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Robles B, Mota-Bertran A, Saez M, Solans M. Association between ultraprocessed food consumption and excess adiposity in children and adolescents: A systematic review. Obes Rev 2024; 25:e13796. [PMID: 38956887 DOI: 10.1111/obr.13796] [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: 07/28/2023] [Revised: 12/17/2023] [Accepted: 06/12/2024] [Indexed: 07/04/2024]
Abstract
Ultraprocessed foods (UPF) consumption is associated with excess adiposity in adults, but this linkage remains unclear among children and adolescents. The present systematic review sought to address this research gap. Publications up to November 2023 were retrieved from PubMed, Web of Science, and Scopus databases. Outcomes included overweight/obesity anthropometric and body composition indicators; the exposure was UPF consumption based on the NOVA classification system. The review included 23 studies (i.e., 8 cohort and 15 cross-sectional); approximately half were carried out in Brazil. Inconclusive and heterogeneous evidence exists as few cohort studies found positive/mixed associations between UPF consumption and excess adiposity in pediatric populations, whereas most cross-sectional studies reported null associations. Such inconsistencies may be attributed to underlying methodological issues, especially heterogeneity in the outcomes assessed and UPF consumption operationalization and/or categorization. Future studies should adopt longitudinal designs with sufficiently extended follow-up periods, account for relevant confounding factors, employ validated and standardized measurement tools to assess dietary exposure, ensure consistent operationalization of variables, and encompass diverse geographic contexts. Ultimately, strengthening the quality of existing research evidence may better inform current and forthcoming policy and practice interventions aimed at mitigating the increasing prevalence of overweight/obesity in childhood and across the life course.
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Affiliation(s)
- Brenda Robles
- Department of Economics, University of Rovira i Virgili, Reus, Spain
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Mota-Bertran
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Solans
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Morales-Suárez-Varela M, Peraita-Costa I, Llopis-Morales A, Llopis-González A. Cross-Sectional Assessment of Nutritional Status, Dietary Intake, and Physical Activity Levels in Children (6-9 Years) in Valencia (Spain) Using Nutrimetry. Nutrients 2024; 16:2649. [PMID: 39203786 PMCID: PMC11356814 DOI: 10.3390/nu16162649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/28/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
The aims of this research were to evaluate the current nutritional status, dietary intake, and level of physical activity and assess the need for intervention. This was a cross-sectional study with 2724 participating children aged 6-9 years old. Nutritional status was assessed using nutrimetry, dietary intake with a 3-day food-recall questionnaire and physical activity with an ad hoc questionnaire. The nutricode with the highest prevalence was healthy weight/normal stature, with 51.3% of the sample. For the BMI for age Z-score, those in the overweight/obesity category represented 37.5% of the sample, while the thinness category included 7.6%. Intake of calories, proteins, sugar, lipids, SFA, MUFA, and cholesterol were significantly higher than recommended. The thinness groups consumed a significantly higher amount of excess calories while the overweight/obesity groups had the lowest mean excess calorie intake. Children in the thinness category presented the highest rates at both ends of the spectrum for sedentary activities. This study showed the high prevalence of malnutrition in schoolchildren. The results for the risk of thinness and overweight/obesity according to individual nutrient intake should be carefully interpreted. Lifestyle is a fundamental aspect to consider when combating malnutrition, especially at the level of dietary and physical activity habits, to combine various methods of intervention to improve nutritional status.
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Affiliation(s)
- María Morales-Suárez-Varela
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy and Food Sciences, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain; (I.P.-C.); (A.L.-M.); (A.L.-G.)
- Biomedical Research Center in Epidemiology and Public Health Network (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Madrid, Spain
| | - Isabel Peraita-Costa
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy and Food Sciences, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain; (I.P.-C.); (A.L.-M.); (A.L.-G.)
- Biomedical Research Center in Epidemiology and Public Health Network (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Madrid, Spain
| | - Agustín Llopis-Morales
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy and Food Sciences, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain; (I.P.-C.); (A.L.-M.); (A.L.-G.)
| | - Agustín Llopis-González
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy and Food Sciences, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain; (I.P.-C.); (A.L.-M.); (A.L.-G.)
- Biomedical Research Center in Epidemiology and Public Health Network (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Madrid, Spain
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Tizazu W, Laillou A, Hirvonen K, Chitekwe S, Baye K. Child feeding practices in rural Ethiopia show increasing consumption of unhealthy foods. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 5:e13401. [PMID: 35852042 PMCID: PMC11258765 DOI: 10.1111/mcn.13401] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 06/15/2023]
Abstract
The quality of complementary feeding can have both short- and long-term health impacts by delaying or promoting child growth and establishing taste preferences and feeding behaviours. We aimed to assess the healthy and unhealthy feeding practices of infants and young children in rural Ethiopia. We conducted two rounds of surveys in December 2017/18 in Habru district, North Wello, rural Ethiopia among caregivers of infants and young children (N = 574). We characterised the consumption of infants and young children using non-quantitative 24 h recall and the World Health Organization infant and young child feeding indicators. Sociodemographic characteristics, anthropometry and haemoglobin concentrations were assessed. Breastfeeding was a norm as 82% and 67% were breastfed in the first and second rounds. Between the two rounds, dietary diversity increased from 5% to 17% (p < 0.05), but more pronounced increases were observed in the consumption of ultra-processed food (UPFs). Up to one-in-five (22%) of the children consumed UFPs. With an average of only three food groups consumed, the consumption of nutrient-dense foods like animal source foods, fruits and vegetables was very low particularly among younger children. UPFs are an additional risk factor that contributes to poor quality diets. Behavioural Change Communication interventions, including those in rural areas, should explicitly discourage the consumption of UPFs. Future studies should aim to quantify the amount of UPFs consumed and evaluate how this is associated with diet adequacy and nutritional outcomes.
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Affiliation(s)
- Woinshet Tizazu
- Center for Food Science and NutritionAddis Ababa UniversityAddis AbabaEthiopia
| | | | - Kalle Hirvonen
- Development Strategy and Governance DivisionInternational Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
- The United Nations UniversityWorld Institute for Development Economics ResearchHelsinkiFinland
| | | | - Kaleab Baye
- Center for Food Science and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- Research Center for Inclusive Development in AfricaAddis AbabaEthiopia
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Li C, Zhang Y, Zhang K, Fu H, Lin L, Cai G, Zhang X, Yang X, Zhang Z, Yang Z, Zhang B. Association Between Ultra-Processed Food Consumption and Leucocyte Telomere Length: A cross-sectional study of UK Biobank. J Nutr 2024:S0022-3166(24)00273-6. [PMID: 38735573 DOI: 10.1016/j.tjnut.2024.05.001] [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: 01/18/2024] [Revised: 04/23/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024] Open
Abstract
OBJECTIVE This study aimed to investigate the association between consumption of ultra-processed foods (UPFs) and leucocyte telomere length (LTL). METHODS This cross-sectional study utilized data from the UK Biobank, including a total of 64,690 participants. LTL was measured using Q-PCR with natural logarithmic conversion and Z-score normalization. Dietary data were collected through a 24-hour recall questionnaire from 2009 to 2010. UPFs were identified using the Nova food classification and analyzed as either a continuous or categorical variable respectively. Multiple linear regression models were employed to analyze the association between UPF consumption and LTL. RESULTS The included participants had an average age of 56.26 years, of whom 55.2% were female. After adjusting for sociodemographic, lifestyle-related and anthropometric variables, LTL exhibited a decrease of 0.005 (95% CI: -0.007, -0.002) with one UPF serving/day increase. Compared to participants consuming ≤ 3.5 servings/day, those consuming 3.5 to < 6, 6 to ≤ 8 and > 8 servings/day showed a shortening of LTL by 0.025 (95% CI: -0.047, -0.004), 0.034 (95% CI: -0.055, -0.012) and 0.038 (95% CI: -0.062, -0.015), respectively (P for trend = 0.001). Subgroup analyses by UPF subclasses revealed that consumption of ready-to-eat/heated food (β = -0.008, 95% CI: -0.014, -0.002), beans and potatoes (β = -0.024, 95% CI: -0.039, -0.009), animal-based products (β = -0.011, 95% CI: -0.019, -0.004), artificial sugar (β = -0.014, 95% CI: -0.025, -0.004), and beverages (β = -0.005, 95% CI: -0.009, -0.001) showed negative associations with LTL. Conversely, breakfast cereals (β = 0.020, 95% CI: 0.004, 0.036) and vegetarian alternatives (β = 0.057, 95% CI: 0.027, 0.086) showed positive correlations with LTL. CONCLUSIONS Our study found that a higher consumption of total UPFs was associated with a shorter LTL. However, some subclass UPFs may be associated with longer LTL, depending on their nutritional composition.
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Affiliation(s)
- Chunhao Li
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Yuchun Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Ke Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Hongna Fu
- Division of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China; NHC Key Laboratory on Assisted Circulation, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Luyang Lin
- Division of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China; NHC Key Laboratory on Assisted Circulation, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Guoyi Cai
- Division of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China; NHC Key Laboratory on Assisted Circulation, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Xiaojun Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Xingfen Yang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Zheqing Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Zhen Yang
- Division of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China; NHC Key Laboratory on Assisted Circulation, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China.
| | - Bo Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China.
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Sherling DH, Hennekens CH, Ferris AH. Newest Updates to Health Providers on the Hazards of Ultra-Processed Foods and Proposed Solutions. Am J Med 2024; 137:395-398. [PMID: 38342198 DOI: 10.1016/j.amjmed.2024.02.001] [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: 01/24/2024] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/13/2024]
Abstract
At present, the United States has the lowest life expectancy of all 12 large, rich countries in the world. While overweight and obesity, as well as lack of regular physical activity, are well recognized, another less well-known plausible hypothesis to explain this observation is the unprecedented consumption of ultra-processed food in the United States. Whether ultra-processed food contributes to our currently rising rates of morbidity and mortality from noncommunicable diseases requires direct testing in analytic studies designed a priori to do so. At present, ultra-processed foods are likely to play major roles in a myriad of diseases such as diabetes, coronary heart disease, stroke, a variety of cancers, and even mental health disorders. As was the case with cigarettes, we find ourselves needing to fight a battle where the entertainment industry, the food industry, and public policy do not align with our patients' needs. This does not mean that we should not begin to engage our patients in this vital conversation. Indeed, it makes it all the more important, and timely, that we do so.
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Affiliation(s)
- Dawn Harris Sherling
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
| | - Charles H Hennekens
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton
| | - Allison H Ferris
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton
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Aljahdali AA, Rossato SL, Baylin A. Ultra-processed foods consumption among a USA representative sample of middle-older adults: a cross-sectional analysis. Br J Nutr 2024; 131:1461-1472. [PMID: 38174358 PMCID: PMC10950447 DOI: 10.1017/s0007114523003033] [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: 08/11/2023] [Revised: 11/27/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024]
Abstract
The study evaluated the association between ultra-processed foods (UPF) and nutrient intake and identified the socio-demographic characteristics associated with UPF consumption among a nationally representative sample of middle-older adults. Dietary assessment was collected in 2013 using a validated FFQ. The Nova system was used to classify food and drinks into UPF. The percentage of dietary energy from UPF was calculated and used throughout the analyses, and average nutrient intake across quintiles of UPF was evaluated. The determinants associated with the dietary caloric contribution of UPF intake were investigated using linear regression models. A cross-sectional analysis of a nationally representative study of Americans over the age of 50, the Health and Retirement Study, was conducted. The analysis included 6220 participants. The mean age was 65 (se 0·28) years, with 55 % being female. UPF intake accounted for 51 % (se 0·25) of total intake. An increase in the percentage of (%UPF) consumption was correlated with an increase in calories, carbohydrates, saturated fat and sugar, and a decrease in fibre, vitamins and minerals. %UPF intake was inversely associated with being Hispanic, higher income, physical activity, vegetarian diet and Mediterranean diet but positively associated with very low food insecurity. UPF represented half of the calories consumed. A higher %UPF intake was associated with a lower nutrient profile, suggesting decreasing %UPF intake as a strategy to improve the nutritional quality of middle-older adults. A few socio-demographic factors were associated with %UPF, which would help in planning strategies to reduce UPF consumption.
