
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Affiliation(s)
- Antoine Meyer
- INSERM, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France; Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Catherine Dong
- INSERM, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France; Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Corinne Casagrande
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Simon S M Chan
- Norwich Medical School, Department of Medicine, University of East Anglia, Norwich, United Kingdom; Department of Gastroenterology, Norfolk and Norwich University Hospital National Health Service Trust, Norwich, United Kingdom
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Geneviève Nicolas
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Fernanda Rauber
- Department of Preventive Medicine, Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom; National School of Public Health, Public Health Research Centre, NOVA University of Lisbon and Comprehensive Health Research Center, Lisbon, Portugal
| | - Bas Oldenburg
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | | | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-Istituto per lo Studio e la Prevenzione Oncologia, Florence, Italy
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-Istituto per lo Studio e la Prevenzione Oncologia, Florence, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Azienda Sanitaria Provinciale, Ragusa, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Sandra M Colorado-Yohar
- Department of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Murcia, Spain; Consorcio de Investigación Biomédica en Red Epidemiologia and Salud Pública, Madrid, Spain; National School of Public Health, Research Group on Demography and Health, University of Antioquia, Medellín, Colombia
| | - Maria-Jose Sánchez
- Consorcio de Investigación Biomédica en Red Epidemiologia and Salud Pública, Madrid, Spain; Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria, Granada, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Olof Grip
- Department of Gastroenterology and Hepatology, University Hospital Malmö, Malmö, Sweden
| | - Stefan Lindgren
- Department of Gastroenterology and Hepatology, University Hospital Malmö, Malmö, Sweden
| | - Robert Luben
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; Institute of Ophthalmology, University College London, London, United Kingdom
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Yahya Mahamat-Saleh
- INSERM, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- INSERM, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Franck Carbonnel
- INSERM, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France; Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Le Kremlin Bicêtre, France.
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Dunford EK, Miles DR, Popkin B. Food Additives in Ultra-Processed Packaged Foods: An Examination of US Household Grocery Store Purchases. J Acad Nutr Diet 2023; 123:889-901. [PMID: 36931919 PMCID: PMC10200736 DOI: 10.1016/j.jand.2022.11.007] [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: 04/12/2022] [Revised: 09/18/2022] [Accepted: 11/18/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Food additives have been used mainly in the past century to perform specific functions in foods. Some types of food additives have been linked to adverse health outcomes, yet there is little research examining food additives in the US food supply. OBJECTIVE To examine the proportion of products purchased by US households containing four common technical food additives using time-specific food composition data and examine whether purchases have changed over time. PARTICIPANTS/SETTING Nielsen Homescan Consumer Panels, 2001 and 2019. MAIN OUTCOME MEASURES The proportion of packaged food products containing common types of food additives purchased by US households was determined overall and by food category. STATISTICAL ANALYSIS PERFORMED Differences were examined using Student t test; P value < 0.001 was considered significant. RESULTS Between 2001 and 2019, the proportion of food products purchased by US households that contained additives increased from 49.6% to 59.5% (P < 0.001). The proportion of carbonated soft drinks purchased containing flavors decreased, with a subsequent increase in purchases containing nonnutritive sweeteners. Baby foods showed a 20% increase in the proportion of purchases containing additives and >15% increase in the proportion of purchases containing three or more additives. CONCLUSIONS There is convincing evidence that US household purchases of common types of technical food additives are increasing. Despite some positive changes such as a decrease in the use of added flavors in carbonated soft drinks, across most food categories an increase in purchases of all types of products containing additives was observed. In particular the finding that purchases of baby food products containing additives have increased substantially is crucial in informing future research in this area and warrants further investigation.
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Affiliation(s)
- Elizabeth K Dunford
- Food Policy Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Donna R Miles
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Barry Popkin
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Harb AA, Shechter A, Koch PA, St-Onge MP. Ultra-processed foods and the development of obesity in adults. Eur J Clin Nutr 2023; 77:619-627. [PMID: 36280730 PMCID: PMC10123172 DOI: 10.1038/s41430-022-01225-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/09/2022]
Abstract
Ultra-processed foods (UPF) are ubiquitous in the modern-day food supply and widely consumed. High consumption of these foods has been suggested to contribute to the development of obesity in adults. The purpose of this review is to present and evaluate current literature on the relationship between UPF consumption and adult obesity. Cross-sectional studies (n = 9) among different populations worldwide show a positive association between UPF consumption and obesity. Longitudinal studies (n = 7) further demonstrate a positive association between UPF consumption and development of obesity, suggesting a potential causal influence of UPF consumption on obesity risk. However, only one randomized controlled trial has tested the causality of this association. The study included in this review found greater energy intake and weight gain with consumption of a high UPF diet compared to a high unprocessed food diet. The potential mechanisms by which UPF increase the risk of obesity include increased energy intake due to increased sugar consumption, decreased fiber consumption, and decreased protein density; however, more research is needed. Overall, the evidence identified in the current review consistently support a positive relation between high UPF consumption and obesity. While there is a need for more experimental research to establish causality and elucidate the mechanisms, the sum of the evidence supports a need for research on treatment modalities that include reductions in UPF consumption for the management of adult obesity.
