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Stariolo JB, Lemos TC, Khandpur N, Pereira MG, de Oliveira L, Mocaiber I, Ramos TC, David IA. Addiction to ultra-processed foods as a mediator between psychological stress and emotional eating during the COVID-19 pandemic. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:39. [PMID: 39292384 PMCID: PMC11410752 DOI: 10.1186/s41155-024-00322-1] [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: 06/13/2024] [Accepted: 09/02/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic induced psychological distress, which is linked to emotional eating and symptoms of addiction to ultra-processed foods (UPFs). OBJECTIVE This study aimed to investigate whether symptoms of addiction to UPFs mediate the relationship between psychological stress due to the COVID-19 pandemic and emotional eating behaviour. METHODS A cross-sectional online study was conducted from May to November 2021 among 368 undergraduate Brazilian students. The participants answered demographic questions and completed validated scales, including the Coronavirus Stress Measure, Modified Yale Food Addiction Scale 2.0 and Emotional Eating Questionnaire. Mediation analysis was employed to examine the hypothesised relationships. RESULTS The results revealed a significant indirect effect, indicating that symptoms of food addiction mediated the association between perceived stress during the COVID-19 pandemic and emotional eating behaviour. Specifically, 61% of the influence of perceived stress on emotional eating during the pandemic was explained by symptoms of UPF addiction. CONCLUSION These findings suggest that addressing symptoms of UPF addiction could be pivotal in public health strategies aimed at promoting healthy eating habits among distressed undergraduate students in the post-COVID-19 era.
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Affiliation(s)
- Jasmin B Stariolo
- Department of Physiology and Pharmacology, Biomedical Institute, Universidade Federal Fluminense, Niterói, Brazil
| | - Thayane C Lemos
- Department of Physiology and Pharmacology, Biomedical Institute, Universidade Federal Fluminense, Niterói, Brazil
| | - Neha Khandpur
- Department of Nutrition, Center for Epidemiological Research in Nutrition and Health, Universidade de São Paulo, São Paulo, Brazil
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Mirtes G Pereira
- Department of Physiology and Pharmacology, Biomedical Institute, Universidade Federal Fluminense, Niterói, Brazil
| | - Leticia de Oliveira
- Department of Physiology and Pharmacology, Biomedical Institute, Universidade Federal Fluminense, Niterói, Brazil
| | - Izabela Mocaiber
- Laboratory of Cognitive Psychophysiology, Department of Natural Sciences, Institute of Humanities and Health, Universidade Federal Fluminense, Rio das Ostras, Brazil
| | - Taiane C Ramos
- Department of Computer Science, Computer Institute, Universidade Federal Fluminense, Niterói, Brazil
| | - Isabel A David
- Department of Physiology and Pharmacology, Biomedical Institute, Universidade Federal Fluminense, Niterói, Brazil.
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Bourque C, Legendre M, Iceta S, Bégin C. Validity of the Addiction-like Eating Behavior Scale among Patients with Compulsive Eating. Nutrients 2024; 16:2932. [PMID: 39275248 PMCID: PMC11396783 DOI: 10.3390/nu16172932] [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: 08/05/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/16/2024] Open
Abstract
Food addiction (FA) and binge eating disorder (BED) co-occur and share compulsive eating symptoms. When using an FA measure, it is important to evaluate its performance in a population presenting compulsive eating. The study aims to validate the Addiction-like Eating Behavior Scale (AEBS) among a clinical sample characterized by compulsive eating and overweight/obesity and to evaluate its incremental validity over the Yale Food Addiction Scale 2.0 (YFAS). Patients seeking help for compulsive eating (n = 220), between January 2020 and July 2023, completed online questionnaires, including FA, compulsive eating, and BMI evaluations. The factor structure, internal consistency, and convergent, divergent, and incremental validity were tested. The sample had a mean age of 44.4 years old (SD = 12.7) and a mean BMI of 38.2 (SD = 8.0). The two-factor structure provided a good fit for the data, with factor loadings from 0.55 to 0.82 (except for item 15) and the internal consistency was high (ω = 0.84-0.89). The AEBS was positively correlated with the YFAS (r = 0.66), binge eating (r = 0.67), grazing (r = 0.47), craving (r = 0.74), and BMI (r = 0.26), and negatively correlated with dietary restraint (r = -0.37), supporting good convergent and divergent validity. For each measure of compulsive eating, linear regression showed that the AEBS "appetite drive" subscale had a unique contribution over the YFAS. This study provided evidence that the AEBS is a valid measure among a clinical sample of patients with compulsive eating and overweight/obesity. However, questions remain as to whether the AEBS is a measure of FA or compulsive eating.
