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Wang M, Wang L, Yang M, Zhang X, Fan X. Associations of dietary patterns and perceived stress with memory deficits in patients with heart failure. J Health Psychol 2024; 29:963-975. [PMID: 38230537 DOI: 10.1177/13591053231221064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
This study aimed to examine the relationships between dietary patterns and perceived stress with memory deficits in 291 patients with heart failure aged 45-85 years. A total of 142 (48.8%) patients reported memory deficit. Three dietary patterns were identified by K-means clustering: nut-fruit-dairy, meat-processed, and traditional (high intake of cereals) diets. Compared to the traditional diet, the nut-fruit-dairy diet and meat-processed diet were associated with lower levels of deficits in short-term memory, delayed memory, and overall memory. What's more, perceived stress was positively associated with deficits in short-term memory and overall memory, but the association was only found in patients adhering to the traditional diet using stratified analyses. Our findings suggest that adhering to a healthy diet may be conducive to improving deficits in short-term memory, delayed memory, and overall memory, while also buffering the adverse association between perceived stress and deficits in short-term memory and overall memory.
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Affiliation(s)
| | - Lyu Wang
- The Chinese University of Hong Kong, P.R. China
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Fu J, Deng Y, Ma Y, Man S, Yang X, Yu C, Lv J, Liu H, Wang B, Li L. Adherence to a Healthy Diet and Risk of Multiple Carotid Atherosclerosis Subtypes: Insights from the China MJ Health Check-Up Cohort. Nutrients 2024; 16:2338. [PMID: 39064782 PMCID: PMC11280435 DOI: 10.3390/nu16142338] [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: 06/23/2024] [Revised: 07/11/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
AIM Early-stage phenotypes of carotid atherosclerosis (CAS), such as increased carotid intima-media thickness (cIMT), and advanced-stage phenotypes, such as carotid plaque (CP), are at risk for adverse ischemic stroke events. There is limited evidence regarding the causal association between dietary patterns and the risk of CAS in Chinese adults. We therefore examined multiple dietary patterns associated with the risk of CAS and identified the optimal dietary pattern for preventing CAS. METHODS We analyzed data collected from the prospective MJ Health Check-up Study (2004-2020), including 13,989 participants 18-80 years of age without CAS. The dietary intake was measured using validated food frequency questionnaires, and dietary pattern scores were calculated for four a priori and four a posteriori dietary patterns. The Cox model was used to estimate the adjusted hazard ratios (HRs) relating various dietary pattern scores to the risk of CAS. RESULTS During 43,903.4 person-years of follow-up, 3732 incidents of increased cIMT and 2861 incident CP events were documented. Overall, the seven dietary patterns, except for the high-protein diet, exhibited significant associations with the risk of increased cIMT and CP. Comparing the highest and lowest quartiles, the a posteriori high-fiber dietary pattern (HFIDP) score demonstrated the strongest inverse associations with the risk of increased cIMT (HR 0.65 [95% confidence interval (CI) 0.59-0.71]) and CP (HR 0.65 [95% CI 0.59-0.73]); conversely, another a posteriori high-fat dietary pattern (HFADP; i.e., incorporating high-fat and processed foods) demonstrated the strongest positive associations with the risk of increased cIMT (HR 1.96 [95% CI 1.75-2.20]) and CP (HR 1.83 [95% CI 1.61-2.08]) (all p for trend < 0.01). CONCLUSIONS Multiple dietary patterns are significantly associated with the risk of early- and advanced-stage phenotypes of CAS. Notably, a high adherence to an HFIDP and low adherence to an HFADP may confer the greatest risk reduction for CAS.
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Affiliation(s)
- Jingzhu Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (J.F.); (S.M.); (C.Y.); (J.L.)
- Peking University Health Science Center, Meinian Public Health Institute, Beijing 100191, China;
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Yuhan Deng
- Meinian Institute of Health, Beijing 100083, China; (Y.D.); (Y.M.); (X.Y.)
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China
- Chongqing Research Institute of Big Data, Peking University, Chongqing 400000, China
| | - Yuan Ma
- Meinian Institute of Health, Beijing 100083, China; (Y.D.); (Y.M.); (X.Y.)
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Sailimai Man
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (J.F.); (S.M.); (C.Y.); (J.L.)
- Peking University Health Science Center, Meinian Public Health Institute, Beijing 100191, China;
- Meinian Institute of Health, Beijing 100083, China; (Y.D.); (Y.M.); (X.Y.)
| | - Xiaochen Yang
- Meinian Institute of Health, Beijing 100083, China; (Y.D.); (Y.M.); (X.Y.)
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (J.F.); (S.M.); (C.Y.); (J.L.)
- Peking University Health Science Center, Meinian Public Health Institute, Beijing 100191, China;
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (J.F.); (S.M.); (C.Y.); (J.L.)
- Peking University Health Science Center, Meinian Public Health Institute, Beijing 100191, China;
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
| | - Hui Liu
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China
| | - Bo Wang
- Peking University Health Science Center, Meinian Public Health Institute, Beijing 100191, China;
- Meinian Institute of Health, Beijing 100083, China; (Y.D.); (Y.M.); (X.Y.)
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (J.F.); (S.M.); (C.Y.); (J.L.)
- Peking University Health Science Center, Meinian Public Health Institute, Beijing 100191, China;
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
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3
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Costa RM, Oliveira AG, Torres KG, Souza AM, Pereira GS, Bezerra IWL. Quantitative Assessment of the Inadequate Intake of Macronutrients, Minerals, and Vitamins Associated with Ultra-Processed Food Consumption. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:888. [PMID: 39063465 PMCID: PMC11276910 DOI: 10.3390/ijerph21070888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/27/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
Studies indicate that ultra-processed food (UP) consumption correlates negatively with essential vitamin and mineral intake and positively with sodium and lipid intake. The objective of this study was to explore the relationship between UP consumption and deviations from nutritional guidelines. An observational, cross-sectional analytical study was conducted on a probability sample of manufacturing workers in the state of Rio Grande do Norte, Brazil. Food consumption was assessed with a 24 h recall survey, and nutrient intake inadequacies were calculated as the difference between individuals' intake of energy, macronutrients, minerals and vitamins, and the dietary reference intakes for individuals of the same sex and age group, and then analyzed for trends across the percentage contribution of UP to total energy intake with nonparametric multiple regression adjusted for covariates. The study included 921 workers from 33 industries, 55.9% male, with a mean age of 32 years. Overall, the study population exhibited deficits in energy, all macronutrients, and in some micronutrients. With increasing UP contribution to total energy intake, there is a trend towards a greater intake of energy (p < 0.001), total, saturated, monounsaturated, and trans fats (p < 0.001), n6-polyunsaturated fatty acids (p = 0.03), carbohydrates (p < 0.001), calcium (p = 0.008), and manganese (p < 0.001), thiamin (p < 0.001), and vitamin B6 (p = 0.01); however, this comes with a negative consequence in terms of reducing the protein consumption (p = 0.037), fiber (p = 0.035), copper (p = 0.033), and vitamin E (p = 0.002) intake. The results show that correcting energy and micronutrient deficiencies by increasing UP consumption can also lead to a decrease in diet quality.