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Affiliation(s)
- Amanda A Harb
- Doctoral Candidate, Teachers College, Columbia University, 525 West 120th Street, Box 137, New York, NY, 10027, USA
| | - Ari Shechter
- Department of Medicine, Columbia University Irving Medical Center, New York, USA
| | - Pamela A Koch
- Teachers College, Columbia University, 525 West 120th Street, Box 137, New York, NY, 10027, USA
| | - Marie-Pierre St-Onge
- Department of Medicine, Columbia University Irving Medical Center, New York, USA.
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Lesmes U. In vitro digestion models for the design of safe and nutritious foods. ADVANCES IN FOOD AND NUTRITION RESEARCH 2023; 104:179-203. [PMID: 37236731 DOI: 10.1016/bs.afnr.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Responsible development of future foods requires in depth understanding of food digestion in the human body based on robust research models, ranging from in vitro models to randomized controlled human trials. This chapter overviews fundamental aspects of food digestion, namely bioaccessibility and bioavailability, and models mirroring gastric, intestinal, and colonic conditions. Second, the chapter demonstrates the potential of in vitro digestion models to help screen adverse effects of food additives, such as Titanium dioxide or carrageenan, or underpin the determinants of macro- and micronutrient digestion in different strata of the population, for example digestion of emulsions. Such efforts support rationalized design of functional foods, such as infant formulae, cheese, cereals and biscuits which are validated in vivo or in randomized controlled trials.
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Affiliation(s)
- Uri Lesmes
- Faculty of Biotechnology and Food Engineering, Technion, Israel.
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Gonçalves HVB, Batista LS, de Amorim ALB, Bandoni DH. Association between Consumption of Ultra-Processed Foods and Sociodemographic Characteristics in Brazilian Adolescents. Nutrients 2023; 15:2027. [PMID: 37432151 DOI: 10.3390/nu15092027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The consumption of ultra-processed foods is associated with several negative health outcomes. Studies on adolescents have shown that this population has a high consumption of these foods, especially in high-income countries. However, there are no studies on the types of ultra-processed foods consumed. The present study evaluated secondary data from a representative sample of the National School Health Survey, the consumption of ultra-processed foods by 159,245 Brazilian adolescents. METHODS Data were collected via a self-administered questionnaire using a mobile device. A Poisson regression model was used to assess the prevalence of ultra-processed food consumption and its correlation with sociodemographic characteristics. RESULTS The consumption of ultra-processed foods was significant among Brazilian adolescents, and almost half of the participants reported consumption the day before. We observed that sociodemographic characteristics such as school type, race/skin color, region, municipality type, age, living with mother, living with father, and maternal education level were associated with greater or lesser consumption of ultra-processed foods. Adolescents who study in private schools, are female, white, and live in non-capital cities consume more ultra-processed foods. CONCLUSIONS Access to in natura and minimally processed foods must be on the agenda of governments and encouraged by food and nutrition education to guarantee the right to adequate and healthy food.
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Affiliation(s)
- Hélida Ventura Barbosa Gonçalves
- Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos 11015-020, SP, Brazil
- Serviço Nacional de Aprendizagem Comercial, Senac Santos, Santos 11015-003, SP, Brazil
| | | | - Ana Laura Benevenuto de Amorim
- Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos 11015-020, SP, Brazil
- Campus Rosinha Viegas, Universidade Metropolitana de Santos, Santos 11045-002, SP, Brazil
| | - Daniel Henrique Bandoni
- Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos 11015-020, SP, Brazil
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Menichetti G, Ravandi B, Mozaffarian D, Barabási AL. Machine learning prediction of the degree of food processing. Nat Commun 2023; 14:2312. [PMID: 37085506 PMCID: PMC10121643 DOI: 10.1038/s41467-023-37457-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 03/16/2023] [Indexed: 04/23/2023] Open
Abstract
Despite the accumulating evidence that increased consumption of ultra-processed food has adverse health implications, it remains difficult to decide what constitutes processed food. Indeed, the current processing-based classification of food has limited coverage and does not differentiate between degrees of processing, hindering consumer choices and slowing research on the health implications of processed food. Here we introduce a machine learning algorithm that accurately predicts the degree of processing for any food, indicating that over 73% of the US food supply is ultra-processed. We show that the increased reliance of an individual's diet on ultra-processed food correlates with higher risk of metabolic syndrome, diabetes, angina, elevated blood pressure and biological age, and reduces the bio-availability of vitamins. Finally, we find that replacing foods with less processed alternatives can significantly reduce the health implications of ultra-processed food, suggesting that access to information on the degree of processing, currently unavailable to consumers, could improve population health.