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Affiliation(s)
- Abeer Ali Aljahdali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sinara Laurini Rossato
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute of Geography, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Ana Baylin
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Global Public Health, University of Michigan, Ann Arbor, MI, USA
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López-Gil JF, Fernandez-Montero A, Bes-Rastrollo M, Moreno-Galarraga L, Kales SN, Martínez-González MÁ, Moreno-Montañés J. Is Ultra-Processed Food Intake Associated with a Higher Risk of Glaucoma? A Prospective Cohort Study including 19,255 Participants from the SUN Project. Nutrients 2024; 16:1053. [PMID: 38613086 PMCID: PMC11013077 DOI: 10.3390/nu16071053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/16/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVE The aim of this study was to examine the relationship of ultra-processed food (UPF) intake with the incidence of glaucoma in a large sample of Spanish university graduates followed prospectively. METHODS Prospective cohort study using data from the SUN Project. A final sample of 19,225 participants (60.1% women) was included in this study, with a mean age of 38.2 years (standard deviation (SD) = 12.4). Participants were followed-up for a mean time of 12.9 years (SD = 5.4). Dietary intake was measured using a 136-item semiquantitative food-frequency questionnaire. UPFs were defined based on the NOVA classification system. Glaucoma diagnosis was determined by asking the participants if they had ever been diagnosed with glaucoma by an ophthalmologist. This self-reported diagnosis of glaucoma has been previously validated. RESULTS After adjusting for several covariates, participants with the highest UPF consumption were at higher risk of glaucoma (hazard ratio (HR) = 1.83; 95% confidence interval (CI) 1.06 to 3.17) when compared to participants in the lowest category of UPF consumption. Regarding subgroup analyses, a significant multiplicative interaction was found for age (p = 0.004) and omega 3:6 ratio (p = 0.040). However, an association between UPF consumption and glaucoma was only found in older participants (aged ≥ 55 years), in men, in the most physically active group, in the group of non- or former smokers, in those with a lower omega 3:6 ratio, and in those with a lower energy intake. Regarding the contribution of each type of UPF group, UPF coming from sweets showed a significant risky effect (HR = 1.51; CI 95% 1.07 to 2.12). CONCLUSIONS This prospective cohort study shows that participants with a greater UPF consumption have a higher risk of developing glaucoma when compared to participants with a lower consumption. Our findings emphasize the relevance of monitoring and limiting the consumption of UPFs as a means of preventing glaucoma incidence.
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Grants
- (RD 06/0045, CIBER-OBN, Grants PI10/02658, PI10/02293, PI13/00615, PI14/01668, PI14/01798, PI14/01764, PI17/01795, and G03/140) Instituto de Salud Carlos III
- (27/2011, 45/2011, 122/2014) Gobierno de Navarra
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Affiliation(s)
| | - Alejandro Fernandez-Montero
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA;
- Department of Occupational Medicine, University of Navarra, 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (M.B.-R.); (M.Á.M.-G.)
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (M.B.-R.); (M.Á.M.-G.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (L.M.-G.); (J.M.-M.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Laura Moreno-Galarraga
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (L.M.-G.); (J.M.-M.)
- Department of Pediatrics, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Stefanos N. Kales
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA;
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (M.B.-R.); (M.Á.M.-G.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (L.M.-G.); (J.M.-M.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - Javier Moreno-Montañés
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (L.M.-G.); (J.M.-M.)
- Department of Ophthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
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Zhu Y, Mierau JO, Riphagen IJ, Heiner-Fokkema MR, Dekker LH, Navis GJ, Bakker SJL. Types of fish consumption differ across socioeconomic strata and impact differently on plasma fish-based omega-3 fatty acids: a cross-sectional study. Eur J Nutr 2024; 63:435-443. [PMID: 37985508 PMCID: PMC10899282 DOI: 10.1007/s00394-023-03274-x] [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: 02/18/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE We investigated the associations of socioeconomic position (SEP) with total and type of fish intake in a large general population and validated whether types of fish intake were differently associated with plasma EPA and DHA in a subset of the population. METHODS From the Lifelines Cohort Study, 94,246 participants aged 44 ± 13 years old were included to test the association of two SEP indicators, i.e., education level and household income level, with dietary intakes of total, oily, lean, fried, and other types of fish. In a subset of 575 participants (mean age: 50 ± 13 years), EPA and DHA levels were measured in plasma phospholipids and triglycerides. Dietary fish intake was assessed using Food Frequency Questionnaire. Linear regressions were applied and adjusted for relevant covariates. RESULTS Compared to the high education level, lower education levels were negatively associated with total, oily, lean, and other fish intake (p < 0.001 for all), and positively associated with fried fish intake (β (SE): 0.04 (0.04), p < 0.001 for middle education; 0.07 (0.04), p < 0.001 for low education), independently of relevant covariates. Similar results were observed for income levels. In the subset population, total and oily fish intakes were positively associated with plasma EPA and DHA (p < 0.02 for all). Lean and other fish intakes were positively associated with only DHA (p < 0.008 for all), but not EPA, while fried fish was not associated with either EPA or DHA in plasma (p > 0.1 for all). CONCLUSION Lower SEP was associated with a lower total intake of fish, and of oily and lean fish, but with higher intake of fried fish. Fried fish was not associated with the fish-based EPA and DHA in plasma. Hence, SEP-related differences in fish consumption are both quantitative and qualitative.
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Affiliation(s)
- Yinjie Zhu
- Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Jochen O Mierau
- Department of Economics, Econometrics & Finance, Faculty of Economics and Business, University of Groningen, University Complex, 9747 AJ, Groningen, The Netherlands
- Lifelines Cohort Study and Biobank, Groningen, The Netherlands
- Team Strategy & External Relations, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Ineke J Riphagen
- Certe Medical Diagnostics and Advice, Medical Center Leeuwarden, 8934 AD, Leeuwarden, The Netherlands
| | - M Rebecca Heiner-Fokkema
- Laboratory of Metabolic Diseases, University Medical Center Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Louise H Dekker
- Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- National Institute for Public Health and the Environment (RIVM), 3720 BA, Bilthoven, The Netherlands
| | - Gerjan J Navis
- Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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9
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Paparo L, Coppola S, Nocerino R, Pisapia L, Picariello G, Cortese M, Voto L, Maglio M, Miele E, Carucci L, Oglio F, Trinchese G, Mollica MP, Bruno C, De Vita S, Tarallo A, Damiano C, Cerulo M, Esposito C, Fogliano V, Parenti G, Troncone R, Berni Canani R. How dietary advanced glycation end products could facilitate the occurrence of food allergy. J Allergy Clin Immunol 2024; 153:742-758. [PMID: 38042501 DOI: 10.1016/j.jaci.2023.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/04/2023] [Accepted: 11/02/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Food allergy (FA) is one of the most common chronic conditions in children with an increasing prevalence facilitated by the exposure to environmental factors in predisposed individuals. It has been hypothesized that the increased consumption of ultra-processed foods, containing high levels of dietary advanced glycation end products (AGEs), could facilitate the occurrence of FA. OBJECTIVE We sought to provide preclinical and clinical evidence on the potential role of AGEs in facilitating the occurrence of FA. METHODS Human enterocytes, human small intestine organ culture, and PBMCs from children at risk for allergy were used to investigate the direct effect of AGEs on gut barrier, inflammation, TH2 cytokine response, and mitochondrial function. Intake of the 3 most common glycation products in Western diet foods, Nε-(carboxymethyl) lysine, Nε-(1-carboxyethyl) lysin, and Nδ-(5-hydro-5- methyl-4-imidazolone-2-yl)-ornithine (MG-H1), and the accumulation of AGEs in the skin were comparatively investigated in children with FA and in age-matched healthy controls. RESULTS Human enterocytes exposed to AGEs showed alteration in gut barrier, AGE receptor expression, reactive oxygen species production, and autophagy, with increased transepithelial passage of food antigens. Small intestine organ cultures exposed to AGEs showed an increase of CD25+ cells and proliferating crypt enterocytes. PBMCs exposed to AGEs showed alteration in proliferation rate, AGE receptor activation, release of inflammatory and TH2 cytokines, and mitochondrial metabolism. Significant higher dietary AGE intake and skin accumulation were observed children with FA (n = 42) compared with age-matched healthy controls (n = 66). CONCLUSIONS These data, supporting a potential role for dietary AGEs in facilitating the occurrence of FA, suggest the importance of limiting exposure to AGEs children as a potential preventive strategy against this common condition.
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Affiliation(s)
- Lorella Paparo
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Laura Pisapia
- Institute of Genetics and Biophysics, National Research Council, Naples, Italy
| | | | - Maddalena Cortese
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Luana Voto
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Mariantonia Maglio
- Department of Translational Medical Science, University Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy
| | - Erasmo Miele
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Franca Oglio
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | | | | | - Cristina Bruno
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Simone De Vita
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Antonietta Tarallo
- Department of Translational Medical Science, University Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Carla Damiano
- Department of Translational Medical Science, University Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Mariapina Cerulo
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Ciro Esposito
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Vincenzo Fogliano
- Food Quality and Design Group, Wageningen University and Research, Wageningen, The Netherlands
| | - Giancarlo Parenti
- Department of Translational Medical Science, University Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Riccardo Troncone
- Department of Translational Medical Science, University Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy; Task Force for Microbiome Studies, University Federico II, Naples, Italy; Task Force for Nutraceuticals and Functional Foods, University Federico II, Naples, Italy.
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10
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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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11
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Kelly M, McCann JR, Chapple CI, Woods J, Russell CG. Visual communication design: a neglected factor in nutrition promotion via packaged food labels. Front Public Health 2024; 12:1296704. [PMID: 38420036 PMCID: PMC10899386 DOI: 10.3389/fpubh.2024.1296704] [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: 09/19/2023] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
Packaging design is a communication device and a critical component in branding strategy, and has relevance for food policy. Presently, packaging-related nutrition policy initiatives focus on the role of regulated claims, nutrition information panels and front-of-pack nutrition labels to help guide consumer food choices and address high prevalences of discretionary and ultra-processed food consumption in many countries. However, these nutrition labelling systems are not optimized as public health policy tools as many consumers do not use them to inform their food choices. Visual communication design theory posits that a designer orders the elements and principles of design into hierarchies that prioritize certain elements over others, and that some of these elements are more dominant and given more emphasis than others. The overall design of the package thereby directs consumer attention to some aspects of pack design (e.g., characters, contents of the package) and away from others (e.g., nutrition details). Dual processing frameworks propose that food decisions are made with the interplay between automatic and rational thinking processes. Packaging designs affect whether consumers rely predominantly on automatic or rational thinking to select a food. This narrative review outlines the role of food packaging design and how it impacts the clear communication of nutrition aspects of food products and how the use of nutrition information by consumers to make decisions may depend upon design structures in packaging. This article attests that nutrition scientists and policy makers should incorporate visual communication design into research on the food packaging as a public health promotion tool. A stronger focus on the communication of regulated front-of-pack nutrition information can be made with a re-evaluation of the hierarchy of elements in the front-of-pack design enabling consumers to make healthier decisions.
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Affiliation(s)
- Meghan Kelly
- School of Communication and Creative Arts, Faculty of Arts and Education, Deakin University, Geelong, VIC, Australia
| | - Jennifer R. McCann
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Celeste I. Chapple
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Julie Woods
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Catherine G. Russell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
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12
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Hajmir MM, Shiraseb F, Hosseininasab D, Aali Y, Hosseini S, Mirzaei K. The mediatory role of inflammatory markers on the relationship between the NOVA classification system and obesity phenotypes among obese and overweight adult women: a cross-sectional study. Front Nutr 2023; 10:1226162. [PMID: 38162517 PMCID: PMC10754978 DOI: 10.3389/fnut.2023.1226162] [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: 05/27/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
Background Diet and inflammation both play important roles in the occurrence of obesity. We aimed to investigate the role of inflammation in the development of both metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) individuals. Methods This cross-sectional study included 221 overweight and obese women aged 18-56 years. The study assessed the metabolic health phenotypes of the participants using the Karelis criterion score. Additionally, dietary intakes were evaluated using a 147-item semi-quantitative questionnaire and the NOVA classification system (comprising 37 food groups and beverages). The study also collected and analyzed the blood parameters, as well as biochemical and anthropometric indices, for all participants. Results Among the women included in the study, 22.9% had MHO phenotypes but 77.1% had MUHO phenotypes. A significant association between the third quartile of the NOVA classification system and the increased likelihood of having the MUHO phenotype was observed (OR = 1.40, 95% CI = 1.09-4.92, p = 0.04). Regarding the potential role of inflammatory markers, high-sensitivity C-reactive protein (hs-CRP) (p = 0.84), transforming growth factor-β (TGF-β) (p = 0.50), monocyte chemoattractant protein-1 (MCP-1) (p = 0.49), plasminogen activator inhibitor-1 (PAI-1) (p = 0.97), and homeostatic model assessment for insulin resistance (HOMA-IR) (p = 0.92) were found to be mediators. Conclusion We observed a significant positive association between ultra-processed food (UPF) consumption and the MUHO phenotype in overweight and obese women. This association appeared to be mediated by some inflammatory markers, such as hs-CRP, TGF-β, MCP-1, PAI-1, and HOMA-IR. Additional studies are needed to validate these findings.