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Affiliation(s)
- Raiane M. Costa
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Antonio G. Oliveira
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
- Pharmacy Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Karina G. Torres
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Anissa M. Souza
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Gabriela S. Pereira
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Ingrid W. L. Bezerra
- Nutrition Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59078-970, RN, Brazil
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Dai S, Wellens J, Yang N, Li D, Wang J, Wang L, Yuan S, He Y, Song P, Munger R, Kent MP, MacFarlane AJ, Mullie P, Duthie S, Little J, Theodoratou E, Li X. Ultra-processed foods and human health: An umbrella review and updated meta-analyses of observational evidence. Clin Nutr 2024; 43:1386-1394. [PMID: 38688162 DOI: 10.1016/j.clnu.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/04/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND & AIMS Ultra-processed food (UPF) intake has increased sharply over the last few decades and has been consistently asserted to be implicated in the development of non-communicable diseases. We aimed to evaluate and update the existing observational evidence for associations between ultra-processed food (UPF) consumption and human health. METHODS We searched Medline and Embase from inception to March 2023 to identify and update meta-analyses of observational studies examining the associations between UPF consumption, as defined by the NOVA classification, and a wide spectrum of health outcomes. For each health outcome, we estimated the summary effect size, 95% confidence interval (CI), between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. These metrics were used to evaluate evidence credibility of the identified associations. RESULTS This umbrella review identified 39 meta-analyses on the associations between UPF consumption and health outcomes. We updated all meta-analyses by including 122 individual articles on 49 unique health outcomes. The majority of the included studies divided UPF consumption into quartiles, with the lowest quartile being the reference group. We identified 25 health outcomes associated with UPF consumption. For observational studies, 2 health outcomes, including renal function decline (OR: 1.25; 95% CI: 1.18, 1.33) and wheezing in children and adolescents (OR: 1.42; 95% CI: 1.34, 1.49), showed convincing evidence (Class I); and five outcomes were reported with highly suggestive evidence (Class II), including diabetes mellitus, overweight, obesity, depression, and common mental disorders. CONCLUSIONS High UPF consumption is associated with an increased risk of a variety of chronic diseases and mental health disorders. At present, not a single study reported an association between UPF intake and a beneficial health outcome. These findings suggest that dietary patterns with low consumption of UPFs may render broad public health benefits.
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Affiliation(s)
- Shuhui Dai
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Judith Wellens
- Translational Gastro-Intestinal Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK; KU Leuven Department of Chronic Diseases and Metabolism, Translational Research Center for Gastrointestinal Disorders (TARGID), Leuven, Belgium
| | - Nan Yang
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Doudou Li
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jingjing Wang
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lijuan Wang
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Shuai Yuan
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Yazhou He
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ron Munger
- Department of Nutrition and Food Sciences and the Center for Epidemiologic Studies, Utah State University, Logan, UT, USA
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Patrick Mullie
- International Prevention Research Institute, Lyon, France; Belgian Centre for Evidence-Based Medicine, Leuven, Belgium
| | - Susan Duthie
- School of Pharmacy and Life Sciences, The Robert Gordon University, Aberdeen, UK
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK; Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China.
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Brewerton TD, Dennis K, Wiss DA. Dismantling the myth of "all foods fit" in eating disorder treatment. J Eat Disord 2024; 12:60. [PMID: 38760858 PMCID: PMC11102136 DOI: 10.1186/s40337-024-01017-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
We call for a reevaluation of the long-standing dogmatic nutritional principle that "all foods fit" for all cases of eating disorders (EDs) and its corollary, "there are no bad foods" (for anyone ever) during ED treatment. Based on accumulated scientific research, we challenge these ideologies as outdated, confusing, and potentially harmful to many patients. We review the evidence that indicates the folly of these assumptions and show there are a variety of exceptions to these rules, including (1) food allergies, sensitivities, and intolerances, (2) religious and spiritual preferences or doctrines, and (3) the ubiquitous emergence and widespread availability of ultra-processed foods leading to the potential development of addiction-like eating and a higher prevalence of various medical and psychiatric comorbidities, as well as higher mortality. This evidence supports a nutritional psychiatry approach that should be integrated into (rather than dissociated from) ED treatment research and practice.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Kim Dennis
- SunCloud Health, Chicago, IL, USA
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago, IL, USA
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Pereira de Araújo T, de Moraes MM, Afonso C, Rodrigues SSP. Trends in ultra-processed food availability and its association with diet-related non-communicable disease health indicators in the Portuguese population. Br J Nutr 2024; 131:1600-1607. [PMID: 38174417 DOI: 10.1017/s0007114523003045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Broad variations in dietary and physical activity patterns are part of nutritional transition concept. An additional nutritional transition has as main characteristic the change of consumption of processed foods for ultra-processed foods (UPF). This study aims to evaluate trends of UPF availability in Portuguese population and its association with diet-related non-communicable diseases (NCD) health indicators. This ecological study used data from the Household Budget Surveys conducted by the National Statistics Institute each 5 years within a national representative sample of households. The percentage of UPF was calculated based on the total daily amount of food and beverages available per capita (in grams). Data from the years 1990, 1995, 2000 and 2005 were used, which were retrieved from DAFNE-Anemos Software. NCD age-standardised mortality, prevalence and incidence were obtained from the Global Burden of Disease database, for the years 2000, 2005, 2010 and 2015. Between 1990 and 2005, the UPF availability increased from 3·9 % to 13·8 %. Over the years, almost all food and beverages categories increased the UPF availability contribution, mainly noticeable for milk, sugar, cereal and meat products. Positive correlations were observed between UPF availability and digestive diseases both in prevalence (r = 0·062; P = 0·037) and incidence (r = 0·005; P = 0·010) measures. Neoplasms incidence also showed positive correlation with UPF availability (r = 0·002; P = 0·012). Trends in UPF availability in Portugal increased exponentially. At the same time, there is a trend towards a decrease in unprocessed and processed food availability. The Portuguese population should be made aware of the health risks resulting from excessive consumption of UPF.