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Affiliation(s)
- Giulia Menichetti
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Network Science Institute and Department of Physics, Northeastern University, Boston, MA, USA
| | - Babak Ravandi
- Network Science Institute and Department of Physics, Northeastern University, Boston, MA, USA
| | - Dariush Mozaffarian
- Tufts Friedman School of Nutrition Science and Policy, Boston, MA, USA
- Tufts School of Medicine and Medical Center, Boston, MA, USA
| | - Albert-László Barabási
- Network Science Institute and Department of Physics, Northeastern University, Boston, MA, USA.
- Department of Network and Data Science, Central European University, Budapest, Hungary.
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Sikorski C, Yang S, Stennett R, Miller V, Teo K, Anand SS, Paré G, Yusuf S, Dehghan M, Mente A. Changes in energy, macronutrient, and food consumption in 47 countries over the last 70 years (1950-2019): a systematic review and meta-analysis. Nutrition 2023; 108:111941. [PMID: 36702047 DOI: 10.1016/j.nut.2022.111941] [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: 06/16/2022] [Revised: 11/18/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We aimed to systematically examine trends in dietary energy, macronutrient, and food consumption in different geographic regions. METHODS We searched Medline, Embase, CINAHL, and organizations for studies and reports using individual-level dietary assessments from 1950 to 2019 (PROSPERO CRD42022302843) and quantified changes using multivariable linear mixed-effects models. RESULTS We identified 109 articles and reports from 47 countries, including Europe and Australasia (47% of studies), Asia (30%), Latin America (13%), the Middle East (6%), and North America (4%). In Southeast and East Asia, carbohydrate intake decreased, whereas fat consumption increased; the opposite pattern occurred in North America; and fat decreased while carbohydrate intake remained stable in Europe and Australasia. Consumption of carbohydrate and fat were stable in South Asia, Latin America, and the Middle East, but data were limited in these regions. A greater increase in national gross domestic product over time was associated with decreased carbohydrate and increased fat and protein intake. Dietary saturated fatty acid intake decreased in Northern and Eastern Europe and was stable in other regions. Changes in food varied by region; East and Southeast Asia increased meat, fish, dairy, egg, fruit, and vegetable consumption and decreased intake of grains, roots and tubers, legumes, whereas North America decreased dairy and red meat but increased eggs, nuts, poultry, and vegetable oil intake. Intakes of fruits, nuts, legumes, and roots and tubers were below recommendations in most regions. CONCLUSIONS Our findings indicate regional variations in dietary trends and identify countries that would benefit from nutritional policies aimed at decreasing lower-quality carbohydrate foods and increasing consumption of fruits, vegetables, nuts, legumes, and dairy.
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Affiliation(s)
- Claudia Sikorski
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
| | - Shuling Yang
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Rosain Stennett
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Victoria Miller
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Koon Teo
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S Anand
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Guillaume Paré
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Thrombosis and Atherosclerosis Research Institute, Department of Medicine, David Braley Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mahshid Dehghan
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Andrew Mente
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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A Diet Profiling Algorithm (DPA) to Rank Diet Quality Suitable to Implement in Digital Tools—A Test Study in a Cohort of Lactating Women. Nutrients 2023; 15:nu15061337. [PMID: 36986066 PMCID: PMC10051632 DOI: 10.3390/nu15061337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Although nutrient profiling systems can empower consumers towards healthier food choices, there is still a need to assess diet quality to obtain an overall perspective. The purpose of this study was to develop a diet profiling algorithm (DPA) to evaluate nutritional diet quality, which gives a final score from 1 to 3 with an associated color (green-yellow-orange). It ranks the total carbohydrate/total fiber ratio, and energy from saturated fats and sodium as potentially negative inputs, while fiber and protein are assumed as positive items. Then, the total fat/total carbohydrate ratio is calculated to evaluate the macronutrient distribution, as well as a food group analysis. To test the DPA performance, diets of a lactating women cohort were analyzed, and a correlation analysis between DPA and breast milk leptin levels was performed. Diets classified as low quality showed a higher intake of negative inputs, along with higher energy and fat intakes. This was reflected in body mass index (BMI) and food groups, indicating that women with the worst scores tended to choose tastier and less satiating foods. In conclusion, the DPA was developed and tested in a sample population. This tool can be easily implemented in digital nutrition platforms, contributing to real-time dietary follow-up of patients and progress monitoring, leading to further dietary adjustment.