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Affiliation(s)
- Mahya Mehri Hajmir
- Students’ Scientific Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Dorsa Hosseininasab
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Yasaman Aali
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shabnam Hosseini
- School of Human Nutrition, McGill University, Quebec, QC, Canada
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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13
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Kokkinopoulou A, Katsiki N, Pagkalos I, Rodopaios NE, Koulouri AA, Vasara E, Papadopoulou SK, Skepastianos P, Hassapidou M, Kafatos AG. Consumption of Ultra-Processed Food and Drink Products in a Greek Christian Orthodox Church Fasting Population. Nutrients 2023; 15:4907. [PMID: 38068765 PMCID: PMC10708049 DOI: 10.3390/nu15234907] [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: 09/20/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The positive effects of the Mediterranean diet on healthy living are widely known, while the health effects of religious fasting have received increased attention during the last decade. However, no study has focused on the consumption of ultra-processed foods (UPFs) in such populations. Therefore, our aim was to investigate UPF intake and its association with metabolic syndrome (MetS) in a Christian Orthodox church (COC) religious fasting population in Greece. In this cross-sectional study, 400 individuals who follow the Mediterranean diet were included, stratified as COC fasters and non-fasters. Dietary intake data were collected via three 24 h diet recalls and a monthly food frequency questionnaire (FFQ). The NOVA food classification system was used to identify the level of processing and categorize all food items. Fasters consumed significantly less chicken, turkey, and beef and significantly more seafood, fish, snails, soy products, and fresh fruits, in terms of unprocessed or minimally processed foods, as well as significantly more fried potatoes and olives in terms of processed foods when compared with non-fasters. Regarding UPFs, a significantly lower intake of pork sausages, ketchup, and mustard as well as a significantly higher consumption of margarine and tarama dip were recorded in fasters compared with non-fasters. Fasters with MetS more frequently consumed UPFs (such as cheese pastries, biscuits, and cakes) than fasters without MetS (p < 0.05 for all comparisons). Similarly, non-fasters with MetS had an increased intake of UPFs (such as Cypriot bread and Coco Pops breakfast cereals) than non-fasters without MetS. Future research should focus on UPF consumption and its associations with clinical outcomes in such populations, thus providing further data for the potential health effects of COC fasting.
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Affiliation(s)
- Anna Kokkinopoulou
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, 70013 Crete, Greece (A.G.K.)
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece (I.P.); (S.K.P.)
| | - Niki Katsiki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece (I.P.); (S.K.P.)
- School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece (I.P.); (S.K.P.)
| | - Nikolaos E. Rodopaios
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, 70013 Crete, Greece (A.G.K.)
| | - Alexandra-Aikaterini Koulouri
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece (I.P.); (S.K.P.)
| | - Eleni Vasara
- Laboratory of Animal Physiology, Department of Zoology, School of Biology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece (I.P.); (S.K.P.)
| | - Petros Skepastianos
- Department of Medical Laboratory Studies, International Hellenic University, 57400 Thessaloniki, Greece
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece (I.P.); (S.K.P.)
| | - Anthony G. Kafatos
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, 70013 Crete, Greece (A.G.K.)
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14
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Tan LJ, Hwang SB, Shin S. The Longitudinal Effect of Ultra-Processed Food on the Development of Dyslipidemia/Obesity as Assessed by the NOVA System and Food Compass Score. Mol Nutr Food Res 2023; 67:e2300003. [PMID: 37650269 DOI: 10.1002/mnfr.202300003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 07/10/2023] [Indexed: 09/01/2023]
Abstract
SCOPE Ultra-processing food (UPF) has been a nutrition and health interest. This study is aimed to investigate the association between UPF consumption and the risk of obesity or dyslipidemia. METHODS AND RESULTS This study is performed using an ongoing cohort study including 17 310 individuals aged ≥40 years in South Korea. UPF is categorized by the NOVA system and FCS, respectively. After an average 5-year follow-up, there is a positive association between NOVA-defined UPF and dyslipidemia. The risk of the Q4 group is almost 20% higher than that of the Q1 group (men, adjusted HR = 1.209 [95% CI 1.039-1.407], women, adjusted HR = 1.195 [95% CI 1.096-1.303]). Consuming high-FCS foods (less processed and healthier foods) show a lower risk for dyslipidemia in both sexes and lower obesity risk in women compared to low-FCS consumption (men, dyslipidemia, adjusted HR = 0.857 [95% CI 0.744-0.988]; women, dyslipidemia, adjusted HR = 0.919 [95% CI 0.850-0.993], obesity, adjusted HR = 0.759 [95% CI 0.628-0.916]). CONCLUSION Higher UPF intakes assessed by the NOVA system and FCS are associated with increased incidences of dyslipidemia and obesity. Furthermore, NOVA-defined UPF shows a statistically significant negative association with AMED score, indicating poor diet quality.
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Affiliation(s)
- Li-Juan Tan
- Department of Food and Nutrition, Chung-Ang University, Anseong, Gyeonggi-do, 17546, South Korea
| | - Su Bin Hwang
- Department of Food and Nutrition, Chung-Ang University, Anseong, Gyeonggi-do, 17546, South Korea
| | - Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Anseong, Gyeonggi-do, 17546, South Korea
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15
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Mazloomi SN, Talebi S, Mehrabani S, Bagheri R, Ghavami A, Zarpoosh M, Mohammadi H, Wong A, Nordvall M, Kermani MAH, Moradi S. The association of ultra-processed food consumption with adult mental health disorders: a systematic review and dose-response meta-analysis of 260,385 participants. Nutr Neurosci 2023; 26:913-931. [PMID: 36094005 DOI: 10.1080/1028415x.2022.2110188] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE We aimed to conduct a systematic review and meta-analysis of observational studies examining the relationship between ultra-processed food (UPF) consumption and the risk of mental health disorders. METHODS The ISI Web of Science, PubMed/MEDLINE, and Scopus databases were searched without date restriction until 28 December 2021. Data were extracted from 26 studies, including 260,385 participants from twelve countries. Risk ratios for mental health disorders were pooled by a random-effects model. RESULTS Meta-analyses suggested that UPF consumption was associated with an increased risk of depression (RR = 1.28; 95% CI: 1.19, 1.38; I2 = 61.8%; p = 0.022) but not anxiety (RR = 1.35; 95% CI: 0.86, 2.11; I2 = 77.8%; p = 0.198). However, when analyzed for the dietary assessment method, UPF consumption was significantly associated with an enhanced risk of depression among studies utilizing food frequency questionnaires (RR = 1.31; 95% CI: 1.21, 1.41; I2 = 60.0%; p < 0.001) as opposed to other forms of dietary recall approaches. Additionally, for every 10% increase in UPF consumption per daily calorie intake, 11% higher risk of depression (RR = 1.11; 95% CI: 1.01, 1.17; I2 = 88.9%; p < 0.001) was observed among adults. Dose-response analysis further emphasized a positive linear association between UPF consumption with depression risk (p-nonlinearity = 0.819, p-dose-response = p < 0.001). CONCLUSION Our findings indicate that UPF consumption is related to an enhanced depressive mental health status risk. There may be different causes for this increased risk, and further studies are needed to investigate if there is a causal relationship between consumption of UPF and mental health.
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Affiliation(s)
- Seyadeh Narges Mazloomi
- The Health of Plant and Livestock Products Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Food and Drug Administration, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Science, Tehran University of Medical Science, Tehran, Iran
| | - Sanaz Mehrabani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Isfahan University of Medical Sciences, Tehran, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Abed Ghavami
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Isfahan University of Medical Sciences, Tehran, Iran
| | - Mahsa Zarpoosh
- General Practitioner, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Science, Tehran University of Medical Science, Tehran, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, United States
| | - Michael Nordvall
- Department of Health and Human Performance, Marymount University, Arlington, VA, United States
| | - Mohammad Ali Hojjati Kermani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sajjad Moradi
- Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Abreu S, Liz Martins M. Cross-Classification Analysis of Food Products Based on Nutritional Quality and Degree of Processing. Nutrients 2023; 15:3117. [PMID: 37513535 PMCID: PMC10383862 DOI: 10.3390/nu15143117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
This study aims to compare the classification of foods available in the Portuguese market using Nutri-Score and NOVA classifications and to analyse their ability to discriminate the fat, saturated fat, sugar, and salt content of foods. A sample of 2682 food products was collected. The nutritional quality of foods was established using the Nutri-Score, classifying them into five categories (from A to E). The NOVA classification was used to classify foods according to the degree of food processing into unprocessed/minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods (UPF). The nutritional content of food products was classified using a Multiple Traffic Light label system. It was observed that 73.7% of UPF were classified as Nutri-Score C, D, and E, 10.1% as Nutri-Score A, and 16.2% as Nutri-Score B. Nutri-Score was positively correlated with NOVA classification (ρ = 0.140, p < 0.001) and with the Multiple Traffic Lights system (ρTotal Fat = 0.572, ρSaturated Fat = 0.668, ρSugar = 0.215, ρSalt = 0.321, p < 0.001). NOVA classification negatively correlated with the Multiple Traffic Lights system for total fat (ρ = -0.064, p < 0.001). Our findings indicate the presence of many UPFs in all Nutri-Score categories. Since food processing and nutritional quality are complementary, both should be considered in labelling.
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Affiliation(s)
- Sandra Abreu
- School of Life Sciences and Environment, University of Trás-os-Montes, and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, 4050-600 Porto, Portugal
| | - Margarida Liz Martins
- Polytechnic Institute of Coimbra, Coimbra Health School (ESTeSC), 3045-093 Coimbra, Portugal
- GreenUPorto-Sustainable Agrifood Production Research Centre, 4200-465 Vairão, Portugal
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), 5000-801 Vila Real, Portugal
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17
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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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Herzl E, Schmitt EE, Shearrer G, Keith JF. The Effects of a Western Diet vs. a High-Fiber Unprocessed Diet on Health Outcomes in Mice Offspring. Nutrients 2023; 15:2858. [PMID: 37447184 DOI: 10.3390/nu15132858] [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: 05/22/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Diet influences critical periods of growth, including gestation and early development. We hypothesized that a maternal/early life diet reflecting unprocessed dietary components would positively affect offspring metabolic and anthropometric parameters. Using 9 C57BL-6 dams, we simulated exposure to a Western diet, a high-fiber unprocessed diet (HFUD), or a control diet. The dams consumed their respective diets (Western [n = 3], HFUD [n = 3], and control [n = 3]) through 3 weeks of pregnancy and 3 weeks of weaning; their offspring consumed the diet of their mother for 4.5 weeks post weaning. Measurements included dual X-ray absorptiometry (DEXA) scans, feed consumption, body weight, blood glucose, and insulin and glycated hemoglobin (HbA1c) in the offspring. Statistical analyses included one-way ANOVA with Tukey's post hoc analysis. The offspring DEXA measures at 5 and 7.5 weeks post parturition revealed higher lean body mass development in the HFUD and control diet offspring compared to the Western diet offspring. An analysis indicated that blood glucose (p = 0.001) and HbA1c concentrations (p = 0.002) were lower among the HFUD offspring compared to the Western and control offspring. The results demonstrate that diet during gestation and early life consistent with traditional diet patterns may influence hyperglycemia and adiposity in offspring.