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Affiliation(s)
- Camille Bourque
- Research Center of the Quebec Heart and Lung Institute, Quebec City, QC G1V 4G5, Canada
| | - Maxime Legendre
- School of Psychology, Laval University, Quebec City, QC G1V 0A6, Canada
- Centre d'Expertise Poids, Image et Alimentation (CEPIA), Laval University, Quebec City, QC G1V 0A6, Canada
| | - Sylvain Iceta
- Research Center of the Quebec Heart and Lung Institute, Quebec City, QC G1V 4G5, Canada
- Department of Psychiatry and Neurosciences, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Catherine Bégin
- School of Psychology, Laval University, Quebec City, QC G1V 0A6, Canada
- Centre d'Expertise Poids, Image et Alimentation (CEPIA), Laval University, Quebec City, QC G1V 0A6, Canada
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Berni Canani R, Carucci L, Coppola S, D'Auria E, O'Mahony L, Roth-Walter F, Vassilopolou E, Agostoni C, Agache I, Akdis C, De Giovanni Di Santa Severina F, Faketea G, Greenhawt M, Hoffman K, Hufnagel K, Meyer R, Milani GP, Nowak-Wegrzyn A, Nwaru B, Padua I, Paparo L, Diego P, Reese I, Roduit C, Smith PK, Santos A, Untersmayr E, Vlieg-Boerstra B, Venter C. Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report. Pediatr Allergy Immunol 2024; 35:e14231. [PMID: 39254357 DOI: 10.1111/pai.14231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 08/07/2024] [Accepted: 08/22/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Consumption of ultra-processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated. METHODS We performed a systematic review and narrative evidence synthesis of the available literature to assess associations between UPF consumption and pediatric allergy outcomes (n = 26 papers), including data on the association seen with the gut microbiome (n = 16 papers) or immune system (n = 3 papers) structure and function following PRISMA guidelines. RESULTS Dietary exposure to fructose, carbonated soft drinks, and sugar intake was associated with an increased risk of asthma, allergic rhinitis, and food allergies in children. Commercial baby food intake was associated with childhood food allergy. Childhood intake of fructose, fruit juices, sugar-sweetened beverages, high carbohydrate UPFs, monosodium glutamate, UPFs, and advanced glycated end-products (AGEs) was associated with the occurrence of allergic diseases. Exposure to UPFs and common ingredients in UPFs seem to be associated with increased occurrence of allergic diseases such as asthma, wheezing, food allergies, atopic dermatitis, and allergic rhinitis, in many, but not all studies. CONCLUSION More preclinical and clinical studies are required to better define the link between UPF consumption and the risk of allergies and asthma. These observational studies ideally require supporting data with clearly defined UPF consumption, validated dietary measures, and mechanistic assessments to definitively link UPFs with the risk of allergies and asthma.