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Kliemann N, Rauber F, Bertazzi Levy R, Viallon V, Vamos EP, Cordova R, Freisling H, Casagrande C, Nicolas G, Aune D, Tsilidis KK, Heath A, Schulze MB, Jannasch F, Srour B, Kaaks R, Rodriguez-Barranco M, Tagliabue G, Agudo A, Panico S, Ardanaz E, Chirlaque MD, Vineis P, Tumino R, Perez-Cornago A, Andersen JLM, Tjønneland A, Skeie G, Weiderpass E, Monteiro CA, Gunter MJ, Millett C, Huybrechts I. Food processing and cancer risk in Europe: results from the prospective EPIC cohort study. Lancet Planet Health 2023; 7:e219-e232. [PMID: 36889863 PMCID: PMC10009757 DOI: 10.1016/s2542-5196(23)00021-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 06/09/2022] [Accepted: 01/25/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Food processing has been hypothesised to play a role in cancer development; however, data from large-scale epidemiological studies are scarce. This study investigated the association between dietary intake according to amount of food processing and risk of cancer at 25 anatomical sites using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS This study used data from the prospective EPIC cohort study, which recruited participants between March 18, 1991, and July 2, 2001, from 23 centres in ten European countries. Participant eligibility within each cohort was based on geographical or administrative boundaries. Participants were excluded if they had a cancer diagnosis before recruitment, had missing information for the NOVA food processing classification, or were within the top and bottom 1% for ratio of energy intake to energy requirement. Validated dietary questionnaires were used to obtain information on food and drink consumption. Participants with cancer were identified using cancer registries or during follow-up from a combination of sources, including cancer and pathology centres, health insurance records, and active follow-up of participants. We performed a substitution analysis to assess the effect of replacing 10% of processed foods and ultra-processed foods with 10% of minimally processed foods on cancer risk at 25 anatomical sites using Cox proportional hazard models. FINDINGS 521 324 participants were recruited into EPIC, and 450 111 were included in this analysis (318 686 [70·8%] participants were female individuals and 131 425 [29·2%] were male individuals). In a multivariate model adjusted for sex, smoking, education, physical activity, height, and diabetes, a substitution of 10% of processed foods with an equal amount of minimally processed foods was associated with reduced risk of overall cancer (hazard ratio 0·96, 95% CI 0·95-0·97), head and neck cancers (0·80, 0·75-0·85), oesophageal squamous cell carcinoma (0·57, 0·51-0·64), colon cancer (0·88, 0·85-0·92), rectal cancer (0·90, 0·85-0·94), hepatocellular carcinoma (0·77, 0·68-0·87), and postmenopausal breast cancer (0·93, 0·90-0·97). The substitution of 10% of ultra-processed foods with 10% of minimally processed foods was associated with a reduced risk of head and neck cancers (0·80, 0·74-0·88), colon cancer (0·93, 0·89-0·97), and hepatocellular carcinoma (0·73, 0·62-0·86). Most of these associations remained significant when models were additionally adjusted for BMI, alcohol and dietary intake, and quality. INTERPRETATION This study suggests that the replacement of processed and ultra-processed foods and drinks with an equal amount of minimally processed foods might reduce the risk of various cancer types. FUNDING Cancer Research UK, l'Institut National du Cancer, and World Cancer Research Fund International.
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Affiliation(s)
- Nathalie Kliemann
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Fernanda Rauber
- Preventive Medicine Department of the Medical School, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Preventive Medicine Department of the Medical School, University of São Paulo, São Paulo, Brazil
| | - Vivian Viallon
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Reynalda Cordova
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Heinz Freisling
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Corinne Casagrande
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Genevieve Nicolas
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK; Department of Nutrition, Oslo New University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Alicia Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; NutriAct-Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Bernard Srour
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Miguel Rodriguez-Barranco
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Giovanna Tagliabue
- Cancer Registry Unit Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO), Nutrition and Cancer Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - María-Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP) Ragusa, Italy
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Anne Tjønneland
- Danish Cancer Society Research Center, Unit of Diet, Genes and Environment, Copenhagen, Denmark
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Carlos Augusto Monteiro
- Department of Nutrition of the Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marc J Gunter
- International Agency for Research on Cancer, World Heath Organization, Lyon, France
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, St Mary's Campus, London, UK; NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Centre (CHRC), NOVA University Lisbon, Lisbon, Portugal
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Heath Organization, Lyon, France.
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Matos JDP, Rodrigues MB, Duarte CK, Horta PM. A Scoping Review of Observational Studies on Food and Beverage Advertising on Social Media: A Public Health Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3615. [PMID: 36834312 PMCID: PMC9960697 DOI: 10.3390/ijerph20043615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Popular social media platforms have been actively used by ultra-processed food companies to promote their products. Being exposed to this type of advertising increases the consumption of unhealthy foods and the risk of developing obesity and other non-communicable diseases (NCDs). Thus, monitoring commercial content on social media is a core public health practice. We aimed to characterize the methods used for monitoring food advertising on social media and summarize the investigated advertising strategies via a scoping review of observational studies. This study is reported according to the MOOSE Statement, and its protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration nº. CRD42020187740). Out of the 6093 citations retrieved, 26 met our eligibility criteria. The studies were published from 2014 to 2021, mostly after 2018. They focused on Australia, Facebook, strategies aimed at children and adolescents, and advertising practices of ultra-processed food companies. We grouped strategies in eight classes: post features (n = 18); connectivity and engagement (n = 18); economic advantages, gifts, or competitions (n = 14); claims (n = 14); promotional characters (n = 12); brand in evidence (n = 8); corporate social responsibility or philanthropy (n = 7); and COVID-19 (n = 3). We found similarities in the investigation of strategies regardless of the type of social media. Our findings can contribute to the designing of tools for monitoring studies and regulatory mechanisms to restrict the exposure of food advertising.