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Affiliation(s)
- Elizabeth Herzl
- Department of Family & Consumer Sciences, University of Wyoming, Laramie, WY 82071, USA
| | - Emily E Schmitt
- Division of Kinesiology & Health, University of Wyoming, Laramie, WY 82071, USA
- WWAMI Medical Education, University of Wyoming, Laramie, WY 82071, USA
| | - Grace Shearrer
- Department of Family & Consumer Sciences, University of Wyoming, Laramie, WY 82071, USA
- WWAMI Medical Education, University of Wyoming, Laramie, WY 82071, USA
| | - Jill F Keith
- Department of Family & Consumer Sciences, University of Wyoming, Laramie, WY 82071, USA
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Rizzolo-Brime L, Orta-Ramirez A, Puyol Martin Y, Jakszyn P. Nutritional Assessment of Plant-Based Meat Alternatives: A Comparison of Nutritional Information of Plant-Based Meat Alternatives in Spanish Supermarkets. Nutrients 2023; 15:nu15061325. [PMID: 36986056 PMCID: PMC10058979 DOI: 10.3390/nu15061325] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/30/2023] Open
Abstract
Since the classification of processed meat as carcinogenic by the International Agency for Research on Cancer (IARC) in 2015, an increase in consumption of plant-based meat alternatives (PBMAs) has been observed worldwide. This occurs in a context characterized by concern for health, animal welfare, and sustainability; however, evidence of their nutritional quality is still limited. Therefore, our objective was to evaluate the nutritional profile and processing degree of PBMAs available in Spain. In 2020, products from seven Spanish supermarkets were analyzed for their nutritional content and ingredients. Of the 148 products, the majority were low in sugars but moderate in carbohydrates, total and saturated fat, and high in salt. The main vegetable protein sources were soy (91/148) and wheat gluten (42/148). Comparatively, 43/148 contained animal protein, the most common being egg. Overall, PBMAs had a long list of ingredients and additives, and they were classified as ultra-processed foods (UPFs) according to the NOVA system. This study shows that the PBMAs available in Spanish supermarkets have a variable nutritional composition within and between categories. Further research is needed to determine if replacing meat with these UPFs could be a good alternative towards healthier and more sustainable dietary patterns.
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Affiliation(s)
- Lucía Rizzolo-Brime
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Alicia Orta-Ramirez
- Blanquerna School of Health Sciences, Ramon Llull University, 08025 Barcelona, Spain
| | - Yael Puyol Martin
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
- Blanquerna School of Health Sciences, Ramon Llull University, 08025 Barcelona, Spain
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20
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Zhou L, Li H, Zhang S, Yang H, Ma Y, Wang Y. Impact of ultra-processed food intake on the risk of COVID-19: a prospective cohort study. Eur J Nutr 2023; 62:275-287. [PMID: 35972529 PMCID: PMC9379888 DOI: 10.1007/s00394-022-02982-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/29/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Nutrition plays a key role in supporting the human immune system and reducing the risk of infections. However, there is limited evidence exploring the relationship between diet and the risk of COVID-19. This study aimed to assess the associations between consumption of ultra-processed foods (UPF) and COVID-19 risk. METHODS In total, 41,012 participants from the UK Biobank study with at least 2 of up to 5 times 24-h dietary assessments were included in this study. Dietary intakes were collected using an online 24-h dietary recall questionnaire and food items were categorized according to their degree of processing by the NOVA classification. COVID-19 infection was defined as individuals tested COVID-19 positive or dead of COVID-19. Association between average UPF consumption (% daily gram intake) and COVID-19 infection was assessed by multivariable logistic regression adjusted for potential confounders. RESULTS Compared to participants in the lowest quartile of UPF proportion (% daily gram intake) in the diet, participants in the 2nd, 3rd, and highest quartiles were associated with a higher risk of COVID-19 with the odds ratio (OR) value of 1.03 (95% CI: 0.94-1.13), 1.24 (95% CI: 1.13-1.36), and 1.22 (95% CI: 1.12-1.34), respectively (P for trend < 0.001), after adjusting for potential confounders. The results were robust in a series of sensitivity analyses. No interaction effect was identified between the UPF proportions and age groups, education level, body mass index, and comorbidity status. BMI mediated 13.2% of this association. CONCLUSION Higher consumption of UPF was associated with an increased risk of COVID-19 infection. Further studies are needed to better understand the underlying mechanisms in such association.
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Affiliation(s)
- Lihui Zhou
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Huiping Li
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.,Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Shunming Zhang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.,Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yue Ma
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
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21
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Guglielmetti M, Grosso G, Ferraris C, Bergamaschi R, Tavazzi E, La Malfa A, Wahidah HAQ, Tagliabue A. Ultra-processed foods consumption is associated with multiple sclerosis severity. Front Neurol 2023; 14:1086720. [PMID: 36761349 PMCID: PMC9902937 DOI: 10.3389/fneur.2023.1086720] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/04/2023] [Indexed: 01/25/2023] Open
Abstract
Background MS is a chronic inflammatory neurological and immune-mediated disease of multifactorial etiology. Ultra-processed foods (UPFs) have been generally considered unhealthy due to their poor nutritional value. Emerging evidence suggests that factors other than their nutritional content may play an additional role toward chronic inflammation. Aim To investigate the potential association of UPF consumption and MS severity in a group of MS Italian consecutive patients. Methods Demographic (age, sex, marital status, educational level), neurological (EDSS, MSSS), and nutritional (anthropometric measures, dietary habits) information were collected. Physical activity and smoking habits were also investigated. Food items were grouped according to the NOVA classification. Patients were classified in two groups based on MS severity ("mild" and "moderate to high"). Results Higher UPF consumption was associated with moderate-to-high MS severity compared to lower consumption in both the unadjusted model (OR = 2.28, 95% CI: 1.04-5.01) and after adjustment for potential background (OR = 2.46, 95% CI: 1.04-5.83) and clinical confounding factors (OR = 2.97, 95% CI: 1.13-7.77). Conclusions Although these results are only preliminary and hypothesis generating, it is important to explore how various aspects of the diet may relate to MS severity in order to identify the best strategy to support MS patients over the disease course.
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Affiliation(s)
- Monica Guglielmetti
- Department of Public Health, Experimental and Forensic Medicine, Human Nutrition and Eating Disorder Research Center, University of Pavia, Pavia, Italy,Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy,*Correspondence: Monica Guglielmetti ✉
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy,Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, Catania, Italy
| | - Cinzia Ferraris
- Department of Public Health, Experimental and Forensic Medicine, Human Nutrition and Eating Disorder Research Center, University of Pavia, Pavia, Italy,Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | | | - Eleonora Tavazzi
- Neurological Institute-Foundation IRCCS Casimiro Mondino, Pavia, Italy
| | | | - H. Al-Qahtani Wahidah
- Department of Food Sciences and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Anna Tagliabue
- Department of Public Health, Experimental and Forensic Medicine, Human Nutrition and Eating Disorder Research Center, University of Pavia, Pavia, Italy
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Zhao G, Zhu S, Zhang F, Zhang X, Zhang X, Li T, Li D, Zhu W. Global Burden of osteoarthritis associated with high body mass index in 204 countries and territories, 1990-2019: findings from the Global Burden of Disease Study 2019. Endocrine 2023; 79:60-71. [PMID: 36190652 DOI: 10.1007/s12020-022-03201-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] [Received: 06/15/2022] [Accepted: 09/15/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To quantify the burden of osteoarthritis (OA) associated with high body mass index (BMI) across 204 countries and territories from 1990 to 2019. METHODS This study extracted global, regional, and national data on years lived with disability (YLD) of OA associated with high BMI from GBD 2019. The YLD burden of OA associated with high BMI was systematically analyzed by age, SDI, sex, and EAPC. RESULTS At the global level, ~2.67 million (95% UI: 1.04, 5.75) YLD were attributable to OA associated with high BMI, with an age-standardized rate of 31.9 (95% UI: 12.4, 68.75) YLD per 100,000 population in 2019. There was a 0.5 increase (95% UI: 0.35, 0.79) over the 30 years with an EAPC of 1.45. In 2019, Australasia {57.49 (95% UI: 23.62, 125.38)}, high-income North America {56.2 (95% UI: 23.32, 121.97)}, and Andean Latin America {49.77 (95% UI: 19.73, 111.73)} had the highest age-standardized YLD rates. The population aged at 60-74 group had a higher YLD rate for both males and females. Females tended to be more sensitive to the OA associated with high BMI than male in any region. CONCLUSIONS In summary, the YLD rate of OA associated with high BMI presented a continuous upward trend in most countries. Women and older people are more sensitive to OA due to physiological and psychological factors. Controlling modifiable risk factors such as maintaining an appropriate BMI is needed for disease prevention.
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Affiliation(s)
- Gaichan Zhao
- Department of Public Health, School of Public Health, Wuhan University, 430071, Wuhan, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, 430071, Wuhan, China
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, 430071, Wuhan, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, 430071, Wuhan, China
| | - Xiaowei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, 430071, Wuhan, China
| | - Tianzhou Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, 430071, Wuhan, China
| | - Dejia Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, 430071, Wuhan, China.
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, 430071, Wuhan, China.
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Phulkerd S. Strengthening Governance and Institutional Capacity at the Nutrition-Food Supply Policy Nexus Comment on "What Opportunities Exist for Making the Food Supply Nutrition Friendly? A Policy Space Analysis in Mexico". Int J Health Policy Manag 2022; 11:3133-3136. [PMID: 35964160 PMCID: PMC10105188 DOI: 10.34172/ijhpm.2022.7325] [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: 04/10/2022] [Accepted: 07/03/2022] [Indexed: 11/09/2022] Open
Abstract
Cervantes et al have provided an insightful addition to the policy literature by identifying the contextual, political, and policy factors that create constraints and opportunities for putting nutrition at the center of the food supply chain policy process. This commentary discusses important elements and features when aiming for reconciling nutrition goals and food supply policy, provides some examples of the salience of nutrition of non-health policies in countries with different income levels, and argues for improving governance for better nutrition outcomes and inspiring institutional interest and idea of food supply policy actors around population nutrition. Cervantes et al highlight the political context that favors nutrition outcomes, nutrition advocacy in the public agenda, and multisectoral mechanisms which can keep the nutrition objective moving forward in the food supply sector. However, a wider view on governance and institutional capacity is needed, recognizing government action by multiple sectors, with diverse sets of actors. The expanded understanding of nutrition, which includes considering nutrition as an emerging facet of food systems, by policy actors is needed. Enhancing discourse involving nutrition and food supply actors is important in order to appeal to the wider public and opinion leaders across the political spectrum. Accomplishing this also requires political will and an advocacy movement, especially by civil society and grassroots movements.
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Affiliation(s)
- Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
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24
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Kelsey PT, Papadopoulou E, Borge TC, Dahl C, Brantsæter AL, Erlund I, Meltzer HM, Haug LS, Caspersen IH. Ultra-processed food consumption and associations with biomarkers of nutrition and inflammation in pregnancy: The Norwegian Environmental Biobank. Front Nutr 2022; 9:1052001. [PMID: 36570121 PMCID: PMC9772468 DOI: 10.3389/fnut.2022.1052001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
Background A high consumption of ultra-processed foods (UPFs) is often associated with low nutritional quality, but data on associations with biomarkers are scarce. We aimed to explore associations between UPF intake, diet quality, and concentrations of biomarkers of nutrition and inflammation measured in mid-pregnancy. Methods This cross-sectional study included n = 2,984 pregnant women recruited during 2002-2008 in the Norwegian Mother, Father, and Child Cohort Study (MoBa). Concentrations of C-reactive protein (CRP) and 21 nutritional biomarkers including carotenes (α-carotene, β-carotene, γ-carotene, α-cryptoxanthin, β-cryptoxanthin, lutein, lycopene), vitamins [α-tocopherol, γ-tocopherol, 25-hydroxyvitamin D (25-OH-D), retinol], creatinine, elements (K, Na, Co, Cu, Mn, Mo, Se, Zn), and ferritin (Fe) were measured in blood and urine collected in mid-pregnancy. Habitual diet in pregnancy was assessed using a validated semi-quantitative food frequency questionnaire. We calculated the relative (%) energy contribution of UPF to overall intake according to the NOVA classification. We also applied a diet quality index (DQI) adapted to assess adherence to Norwegian dietary guidelines (DQI; min-max: 0-110, higher score meaning higher adherence). We present summary statistics for biomarker concentrations and explored associations between UPF intake or the DQI and measured biomarkers using adjusted linear, logistic, and generalized additive regression models. Results Ultra-processed food intake was positively associated with biomarker concentrations of vitamin E (γ-tocopherol), creatinine, K, and Na [βs: 5.6 to 17% increase in biomarker concentration per interquartile range (IQR) increase in UPF intake] and negatively associated with carotenoids (α-carotene, β-carotene, γ-carotene, α-cryptoxanthin, β-cryptoxanthin, lutein, lycopene), vitamin A, Mo, and Se (βs: -2.1 to -18%). Inversely, high diet quality (i.e., the DQI) was positively associated with concentrations of carotenoids, vitamins [vitamin A (retinol) and D (25-OH-D)], and Se (β: 1.5 to 25%) and negatively associated with vitamin E (γ-tocopherol), creatinine, and Na (β: -4.8 to -8.3%). A weak, positive association was found between UPF and CRP (β: 5.4%, 95% CI 0.12-11%). Conclusion High UPF intake was associated with reduced concentrations of nutrition biomarkers in mid-pregnancy. Associations in the opposite direction were found with high adherence to the Norwegian dietary guidelines, suggesting that the two dietary scoring systems capture diet quality in a mirrored manner in this population.