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Affiliation(s)
- Taissa Pereira de Araújo
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Milena Miranda de Moraes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Sara Simões Pereira Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
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Jalali M, Bahadoran Z, Mirmiran P, Khalili D, Symonds ME, Azizi F, Faghih S. Higher ultra-processed food intake is associated with an increased incidence risk of cardiovascular disease: the Tehran lipid and glucose study. Nutr Metab (Lond) 2024; 21:14. [PMID: 38504359 PMCID: PMC10949749 DOI: 10.1186/s12986-024-00788-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a major cause of death worldwide, although limited data are currently available regarding the impact of consuming ultra-processed food (UPF) on its incidence. Given the increased consumption of UPF in Iran, we aimed to investigate the association between UPF intake and CVD risk. METHODS Individuals without CVD (n = 2050) aged ≥ 30 years old were recruited from the Tehran Lipid and Glucose Study (TLGS). Dietary data were collected using a validated food frequency questionnaire (FFQ) and UPF intakes were assessed based on the Nova food classification. Multivariable Cox proportional hazard models adjusted for potential confounders were used to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for the risk of CVD across tertiles of UPF intake. RESULTS A 10.1% incidence of CVD occurred over a median follow-up of 10.6 years, with a 22% increase in CVD risk per each 50 g/day UPF intake. Participants with the highest intake of UPF had a 68% greater incidence of CVD compared to those with the lowest intake (HR = 1.68, 95% CI=1.14-2.48) after controlling for potential confounders. Regarding sub-groups of UPF, participants in the 3rd tertile compared to the reference had a significantly increased risk of CVD (HR = 1.56, 95% CI=1.04-2.34). Nevertheless, intake of bread, fast food, sweetened beverages, sweets and desserts, high-fat dairy products, and other UPFs were not associated with greater CVD risk. CONCLUSION Our findings support the hypothesis that the incidence of CVD is enhanced with the higher consumption of UPF in a representative sample of the Iranian population.
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Affiliation(s)
- Mohammad Jalali
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Ave, Shiraz, Iran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran.
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran
| | - Davood Khalili
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Ave, Shiraz, Iran.
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Shateri Z, Eskandarzadeh S, Nouri M, Jahromi SE, Mansouri F, Babajafari S. The role of ultra-processed food consumption in protein-energy wasting and sarcopenia development in patients with chronic kidney diseases. BMC Nephrol 2024; 25:4. [PMID: 38172690 PMCID: PMC10763225 DOI: 10.1186/s12882-023-03409-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/23/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The effect of ultra-processed foods (UPFs) on chronic kidney disease (CKD) has been studied in some studies. The present study aimed to investigate the association between UPF consumption and the risk of protein-energy wasting (PEW) and sarcopenia in patients with CKD in the Iranian population. METHODS The current cross-sectional study included 110 patients with CKD referred to two clinics in Shiraz, Iran. The International Society of Renal Nutrition and Metabolism (ISRNM) criteria and the Asian Working Group for Sarcopenia (AWGS) guideline were considered for the diagnosis of PEW and sarcopenia, respectively. The valid semi-quantitative food frequency questionnaire was used to assess participants' dietary intake. The logistic regression was used to examine the association of UPFs with PEW and sarcopenia. RESULTS We observed no significant association between sarcopenia and PEW with UPFs in the crude model. After adjusting for confounders, we observed a significantly higher odds of sarcopenia in the upper versus lower median of UPF intake (odds ratio (OR) = 3.59, 95% confidence interval (CI): 1.02-12.62, P = 0.046). CONCLUSIONS Our findings suggest a positive relationship between UPF intake and sarcopenia among CKD patients. Therefore, reducing the intake of UPFs may decrease the odds of sarcopenia in patients suffering from CKD.
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Affiliation(s)
- Zainab Shateri
- Department of Nutrition and Biochemistry, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Sevda Eskandarzadeh
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mehran Nouri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrokh Ezzatzadegan Jahromi
- Department of Medicine, School of Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Mansouri
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Siavash Babajafari
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Clinical Nutrition, Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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9
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Iglesies-Grau J, Dionne V, Latour É, Gayda M, Besnier F, Gagnon D, Debray A, Gagnon C, Pelletier V, Nigam A, L'Allier PL, Juneau M, Bouabdallaoui N, Bherer L. Mediterranean diet and time-restricted eating as a cardiac rehabilitation approach for patients with coronary heart disease and pre-diabetes: the DIABEPIC-1 protocol of a feasibility trial. BMJ Open 2023; 13:e073763. [PMID: 37848307 PMCID: PMC10582969 DOI: 10.1136/bmjopen-2023-073763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/06/2023] [Indexed: 10/19/2023] Open
Abstract
INTRODUCTION Despite proven programmes, implementing lifestyle interventions for pre-diabetes and type 2 diabetes is challenging. Cardiac rehabilitation, provide a valuable opportunity to promote the adoption of healthy lifestyle behaviours for patients with atherosclerotic cardiovascular disease (ASCVD). However, only a limited number of studies have explored the potential for reversing the underlying causes of ASCVD in this setting. OBJECTIVES The DIABEPIC1 study is an ongoing single-arm lifestyle clinical trial to assess the feasibility of an upgraded 6-month intensive cardiac rehabilitation programme combining an innovative diet assignment with exercise training to reverse newly onset pre-diabetes (glycated haemoglobin 5.7%-6.4%) to normal glucose concentrations in patients with coronary heart disease. METHODS AND ANALYSIS 36 patients referred from the Montreal Heart Institute for cardiac rehabilitation, aged ≥40 years with a recent diagnosis of pre-diabetes in the last 6 months, will be offered to participate in the upgraded programme. Interventions will include four sessions of nutritional counselling on ultra-processed foods intake reduction and a moderate-carbohydrate (<40%) ad libitum Mediterranean diet coupled with 36 1-hour sessions of supervised exercise training (continuous and interval aerobic training, and resistance training) and educational intervention. Phase 2 will continue the same interventions adding 8:16 hour time-restricting eating (TRE) at least 5 days per week. During this second phase, exercise training will be performed with autonomy. The primary objectives will be to evaluate the recruitment rate, the completion rates at 3 and 6 months, and the compliance of participants. The secondary objectives will be to assess the proportion of prediabetic participants in remission of pre-diabetes at the programme's end and to characterise the factors associated with remission. ETHICS AND DISSEMINATION The DIABEPIC1 feasibility study is approved by the Research Ethics Board of the Montreal Heart Institute (Project Number ICM 2022-3005). Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. CONCLUSIONS The DIABEPIC1 trial will examine the feasibility and effectiveness of an enhanced cardiac rehabilitation programme combining exercise training with an ultra-processed food reduction intervention, a Mediterranean diet, and TRE counselling to remit pre-diabetes to normal glucose concentrations. TRIAL REGISTRATION NUMBER NCT05459987.