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Affiliation(s)
| | | | | | - Paula Martins Horta
- Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte 30130-100, MG, Brazil
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Saner C, Senior AM, Zhang H, Eloranta AM, Magnussen CG, Sabin MA, Juonala M, Janner M, Burgner DP, Schwab U, Haapala EA, Heitmann BL, Simpson SJ, Raubenheimer D, Lakka TA. Evidence for protein leverage in a general population sample of children and adolescents. Eur J Clin Nutr 2023:10.1038/s41430-023-01276-w. [PMID: 36797489 DOI: 10.1038/s41430-023-01276-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 01/28/2023] [Accepted: 02/02/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND/OBJECTIVES The strong regulation of protein intake can lead to overconsumption of total energy on diets with a low proportion of energy from protein, a process referred to as protein leverage. The protein leverage hypothesis posits that protein leverage explains variation in energy intake and potentially obesity in ecological settings. Here, we tested for protein leverage and the protein leverage hypothesis in children and adolescents. SUBJECTS/METHODS A population sample of children, mean (SD) age 7.6 (0.4) years (n = 422), followed up at age 9.8 (0.4) years (n = 387) and at age 15.8 (0.4) years (n = 229), participating for the Physical Activity and Nutrition in Children (PANIC) study. EXPOSURES 4-day food records-related proportional energy intake of proteins, fats, and carbohydrates. OUTCOMES energy intake, body mass index (BMI) z-score and dual-energy X-ray absorptiometry-related energy expenditure. RESULTS Proportional energy intake of proteins was inversely associated with energy intake following power functions at all 3 ages (mean [95%CI] strength of leverage of L = -0.36 [-0.47 to -0.25]; L = -0.26 [-0.37 to -0.15]; L = -0.25 [-0.38 to -0.13]; all P < 0.001). Mixture analysis indicated that variance in energy intake was associated primarily with the proportional intake of energy from proteins, not with either fats or carbohydrates. At all 3 ages, energy intake was not associated with BMI z-score but positively associated with energy expenditure (all P < 0.001). CONCLUSIONS This study provides evidence consistent with protein leverage in a population sample of children and adolescents. Increased energy intake on diets with lower protein content was counterbalanced by increased energy expenditure and therefore did not translate into increased adiposity.
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Affiliation(s)
- Christoph Saner
- Division of Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. .,Department of Biomedical Research, University of Bern, Bern, Switzerland. .,Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.
| | - Alistair M Senior
- Charles Perkins Centre and School of Life & Environmental Science, University of Sydney, Sydney, New South Wales, Australia
| | - Hanyue Zhang
- Research Unit for Dietary Studies at the Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark.,Department of Public Health, Section for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Aino-Maija Eloranta
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Matthew A Sabin
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Marco Janner
- Division of Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David P Burgner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Eero A Haapala
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Berit L Heitmann
- Charles Perkins Centre and School of Life & Environmental Science, University of Sydney, Sydney, New South Wales, Australia.,Research Unit for Dietary Studies at the Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark.,Department of Public Health, Section for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Stephen J Simpson
- Charles Perkins Centre and School of Life & Environmental Science, University of Sydney, Sydney, New South Wales, Australia
| | - David Raubenheimer
- Charles Perkins Centre and School of Life & Environmental Science, University of Sydney, Sydney, New South Wales, Australia
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.,Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Intake of ultra-processed foods and sleep-related outcomes: A systematic review and meta-analysis. Nutrition 2023; 106:111908. [PMID: 36470114 DOI: 10.1016/j.nut.2022.111908] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 11/07/2022]
Abstract
The aim of this review article was to evaluate the association between the intake of ultra-processed foods and sleep-related outcomes through a systematic review and meta-analysis. Pubmed, LILACS, Scielo, Scopus, Embase, and Web of Science were searched on December 31, 2021, for studies that evaluated the association between ultra-processed foods and sleep-related outcomes (self-reported sleep duration and quality). Pooled odds ratios were assessed through a random-effects model; heterogeneity was evaluated using the I2 statistic. Fifteen cross-sectional studies were included; 14 showed that the high intake of ultra-processed foods was statistically significantly associated with sleep-related outcomes (sleep duration and quality). In the crude analysis, compared with low intake, high intake of ultra-processed foods increased the odds of sleep-related outcomes, with increased odds among children and/or adolescents, and null results among adults. When adjusted for cofounders, we found statistically significant results for all ages. The high intake of ultra-processed foods was associated with sleep-related outcomes, with moderate credibility of the evidence. Longitudinal studies and clinical trials confirming these findings are necessary.