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Affiliation(s)
- Pieta Tasnim Kelsey
- Division of Climate and Environmental Health, Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway,Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Eleni Papadopoulou
- Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Tiril Cecilie Borge
- Cluster for Reviews and Health Technology Assessments, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Cecilie Dahl
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anne Lise Brantsæter
- Division of Climate and Environmental Health, Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Iris Erlund
- Department of Government Services, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Helle Margrete Meltzer
- Division of Climate and Environmental Health, Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Line Småstuen Haug
- Division of Climate and Environmental Health, Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Ida Henriette Caspersen
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway,*Correspondence: Ida Henriette Caspersen,
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Gutiérrez-Villar B, Melero-Bolaños R, Montero-Simo MJ, Araque-Padilla RA. Profiling consumers with an environmentally sustainable and healthy diet: The case of Spanish households. Front Nutr 2022; 9:1035142. [PMID: 36438776 PMCID: PMC9684671 DOI: 10.3389/fnut.2022.1035142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/26/2022] [Indexed: 01/18/2023] Open
Abstract
Our diet has substantial implications not only for our health but also for the environment. However, the two dimensions are not comparable, even though consumers often associate them with their purchasing choices. Promoting more sustainable diets requires a better knowledge of household profiles considering the healthy and organically sustainable character of the food purchased. Previous studies have approached the analysis of consumer profiles separately, differentiating both dimensions without clear conclusion regarding the variables that make up these profiles. In this study, we looked for household profiles by cross-referencing the organic nature of the products consumed (environmental sustainability) with their degree of processing (healthfulness) in Spain. The results show that the most sustainable products are consumed in tiny municipalities (less than 2,000 inhabitants). In contrast, less sustainable products are consumed in high-income, single-family households or households with small children. The person responsible for the purchase is working or between 39 and 45 years old. In conclusion, our study shows that socio-demographic variables are statistically significant in identifying household profiles with sustainable diets.
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Ultra-processed food consumption and its association with nutritional, functional, and health characteristics in Brazilian elders. PAJAR - PAN AMERICAN JOURNAL OF AGING RESEARCH 2022. [DOI: 10.15448/2357-9641.2022.1.42968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aims: to estimate the dietary energy contribution of ultra-processed foods and the association on nutritional dietary profile, nutritional status, chronic disease, and functional capacity of Brazilian elders. Methods: we performed an epidemiology cross-sectional study conducted with 332 participants (≥60 years old). Food consumption was measured by three 24-h food recall. Foods were classified according to NOVA classification as in natura/minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. Anthropometric variables were used to assess nutritional status, and scales of activities of daily living to assess functional capacity. Chronic diseases were self-reported. Results: the average daily consumption of energy was 2433,96 kcal, being 10.44% from ultra-processed foods. Elders with higher ultra-processed foods intake showed higher consumption of energy, added sugar, total and saturated fat, and fewer consumption of proteins, fibres, potassium, magnesium, iron, zinc, copper, selenium, B6 vitamin e folate. Most participants were independent for functional capacity, overweight, and very high risk for cardiovascular disease, but no statistical significance was observed. No association was found between ultra-processed foods and nutritional dietary profile, nutritional status, chronic disease, and functional capacity. Conclusions: elders who had the highest ultra-processed foods consumption had lower diet quality, although no influences on nutritional status and health variables assessed were observed in this sample.
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Consumption Patterns of Processed Foods in Singapore-A Cross-Sectional Study. Foods 2022; 11:foods11182782. [PMID: 36140910 PMCID: PMC9498269 DOI: 10.3390/foods11182782] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/19/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
The consumption of processed foods is increasingly widespread and could have an impact on diet quality and health. Understanding the factors influencing people's eating habits is useful for assessing such impact. There are limited data on the consumption patterns of processed foods and associated factors influencing the dietary patterns in Singapore. This cross-sectional study based on a food frequency questionnaire aimed to examine how the consumption of processed foods among 2079 Singapore residents aged 18 to 89 years varies with sociodemographic factors. The analysis of the consumption by processed food groups showed that the studied factors, i.e., age, gender, ethnicity, housing and health status, all contributed to differences in processed food consumption to varying extents, with ethnicity being the key factor driving the variation. Such differences were also confirmed to a limited degree by determining another measure of consumption, i.e., a processed food variety score. The findings in this study could inform further work in relation to dietary risks.
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Godos J, Giampieri F, Al-Qahtani WH, Scazzina F, Bonaccio M, Grosso G. Ultra-Processed Food Consumption and Relation with Diet Quality and Mediterranean Diet in Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11360. [PMID: 36141629 PMCID: PMC9517140 DOI: 10.3390/ijerph191811360] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/29/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Ultra-processed food (UPF) consumption has been the focus of major attention due to their potential effects on human health. The aim of this study was to investigate the intake of UPFs in a sample of southern Italian individuals and assess its relationship with nutrient profile and dietary quality parameters. A cross-sectional study was conducted on 1936 individuals older than 18 years randomly selected from the general population. A total of 110 food times have been categorized based on the level of processing using the NOVA classification. The average daily energy intake of the sample was 2091.1 kcal, 38.7% of which were from the NOVA group of unprocessed/minimally processed foods, 5.7% from processed culinary ingredients, 38.3% from processed foods, and 17.9% from the UPFs group. UPFs were more consumed among young, unmarried individuals, with high cultural level, smokers, and often eating out of home. The mean energy share of UPFs varied from 6.3% of total daily energy intake for individuals in the lowest quintile of UPF consumption to 34.2% for those in the upper quintile. Within the UPF group, the highest energy contribution was provided by fast foods and sweets. Compared to the lowest quintile of UPF consumption, individuals in the highest quintile consumed, on average, additional 300 kcals per day and less fiber. Some plant-derived vitamins, such as vitamin A and vitamin C showed an inverse trend toward increasing shares of UPF consumption, while sodium intake increased. A significant higher intake of UPFs in individuals meeting the European and Italian dietary recommendations for carbohydrates, vitamin B12, vitamin D, and vitamin E was found, while UPFs were less consumed among those meeting the recommendations for total fats, fiber, sodium, potassium, and vitamin C. Finally, individuals displaying a "healthier" dietary profile, such as higher adherence to either the Mediterranean diet, the Dietary Approaches to Stop Hypertension, the Alternate Diet Quality Index, and the Diet Quality Index-International, consumed less UPFs and more unprocessed/minimally processed foods, with minor variation in the other NOVA food categories. In conclusion, consumption of UPF in southern Italy is in line with those reported in some other Mediterranean countries, although it negatively impacted the nutrient profile. It is important to monitor the consumption of UPFs before their availability and popularity put the grounds on younger generations' dietary habits.
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Affiliation(s)
- Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Francesca Giampieri
- Research Group on Food, Nutritional Biochemistry and Health, European University of the Atlantic, 39011 Santander, Spain
| | - Wahidah H. Al-Qahtani
- Department of Food Sciences & Nutrition, College of Food & Agriculture Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Francesca Scazzina
- Department of Food and Drug, University of Parma, Via Volturno 39, 43125 Parma, Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
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Reuzé A, Méjean C, Carrère M, Sirieix L, Druesne-Pecollo N, Péneau S, Touvier M, Hercberg S, Kesse-Guyot E, Allès B. Rebalancing meat and legume consumption: change-inducing food choice motives and associated individual characteristics in non-vegetarian adults. Int J Behav Nutr Phys Act 2022; 19:112. [PMID: 36050684 PMCID: PMC9438278 DOI: 10.1186/s12966-022-01317-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/13/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A shift toward more plant-based foods in diets is required to improve health and to reduce environmental impact. Little is known about food choice motives and associated characteristics of those individuals who have actually reduced their consumption of animal-based foods. The aim of this cross-sectional study was to identify change-inducing motives related to meat and legume consumptions among non-vegetarians. The association between change-inducing motives and individual characteristics was also studied. METHODS This study included 25,393 non-vegetarian participants in the French NutriNet-Santé cohort (77.4% women, mean age 55.4 ± 13.9 y.). The motives related to the declared change in meat and legume consumptions (e.g., taste, environment, social pressure) were assessed by an online questionnaire in 2018. For each motive, respondents could be classified into three groups: no motive; motive, not change-inducing; change-inducing motive. Associations between change-inducing motives and individual characteristics were evaluated using multivariable polytomic logistic regressions. Characteristics of participants who rebalanced their meat and legume consumptions were also compared to those who reduced their meat but did not increase their legume consumption. RESULTS Motives most strongly declared as having induced a change in meat or legume consumptions were health and nutrition (respectively 90.7 and 81.0% declared these motives as change-inducing for the meat reduction), physical environment (82.0% for meat reduction only) and taste preferences (77.7% for legume increase only). Other motives related to social influences, meat avoidance and meat dislike were reported by fewer individuals, but were declared as having induced changes in food consumption. Most motives that induced a meat reduction and a legume increase were more likely to be associated with specific individual characteristics, for example being a woman or highly educated for health motives. CONCLUSIONS Besides the motives reported as important, some motives less frequently felt important were declared as having induced changes in meat or legume consumptions. Change-inducing motives were reported by specific subpopulations. Public campaigns on health and sustainability could usefully develop new tools to reach populations less willing to change. TRIAL REGISTRATIONS The study was registered at ClinicalTrials.gov (NCT03335644).
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Affiliation(s)
- Anouk Reuzé
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.
- Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France.
| | - Caroline Méjean
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Myriam Carrère
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Lucie Sirieix
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Nathalie Druesne-Pecollo
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France
- Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Sandrine Péneau
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France
- Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Mathilde Touvier
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France
- Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Serge Hercberg
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France
- Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
- Department of Public Health, AP-HP Hôpital Avicenne, 93017, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France
- Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Benjamin Allès
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France
- Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
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Impact of Clarified Apple Juices with Different Processing Methods on Gut Microbiota and Metabolomics of Rats. Nutrients 2022; 14:nu14173488. [PMID: 36079746 PMCID: PMC9460580 DOI: 10.3390/nu14173488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
The consumption of processed foods has increased compared to that of fresh foods in recent years, especially due to the coronavirus disease 2019 pandemic. Here, we evaluated the health effects of clarified apple juices (CAJs, devoid of pectin and additives) processed to different degrees, including not-from-concentrate (NFC) and from-concentrate (FC) CAJs. A 56-day experiment including a juice-switch after 28 days was designed. An integrated analysis of 16S rRNA sequencing and untargeted metabolomics of cecal content were performed. In addition, differences in the CAJs tested with respect to nutritional indices and composition of small-molecule compounds were analyzed. The NFC CAJ, which showed a higher phenolic content resulting from the lower processing degree, could improve microbiota diversity and influence its structure. It also reduced bile acid and bilirubin contents, as well as inhibited the microbial metabolism of tryptophan in the gut. However, we found that these effects diminished with time by performing experiment extension and undertaking juice-switching. Our study provides evidence regarding the health effects of processed foods that can potentially be applied to public health policy decision making. We believe that NFC juices with a lower processing degree could potentially be healthier than FC juice.