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Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
- Task Force on Microbiome Studies University of Naples Federico II, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Enza D'Auria
- Allergy Unit-Buzzi Children's Hospital-University of Milan, Milan, Italy
| | - Liam O'Mahony
- Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Franziska Roth-Walter
- Department of Interdisciplinary Life Sciences, Messerli Research Institute, University of Veterinary Medicine, Medical University and University of Vienna, Vienna, Austria
- Center of Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Emilia Vassilopolou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Iaona Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Fiorenza De Giovanni Di Santa Severina
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Gaby Faketea
- Department of Pediatrics, "Karamandaneio" Children's Hospital of Patra, Patras, Greece
- Department of Pharmacology, "luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Matt Greenhawt
- Section of Pediatric Allergy and Immunology, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Karin Hoffman
- Center of Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Karin Hufnagel
- Department of Interdisciplinary Life Sciences, Messerli Research Institute, University of Veterinary Medicine, Medical University and University of Vienna, Vienna, Austria
- Center of Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Rosan Meyer
- Department of Nutrition and Dietetics, Winchester University, Winchester, UK
- Department of Medicine, KU Leuven, Leuven, Belgium
| | - Gregorio Paolo Milani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Nowak-Wegrzyn
- Department of Pediatrics, Hassenfeld Children's Hospital, NYU Grossman School of Medicine, New York, New York, USA
- Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Bright Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Ines Padua
- Department of Sciences, University Institute of Health Sciences, Gandra, Portugal
- i4HB/UCIBIO - Translational Toxicology Research Laboratory, Gandra, Portugal
- CUF Porto Trindade Hospital, Porto, Portugal
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Peroni Diego
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Imke Reese
- Practice for Dietary Advice & Nutrition Therapy in Adverse Food Reactions, Munich, Germany
| | - Caroline Roduit
- Division of Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland
- CK-CARE, Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Peter K Smith
- Griffith University, Southport, Queensland, Australia
| | - Alexandra Santos
- Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Eva Untersmayr
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Berber Vlieg-Boerstra
- Department of Paediatrics, OLVG Hospital, Amsterdam, The Netherlands
- Rijnstate Allergy Centre, Rijnstate Hospital, Arnhem, The Netherlands
| | - Carina Venter
- Section of Pediatric Allergy and Immunology, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA
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Hussain S. Fruit for thought. Australas Psychiatry 2024; 32:383-386. [PMID: 38770659 DOI: 10.1177/10398562241253171] [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] [Indexed: 05/22/2024]
Abstract
OBJECTIVE This commentary discusses the New Zealand Labour Party's announcement to remove tax on fresh and frozen fruits and vegetables. It aims to explore its potential impact on the psychological well-being of New Zealanders in the context of the growing global burden of mental illnesses in the current food environment. CONCLUSIONS The proposed tax exemption on fruits and vegetables demonstrates the government's commitment to improving the food environment. While the precise mental health effects of this potential tax change remain unstudied, existing evidence suggests a positive impact on New Zealanders' well-being, marking a pivotal step in addressing broader health issues and fostering a healthier, more equitable food landscape.
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Affiliation(s)
- Shehnaz Hussain
- Te Whatu Ora Health New Zealand Counties Manukau, Auckland, New Zealand
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5
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O’Hea EL, Edwards-Hampton SA, Beall Brown DL, Sonneville KR, Ziedonis DM, Gearhardt AN. The Food Addiction Clinical Treatment (FACT) Manual: A Harm Reduction Treatment Approach. Behav Sci (Basel) 2024; 14:557. [PMID: 39062380 PMCID: PMC11273413 DOI: 10.3390/bs14070557] [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: 05/31/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
While the construct of food addiction has been controversial, there is growing evidence that certain foods can activate biobehavioral and neurological mechanisms consistent with addiction to other substances. Despite increased evidence and acceptance of certain foods as addictive substances amongst the scientific community, there is a paucity of interventions available that are uniquely suited for the treatment of this condition. Further, many of the addiction and disordered eating treatment models currently utilized for food addiction are seemingly at odds, with the former often recommending complete abstinence from trigger foods and the latter promoting intake of all foods in moderation. The Food Addiction Clinical Treatment (FACT) manual was created as an alternative using an empirically supported harm-reduction model specifically targeted to treat the addiction and disordered eating features of food addiction. The purpose of the current article is to expose readers to the key tenets of the FACT manual, demonstrate the feasibility of this intervention with a sample of participants with severe food addiction, and discuss future directions for the treatment of food addiction. Positive outcomes from this intervention provide preliminary evidence for the efficacy of FACT for the treatment of food addiction with minimal negative adverse effects. Future research using randomized control trials and longer follow-up is needed to validate the FACT manual as an empirically supported treatment for food addiction.