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Louzada MLDC, Costa JC, Costa CDS, Wendt A, Azeredo CM. Changes in socioeconomic inequalities in food consumption among Brazilian adults in a 10-years period. Front Nutr 2022; 9:1020987. [PMID: 36590226 PMCID: PMC9797961 DOI: 10.3389/fnut.2022.1020987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Objective To evaluate changes in socioeconomic inequalities in food consumption in Brazil over a 10-year period. Methods Data on 24-h recalls of adults (aged 20 years or more) from the 2008/9 (n = 26,327) and 2017/8 (n = 37,689). Brazilian Dietary Survey were analyzed. We used the Nova classification system to group food items and estimate the percentage of total energy from ultra-processed foods and plant-based natural or minimally processed foods. For sex and area of residence, we calculated the percentage points (p.p.) difference between the estimates for women and men, and rural and urban populations. Negative values indicate higher consumption among men or urban residents, positive values indicate higher consumption among women or rural residents, and zero indicates equality. For education and wealth levels we calculated the slope index of inequality (SII). The SII varies from -100 to 100, with positive values indicating higher consumption among more educated or wealthiest groups, negative values indicating higher consumption among less educated or poorest groups, and zero equality. Results Over the period, we observed a reduction in the percentage of total energy from plant-based natural/minimally processed foods from 13.0 to 12.2% and an increase in that of ultra-processed foods from 17.0 to 18.3%. The urban population and those in the wealthier and more educated groups presented higher consumption of ultra-processed foods and lower consumption of plant-based natural/minimally processed foods in both survey years. Over the 10-year period, there was an overall reduction of the socioeconomic inequalities, mainly explained by the greater increase in ultra-processed food consumption by the rural population and those from the poorest and less educated groups (difference for area -7.2 p.p. in 2008/9 and -5.9 p.p. in 2017/8; SII for education 17.7 p.p. in 2008/9 and 13.8 p.p. in 2017/8; SII for wealth 17.0 p.p. in 2008/9 and 11.2 p.p. in 2017/8). Conclusion Socioeconomic inequalities in food consumption decreased in Brazil, but it may lead to the overall deterioration of the dietary quality of the more vulnerable groups.
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Affiliation(s)
- Maria Laura da Costa Louzada
- Center of Epidemiological Studies in Nutrition and Health (NUPENS), University of São Paulo, São Paulo, Brazil,School of Public Health, Department of Nutrition, University of São Paulo, São Paulo, Brazil,*Correspondence: Maria Laura da Costa Louzada ✉
| | - Janaína Calu Costa
- International Center for Equity in Health, University of Pelotas, Pelotas, Brazil
| | - Caroline dos Santos Costa
- Center of Epidemiological Studies in Nutrition and Health (NUPENS), University of São Paulo, São Paulo, Brazil,School of Public Health, Department of Nutrition, University of São Paulo, São Paulo, Brazil
| | - Andrea Wendt
- Postgraduate Program in Health Technology, Catholic University of Paraná, Curitiba, Brazil
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Borges CA, Khandpur N, Neri D, Duran AC. Comparing Latin American nutrient profile models using data from packaged foods with child-directed marketing within the Brazilian food supply. Front Nutr 2022; 9:920710. [PMID: 36532519 PMCID: PMC9755586 DOI: 10.3389/fnut.2022.920710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/08/2022] [Indexed: 01/18/2024] Open
Abstract
OBJECTIVES This study aimed to examine and compare the extent to which different nutrient profile models (NPMs) from Latin America (LA) identify packaged foods and beverages with child-directed marketing sold in Brazil as being high in nutrients associated to the risk of non-communicable diseases (NCDs). MATERIALS AND METHODS In this cross-sectional study, we evaluated 3,464 foods found in the five largest Brazilian supermarkets. Child-directed marketing was coded using the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) protocol. Differences in medians of sugar, saturated fats, and sodium per 100 kcal in foods, with the presence and absence of child-directed marketing, were tested using the Mann-Whitney test. We compared six NPMs in LA and examined to what extent they targeted these products using prevalence ratios. Analyses were performed overall and by the degree of food processing according to the Nova food classification. RESULTS We found 1,054 packages with child-directed marketing. Among these, candies, cakes and pies, sauces and creams, and sugar-sweetened beverages were significantly higher in sugar, saturated fat, and sodium per 100 kcal than products that are not targeted at children (p < 0.05). Compared with PAHO and the Mexico models, the Brazilian NPMs would allow three times more ultra-processed foods to omit warnings for sodium (p < 0.05). The Uruguayan NPM also flagged fewer ultra-processed foods high in sodium (p < 0.05). The Brazilian model also allows four times more sugar-sweetened beverages and six times more dairy drinks to omit warnings for sugar than the Mexico and PAHO models. In comparison to all other NPMs, the Brazilian model showed the worst performance in identifying baked goods as high in sodium. Chile, Uruguay, and Peru models would also target significantly less sugar-sweetened beverages and high in at least one critical nutrient than PAHO and Mexico models. CONCLUSION Compared with other NPMs in LA, the NPM criteria adopted in Brazil are more permissive and less likely to inform consumers of the poor nutritional quality of ultra-processed foods and beverages with child-directed marketing.