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Affiliation(s)
- Josep Iglesies-Grau
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Valérie Dionne
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Élise Latour
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Mathieu Gayda
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
| | | | - Daniel Gagnon
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
| | - Amélie Debray
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Christine Gagnon
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Véronique Pelletier
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Anil Nigam
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Philippe L L'Allier
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Martin Juneau
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Nadia Bouabdallaoui
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Montreal Heart Institute, Montreal, Québec, Canada
| | - Louis Bherer
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
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10
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Yuan S, Chen J, Fu T, Li X, Bruzelius M, Åkesson A, Larsson SC. Ultra-processed food intake and incident venous thromboembolism risk: Prospective cohort study. Clin Nutr 2023; 42:1268-1275. [PMID: 37348154 DOI: 10.1016/j.clnu.2023.06.016] [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: 03/02/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND & AIMS Ultra-processed food (UPF) intake has been associated with multiple health outcomes, but data on the association between UPF intake and venous thromboembolism (VTE) risk are lacking. We conducted this study to examine the association between UPF intake and the risk of incident VTE. METHODS This prospective cohort study was based on 186,323 participants free of baseline VTE from the UK Biobank. UPF intake was assessed by 24-h recall questionnaires. Data on incident VTE came from the nationwide inpatient and primary care datasets and the death registry. Cox proportional hazards regression was used to estimate the association between UPF intake and incident VTE risk. Multiplicative interactions and stratified analyses by age, sex, and body mass index were performed. RESULTS During a 10.5-year (median) follow-up, 4235 incident VTE cases were diagnosed. After adjusting for covariates, the hazard ratio of VTE among individuals with the highest quintile of UPF intake was 1.05 (95% confidence interval [CI] 0.94, 1.17) for UPF in servings, 1.12 (95% CI 1.01, 1.24) in grams, 1.10 (95% CI 1.00, 1.22) in grams %, 1.21 (95% CI 1.10, 1.33) in energy, and 1.15 (95% CI 1.05, 1.27) in energy % compared to those in the lowest quintile. Age, sex, and body mass index did not modify the associations (Pinteraction > 0.05). CONCLUSIONS Higher UPF intake was associated with a moderately increased risk of VTE.
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Affiliation(s)
- Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Jie Chen
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tian Fu
- Department of Gastroenterology, Central South University, Changsha, China
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Maria Bruzelius
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Coagulation Unit, Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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11
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Quetglas-Llabrés MM, Monserrat-Mesquida M, Bouzas C, Mateos D, Ugarriza L, Gómez C, Tur JA, Sureda A. Oxidative Stress and Inflammatory Biomarkers Are Related to High Intake of Ultra-Processed Food in Old Adults with Metabolic Syndrome. Antioxidants (Basel) 2023; 12:1532. [PMID: 37627527 PMCID: PMC10451674 DOI: 10.3390/antiox12081532] [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: 06/21/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/27/2023] Open
Abstract
In the last few decades the consumption of ultra-processed foods (UPFs) worldwide has substantially augmented. Increasing evidence suggests that high UPF consumption is associated with an increase in non-communicable diseases, being overweight, and obesity. The aim of this study was to assess how UPF consumption affects oxidative and inflammatory status in the plasma, neutrophils, and urine of old adults with metabolic syndrome. Participants (n = 92) were classified into two groups according to UPF consumption. Dietary intakes were measured by a validated semi-quantitative 143-item food frequency questionnaire and UPF consumption was determined according to the NOVA classification system. Low UPF consumers showed higher adherence to the Mediterranean diet than high UPF consumers. A high intake of fiber and a high concentration of polyphenols in urine were also observed in subjects with low UPF consumption. Despite the absence of differences in biochemical profile, oxidative and inflammatory biomarkers showed some significant changes. Catalase and superoxide dismutase activities were lower in high UPF consumers, whereas myeloperoxidase activity was higher. ROS production in neutrophils stimulated with zymosan was higher in high UPF consumers than in low UPF consumers. Biomarkers such as xanthine oxidase, tumor necrosis factor α (TNFα), interleukin (IL)-6, IL-15, and leptin levels were higher in participants with high intake of UPF. No differences were found in malondialdehyde and other inflammatory cytokines. The current study evidenced that MetS participants with high UPF consumption have a more pro-oxidant and inflammatory profile than those with low UPF consumption, despite showing similar blood biochemical profiles.
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Affiliation(s)
- Maria Magdalena Quetglas-Llabrés
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Margalida Monserrat-Mesquida
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - David Mateos
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Lucía Ugarriza
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Cristina Gómez
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
- Clinical Analysis Service, University Hospital Son Espases, 07198 Palma de Mallorca, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
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12
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Ansari S, Mohammadifard N, Haghighatdoost F, Zarepur E, Mahmoudi S, Nouri F, Nouhi F, Alikhasi H, Sharifianjazi F, Tavamaishvili K, Shirani S, Kazemi T, Azdaki N, Salehi N, Lotfizadeh M, Solati K, Ghaffari S, Javanmardi E, Salari A, Dehghani M, Cheraghi M, Assareh A, Haybar H, Namayandeh SM, Madadi R, Sarrafzadegan N. The relationship between ultra processed food consumption and premature coronary artery disease: Iran premature coronary artery disease study (IPAD). Front Nutr 2023; 10:1145762. [PMID: 37476400 PMCID: PMC10354702 DOI: 10.3389/fnut.2023.1145762] [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: 01/16/2023] [Accepted: 03/27/2023] [Indexed: 07/22/2023] Open
Abstract
Background Ultra-processed foods (UPF) consumption may affect the risk of PCAD through affecting cardio metabolic risk factors. This study aimed to evaluate the association between UPFs consumption and premature coronary artery disease (PCAD). Methods A case-control study was conducted on 2,354 Iranian adults (≥ 19 years). Dietary intake was assessed using a validated 110-item food frequency questionnaire (FFQ) and foods were classified based on the NOVA system, which groups all foods according to the nature, extent and purposes of the industrial processes they undergo. PCAD was defined as having an stenosis of at least single coronary artery equal and above 75% or left main coronary of equal or more than 50% in women less than 70 and men less than 60 years, determined by angiography. The odds of PCAD across the tertiles of UPFs consumption were assessed by binary logistic regression. Results After adjustment for potential confounders, participants in the top tertile of UPFs were twice as likely to have PCAD compared with those in the bottom tertile (OR: 2.52; 95% CI: 1.97-3.23). Moreover, those in the highest tertile of the UPFs consumption had more than two times higher risk for having severe PCAD than those in the first tertile (OR: 2.64; 95% CI: 2.16-3.22). In addition, there was a significant upward trend in PCAD risk and PCAD severity as tertiles increased (P-trend < 0.001 for all models). Conclusion Higher consumption of UPFs was related to increased risk of PCAD and higher chance of having severe PCAD in Iranian adults. Although, future cohort studies are needed to confirm the results of this study, these findings indicated the necessity of reducing UPFs intake.