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Affiliation(s)
- Erin L. O’Hea
- Department of Psychology, Stonehill College, North Easton, MA 02357, USA
| | | | - Dana L. Beall Brown
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, USA;
| | - Kendrin R. Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
| | - Douglas M. Ziedonis
- Department of Psychiatry and Behavioral Science, University of New Mexico, Albuquerque, NM 87131, USA;
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Darcey VL, Guo J, Chi M, Chung ST, Courville AB, Gallagher I, Herscovitch P, Joseph PV, Howard R, LaNoire M, Milley L, Schick A, Stagliano M, Turner S, Urbanski N, Yang S, Zhai N, Zhou MS, Hall KD. Brain dopamine responses to ultra-processed milkshakes are highly variable and not significantly related to adiposity in humans. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.24.24309440. [PMID: 39108535 PMCID: PMC11302720 DOI: 10.1101/2024.06.24.24309440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
Ultra-processed foods high in fat and sugar may be addictive, in part, due to their purported ability to induce an exaggerated postingestive brain dopamine response akin to drugs of abuse. Using standard [11C]raclopride positron emission tomography (PET) displacement methods used to measure brain dopamine responses to addictive drugs, we measured postingestive striatal dopamine responses to an ultra-processed milkshake high in fat and sugar in 50 young, healthy adults over a wide body mass index range (BMI 20-45 kg/m2). Surprisingly, milkshake consumption did not result in significant postingestive dopamine response in the striatum (p=0.62) nor any striatal subregion (p>0.33) and the highly variable interindividual responses were not significantly related to adiposity (BMI: r=0.076, p=0.51; %body fat: r=0.16, p=0.28). Thus, postingestive striatal dopamine responses to an ultra-processed milkshake were likely substantially smaller than many addictive drugs and below the limits of detection using standard PET methods.
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Affiliation(s)
- Valerie L Darcey
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
- Center on Compulsive Behaviors, Intramural Research Program, NIH, Bethesda, MD, USA
| | - Juen Guo
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Meible Chi
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Stephanie T Chung
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Amber B Courville
- Human Energy and Body Weight Regulation Core, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Isabelle Gallagher
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Peter Herscovitch
- Positron Emission Tomography Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Paule V Joseph
- Section of Sensory Science and Metabolism, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892, USA
- National Institute of Nursing Research, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892, USA
- National Institute on Deafness and Other Communication Disorders, Smell and Taste Center, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892, USA
| | - Rebecca Howard
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Melissa LaNoire
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Lauren Milley
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Alex Schick
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Michael Stagliano
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sara Turner
- Nutrition Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Nicholas Urbanski
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Shanna Yang
- Nutrition Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Nan Zhai
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Megan S Zhou
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kevin D Hall
- Integrative Physiology Section, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
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Wiss DA, LaFata EM. Ultra-Processed Foods and Mental Health: Where Do Eating Disorders Fit into the Puzzle? Nutrients 2024; 16:1955. [PMID: 38931309 PMCID: PMC11206753 DOI: 10.3390/nu16121955] [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: 04/25/2024] [Revised: 06/01/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