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Affiliation(s)
- Camila Aparecida Borges
- Center for Epidemiological Research in Nutrition and Health, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Food Studies and Research, State University of Campinas, São Paulo, Brazil
| | - Neha Khandpur
- Center for Epidemiological Research in Nutrition and Health, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, Harvard University, Boston, MA, United States
| | - Daniela Neri
- Center for Epidemiological Research in Nutrition and Health, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | - Ana Clara Duran
- Center for Food Studies and Research, State University of Campinas, São Paulo, Brazil
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Adjei AP, Amevinya GS, Quarpong W, Tandoh A, Aryeetey R, Holdsworth M, Agyemang C, Zotor F, Laar ME, Mensah K, Addo P, Laryea D, Asiki G, Sellen D, Vandevijvere S, Laar A. Availability of healthy and unhealthy foods in modern retail outlets located in selected districts of Greater Accra Region, Ghana. Front Public Health 2022; 10:922447. [PMID: 36438248 PMCID: PMC9682120 DOI: 10.3389/fpubh.2022.922447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/26/2022] [Indexed: 11/11/2022] Open
Abstract
Background Intake of unhealthy foods is linked to the onset of obesity and diet-related non-communicable diseases (NCDs). Availability of unhealthy (nutritionally poor) foods can influence preference, purchasing and consumption of such foods. This study determined the healthiness of foods sold at modern retail outlets- supermarkets and mini-marts in the Greater Accra Region of Ghana. Methods All modern retail outlets located in six districts of Greater Accra were eligible. Those < 200 m2 of floor area and with permanent structures were categorized as mini-marts; and those ≥200 m2 as supermarkets. Shelf length of all available foods were measured. Healthiness of food was determined using two criteria - the NOVA classification and energy density of foods. Thus, ultra-processed foods or food items with >225 kcal/100 g were classified as unhealthy. The ratio of the area occupied by unhealthy to healthy foods was used to determine the healthiness of modern retail outlets. Results Of 67 retail outlets assessed, 86.6% were mini-marts. 85.0% of the total SHELF area was occupied by foods categorized as unhealthy (ranging from 9,262 m2 in Ashiaman Municipality to 41,892 m2 in Accra Metropolis). Refined grains/grain products were the most available, occupying 30.0% of the total food shelf space, followed by sugar-sweetened beverages (20.1% of total shelf space). The least available food group-unprocessed staples, was found in only one high income district, and occupied 0.1% of the total food shelf space. Retail outlets in two districts did not sell fresh fruits or fresh/unsalted canned vegetables. About two-thirds of food products available (n = 3,952) were ultra-processed. Overall, the ratio of ultra-processed-to-unprocessed foods ranged from 3 to 7 with an average (SD) of 5(2). Thus, for every healthy food, there were five ultra-processed ones in the studied retail outlets. Conclusion This study reveals widespread availability of ultra-processed foods in modern retail outlets within the selected districts. Toward a healthier food retail environment, public health and food regulators, in partnership with other stakeholders need to institute measures that improve availability of healthy foods within supermarkets and mini-marts.