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Campos-Nonato I, Cervantes-Armenta MA, Pacheco-Miranda S, Quezada-Sánchez AD, Contreras-Manzano A, Barquera S, Vargas-Meza J. Perception and Understanding of Guideline Daily Amount and Warning Labeling among Mexican Adults during the Law Modification Period. Nutrients 2022; 14:nu14163403. [PMID: 36014909 PMCID: PMC9415154 DOI: 10.3390/nu14163403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 12/05/2022] Open
Abstract
Front-of-pack labeling (FOPL) is a tool that enables consumers to compare foods and select healthier options. Due to low understanding of the Guideline Daily Amount (GDA) labeling among Mexicans, a law was implemented in October 2020 that modified the FOPL to a warning labeling (WL) system. The purpose of this study was to compare the perception and understanding of GDA and WL during the law modification period. We conducted a panel design with two measurements: (1) using GDA label (September 2020) and (2) using WL (October–November). We estimated differences in GDA vs. WL through multinomial logistic regression models and changes were measured through predictive margin contrasts and Wald tests. When comparing the same products with different labels, the participants reported that it would be unlikely/very unlikely that they would consume products packaged with the WL (81.5%; 95%CI: 79.2, 83.8) compared to those with GDA (24.2%; 95%CI: 21.7, 26.7). Consumers’ perception was that the quantities of packaged products they should consume was small or very small when they used the WL (93.8%; 95%CI: 92.4, 95.5) compared to GDA (41.6%; 95%CI: 39.7, 44.6). When comparing food groups, participants were more confident about choosing healthy products when using the WL compared to the GDA. During the implementation of WL in Mexico, the studied population had a better perception and understanding of less healthy packaged foods when using WL, compared to the GDA label.
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Affiliation(s)
- Ismael Campos-Nonato
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Manuel A. Cervantes-Armenta
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Selene Pacheco-Miranda
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Amado D. Quezada-Sánchez
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Alejandra Contreras-Manzano
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Jorge Vargas-Meza
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
- Correspondence:
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Estimation of Sodium Availability and Food Sources from 2018 to 2019 and Its Trends during the 2004-2019 Period in Costa Rica. Nutrients 2022; 14:nu14153200. [PMID: 35956376 PMCID: PMC9370525 DOI: 10.3390/nu14153200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 12/03/2022] Open
Abstract
Sodium availability and food sources in 2018−2019 were estimated and trends analyzed for 15 years (2004−2019) in Costa Rica. Food purchase records from the National Household Income and Expenditure Survey (ENIGH) 2018−2019 were converted to energy and sodium using food composition tables measuring “apparent consumption”. Foods were classified by sodium content. ENIGH is a probabilistic, stratified, two-stage and replicated national survey, carried out regularly by the national statistics institution. Results from the 2004−2005 and 2012−2013 ENIGHs came from previous analysis. Differences between periods were determined through descriptive and inferential statistics. The available sodium adjusted to 2000 kcal/person/day was 3.40, 3.86, and 3.84 g/person/day (g/p/d) for periods 2004−2005, 2013−2014, and 2018−2019, respectively. In this last period, this was 3.94 urban and 3.60 g/p/d rural (p < 0.05), with a non-linear increase with income. During 2004−2019 sodium from salt and salt-based condiments increased from 69.5 to 75.5%; the contribution of common salt increased, from 60.2 to 64.8% and condiments without added salt from 9.3 to 10.7%. From 2012−2013 to 2018−2019, processed and ultra-processed foods with added sodium intake increased from 14.2 to 16.9% and decreased in prepared meals (7.2 to 2.8%). Costa Rica has been successful in reducing salt/sodium available for consumption; after a 12% increase of salt consumption between 2004−2005 and 2012−2013, to a level almost twice as high as recommended, it has stabilized in the last period.
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Puig-Vallverdú J, Romaguera D, Fernández-Barrés S, Gignac F, Ibarluzea J, Santa-Maria L, Llop S, Gonzalez S, Vioque J, Riaño-Galán I, Fernández-Tardón G, Pinar A, Turner MC, Arija V, Salas-Savadó J, Vrijheid M, Julvez J. The association between maternal ultra-processed food consumption during pregnancy and child neuropsychological development: A population-based birth cohort study. Clin Nutr 2022; 41:2275-2283. [PMID: 36087519 DOI: 10.1016/j.clnu.2022.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/03/2022]
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De Siena M, Raoul P, Costantini L, Scarpellini E, Cintoni M, Gasbarrini A, Rinninella E, Mele MC. Food Emulsifiers and Metabolic Syndrome: The Role of the Gut Microbiota. Foods 2022; 11:2205. [PMID: 35892789 PMCID: PMC9331555 DOI: 10.3390/foods11152205] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 12/04/2022] Open
Abstract
The use of emulsifiers in processed foods and the rapid epidemic development of metabolic syndrome in Western countries over the past 20 years have generated growing interest. Evidence for the role of emulsifiers in metabolic syndrome through gut microbiota has not been clearly established, thus making it challenging for clinical nutritionists and dietitians to make evidence-based associations between the nature and the quantity of emulsifiers and metabolic disorders. This narrative review summarizes the highest quality clinical evidence currently available about the impact of food emulsifiers on gut microbiota composition and functions and the potential development of metabolic syndrome. The state-of-the-art of the different common emulsifiers is performed, highlighting where they are present in daily foods and their roles. Recent findings of in vitro, in vivo, and human studies assessing the effect of different emulsifiers on gut microbiota have been recently published. There is some progress in understanding how some food emulsifiers could contribute to developing metabolic diseases through gut microbiota alterations while others could have prebiotic effects. However, there are still many unanswered questions regarding daily consumption amounts and the synergic effects between emulsifiers' intake and responses by the microbial signatures of each individual.
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Affiliation(s)
- Martina De Siena
- UOC di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.D.S.); (A.G.)
| | - Pauline Raoul
- UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.R.); (M.C.); (M.C.M.)
| | - Lara Costantini
- Department of Ecological and Biological Sciences (DEB), Tuscia University, 01100 Viterbo, Italy;
| | - Emidio Scarpellini
- Nutrition and Internal Medicine Unit, “Madonna del Soccorso” General Hospital, 63074 San Benedetto del Tronto, Italy;
- T.A.R.G.I.D., Gasthuisberg University Hospital, KU Leuven, Herestraat 49, 3000 Lueven, Belgium
| | - Marco Cintoni
- UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.R.); (M.C.); (M.C.M.)
| | - Antonio Gasbarrini
- UOC di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.D.S.); (A.G.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - Emanuele Rinninella
- UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.R.); (M.C.); (M.C.M.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - Maria Cristina Mele
- UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.R.); (M.C.); (M.C.M.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
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Menezes-Júnior LAAD, Andrade ACDS, Coletro HN, Mendonça RDD, Menezes MCD, Machado-Coelho GLL, Meireles AL. Food consumption according to the level of processing and sleep quality during the COVID-19 pandemic. Clin Nutr ESPEN 2022; 49:348-356. [PMID: 35623836 PMCID: PMC8942582 DOI: 10.1016/j.clnesp.2022.03.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Consumption of ultra-processed foods is negatively associated with health outcomes, however, the contribution to sleep quality is limited. Therefore, the objective of this study was to evaluate the association between food intake by frequency and degree of processing and sleep quality in adults during the covid-19 pandemic. METHODS Population-based survey of adults from October to December 2020 in the Iron Quadrangle region, Brazil. The exposure variable was a food intake score that considered the frequency of consumption and food processing degree. The total score ranged from 0 (best) to 48 points (worst food quality), categorized into quartiles. Furthermore, we also evaluated whether individuals replaced their lunch and/or dinner based mostly on fresh/minimally processed foods for ultra-processed foods, for five or more days in the week. The outcome variable was sleep quality assessed with the Pittsburgh Sleep Quality Index. We constructed a contrasting directed acyclic graph (DAG) model to estimate the adjusted odds ratio of the association between score eating and sleep, by logistic regression. RESULTS Most of the 1762 individuals evaluated had poor sleep quality (52.5%). The minimum and maximum food scores were 0 and 30 points (mean 9.16; 95% CI 8.50, 9.81). The higher values of the score corresponded to lower consumption of fresh and minimally processed foods and higher consumption of ultraprocessed foods. In multivariate analysis, individuals in the third food consumption score had 71% greater odds of poor sleep quality (OR = 1.71; 95% CI: 1.03, 2.85) and in the fourth quartile 144% greater odds (OR = 2.44; 95% CI: 1.32, 2.44). Besides, replacing the dinner meal with ultra-processed foods five days or more in the week was also associated with poor sleep quality (OR = 2.01; 95%CI: 1.14, 3.57). CONCLUSION Higher consumption of ultra-processed foods concomitant with lower consumption of fresh and minimally processed foods is associated with a higher chance of poor sleep quality.
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Affiliation(s)
- Luiz Antônio Alves de Menezes-Júnior
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil.
| | | | - Hillary Nascimento Coletro
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil.
| | - Raquel de Deus Mendonça
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil; Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
| | - Mariana Carvalho de Menezes
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil; Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
| | - George Luiz Lins Machado-Coelho
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; School of Medicine, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
| | - Adriana Lúcia Meireles
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil; Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
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Nutrition and Health Claims: Consumer Use and Evolving Regulation. Curr Nutr Rep 2022; 11:431-436. [PMID: 35606620 PMCID: PMC9381452 DOI: 10.1007/s13668-022-00422-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/01/2022]
Abstract
Abstract
Purpose of Review
The value of nutrition and health claims (N&HC) depends on how consumers use them and the regulatory framework that enables them. This paper aims to explore the impact of claims on consumer behaviour and identify evolving regulatory challenges, using the Australian experience as a reference point.
Recent Findings
N&HC can influence consumer food purchasing and consumption, but how consumers interpret and act on specific claims is less well understood, and regulatory frameworks are evolving. In the last 10 years, changes to the Australian regulatory framework have exposed greater opportunities for promoting foods, albeit with challenges regarding self-substantiation of claims.
Summary
N&HC can play a significant role in driving consumer choices towards a healthier food supply. The Australian experience demonstrates how N&HC can continue to evolve, reflecting developments in methodologies and a fundamental appreciation of the relationship between food and health.
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Physical Activity and Food Environments in and around Schools: A Case Study in Regional North-West Tasmania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106238. [PMID: 35627775 PMCID: PMC9140536 DOI: 10.3390/ijerph19106238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 02/04/2023]
Abstract
A better understanding of the physical activity (PA) infrastructure in schools, the walkability of neighborhoods close to schools, and the food environments around schools, particularly in rural, socioeconomically challenged areas such as the North-West (NW) of Tasmania, could be important in the wider effort to improve the health of school-age children. Accordingly, this research aimed to assess PA resources, walkability, and food environments in and around schools in three socioeconomically disadvantaged, regional/rural Local Government Areas (LGAs) of Tasmania, Australia. A census of schools (including assessment of the PA infrastructure quality within school grounds), a walkability assessment, and a census of food outlets surrounding schools (through geospatial mapping) were executed. Most of the schools in the study region had access to an oval, basketball/volleyball/netball court, and free-standing exercise equipment. In all instances (i.e., regardless of school type), the quality of the available infrastructure was substantially higher than the number of incivilities observed. Most schools also had good (i.e., within the first four deciles) walkability. Numerous food outlets were within the walking zones of all schools in the study region, with an abundance of food outlets that predominantly sold processed unhealthy food.
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Wang T, Zeng M, Xie C, Zhu Y, Shi Z, Sharma M, Zhao Y. Development of Nutrition Literacy Scale for Middle School Students in Chongqing, China: A Cross-Sectional Study. Front Nutr 2022; 9:888137. [PMID: 35669068 PMCID: PMC9165640 DOI: 10.3389/fnut.2022.888137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background Information on nutrition literacy of middle schoolers is limited and tools for measuring nutrition literacy of middle schoolers are inadequate. Nutrition literacy has a positive effect on health. Improving children's nutrition literacy can help them to master the necessary nutritional knowledge, develop a healthy lifestyle, and learn to supplement nutrition according to their own needs for healthy growth. Objectives To develop the Chongqing Middle school student Nutrition Literacy Scale (CM-NLS). Methods Three experiments were conducted. A theoretical framework and an initial item pool of CM-NLS were established based on the literature review. And the two-round Delphi method was used to explore the suitable acceptance indicators and items. Item evaluation and reduction were performed using the classical test theory. Then, the items in the final CM-NLS were tested for their validity and reliability amongst 462 middle school students. The construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The internal consistency reliability and split-half reliability were evaluated using Cronbach's alpha coefficients. Results The final CM-NLS consisting of 52 items that were based on three primary items (functional, interactive and critical) and six sub-items (obtain, understand, apply, interact, medial literacy and critical skill) was developed and validated. EFA suggested six factors explaining 69.44% of the total variance (Kaiser-Meyer-Olkin test = 0.916, Bartlett's test χ2 = 5,854.037, P < 0.001). CFA showed that the model fit the data adequately, with χ2/df = 1.911, root mean square error of approximation = 0.063, goodness-of-fit index = 0.822 and adjusted goodness of fit index = 0.790. The total CM-NLS Cronbach's alpha values of internal consistency and split-half reliability were 0.849 and 0.521, respectively, with reasonable reliability. Conclusions CM-NLS is a valid and reliable instrument for assessing nutrition literacy among middle school students in Chongqing. Specifically, it could be used by practitioners for needs assessment before the implementation of a nutrition education program.