Ultra-processed foods (UPFs) like pastries, packaged snacks, fast foods, and sweetened beverages have become dominant in the modern food supply and are strongly associated with numerous public health concerns. While the physical health consequences of UPF intake have been well documented (e.g., increased risks of cardiometabolic conditions), less empirical discussion has emphasized the mental health consequences of chronic UPF consumption. Notably, the unique characteristics of UPFs (e.g., artificially high levels of reinforcing ingredients) influence biological processes (e.g., dopamine signaling) in a manner that may contribute to poorer psychological functioning for some individuals. Importantly, gold-standard behavioral lifestyle interventions and treatments specifically for disordered eating do not acknowledge the direct role that UPFs may play in sensitizing reward-related neural functioning, disrupting metabolic responses, and motivating subsequent UPF cravings and intake. The lack of consideration for the influences of UPFs on mental health is particularly problematic given the growing scientific support for the addictive properties of these foods and the utility of ultra-processed food addiction (UPFA) as a novel clinical phenotype endorsed by 14-20% of individuals across international samples. The overarching aim of the present review is to summarize the science of how UPFs may affect mental health, emphasizing contributing biological mechanisms. Specifically, the authors will (1) describe how corporate-sponsored research and financial agendas have contributed to contention and debate about the role of UPFs in health; (2) define UPFs and their nutritional characteristics; (3) review observed associations between UPF intake and mental health conditions, especially with depression; (4) outline the evidence for UPFA; and (5) describe nuanced treatment considerations for comorbid UPFA and eating disorders.
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Affiliation(s)
- David A. Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
- Nutrition in Recovery LLC, 1902 Westwood Blvd. #201, Los Angeles, CA 90025, USA
| | - Erica M. LaFata
- Center for Weight Eating and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA 19104, USA;
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8
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Gao P, Mei Z. Food in Brain Health: Does Processing Level Matter? Neurology 2024; 102:e209511. [PMID: 38776520 DOI: 10.1212/wnl.0000000000209511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Affiliation(s)
- Peipei Gao
- From the Department of Nutrition (P.G.), Harvard T.H. Chan School of Public Health, Boston, MA; Human Phenome Institute (P.G.), Fudan University, Shanghai, China; and Brigham and Women's Hospital and Harvard Medical School (Z.M.), Boston, MA
| | - Zhendong Mei
- From the Department of Nutrition (P.G.), Harvard T.H. Chan School of Public Health, Boston, MA; Human Phenome Institute (P.G.), Fudan University, Shanghai, China; and Brigham and Women's Hospital and Harvard Medical School (Z.M.), Boston, MA
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9
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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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LaFata EM, Allison KC, Audrain-McGovern J, Forman EM. Ultra-Processed Food Addiction: A Research Update. Curr Obes Rep 2024; 13:214-223. [PMID: 38760652 PMCID: PMC11150183 DOI: 10.1007/s13679-024-00569-w] [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] [Accepted: 04/22/2024] [Indexed: 05/19/2024]
Abstract
PURPOSE OF REVIEW Detail recent advancements in the science on ultra-processed food (UPF) addiction, focusing on estimated prevalence rates and emerging health disparities; progress towards identifying biological underpinnings and behavioral mechanisms; and implications for weight management. RECENT FINDINGS Notable developments in the field have included: (1) estimating the global prevalence of UPF addiction at 14% of adults and 15% of youths; (2) revealing health disparities for persons of color and those with food insecurity; (3) observing altered functioning across the brain-gut-microbiome axis; (4) providing early evidence for UPF withdrawal; and (5) elucidating poorer weight management outcomes among persons with UPF addiction. The breadth of recent work on UPF addiction illustrates continued scientific and public interest in the construct and its implications for understanding and treating overeating behaviors and obesity. One pressing gap is the lack of targeted interventions for UPF addiction, which may result in more optimal clinical outcomes for this underserved population.