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Affiliation(s)
- Akosua Pokua Adjei
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Gideon Senyo Amevinya
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Wilhemina Quarpong
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States
| | - Akua Tandoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Richmond Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Francis Zotor
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
| | - Matilda E. Laar
- Department Family and Consumer Sciences, School of Agriculture, University of Ghana, Accra, Ghana
| | - Kobby Mensah
- Department of Marketing and Entrepreneurship, University of Ghana Business School, University of Ghana, Accra, Ghana
| | - Phyllis Addo
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
| | - Dennis Laryea
- Non-Communicable Disease Programme, Ghana Health Service, Accra, Ghana
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Daniel Sellen
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | | | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana,*Correspondence: Amos Laar
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Oliveira N, Canella DS. Trend of minimally processed and ultra-processed beverages purchased in Brazilian households: Less milk and much soft drink (2002-2003 to 2017-2018). Front Public Health 2022; 10:956142. [PMID: 36408053 PMCID: PMC9669963 DOI: 10.3389/fpubh.2022.956142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
The consumption of ultra-processed beverages, including sugar-sweetened and artificially sweetened ones, is associated with several health problems, which is different considering minimally processed beverages. The objective of this study was to assess the trends in the volume of minimally and ultra-processed beverages purchased for consumption in Brazilian households and their relationship with the proportion of dietary energy derived from ultra-processed foods and beverages. Drawing on data from the nationwide 2002-03, 2008-09, and 2017-18 Household Budget Surveys, the daily volume of beverages purchased per capita (milligrams) was investigated. The minimally processed beverages purchased declined over the period [2002-2003: x ¯ 156.5 ml (95%CI: 148.3-164.8); 2017-2018: x ¯ 101.6 ml (95%CI: 98.1-105.1)] and ultra-processed beverages were stable [2002-03: x ¯ 117.9 ml (95%CI: 108.1-127.7); 2017-18: x ¯ 122.8 (95%CI: 111.2-134.4)]. The most purchased beverage in 2002-2003 was milk [ x ¯ : 154.7 ml (95%CI: 146.4-162.9)], while in 2017-2018 regular soft drinks were the most purchased [ x ¯ : 110.7 ml (95%CI: 99.2-122.2)]. There was a decrease in the purchase of whole and skimmed milk and an increase in the purchase of other ultra-processed beverages between the periods. With the increase in the proportion of ultra-processed foods and beverages in the diet, the volume of ultra-processed beverage purchases rose and minimally processed beverages declined. The monitoring of beverage consumption and the implementation of public policies, such as taxation on ultra-processed beverages, are essential to promote improvements in health and curbing non-communicable diseases.
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Affiliation(s)
- Natália Oliveira
- Postgraduate Program in Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Daniela Silva Canella
- Institute of Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil,*Correspondence: Daniela Silva Canella
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Market concentration and the healthiness of packaged food and non-alcoholic beverage sales across the European single market. Public Health Nutr 2022; 25:3131-3136. [PMID: 36073156 PMCID: PMC9991654 DOI: 10.1017/s1368980022001926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the relationship between market concentration and diversity, as indicators of market structure, and the healthiness of food and beverage sales across Europe. DESIGN Market share (MS) data per country were used to calculate market concentration, assessed by the four-firm concentration ratio and market diversity, and by the number of companies with ≥1 % MS and the number of companies uniquely present in one European country. The healthiness of food sales was assessed by applying the NOVA classification (level of processing). Simple and multiple linear regressions were performed to assess the relationship between market concentration, diversity and the healthiness of food and beverage sales. SETTING The European single market. PARTICIPANTS The twenty-seven European single market member states for which Euromonitor sales data were available at the most fine-grained Euromonitor packaged food and non-alcoholic beverage product subcategory level. RESULTS Increased market concentration with a country and a product category fixed effect significantly predicted increased sales of ultra-processed packaged food products. There was insufficient data variability in the level of processing of non-alcoholic beverage product categories to formulate conclusions for non-alcoholic beverages. Increased market diversity in turn significantly predicted reduced country-level sales of ultra-processed products. CONCLUSIONS The results indicated a relationship between market structure and the healthiness of packed food products sold on the European market. However, more research with detailed nutritional data is warranted to document and quantify this interaction.
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50
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Chen A, Kayrala N, Trapeau M, Aoun M, Bordenave N. The clean label trend: An ineffective heuristic that disserves both consumers and the food industry? Compr Rev Food Sci Food Saf 2022; 21:4921-4938. [PMID: 36076364 DOI: 10.1111/1541-4337.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/07/2022] [Accepted: 08/03/2022] [Indexed: 01/28/2023]
Abstract
What started around the late 2000s as the "Clean Label" (CL) trend has now become a meaningful segment of the food market, appealing to consumers who want foods made of a limited number of simple and recognizable ingredients. However, this description and tentative definitions of CL foods are vague, subject to multiple interpretations, and CL remains an informal denomination for foods, making consumers' demands and food manufacturers' offerings hardly compatible. Therefore, rather than attempting an illusory definition of CL foods, this narrative review aims to (1) show how CL appears to be a heuristic used by consumers to attempt to make safe and healthful food choices, (2) discuss how this heuristic overlooks many critical aspect of food safety and healthfulness and is consequently ineffective to guide consumers' choices, and (3) discuss the implications of the CL trend on the food chain's stakeholders and their relationships.
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Affiliation(s)
- Aidan Chen
- School of Biology, Faculty of Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Nicole Kayrala
- School of Biology, Faculty of Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Maëliss Trapeau
- School of Chemistry and Biomolecular Sciences, Faculty of Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Maria Aoun
- School of Chemistry and Biomolecular Sciences, Faculty of Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Nicolas Bordenave
- School of Chemistry and Biomolecular Sciences, Faculty of Sciences, University of Ottawa, Ottawa, Ontario, Canada.,School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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