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Affiliation(s)
- Tiankun Wang
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Mao Zeng
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Changxiao Xie
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Yuzhao Zhu
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Manoj Sharma
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV, United States
| | - Yong Zhao
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, Chongqing, China
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Vellinga RE, van Bakel M, Biesbroek S, Toxopeus IB, de Valk E, Hollander A, van 't Veer P, Temme EHM. Evaluation of foods, drinks and diets in the Netherlands according to the degree of processing for nutritional quality, environmental impact and food costs. BMC Public Health 2022; 22:877. [PMID: 35501799 PMCID: PMC9063197 DOI: 10.1186/s12889-022-13282-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 04/18/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study investigates nutritional quality, environmental impact and costs of foods and drinks and their consumption in daily diets according to the degree of processing across the Dutch population. DESIGN The NOVA classification was used to classify the degree of processing (ultra-processed foods (UPF) and ultra-processed drinks (UPD)). Food consumption data were derived from the Dutch National Food Consumption Survey 2012-2016. Indicators assessed were nutritional quality (saturated fatty acids (SFA), sodium, mono and disaccharides (sugar), fibre and protein), environmental impact (greenhouse gas (GHG) emissions and blue water use) and food costs. SETTING The Netherlands. PARTICIPANTS Four thousand three hundred thirteen Dutch participants aged 1 to 79 years. RESULTS Per 100 g, UPF were more energy-dense and less healthy than unprocessed or minimally processed foods (MPF); UPF were associated with higher GHG emissions and lower blue water use, and were cheaper. The energy and sugar content of UPD were similar to those of unprocessed or minimally processed drinks (MPD); associated with similar GHG emissions but blue water use was less, and they were also more expensive. In the average Dutch diet, per 2000 kcal, ultra-processed foods and drinks (UPFD) covered 29% (456 g UPF and 437 g UPD) of daily consumption and 61% of energy intake. UPFD consumption was higher among children than adults, especially for UPD. UPFD consumption determined 45% of GHG emissions, 23% of blue water use and 39% of expenses for daily food consumption. UPFD consumption contributed 54% to 72% to daily sodium, sugar and SFA intake. CONCLUSIONS Compared with unprocessed or minimally processed foods and drinks, UPF and UPD were found to be less healthy considering their high energy, SFA, sugar and sodium content. However, UPF were associated higher GHG emissions and with less blue water use and food costs. Therefore daily blue water use and food costs might increase if UPF are replaced by those unprocessed or minimally processed. As nutritional quality, environmental impacts and food costs relate differently to the NOVA classification, the classification is not directly applicable to identify win-win-wins of nutritional quality, environmental impact and costs of diets.
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Affiliation(s)
- Reina E Vellinga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands.
| | - Marieke van Bakel
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands
| | - Sander Biesbroek
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, The Netherlands
| | - Ido B Toxopeus
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands
| | - Elias de Valk
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands
| | - Anne Hollander
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands
| | - Pieter van 't Veer
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, The Netherlands
| | - Elisabeth H M Temme
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands
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Mottl AK, Alicic R, Argyropoulos C, Brosius FC, Mauer M, Molitch M, Nelson RG, Perreault L, Nicholas SB. KDOQI US Commentary on the KDIGO 2020 Clinical Practice Guideline for Diabetes Management in CKD. Am J Kidney Dis 2022; 79:457-479. [PMID: 35144840 PMCID: PMC9740752 DOI: 10.1053/j.ajkd.2021.09.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/14/2022]
Abstract
In October 2020, KDIGO (Kidney Disease: Improving Global Outcomes) published its first clinical practice guideline directed specifically to the care of patients with diabetes and chronic kidney disease (CKD). This commentary presents the views of the KDOQI (Kidney Disease Outcomes Quality Initiative) work group for diabetes in CKD, convened by the National Kidney Foundation to provide an independent expert perspective on the new guideline. The KDOQI work group believes that the KDIGO guideline takes a major step forward in clarifying glycemic targets and use of specific antihyperglycemic agents in diabetes and CKD. The purpose of this commentary is to carry forward the conversation regarding optimization of care for patients with diabetes and CKD. Recent developments for prevention of CKD progression and cardiovascular events in people with diabetes and CKD, particularly related to sodium/glucose cotransporter 2 (SGLT2) inhibitors, have filled a longstanding gap in nephrology's approach to the care of persons with diabetes and CKD. The multifaceted benefits of SGLT2 inhibitors have facilitated interactions between nephrology, cardiology, endocrinology, and primary care, underscoring the need for innovative approaches to multidisciplinary care in these patients. We now have more interventions to slow kidney disease progression and prevent or delay kidney failure in patients with diabetes and kidney disease, but methods to streamline their implementation and overcome barriers in access to care, particularly cost, are essential to ensuring all patients may benefit.
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Aceves-Martins M, Bates RL, Craig LCA, Chalmers N, Horgan G, Boskamp B, de Roos B. Nutritional Quality, Environmental Impact and Cost of Ultra-Processed Foods: A UK Food-Based Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3191. [PMID: 35328877 PMCID: PMC8948822 DOI: 10.3390/ijerph19063191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022]
Abstract
Food-based analyses of the healthiness, environmental sustainability and affordability of processed and ultra-processed foods are lacking. This paper aimed to determine how ultra-processed and processed foods compare to fresh and minimally processed foods in relation to nutritional quality, greenhouse gas emissions and cost on the food and food group level. Data from the National Diet and Nutrition Survey nutrient databank year 11 (2018/2019) were used for this analysis. Median and bootstrapped medians of nutritional quality (NRF8.3 index), greenhouse gas emissions (gCO2-equivalents) and cost (in GBP) were compared across processing categories. An optimal score based on the medians was created to identify the most nutritional, sustainable, and affordable options across processing categories. On a per 100 kcal basis, ultra-processed and processed foods had a lower nutritional quality, lower greenhouse gas emissions, and were cheaper than minimally processed foods, regardless of their total fat, salt and/or sugar content. The most nutritious, environmentally friendly, and affordable foods were generally lower in total fat, salt, and sugar, irrespective of processing level. The high variability in greenhouse gas emissions and cost across food groups and processing levels offer opportunities for food swaps representing the healthiest, greenest, and most affordable options.
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Affiliation(s)
- Magaly Aceves-Martins
- The Rowett Institute, University of Aberdeen, Aberdeen AB25 2ZD, UK; (R.L.B.); (N.C.); (B.d.R.)
| | - Ruth L. Bates
- The Rowett Institute, University of Aberdeen, Aberdeen AB25 2ZD, UK; (R.L.B.); (N.C.); (B.d.R.)
| | - Leone C. A. Craig
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK;
| | - Neil Chalmers
- The Rowett Institute, University of Aberdeen, Aberdeen AB25 2ZD, UK; (R.L.B.); (N.C.); (B.d.R.)
| | - Graham Horgan
- Biomathematics & Statistics Scotland, Aberdeen AB25 2ZD, UK;
| | - Bram Boskamp
- Biomathematics & Statistics Scotland, The King’s Buildings, Edinburgh EH9 3FD, UK;
| | - Baukje de Roos
- The Rowett Institute, University of Aberdeen, Aberdeen AB25 2ZD, UK; (R.L.B.); (N.C.); (B.d.R.)
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Dunford EK, Popkin B, Ng SW. Junk Food Intake Among Adults in the United States. J Nutr 2022; 152:492-500. [PMID: 34224563 PMCID: PMC8826924 DOI: 10.1093/jn/nxab205] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/14/2021] [Accepted: 06/03/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND There is no consensus on how to define "junk food." In 2016, Chile implemented the most comprehensive set of obesity-preventive regulations in the world, including criteria to define unhealthy foods. OBJECTIVES The objective of this study was to examine the amount of energy, sodium, sugar, and saturated fat consumed by US adults defined as junk food using the Chilean criteria. METHODS We used 2 nationally representative surveys of food intake in 10,001 US adults: NHANES 2015-2016 and NHANES 2017-2018. The main outcome measures were the contributions of energy, total sugars, saturated fat, and sodium deriving from junk food sources. Mean intake and proportion of energy, sugar, saturated fat, and sodium for junk food overall and each food category were calculated. RESULTS Overall, 47% of energy, 75% of total sugar, 46% of sodium, and 48% of saturated fat consumed by US adults derived from junk food sources. Sugar-sweetened beverages (SSBs) were responsible for more than 40% of total sugar intake deriving from junk foods. Non-Hispanic black adults had the highest mean energy, total sugar, and sodium intake deriving from junk foods, with non-Hispanic white adults having the highest saturated fat intake. Non-Hispanic black adults had the highest intake of total sugar deriving from junk food sources of SSBs (26.7 g/d), with SSBs representing >40% of total sugar intake deriving from junk food sources for all race/ethnic groups. CONCLUSIONS Foods that meet the Chilean criteria for junk food provide approximately half or more daily energy and food components to limit in the diet of US adults, with important differences observed between race/ethnic groups. Policy efforts to reduce junk food intake, particularly the intake of SSBs, must be expanded to improve the cardiometabolic health equitably in the United States.
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Affiliation(s)
- Elizabeth K Dunford
- Food Policy Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Barry Popkin
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shu Wen Ng
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Application of a Platform for Gluten-Free Diet Evaluation and Dietary Advice: From Theory to Practice. SENSORS 2022; 22:s22030732. [PMID: 35161479 PMCID: PMC8838721 DOI: 10.3390/s22030732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 11/21/2022]
Abstract
The present work aimed to analyze, through the GlutenFreeDiet digital platform, the evolution over one year of the nutritional status, dietary profile and symptoms present among celiac people on a gluten-free diet (GFD) while receiving individualized dietary advice. Twenty-seven adults and thirty-one celiac children/adolescents participated in the study. This was then followed up by three visits, at diagnosis, and after 3 and 12 months (vt0, vt3 and vt12). Participants filled out dietary and gastrointestinal symptoms questionnaires. All patients received written personalized dietary advice from dietitians who interpreted data from the platform. Results obtained indicated that participants consumed proteins and lipids in excess and carbohydrates in defect. Low intakes of cereals, fruit and vegetables and high meat intakes were observed. However, gluten-free product (GFP) consumption and that of ultra-processed foods was reduced after 1 year in adults. Symptoms decreased after vt3 but recurred in vt12. Changes in ultra-processed foods and GFP intake, but lack of changes in the rest of the parameters suggested that the platform support was not effective enough. Even though the platform represents a useful tool for monitoring celiac patients and giving dietary advice, modules that require more continuous attention and nutritional education of patients should be provided for interventions to be more effective.
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Evaluating intake levels of nutrients linked to non-communicable diseases in Australia using the novel combination of food processing and nutrient profiling metrics of the PAHO Nutrient Profile Model. Eur J Nutr 2022; 61:1801-1812. [PMID: 35034166 DOI: 10.1007/s00394-021-02740-8] [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] [Received: 05/16/2021] [Accepted: 11/11/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE To investigate intake levels of nutrients linked to non-communicable diseases in Australia using the novel combination of food processing and nutrient profiling metrics of the PAHO Nutrient Profile Model. METHODS Dietary intakes of 12,153 participants from the Australian Health Survey (2011-12) aged 2 + years were evaluated. Food items reported during a 24 h recall were classified using the NOVA system. The Pan-American Health Organization Nutrient Profile Model (PAHO NPM) was applied to identify processed and ultra-processed products with excessive content of critical nutrients. Differences in mean intakes and prevalence of excessive intakes of critical nutrients for groups of the population whose diets were made up of products with and without excessive content in critical nutrients were examined. RESULTS The majority of Australians consumed daily at least three processed and ultra-processed products identified as excessive in critical nutrients according to the PAHO NPM. Individuals consuming these products had higher intakes of free sugars (β = 8.9), total fats (β = 11.0), saturated fats (β = 4.6), trans fats (β = 0.2), and sodium (β = 1788 for adolescents and adults; β = 1769 for children 5-10 years; β = 1319 for children aged < 5 years) (p ≤ 0.001 for all nutrients) than individuals not consuming these foods. The prevalence of excessive intake of all critical nutrients also followed the same trend. CONCLUSION The PAHO NPM has shown to be a relevant tool to predict intake levels of nutrients linked to non-communicable diseases in Australia and, therefore, could be used to inform policy actions aimed at increasing the healthiness of food environments.