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Affiliation(s)
- Shakila Ansari
- Department of Community Nutrition, Nutrition and Food Security Research Center, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Zarepur
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Cardiology, Medicine School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Mahmoudi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereidoon Nouhi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
- Iranian Network of Cardiovascular Research (INCVR), Tehran, Iran
| | - Hassan Alikhasi
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Shahin Shirani
- Department of Cardiology, Tehran University of Medical Science, Dr Ali Shariati Hospital, Tehran, Iran
| | - Tooba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Nahid Azdaki
- Clinical Research Development Unit, Razi Hospital, Birjand University of Medical Sciences, Birjand, Iran
| | - Nahid Salehi
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Kamal Solati
- Department of Psychiatry, Shahrekord University of Medical Science, Shahrekord, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elmira Javanmardi
- Department of Cardiovascular Medicine, Amiralmomenin Hospital, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Arsalan Salari
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mostafa Dehghani
- Department of Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Science, Khorramabad, Iran
| | - Mostafa Cheraghi
- Department of Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Science, Khorramabad, Iran
| | - Ahmadreza Assareh
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Haybar
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyedeh M. Namayandeh
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Science, Yazd, Iran
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reza Madadi
- Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Cerrillo I, Saralegui-Díez P, Morilla-Romero-de-la-Osa R, González de Molina M, Guzmán GI. Nutritional Analysis of the Spanish Population: A New Approach Using Public Data on Consumption. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1642. [PMID: 36674397 PMCID: PMC9867222 DOI: 10.3390/ijerph20021642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
Official population consumption data are frequently used to characterize the diet of countries; however, this information may not always be representative of reality. This study analyses the food consumption of the Spanish population by reconstructing the whole food chain. The results have been compared with the data provided by the National Consumption Panel to which the food losses/waste reported in the literature along the distribution chain have been added. The difference between them allowed a new calculation of the estimated food consumption that was subjected to a dietary-nutritional analysis. Most of the foods were consumed more than those officially reported (range of 5-50%). The unhealthy ratios of consumed foods and recommended servings were: meat products (Rcr = 3.6), fruits and legumes (Rcr = 0.5), and nuts (Rcr = 0.14). Caloric intake surpasses needs. The results were consistent with the data on the prevalence of overweight and obesity in Spain, as well as with the prevalence of associated diseases. To make a judgment about the quality of a country's diet, it is necessary to have reliable data on food consumption, as well as energy and nutrient intake. This study encourages other authors to implement this method to verify and quantify the possible difference between official and real consumption data.
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Affiliation(s)
- Isabel Cerrillo
- Department of Molecular Biology and Biochemistry Engineering, Area of Nutrition and Food Sciences, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
| | - Pablo Saralegui-Díez
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Laboratory of the History of Agroecosystems, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
| | - Rubén Morilla-Romero-de-la-Osa
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41015 Seville, Spain
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Spanish National Research Council (CSIC), Universidad de Sevilla, 41015 Seville, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Hospital Universitario Virgen del Rocío, 41015 Seville, Spain
| | - Manuel González de Molina
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Laboratory of the History of Agroecosystems, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
| | - Gloria I. Guzmán
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Laboratory of the History of Agroecosystems, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
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Sinha S, Haque M. Obesity, Diabetes Mellitus, and Vascular Impediment as Consequences of Excess Processed Food Consumption. Cureus 2022; 14:e28762. [PMID: 36105908 PMCID: PMC9441778 DOI: 10.7759/cureus.28762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2022] [Indexed: 12/15/2022] Open
Abstract
Regular intake of ready-to-eat meals is related to obesity and several noninfectious illnesses, such as cardiovascular diseases, hypertension, diabetes mellitus (DM), and tumors. Processed foods contain high calories and are often enhanced with excess refined sugar, saturated and trans fat, Na+ andphosphate-containing taste enhancers, and preservatives. Studies showed that monosodium glutamate (MSG) induces raised echelons of oxidative stress, and excessive hepatic lipogenesis is concomitant to obesity and type 2 diabetes mellitus (T2DM). Likewise, more than standard salt intake adversely affects the cardiovascular system, renal system, and central nervous system (CNS), especially the brain. Globally, excessive utilization of phosphate-containing preservatives and additives contributes unswervingly to excessive phosphate intake through food. In addition, communities and even health experts, including medical doctors, are not well-informed about the adverse effects of phosphate preservatives on human health. Dietary phosphate excess often leads to phosphate toxicity, ultimately potentiating kidney disease development. The mechanisms involved in phosphate-related adverse effects are not explainable. Study reports suggested that high blood level of phosphate causes vascular ossification through the deposition of Ca2+ and substantially alters fibroblast growth factor-23 (FGF23) and calcitriol.
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Abstract
Dramatically increasing trends in consumption of ultra-processed foods have been reported across the globe. Public concern about the health consequences of ultra-processed foods is high. This manuscript provides a comprehensive review of trends in global consumption of ultra-processed foods, dietary nutrient profile of ultra-processed foods, demographic, socioeconomic, psychological, and behavioral characteristics of ultra-processed food consumers, current evidence from longitudinal studies at the population level on the association between ultra-processed foods consumption and major health outcomes (including all-cause and cause-specific mortality, cardiovascular disease, overweight and obesity, body composition and fat deposition, diabetes, cancer, and gastrointestinal and other diseases), potential mechanisms linking ultra-processed foods with these outcomes (nutrient displacement, factors that influence adiposity, and processing), and challenges and future research directions. The global trends in consumption of ultra-processed foods, the generally unfavorable nutrient profile of ultra-processed foods, the characteristics of ultra-processed food consumers, the accumulating longitudinal studies associating ultra-processed foods with major health outcomes, and the uncertainties and complexities in putative mechanisms all highlight the need for future high-quality epidemiologic and mechanistic investigations on this topic. It is critical to interpret findings in the light of the totality of evidence.