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Affiliation(s)
- Erica M LaFata
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States.
| | - Kelly C Allison
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States
- Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States
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11
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Nguyen NTA, Jiang Y, McQuade JL. Eating away cancer: the potential of diet and the microbiome for shaping immunotherapy outcome. Front Immunol 2024; 15:1409414. [PMID: 38873602 PMCID: PMC11169628 DOI: 10.3389/fimmu.2024.1409414] [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: 03/30/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024] Open
Abstract
The gut microbiome (GMB) plays a substantial role in human health and disease. From affecting gut barrier integrity to promoting immune cell differentiation, the GMB is capable of shaping host immunity and thus oncogenesis and anti-cancer therapeutic response, particularly with immunotherapy. Dietary patterns and components are key determinants of GMB composition, supporting the investigation of the diet-microbiome-immunity axis as a potential avenue to enhance immunotherapy response in cancer patients. As such, this review will discuss the role of the GMB and diet on anti-cancer immunity. We demonstrate that diet affects anti-cancer immunity through both GMB-independent and GMB-mediated mechanisms, and that different diet patterns mold the GMB's functional and taxonomic composition in distinctive ways. Dietary modulation therefore shows promise as an intervention for improving cancer outcome; however, further and more extensive research in human cancer populations is needed.
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Affiliation(s)
| | | | - Jennifer L. McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Hosseininasab D, Shiraseb F, Bahrampour N, da Silva A, Hajinasab MM, Bressan J, Mirzaei K. Ultra-processed food consumption and quality of life: a cross-sectional study in Iranian women. Front Public Health 2024; 12:1351510. [PMID: 38665244 PMCID: PMC11043594 DOI: 10.3389/fpubh.2024.1351510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 04/28/2024] Open
Abstract
Background Ultra-processed foods (UPFs) have been associated with a higher intake of added sugars, sodium, and unhealthy fats; however, the relationship between UPFs and quality of life (QoL) is not well understood. Methods The present cross-sectional study included 193 Iranian women aged 18-48 years with a body mass index (BMI) of ≥25 kg/m2. UPFs were identified using the NOVA classification. QoL was evaluated using the SF-36 questionnaire. Anthropometric measurements and body composition were assessed using an appropriate method. Results The mean BMI and fat-free mass (FFM) of the subjects were 30.90 kg/m2 and 46.69 kg, respectively. At first, a significant difference was observed in the height of women across tertiles of UPF consumption. The mean score of the total QoL scale was 66.90. Women who were in the tertile 3 of UPFs intake had 23.59 units lower the scale of limitation in physical capabilities and activity (score of role-physical) (β = -23.59, 95% CI: -37.77-9.40, p = 0.001). Among those with the highest adherence to UPF intake, there was an 8.76 unit reduction in addressing feelings of energy and fatigue (vitality domain) in model 2 (β = -8.76, 95% CI: -16.42-1.11, p = 0.02). Finally, a reduction of 15.78 units was observed in the mental health scale, specifically in the mental states of anxiety and depression, among participants in the third tertile of UPF intake (β = -15.78, 95% CI: -24.11-7.45, p < 0.001). Conclusion Increased UPF consumption was associated with lower QoL in Iranian women. Further studies are needed to confirm these findings and develop effective strategies to promote healthy food choices.
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Affiliation(s)
- Dorsa Hosseininasab
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Niki Bahrampour
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Alessandra da Silva
- Laboratory of Energy Metabolism and Body Composition, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Mohammad Mahdi Hajinasab
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Josefina Bressan
- Laboratory of Energy Metabolism and Body Composition, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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McKenzie BL, Pinho-Gomes AC, Woodward M. Addressing the global obesity burden: a gender-responsive approach to changing food environments is needed. Proc Nutr Soc 2024:1-9. [PMID: 38351635 DOI: 10.1017/s0029665124000120] [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: 03/26/2024]
Abstract
Obesity is a leading cause of death and disability globally. There is a higher proportion of women living with obesity than men, with differences in prevalence rates between women and men particularly staggering in low- and middle-income countries. The food environments that most people live in have been defined as 'obesogenic', characterised by easy access to energy dense, highly palatable foods with poor nutritional value. There is an established need to intervene to change food environments to prevent obesity. However, minimal successes are evident with no country set to meet the WHO goal of reducing obesity prevalence to 2010 numbers by 2025. In this review, we provide a narrative around the sex (biological)- and gender (sociocultural)-related considerations for the relationship between nutrition, interactions with the food environment and obesity risk. We provide an argument that there are gendered responses to food environments that place women at a higher risk of obesity particularly in relation to food industry influences, due to gendered roles and responsibilities in relation to paid and unpaid labour, and due to specific food security threats. This review concludes with hypotheses for addressing the obesity burden in a gender-responsive manner, with a call for gender equity to be a key component of the development, implementation and monitoring of obesity prevention focused policies going forward.