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Valizadeh P, Popkin BM, Ng SW. Linking a sugar-sweetened beverage tax with fruit and vegetable subsidies: A simulation analysis of the impact on the poor. Am J Clin Nutr 2022; 115:244-255. [PMID: 34610088 PMCID: PMC8755035 DOI: 10.1093/ajcn/nqab330] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/27/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND US individuals, particularly from low-income subpopulations, have very poor diet quality. Policies encouraging shifts from consuming unhealthy food towards healthy food consumption are needed. OBJECTIVES We simulate the differential impacts of a national sugar-sweetened beverage (SSB) tax and combinations of SSB taxes with fruit and vegetable (FV) subsidies targeted to low-income households on SSB and FV purchases of lower and higher SSB purchasers. METHODS We considered a 1-cent-per-ounce SSB tax and 2 FV subsidy rates of 30% and 50% and used longitudinal grocery purchase data for 79,044 urban/semiurban US households from 2010-2014 Nielsen Homescan data. We used demand elasticities for lower and higher SSB purchasers, estimated via longitudinal quantile regression, to simulate policies' differential effects. RESULTS Higher-SSB-purchasing households made larger reductions (per adult equivalent) in SSB purchases than lower SSB purchasers due to the tax (e.g., 4.4 oz/day at SSB purchase percentile 90 compared with 0.5 oz/day at percentile 25; P < 0.05). Our analyses by household income indicated low-income households would make larger reductions than higher-income households at all SSB purchase levels. Targeted FV subsidies induced similar, but nutritionally insignificant, increases in FV purchases of low-income households, regardless of their SSB purchase levels. Subsidies, however, were effective in mitigating the tax burdens. All low-income households experienced a net financial gain when the tax was combined with a 50% FV subsidy, but net gains were smaller among higher SSB purchasers. Further, low-income households with children gained smaller net financial benefits than households without children and incurred net financial losses under a 30% subsidy rate. CONCLUSIONS SSB taxes can effectively reduce SSB consumption. FV subsidies would increase FV purchases, but nutritionally meaningful increases are limited due to low purchase levels before policy implementation. Expanding taxes beyond SSBs, providing larger FV subsidies, or offering subsidies beyond FVs, particularly for low-income households with children, may be more effective.
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Affiliation(s)
- Pourya Valizadeh
- Agricultural & Food Policy Center, Department of Agricultural Economics, Texas A&M University, College Station, TX, USA
- Department of Agricultural Economics, Texas A&M University, College Station, TX, USA
| | - Barry M Popkin
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shu Wen Ng
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Byker Shanks C, Vanderwood K, Grocke M, Johnson N, Larison L, Wytcherley B, Yaroch AL. The UnProcessed Pantry Project (UP3): A Community-Based Intervention Aimed to Reduce Ultra-Processed Food Intake Among Food Pantry Clients. FAMILY & COMMUNITY HEALTH 2022; 45:23-33. [PMID: 34783688 PMCID: PMC8604383 DOI: 10.1097/fch.0000000000000310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Low-income populations are more likely to experience food and nutrition insecurity and suffer a greater burden of noncommunicable disease than the general population. The UnProcessed Pantry Project (UP3) is an intervention aimed to reduce ultra-processed food availability and consumption of food pantry clients accessing the emergency food system. The pilot study included nutrition education, food boxes, and social support for 16 weeks at 2 food pantries. Data collection included the ASA24 dietary recall to calculate Healthy Eating Index-2015 (HEI-2015) scores, biomarkers (hemoglobin A1c, total cholesterol, blood pressure, waist circumference, body mass index [BMI]), and a demographic and psychosocial survey. Dietary quality among 43 participants significantly (P < .05) improved as measured by the HEI-2015 for total HEI-2015, whole grains, total protein foods, and added sugars scores. BMI, total cholesterol, and waist circumference also significantly improved across study participants. Findings indicate that the emergency food system may be an effective access point to apply frameworks including UP3 to address ultra-processed food consumption, dietary quality, and noncommunicable chronic disease risk among food-insecure populations. Programs and policies that limit the amount of ultra-processed food in the emergency food system should be further tested and could be efficacious in addressing inequities among vulnerable populations.
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Affiliation(s)
- Carmen Byker Shanks
- Department of Health and Human Development, Montana State University, Bozeman, Montana (Drs Byker Shanks and Grocke, Mr Johnson, and Mss Larison and Wytcherley); Gretchen Swanson Center for Nutrition, Omaha, Nebraska (Drs Byker Shanks and Yarock); and Gallatin County Health Department, Bozeman, Montana (Dr Vanderwood)
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RODRÍGUEZ ALBERTHOMIER, AMARILLA NJDUARTE, RODRÍGUEZ MMTRINIDAD, MARTÍNEZ BENÚÑEZ, MEZA-MIRANDA ER. Processed and ultra-processed foods consumption in adults and its relationship with quality of life and quality of sleep. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e220173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ABSTRACT Objective: To evaluate the consumption of processed and ultra-processed foods in Paraguayan adults and its relationship with quality of life and sleep quality. Methods: A cross-sectional descriptive observational study was carried out on Paraguayan adults in May 2022. An online survey was applied in which sociodemographic data, frequency of food consumption using the NOVA classification and Pan American Health Organization criteria, quality of life evaluated by the European Quality of Life-5 Dimensions and report of hours of sleep were collected. Results: A total of 273 Paraguayan adults were included in the study, of which 71.1% were female, 51.6% lived in the capital, 53.1% were single, 66% had a university educational level and the average age was 36.48±13.2. Regarding the consumption of processed and ultra-processed foods, the critical nutrients most consumed daily were free sugars by 34.0%, and fats by 23.4% of the population. The global quality of life index was low (0,58±0,05) and 69.0% reported insufficient hours of sleep. Statistically significant relationships were found between the consumption of processed and ultra-processed foods with quality of life and quality of sleep (p<0.05 for both). Conclusion: The most consumed critical nutrients in the Paraguayan adult population are free sugars and fats, finding a significant relationship between the consumption of processed and ultra-processed foods with quality of life and quality of sleep.
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Colchero MA, Paraje G, Popkin BM. The impacts on food purchases and tax revenues of a tax based on Chile's nutrient profiling model. PLoS One 2021; 16:e0260693. [PMID: 34855853 PMCID: PMC8638973 DOI: 10.1371/journal.pone.0260693] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 11/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In June 2016, Chile implemented the Law of Food Labelling and Advertising, which included a mandatory front-of-pack warning labels on food and beverages high in added sugar, saturated fat, sodium or energy density, restrictions on child-directed marketing and on the promotion and sales of these products in schools. The regulation does not include taxes although Chile had implemented a tiered tax on SSBs two years before this law was implemented. Therefore, the objective of the study was to simulate the impact of taxing food and beverages based on the cutoff's points for warning labels on purchases and revenues. METHODS We derived price elasticities using the linear approximation of the almost ideal demand system for six groups of labeled food and beverages (with a warning label based on the regulation) and unlabeled (with no warning label): 1) unlabeled beverages, 2) labeled beverages, 3) unlabeled cereal based products, 4) labeled cereal based products, 5) labeled meat and fish and 6) labeled sweet snacks and desserts. The study used data on household food beverage purchases from the Kantar WorldPanel Chile and Euromonitor sales to adjust the Kantar elasticity results to the national average. We estimated revenues under three tax scenarios for all labeled food and beverages: 10%, 20%, 30% of the final price excluding taxes. RESULTS Except for labeled fish and meat, all food and beverage groups were price elastic. After accounting for a reduction in consumption after the taxes, economic and population growth, revenues for all groups could reach between 457 million USD to 1.3 billion USD. These results based on the much larger tax base of these labeled "high in added sugar, salt or saturated fat or energy density" foods and beverages is much larger. CONCLUSION This fiscal package could be implemented in countries with warning labels to enhance health and welfare. The Chilean warning label front-of-the-package system provides an important guide for countries considering policies to reduce diet-related non communicable diseases, including obesity. The fiscal policy impact alone, as shown here for Chile, will be highly impactful in reducing ultra-processed food intake and generating revenues.
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Affiliation(s)
| | - Guillermo Paraje
- Escuela de Negocios, Universidad Adolfo Ibáñez, Peñalolén, Chile
| | - Barry M. Popkin
- Department of Nutrition and Carolina Population Center, The University of North Carolina at Chapel Hill, North Carolina, United States of America
- * E-mail:
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de Araújo CRB, Ribeiro KDDS, de Oliveira AF, de Morais IL, Breda J, Padrão P, Moreira P. Degree of processing and nutritional value of children's food products. Public Health Nutr 2021; 24:5977-5984. [PMID: 34494515 PMCID: PMC11096954 DOI: 10.1017/s1368980021003876] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/18/2021] [Accepted: 09/03/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to characterise the availability, the nutritional composition and the processing degree of industrial foods for 0-36-month-old children according to the neighbourhoods affluence. DESIGN A cross-sectional exploratory study. SETTING All food products available in retail stores for children aged 0-36 months were analysed. Data collection took place in two neighbourhoods, comparing two different sociodemographic districts (high v. low per capita income), Campanhã and Foz do Douro in Porto, Portugal. PARTICIPANTS A total of 431 commercially processed food products for children aged 0-36 months which are sold in 23 retail stores were identified. Food products were classified according to their processing degree using the NOVA Food Classification System. RESULTS For NOVA analysis, of the 244 food products that were included 82 (33·6 %) were minimally processed, 25 (10·2 %) processed and 137 (56·1 %) ultra processed. No food product was classified as a culinary ingredient. The products included mostly cereals, yogurts, prevailed in high-income neighbourhoods for the 0-6-month-old group. It was observed that some categories of ultra-processed food (UPF) presented higher amounts of energy, sugars, saturated fat and salt than unprocessed/minimally processed products. CONCLUSIONS The high availability of UPF offered for 0-36-month-old children should be considered when designing interventions to promote a healthy diet in infancy.
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Affiliation(s)
- Célia Regina Barbosa de Araújo
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- Departmento de Nutritição, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, 59.078-970, Natal, RN, Brazil
| | - Karla Danielly da S Ribeiro
- Departmento de Nutritição, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, 59.078-970, Natal, RN, Brazil
| | - Amanda Freitas de Oliveira
- Departmento de Nutritição, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, 59.078-970, Natal, RN, Brazil
| | | | - João Breda
- Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Centro de Investigação em Actividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
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da Silva DCG, Fiates GMR, Botelho AM, Vieira FGK, Medeiros KJ, Willecke RG, Longo GZ. Food consumption according to degree of food processing, behavioral variables, and sociodemographic factors: Findings from a population-based study in Brazil. Nutrition 2021; 93:111505. [PMID: 34763312 DOI: 10.1016/j.nut.2021.111505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/13/2021] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to investigate the consumption levels of foods at different degrees of processing and their associations with sociodemographic and behavioral characteristics of Brazilian adults. METHODS This is a cross-sectional, population-based study involving 976 adult individuals (ages 20 to 59 y) of both sexes, living in the municipality of Viçosa, Minas Gerais State, Brazil. Participants were selected using a probabilistic sampling technique. Consumed foods were categorized into four groups: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultraprocessed foods. Associations were tested using linear regression. RESULTS Unprocessed and minimally processed foods accounted for 61.3% of the total energy intake and were positively associated with age and negatively associated with level of education (β = -6.86; 95% confidence interval [CI] [-10.16 to -3.57]) and sedentary behavior (β = 3.24; 95% CI [-5.88 to -0.61]). Ultraprocessed foods accounted for 23.6% of the total energy intake, and consumption was negatively associated with age and positively associated with sedentary behavior (β = 0.005; 95% CI [0.00008-0.01]) and tertiary education (β = 5.42; 95% CI [2.71-8.13]). CONCLUSIONS Ultraprocessed foods contribute more to the daily energy intake of younger individuals, and ultraprocessed food consumption is positively associated with sedentary activity and level of education.
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