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Affiliation(s)
- Yin Zhang
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Montero-Salazar Henry X, Guallar-Castillón P, Banegas JR, Åkesson A, Rey-García J, Rodríguez-Artalejo F, Donat-Vargas C. Food consumption based on the nutrient profile system underlying the Nutri-Score and renal function in older adults. Clin Nutr 2022; 41:1541-1548. [DOI: 10.1016/j.clnu.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/01/2022] [Accepted: 05/07/2022] [Indexed: 11/30/2022]
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Cai Q, Duan MJ, Dekker LH, Carrero JJ, Avesani CM, Bakker SJL, de Borst MH, Navis GJ. Ultraprocessed food consumption and kidney function decline in a population-based cohort in the Netherlands. Am J Clin Nutr 2022; 116:263-273. [PMID: 35348601 PMCID: PMC9257475 DOI: 10.1093/ajcn/nqac073] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/25/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Ultraprocessing makes food products more convenient, appealing, and profitable. Recent studies show that high ultraprocessed food (UPF) intake is associated with cardiometabolic diseases. OBJECTIVES The aim of this study is to investigate the association between UPF consumption and risks of kidney function decline in the general population. METHODS In a prospective, general population-based Lifelines cohort from Northern Netherlands, 78,346 participants free of chronic kidney disease (CKD) at baseline responded to a 110-item FFQ. We used a multivariable regression analysis to study the associations of the proportion (in grams/day) of UPFs in the total diet with a composite kidney outcome [incident CKD or a ≥30% estimated glomerular filtration rate (eGFR) decline relative to baseline] and annual change in eGFR. RESULTS On average, 37.7% of total food intake came from UPFs. After 3.6 ± 0.9 years of follow-up, 2470 participants (3.2%) reached the composite kidney outcome. Participants in the highest quartile of UPF consumption were associated with a higher risk of the composite kidney outcome (OR, 1.27; 95% CI, 1.09-1.47; P = 0.003) compared with those in the lowest quartile, regardless of their macro- or micronutrient intake or diet quality. Participants in the highest quartile had a more rapid eGFR decline (β, -0.17; 95% CI, -0.23 to -0.11; P < 0.001) compared with those in the lowest quartile. Associations were generally consistent across different subgroups. CONCLUSIONS Higher UPF consumption was associated with a higher risk of a composite kidney outcome (incident CKD or ≥30% eGFR decline) and a more rapid eGFR decline in the general population, independent of confounders and other dietary indices.
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Affiliation(s)
| | - Ming-Jie Duan
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Louise H Dekker
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Juan Jesús Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Carla Maria Avesani
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Stephan J L Bakker
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Martin H de Borst
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerjan J Navis
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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18
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Oselame da Silva Dohms P, Stangarlin-Fiori L, Medeiros CO. Elaboration and validation of an instrument for qualitative assessment of food preparations offered to workers. Int J Gastron Food Sci 2022. [DOI: 10.1016/j.ijgfs.2022.100488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Jardim MZ, Costa BVDL, Pessoa MC, Duarte CK. Ultra-processed foods increase noncommunicable chronic disease risk. Nutr Res 2021; 95:19-34. [PMID: 34798466 DOI: 10.1016/j.nutres.2021.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Several studies have associated the food processing classification - NOVA - and health, but this is not true for all noncommunicable chronic diseases (NCDs). This study aimed to systematically review the association between the intake of NOVA food groups and NCDs. We hypothesized that ultra-processed foods and drinks (UPFD) and processed foods (PF) could increase the risk of NCDs, and that unprocessed (UPF) and minimally processed foods (MPF) may provide protection. We carried out a systematic review of observational studies in January 2021. Searches were performed in SCOPUS, MEDLINE (via PubMed), EMBASE, WEB OF SCIENCE, SCIELO, related articles, hand-searching of reference lists, and direct author contact. In all, 2217 citations were identified and 38 articles met the eligibility criteria for inclusion in this systematic review. Among the analyzed food groups, higher UPFD consumption was positively associated with obesity and associated with the development of all NCDs, mainly hypertension, diabetes and dyslipidemia. However, only a few studies have demonstrated the protective effect of natural foods and MPF consumption on the occurrence of NCDs. In conclusion, UPF may increase the risk of NCDs, and natural foods and MPF may reduce it. Our results reinforce the need for the implementation of policies to mitigate the intake of UPF by the population, as it would improve the quality of the dietary patterns, and directly impact on the incidence of NCDs.
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Affiliation(s)
- Mariana Zogbi Jardim
- Post-Graduate Program in Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruna Vieira de Lima Costa
- Department of Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Milene Cristine Pessoa
- Department of Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila Kümmel Duarte
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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20
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Zhang S, Gan S, Zhang Q, Liu L, Meng G, Yao Z, Wu H, Gu Y, Wang Y, Zhang T, Wang X, Sun S, Wang X, Zhou M, Jia Q, Song K, Qi L, Niu K. Ultra-processed food consumption and the risk of non-alcoholic fatty liver disease in the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. Int J Epidemiol 2021; 51:237-249. [PMID: 34528679 DOI: 10.1093/ije/dyab174] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 08/01/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Growing evidence supports a link between ultra-processed food consumption and human health outcomes. However, the association between ultra-processed food consumption and non-alcoholic fatty liver disease (NAFLD) is not known. We aimed to explore the association between ultra-processed food consumption and risk of NAFLD. METHODS The prospective study included 16 168 participants aged 18-90 years from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study. Information on ultra-processed food consumption was collected at baseline using a validated food frequency questionnaire. NAFLD was defined as the presence of sonographic fatty liver in the absence of significant alcohol intake (≥210 g/week for men and ≥140 g/week for women, respectively) and other liver diseases. Multivariable Cox proportional hazards models were used to examine the association between ultra-processed food consumption and risk of NAFLD. RESULTS During 56 935 person-years of follow-up, we documented 3752 incident NAFLD cases. After adjusting for age, sex, body mass index, smoking, alcohol drinking, education, occupation, income, physical activity, total energy intake, personal and family history of disease and overall diet quality, the multivariable hazard ratios (95% confidence interval) of NAFLD across increasing quartiles of ultra-processed food consumption were 1.00 (reference), 0.99 (0.90, 1.08), 1.13 (1.03, 1.25) and 1.18 (1.07, 1.30), respectively (P for trend <0.0001). The hazard ratio (95% confidence interval) per one standard deviation increase in ultra-processed food consumption, equivalent to a 62.7 g/1000 kcal per day, was 1.06 (1.03, 1.09), P = 0.0001. CONCLUSIONS Our study indicates that higher ultra-processed food consumption is associated with a higher risk of NAFLD. This finding suggests that ultra-processed food, which is widely consumed worldwide, might be a modifiable dietary target to reduce the risk of NAFLD.