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Affiliation(s)
- Briar L McKenzie
- The George Institute for Global Health, UNSW, Level 18, International Towers 3, 300 Barangaroo Ave, Barangaroo, NSW2000, Australia
| | - Ana-Catarina Pinho-Gomes
- Institute of Health Informatics, University College London, London, UK
- The George Institute for Global Health, Imperial College London, London, UK
| | - Mark Woodward
- The George Institute for Global Health, UNSW, Level 18, International Towers 3, 300 Barangaroo Ave, Barangaroo, NSW2000, Australia
- The George Institute for Global Health, Imperial College London, London, UK
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Xiao W, Wang B, Bai X, Tang S, Zhang Y. Taoist way of a balanced exercise training cocktail for the management of primary hypertension in older persons. Front Public Health 2023; 11:1308375. [PMID: 38155893 PMCID: PMC10754045 DOI: 10.3389/fpubh.2023.1308375] [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: 10/06/2023] [Accepted: 11/20/2023] [Indexed: 12/30/2023] Open
Abstract
High blood pressure is the world's leading risk factor for mortality, affecting nearly half of the global population aged 50-79 years. Physical inactivity is one factor contributing to the prevalence of hypertension. This paper discusses a new concept for the management of hypertension in older persons. We are inclined to fade the current guidelines used in China, the United States, and Europe. Although demonstrating irrefutable benefits for blood pressure regulation, the guidelines fail to address the need to incorporate balance exercises, which are crucial for mitigating the risk of falling. We address three pressing questions regarding the efficacy of various combinations of exercise modes for blood pressure regulation, alongside providing an overview of balance exercises. At the core of our concept, we explicate the challenges inherent in addressing the global pandemic of physical inactivity and hypertension in regular socioeconomic people. No guidelines could change the state of inactivity by jumping between zero and all things, where "zero" symbolizes conditions such as physical inactivity and hypertension, and the concept of "all things" encompasses the ideals of an active lifestyle and healthy aging. We advocate a Taoist way, "zero-one-all things," where "one" in this context refers to an inclusive and culturally diverse exercise training cocktail. The Tao guides us to illuminate an ancient way of overcoming physical inactivity-associated diseases in the present day.
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Affiliation(s)
- Wensheng Xiao
- School of Physical Education, Huzhou University, Huzhou, China
| | - Bihan Wang
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Xiaorong Bai
- School of Physical Education, Huzhou University, Huzhou, China
| | - Shouyong Tang
- Institute of Sports and Health Industry, HEHA CAT Fitness, Changsha, China
| | - Yang Zhang
- Independent Person, Windermere, FL, United States
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Hoffman RM. General health warnings about ultra-processed foods are not enough. BMJ 2023; 383:2609. [PMID: 37945048 DOI: 10.1136/bmj.p2609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
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Ladher N, Hinton R, Veitch E. Challenges of obesity and type 2 diabetes require more attention to food environment. BMJ 2023; 383:2269. [PMID: 37813474 PMCID: PMC10561015 DOI: 10.1136/bmj.p2269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Affiliation(s)
| | | | - Emma Veitch
- The BMJ, London, UK
- Correspondence to: E Veitch
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