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Affiliation(s)
- Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shinan Gan
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhanxin Yao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Institute of Environmental & Operational Medicine, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Yawen Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tingjing Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.,Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
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21
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Donat-Vargas C, Sandoval-Insausti H, Rey-García J, Moreno-Franco B, Åkesson A, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P. High Consumption of Ultra-Processed Food is Associated with Incident Dyslipidemia: A Prospective Study of Older Adults. J Nutr 2021; 151:2390-2398. [PMID: 34038538 DOI: 10.1093/jn/nxab118] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/18/2020] [Accepted: 04/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption has been associated with higher cardiovascular disease (CVD) and mortality risks. OBJECTIVES The aim of this study was to assess the relationship between UPF consumption and incident dyslipidemia in older adults, where evidence is limited. METHODS We studied a prospective cohort of 1082 community-dwelling adults in Spain, older than 60 (mean age, 68 ± 6 years old). Participants (52% were women) were recruited between 2008-10 and followed up to 2015. At baseline, food intake data were collected using a validated computerized face-to-face dietary history. UPFs were identified according to the nature and extent of their industrial processing (NOVA classification). Triglycerides, HDL cholesterol, and LDL cholesterol were measured in fasting plasma samples collected at baseline and at follow-up. Statistical analyses were performed with logistic regression adjusted for the main potential confounders. RESULTS Among those free of corresponding dyslipidemia at baseline, and after a follow-up of between 5 to 7 years, 60 (out of 895) developed incident hypertriglyceridemia (≥150 mg/dL), 112 (out of 878) had low HDL cholesterol (<40 in men/<50 mg/dL in women), and 54 (out of 472) had high LDL cholesterol (>129 mg/dL). The mean percentage of UPF consumption was 19% ± 11% of total energy intake. Those in the highest versus the lowest tertile of energy intake from UPFs had more than twice the odds of incident hypertriglyceridemia (OR, 2.66; 95% CI: 1.20-5.90; P-trend, 0.011) or low HDL cholesterol (OR, 2.23; 95% CI: 1.22-4.05; P-trend, 0.012). UPF consumption was not associated with high LDL cholesterol plasma concentrations. CONCLUSIONS Although UPF consumption in Spain was low among older adults, high consumption of UPFs was clearly associated with incident dyslipidemia. The increase in CVD risk recently found to be associated with UPF consumption might be mediated by these atherogenic lipid abnormalities.
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Affiliation(s)
- Carolina Donat-Vargas
- Instituto Madrileño de Estudios Avanzados (IMDEA)-Alimentación, Campus of International Excellence, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jimena Rey-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Belén Moreno-Franco
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,Biomedical Research Center Network for Cardiovascular (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Department of Microbiology, Preventive Medicine, and Public Health of the University of Zaragoza, Zaragoza, Spain
| | - Agneta Åkesson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jose Ramón Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Instituto Madrileño de Estudios Avanzados (IMDEA)-Alimentación, Campus of International Excellence, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pilar Guallar-Castillón
- Instituto Madrileño de Estudios Avanzados (IMDEA)-Alimentación, Campus of International Excellence, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
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22
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Martinez-Perez C, San-Cristobal R, Guallar-Castillon P, Martínez-González MÁ, Salas-Salvadó J, Corella D, Castañer O, Martinez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem L, Bueno-Cavanillas A, Tur JA, Sánchez VM, Pintó X, Gaforio JJ, Matía-Martín P, Vidal J, Vázquez C, Ros E, Bes-Rastrollo M, Babio N, Sorlí JV, Lassale C, Pérez-Sanz B, Vaquero-Luna J, Bazán MJA, Barceló-Iglesias MC, Konieczna J, Ríos AG, Bernal-López MR, Santos-Lozano JM, Toledo E, Becerra-Tomás N, Portoles O, Zomeño MD, Abete I, Moreno-Rodriguez A, Lecea-Juarez O, Nishi SK, Muñoz-Martínez J, Ordovás JM, Daimiel L. Use of Different Food Classification Systems to Assess the Association between Ultra-Processed Food Consumption and Cardiometabolic Health in an Elderly Population with Metabolic Syndrome (PREDIMED-Plus Cohort). Nutrients 2021; 13:nu13072471. [PMID: 34371982 PMCID: PMC8308804 DOI: 10.3390/nu13072471] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/07/2021] [Accepted: 07/13/2021] [Indexed: 01/12/2023] Open
Abstract
The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus (“PREvention with MEDiterranean DIet”) trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI (p = 0.001) when using the NOVA system, and with systolic (p = 0.018) and diastolic (p = 0.042) blood pressure when using the UNC system. Food classification methodologies markedly influenced the association between UPF consumption and cardiometabolic risk markers.
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Affiliation(s)
- Celia Martinez-Perez
- Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (C.M.-P.); (J.M.O.); (L.D.)
| | - Rodrigo San-Cristobal
- Cardiometabolic Nutrition Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain;
- Correspondence: ; Tel.: +34-917-278-100 (ext. 309)
| | - Pilar Guallar-Castillon
- Cardiovascular and Nutritional Epidemiology Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain;
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid—IdiPaz Hospital, 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (V.M.S.); (J.J.G.)
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Miguel Ángel Martínez-González
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31009 Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain;
- Human Nutrition Unit, Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Olga Castañer
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (M.D.Z.); (J.M.-M.)
| | - Jose Alfredo Martinez
- Cardiometabolic Nutrition Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain;
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, 31009 Pamplona, Spain;
| | - Ángel M. Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Nursing, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, 29016 Málaga, Spain;
| | - Jesús Vioque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (V.M.S.); (J.J.G.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), 03010 Alicante, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14071 Córdoba, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, 08007 Barcelona, Spain
| | - Francisco J. Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, 29016 Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
| | - Lluis Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria and Service of Preventive Medicine, Complejo Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canary Health Service, 35001 Las Palmas de Gran Canaria, Spain
| | - Aurora Bueno-Cavanillas
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (V.M.S.); (J.J.G.)
- Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain
| | - Josep A. Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS & IDISBA, 07122 Palma de Mallorca, Spain
| | - Vicente Martín Sánchez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (V.M.S.); (J.J.G.)
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - José J. Gaforio
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (V.M.S.); (J.J.G.)
- Departamento de Ciencias de la Salud, Centro de Estudios Avanzados en Olivar y Aceites de Oliva, Universidad de Jaén, 23071 Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Josep Vidal
- Biomedical Research Centre for Diabetes and Metabolic Diseases Network (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, University of Barcelona, 08007 Barcelona, Spain
| | - Clotilde Vázquez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Endocrinology and Nutrition, Hospital Fundación Jiménez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autónoma, 28015 Madrid, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, University of Barcelona, 08007 Barcelona, Spain
| | - Maira Bes-Rastrollo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31009 Pamplona, Spain
| | - Nancy Babio
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain;
- Human Nutrition Unit, Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
| | - Jose V. Sorlí
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Camille Lassale
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (M.D.Z.); (J.M.-M.)
| | - Beatriz Pérez-Sanz
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, 31009 Pamplona, Spain;
| | - Jessica Vaquero-Luna
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - María Julia Ajejas Bazán
- Department of Nursing, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, 29016 Málaga, Spain;
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | | | - Jadwiga Konieczna
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - Antonio García Ríos
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14071 Córdoba, Spain
| | - María Rosa Bernal-López
- Internal Medicine Department, Instituto de Investigación Biomédica de Málaga (IBIMA), Regional University Hospital of Malaga, 29010 Malaga, Spain;
| | - José Manuel Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
| | - Estefanía Toledo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31009 Pamplona, Spain
| | - Nerea Becerra-Tomás
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain;
- Human Nutrition Unit, Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Olga Portoles
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - María Dolores Zomeño
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (M.D.Z.); (J.M.-M.)
- School of Health Sciences, Blanquerna-Ramon Llull University, 08001 Barcelona, Spain
| | - Itziar Abete
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, 31009 Pamplona, Spain;
| | - Anai Moreno-Rodriguez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (J.S.-S.); (D.C.); (O.C.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (F.J.T.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (C.V.); (E.R.); (M.B.-R.); (N.B.); (J.V.S.); (C.L.); (J.V.-L.); (J.K.); (A.G.R.); (J.M.S.-L.); (E.T.); (N.B.-T.); (O.P.); (I.A.); (A.M.-R.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Oscar Lecea-Juarez
- Atención Primaria, Osasunbidea, Servicio Navarro de Salud, 31003 Pamplona, Spain;
| | - Stephanie K. Nishi
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain;
| | - Júlia Muñoz-Martínez
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (M.D.Z.); (J.M.-M.)
| | - José M. Ordovás
- Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (C.M.-P.); (J.M.O.); (L.D.)
- Nutrition and Genomics Laboratory, JM_USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02155, USA
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (C.M.-P.); (J.M.O.); (L.D.)
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Abstract
PURPOSE OF REVIEW Ultra-processed foods (UPF) have been associated with poor diet quality and adverse health outcomes. Our aim in this review is to summarize recent research assessing the impact of UPF consumption, classified according to the NOVA system, on outcomes related to metabolic health. RECENT FINDINGS Thirty recent studies with different design, quality and target population have investigated the impact of UPF consumption on parameters related to metabolic health, which were organized into: metabolic syndrome; body weight change and obesity indicators; blood pressure and hypertension; glucose profile, insulin resistance and type 2 diabetes; other metabolic risks and cardiovascular diseases and mortality. Most of the studies demonstrated adverse associations between high UPF consumption and metabolic health, mainly those with robust design and involving adults. SUMMARY Most of the latest findings have revealed an adverse impact of high UPF consumption on metabolic health, including cardiovascular diseases and mortality. Scientific evidence is accumulating towards the necessity of curbing UPF consumption worldwide at different life stages. Nevertheless, other studies are needed to confirm the causality between UPF consumption and metabolic health in diverse scenarios and to better elucidate all likely mechanisms involved in this relationship.
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Affiliation(s)
- Renata Costa de Miranda
- Department of Preventive Medicine, School of Medicine
- Center for Epidemiological Research in Nutrition and Health
| | - Fernanda Rauber
- Department of Preventive Medicine, School of Medicine
- Center for Epidemiological Research in Nutrition and Health
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine
- Center for Epidemiological Research in Nutrition and Health
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Louzada MLDC, Costa CDS, Souza TN, Cruz GLD, Levy RB, Monteiro CA. Impacto do consumo de alimentos ultraprocessados na saúde de crianças, adolescentes e adultos: revisão de escopo. CAD SAUDE PUBLICA 2021; 37:e00323020. [DOI: 10.1590/0102-311x00323020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste trabalho foi realizar uma revisão de escopo da literatura acerca da associação entre o consumo de alimentos ultraprocessados e desfechos em saúde. A busca foi realizada nas bases PubMed, Web of Science e LILACS. Foram elegíveis os estudos que avaliaram a associação entre o consumo de alimentos ultraprocessados identificados com base na classificação NOVA e os desfechos em saúde. O processo de revisão resultou na seleção de 63 estudos, os quais foram analisados em termos de qualidade com base em ferramenta do Instituto Nacional de Saúde dos Estados Unidos. Os desfechos encontrados incluíram indicadores de obesidade, marcadores de risco metabólico, diabetes, doenças cardiovasculares, câncer, asma, depressão, fragilidade, doenças gastrointestinais e mortalidade. A evidência foi particularmente consistente para obesidade (ou indicadores relacionados a ela) em adultos, cuja associação com o consumo de ultraprocessados foi demonstrada, com efeito dose-resposta, em estudos transversais com amostras representativas de cinco países, em quatro grandes estudos de coorte e em um ensaio clínico randomizado. Grandes estudos de coorte também encontraram associação significativa entre o consumo de alimentos ultraprocessados e o risco de doenças cardiovasculares, diabetes e câncer, mesmo após ajuste para obesidade. Dois estudos de coorte demonstraram associação do consumo de alimentos ultraprocessados com depressão e quatro estudos de coorte com mortalidade por todas as causas. Esta revisão sumarizou os resultados de trabalhos que descreveram a associação entre o consumo de alimentos ultraprocessados e as diversas doenças crônicas não transmissíveis e seus fatores de risco, o que traz importantes implicações para a saúde pública.
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